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DLNews Guest article:

Doctors Want Lower Drug Costs -- But Not Like This
By Peter Rheinstein

Roughly 30% of American patients have skipped doses of their medicines, cut pills in half, or declined to fill a prescription due to cost concerns in the past year.

These affordability struggles aren't merely personal tragedies. They're a threat to public health. My fellow doctors know all too well what happens when patients don't adhere to their prescribed treatment regimens -- their health spirals, and they often need more expensive interventions.

Reforms to make medicines more affordable are urgently needed. But unfortunately, both Republicans and Democrats keep embracing a proposal that, though well-intended, would unintentionally make American patients, doctors, and biotech workers worse off.

President Trump's recent most-favored-nation executive order -- which calls for capping U.S. drug prices at the lower levels charged in European countries -- is merely the latest example of an idea that's been floated in various forms by members of both parties for years.

It'd be far better for the White House and Congress to work together on alternative reforms -- which already have bipartisan support -- that'd make drugs more affordable without jeopardizing patients' access to current or future treatments.

Most other developed countries, like the United Kingdom and Germany, restrict access to innovative therapies in the name of cost containment. In those nations, many groundbreaking medicines -- especially for cancer, rare diseases, and neurodegenerative conditions -- are either not covered or only accessible after long delays.

Adopting similar pricing here would deter biotech companies from making the massive, risky investments required to develop new treatments for our patients. One recent analysis projected that price controls of the scale envisioned by the White House could slash research spending by 60%, leading to hundreds fewer new drug approvals over the next two decades. As a result of not having those new lifesaving treatments available, American patients could collectively see nearly 1 billion years shaved off their lifespans.

But patients wouldn't merely lose access to yet-to-be-developed drugs. They'd also struggle to obtain existing, already-approved ones -- because the price controls would also slash insurer reimbursements to doctors and clinics, putting many of them out of business and depriving patients of local treatment options.

Doctor's offices, clinics, and other providers of injectable and intravenously administered medicines are already set to lose up to $37 billion in reimbursement on a few dozen drugs selected for Medicare's existing price negotiation program. Indexing drug prices -- and thus reimbursements -- to the much lower prices in Europe would multiply those losses, and leave patients unable to obtain treatment.

The prospect of cutting off drug access is especially concerning in today's geopolitical climate. A congressional commission recently warned that China is "quickly ascending to biotechnology dominance." During my 25 years at the Food and Drug Administration, I saw the origins of this "ascension" firsthand.

Over the past decade, the Chinese Communist Party has increased its biopharmaceutical research and development spending 400-fold -- and tightened its grip on global supply chains.

Relying on China for existing and future treatments would be disastrous from a national security perspective.

There are better ways to make medicines affordable -- without cutting off access to them and ceding biotech dominance to our rivals.

For example, policymakers could crack down on pharmacy benefit managers. These supply chain middlemen don't invent or administer medicines -- yet they siphon off tens of billions of dollars in drug payments each year.

Legislation to curb the power of PBMs already commands bipartisan support in Congress.

Patients and doctors are counting on Washington to get this right.

Peter Rheinstein, M.D., J.D. is president of Severn Health Solutions, past president of the Academy of Medicine of Washington, DC, chairman of the United States Adopted Names Council, chairman of the American Board of Legal Medicine, a delegate to the American Medical Association House of Delegates, and a former president of the Academy of Physicians in Clinical Research. The Well News initially published this.