At the HHS Pharmaceutical Forum, We Need to Consider All Health Care Costs

On November 20, stakeholders will come together for a day-long event—“HHS Pharmaceutical Forum: Innovation, Access, Affordability and Better Health”—to take on the issue of drug costs.  Convened by U.S. Department of Health and Human Services (HHS) Secretary Sylvia Burwell, the discussion will focus on how to foster a health system that “leads in innovation, delivers the most affordable, highest quality medicines and results in healthier people.”  

The issue of drug costs is a pressing topic and, at the National Pharmaceutical Council (NPC), we welcome the discussion, but all health costs need to be on the table. In too many ways, the current health care system isn’t working and fails to put value on what patients need most—progress over process. While the health care system is rapidly evolving today, it remains fundamentally fragmented, leaving stakeholders with a scattershot understanding of costs, value and patient benefit. 

For example, under typical health benefits, patients pay a greater share of pharmaceutical costs than any other health care service they receive.[i]  They face a far smaller share of hospital and physician costs (which are sometimes negotiated), a structural leftover from the way health care worked in the earlier part of the 20th century, when we had far fewer drugs available to treat or prevent disease. That leaves all stakeholders with a skewed view and challenge in assigning how we should spend health care dollars to derive the most positive impact for patients.    

The HHS forum will serve as a good opportunity for all stakeholders—consumers, patient advocates, health care professionals, employers, payers, policymakers and manufacturers—to question outdated approaches and make room for new solutions, innovative thinking and true collaboration. To achieve that aim and generate meaningful outcomes, those who participate will need to look across the entire health care system and ask the right questions, such as: 

• Has pharmaceutical innovation brought value and made a difference to patients?
• How do costs for pharmaceuticals compare to all other health care costs?  How do we pay for these overall health care costs?  What share of overall health care costs should patients pay?
• How do we ensure patients can access treatments they need and still foster a sustainable environment of innovation?

These issues are not new to NPC’s members, and over the next two weeks NPC will share research and resources that will help inform new thinking and generate forward momentum in this discussion. We hope you’ll stay connected with us as this important conversation progresses. Follow us on Twitter at @npcnow.  

[Note: Read the next posts in this series, which are focused on strengthening an innovative environment; balancing quality improvement with patient access as we shift to value-based care; and working together to ensure patient access to treatments and encourage innovation.]

*Wilkerson, J. PhRMA: Public Dislikes High Rx Plan Cost-Sharing, Not Just Drug Prices. InsideHealthPolicy.com. November 4, 2015.