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Discussion: (3 comments)

  1. Alex, it’s great to see AEI scholars focused on and concerned with the major problem of prescription drug adherence in the United States. Too often America’s conservative scholars are tagged as heartless when they are just looking at presenting the facts. Indeed, people are getting sick and dying because they’re not taking prescribed medication, and shifting costs through rebates on Medicare Part D drugs wont’ solve it! I should say it could help a little, however, but it’s not a real solution.

    You forgot to mention the main reason why so many Americans are skipping taking medication: high drug prices. The numbers are almost unbelievable: 50 million Americans did not take prescribed medication in 2012 due to drug costs, according to the Commonwealth Fund:

    We agree that that the National Consumers League “Script Your Future” program will not be impactful but you should know that calling it “left-leaning” isn’t true. There’s nothing left or right leaning about that program. The program sponsors and partners include left-leaning groups for sure, such as AARP, but many of the funders are pharmaceutical companies and their main trade associations the Pharmaceutical Researchers and Manufacturers of America (PhRMA) and the Generic Pharmaceutical Association, as well as U.S. pharmacies. Here’s the source: One could argue that these companies support NCL’s adherence programs because they do nothing to actually challenge the status quo but present band aids, such as enhancing NCL’s social media campaign, as you point to.

    Alex, what’s the solution to high drug prices for Americans who are struggling? Your colleague, Roger Bate, recommends personal drug importation as helpful:

    Gabriel Levitt
    Vice President

    1. Practicing PharmD

      Drug prices are certainly out of this world, but utilizing a pharmacist to reduce those costs has been proven over and over again to improve health outcomes and reduce health care costs. However, the patients compliance isn’t just a factor of cost. Many times, as a practicing pharmacy professional, I see patients who CAN afford their medications who are just as negligent in adherence to their medications as those who cannot afford them.

      Adherence is much more complex than just cost. It’s a complex mix of patient specific factors and economic factors which require the presence of a health care professional to improve. Until we expand the services of certain health care professionals (such as pharmacists) and encourage these new services to be reimbursed by the government and private insurances, we cannot address the problem of adherence.

      Utilization of the health care system has become routine and almost habitual in many cases. I have seen a much more responsible use of the system and of prescription drugs with the movement to higher deductible plans where patients are MORE responsible for the cost of their care and utilize the system only when necessary.

      Practicing PharmD

      1. Hi PharmD –

        Thank you for your comments. Certainly there are many factors that explain the crisis of non-adherence. My point is that cost is the #1 factor and pharmacist’s know this as well. A CVS/Caremark survey finds that 62% of pharmacists view cost as the biggest adherence barrier:

        Please explain your position on the pharmacist’s role in adherence.

        High deductible plans will force people to shop around for the lowest prices. That is certainly true.


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