Americans are upset and confused about their out-of-pocket costs for prescription drugs. And rightly so.
One bottle of pills costs a few dollars, but a different bottle costs a few hundred dollars. The same medicine costs a lot in January, but nothing in December. People hear about coupons and other financial assistance, but who can keep track of it all? And does anyone understand how deductibles really work?
Eli Lilly and Company, along with the pharmaceutical industry, is committed to work with the rest of the health care system to fix this problem.
Starting today, TV ads for one of Lilly's most widely used medicines will direct people to a new website, lillypricinginfo.com, or an 800 number, where they can learn about the list price, average out-of-pocket costs and patient assistance programs. By the end of February, we will do the same for the other medicines we advertise on TV. And in the months following, we will post this information for our other Lilly medicines, whether we advertise about them or not.
This is the first direct-to-consumer (DTC) TV commercial implementing revised marketing principles adopted by PhRMA in October. We recognize that the U.S. health care system has asked Americans to pay more out-of-pocket – including for prescription medicines. So people need new tools to help them.
Already, there is more price transparency for pharmaceuticals than nearly any other health care product or service. GoodRx.com allows all Americans to type in the name of a medicine and their ZIP code, and immediately receive list price information from pharmacies near them—for free. Also, Lilly and other pharmaceutical companies report the annual net price increases across our portfolios of medicines.
All parts of the health care system should have this level of price transparency. Right now, they don’t.
Of course, people need more than information. Merely requiring pharmaceutical companies to put list prices in their TV ads, as the current administration has proposed, won’t give patients what they need. A recent article in the New England Journal of Medicine suggests it may even dissuade them from seeking care because of the perception that they cannot afford the treatment.
What Americans really need are ways to reduce their out-of-pocket costs. Keeping patients’ costs affordable is vital to help them stay on their medicines and stay healthy.
People in high-deductible plans – now nearly half of adults with private insurance – need help the most. They abandon their prescriptions at the pharmacy counter twice as often as people in traditional co-pay insurance plans, according to data from IQVIA.
High-deductible health plans typically don’t pass on to patients the billions of dollars in rebates pharmaceutical companies pay those plans each year. Most Medicare Part D plans for seniors don’t either. They use rebates partly to reduce premiums, which is good, but not if it means the insurance no longer covers health costs if you get sick. We think health plans should share pharmaceutical rebates with patients.
High-deductible plans should also exempt from their deductibles preventive medicines needed for chronic diseases. Lilly and many pharmaceutical companies have joined a coalition of health insurers, physician groups and others to urge the federal government to explicitly allow high-deductible health plans to do this.
No single solution works for all people, due to the complexity of U.S. health care system. So the pharmaceutical trade group PhRMA is setting up a central affordability hub, which will provide price, cost and patient assistance information to uninsured and underinsured patients.
Lilly set up a similar hub last summer for people who need insulin. Now nearly 10,000 people a month are getting help lowering their out-of-pocket costs to affordable levels. People can also reach the Lilly Diabetes Solution Center by calling 833-808-1234.
Since the U.S. health care system has asked patients to pay more of their health care expenses, all of us must work together to make sure everyone can get the medicines they need – at out-of-pocket costs they can afford.