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Efforts are underway to reduce the high costs of prescription drugs for U.S. patients

LEILA FADEL, HOST:

Americans pay way more than people in other countries for prescription drugs, and several provisions in the Inflation Reduction Act that the Senate passed late yesterday aim to address this problem. NPR's Allison Aubrey joins us now. Good morning, Allison.

ALLISON AUBREY, BYLINE: Good morning, Leila.

FADEL: So Allison, this is a real problem for so many families, and a lot of people struggle to afford their medicine.

AUBREY: Absolutely. There's probably no better example than the diabetes medicine insulin. The cost of leading brands has actually tripled over the past decade. And what really upsets the folks I talked to is that insulin prices are about four times higher here in the U.S. compared to other countries.

Here's Bob Parant. He's turning 70 this year. He lives in Long Island, N.Y. He has type 1 diabetes. He pays about $5,000 out of pocket each year for his diabetes medicines. This is on top of the thousands he pays for his heart medication.

BOB PARANT: Absolutely, it's a financial hardship. It's really a disgrace what we have to pay for the cost of drugs to stay alive. If you don't have insulin, you die.

AUBREY: He says he'd like to take trips to visit his grandkids more often, not worry about things like household repairs or the grocery bill. He worries he won't be able to pay for his medicines if the prices keep going up.

FADEL: And, of course, he's not alone.

AUBREY: That's right. Twenty-five percent of patients with diabetes have reported using less insulin than prescribed because they just can't afford it. This is millions of people potentially skimping on insulin, which can be dangerous.

FADEL: So what provisions in this just-passed Senate bill would help lower the cost of prescription drugs?

AUBREY: Well, the bill includes a cap on out-of-pocket expenses - a $2,000 cap. Now, this is only for people in Medicare. So seniors would not have to pay more than $2,000 a year total for their prescription drugs. And Bob Parant says this will be very helpful.

PARANT: The proposal to limit out-of-pocket expenses that's on the table right now would absolutely make a huge difference in my life.

AUBREY: And the bill also includes a measure that would empower the federal health secretary to negotiate Medicare drug prices for some of the most expensive drugs. It's something that has been talked about for years as a way to give the federal government more leverage to bring down costs.

FADEL: So seniors may get some financial relief, but what about everybody else? What other reforms are being considered here?

AUBREY: Well, there was a provision aimed at capping patients' out-of-pocket costs for insulin to $35 a month for people with private insurance, but this was ruled out by the Senate parliamentarian, and this is something that many diabetes patients tell me would be really helpful. I spoke to a school teacher in Indiana, Kathy Sego. She's had a health insurance plan with a very high deductible - has paid up to $8,000 a year out of pocket for medicines for her son. She says she's very frustrated with the pharmaceutical companies because she says, as their profits have soared, she's had to decide between paying for her son's insulin or paying the utility bill.

FADEL: Wow.

AUBREY: At one point, she actually had her electricity cut off.

KATHY SEGO: I'm all for people making money. I get it. And I think people should make money. But should you make so much money that, you know, you're living the high life while people are having their electricity turned off - that their bodies are suffering because you want a profit? Of course it makes me angry.

AUBREY: You can just really hear it there in her voice.

FADEL: Yeah.

AUBREY: And she says she's angry the pharmaceutical industry spends millions of dollars to lobby against these reforms.

FADEL: I mean, that's really hard to listen to - a mom having to choose between her son's health and electricity. What exactly is the pharmaceutical industry lobbying against here?

AUBREY: The pharmaceutical industry opposes Medicare negotiation. I spoke to PhRMA. That's the industry's trade association. They say they agree Americans are paying too much for medicines, but they argue this is not the way to fix it. They say government negotiation is, quote, "nothing short of government price setting" and it would stifle innovation - lead to fewer new medicines coming to market. But many economists and policymakers disagree. I mean, the Congressional Budget Office estimates the effect would be very modest. And it's worth noting most big drug companies spend more on advertising and marketing than they do on research and development. Bob Parant says this makes him angry.

PARANT: They are making so much money. It is ridiculous that they can't pass along some of these savings and negotiate Medicare prices.

AUBREY: He says he's particularly upset by the ads airing across the country now that claim the Senate bill would siphon billions of dollars away from Medicare. He says the misleading implication is that seniors would have their benefits cut.

PARANT: These campaigns that I've been seeing are scare tactics and lies to change the opinions of some of the seniors.

FADEL: So who is behind these ads?

AUBREY: The ads are part of a seven-figure campaign by a group that calls itself Commitment to Seniors. Their ads claim the Senate bill would, quote, "siphon nearly $300 billion out of Medicare," which is very misleading. Michael Beckel, who tracks dark money for a group called Issue One, says this is a common tactic.

MICHAEL BECKEL: When people see an ad on TV from a group called Commitment to Seniors, that sounds pretty innocuous. They might not know who's funding it, and it's very hard to tell from the public record who funds a group like that.

AUBREY: It turns out Commitment to Seniors is a project of another group, American Commitment, that has received more than a million dollars from PhRMA in the past years. Bottom line - their message is misleading. Rather than siphoning money from Medicare, the Congressional Budget Office projects the reforms would actually save taxpayers money by lowering drug prices. And most importantly, seniors' benefits would not be cut.

FADEL: NPR's Allison Aubrey. Thanks so much.

AUBREY: Thank you, Leila.

FADEL: The bill now moves on to the House, where it's expected to pass this week. Transcript provided by NPR, Copyright NPR.

Leila Fadel is a national correspondent for NPR based in Los Angeles, covering issues of culture, diversity, and race.
Allison Aubrey is a correspondent for NPR News, where her stories can be heard on Morning Edition and All Things Considered. She's also a contributor to the PBS NewsHour and is one of the hosts of NPR's Life Kit.

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