Issue Brief Release: Rx Reform in Congress Must Include Rx Price Negotiations to Make Medicines Affordable for More Veterans and Their Families

For Immediate Release: July 2, 2021
Contacts:
Claire Zautke, Healthcare for All Director, Citizen Action of Wisconsin, 414-940-3375, [email protected]
Alex Brower, Executive Director, Wisconsin Alliance for Retired Americans, 414-949-8756, [email protected]

 

Issue Brief Release: Rx Reform in Congress Must Include Rx Price Negotiations to Make Medicines Affordable for More Veterans and Their Families

Milwaukee, Wisconsin: The Wisconsin Alliance for Retired Americans and Citizen Action of Wisconsin are calling on Congress this Independence Day to lower drug prices through negotiations that will make prescription medicines more affordable and accessible for everyone, including millions of veterans struggling with service related health conditions. Veterans often have complex health care needs that require treatment with prescription medicines, but the high price of prescription drugs limits access for veterans and their families including for veterans struggling with PTSD ((Post-Traumatic Stress Disorder), an all too common consequence of military service. 

There are currently approximately 19 million U.S. veterans, according to the Department of Veterans Affairs, including over 363,000 in Wisconsin. Gulf War-era veterans make up the largest share of the national total, surpassing Vietnam-era veterans based on the VA’s 2018 population model estimates. A third of veterans in a recent study say they had trouble paying their bills in their first few years after leaving the military. Among veterans who report PTSD, six-in-ten (61%) say they had trouble paying their bills and four-in-ten (42%) say they had trouble getting medical care for themselves or their families.

Veterans Commonly Have Service-Related Health Conditions

Veterans often have complex health care needs and conditions related to their military service including higher rates of traumatic brain injury, mental illnesses like depression and PTSD (Post-Traumatic Stress Disorder). Research shows that one in five U.S. veterans of Iraq and Afghanistan experience depression or PTSD.  Climbing suicide rates among younger veterans attest to the real and lasting impact of military service on mental health and the need for accessible treatment.

Veterans also face occupational hazards like exposure to hazardous chemicals and environmental conditions that impact their health. Many face service-connected hearing loss. A 2015 report showed that 16% to 26% of male veterans and 7% to 13% of female veterans from the Iraq and Afghanistan Wars were diagnosed with hearing problems. Veterans are also more likely to experience musculoskeletal injuries because of the physical nature of the work that includes marching, running and carrying heavy equipment. Veterans have twice the incidence of osteoarthritis as their civilian counterparts, for instance, because of physical demands, traumatic injuries, and repetitive physical activities. There is a documented link between chronic pain from physical impacts of occupation or injury and mental health conditions like PTSD and depression.

Veterans Get Health Coverage From a Variety of Sources and Face Gaps in Care

Veterans receive health coverage from a variety of sources including the  Veterans Health Administration, Tricare, Medicaid, Medicare and through private insurance.  About 6% of veterans still remain uninsured despite broad gains for veterans under the Affordable Care Act between 2013 and 2015. Coverage gains for veterans were more pronounced in states that expanded Medicaid as part of ACA implementation. The two states with the highest number of uninsured veterans, Texas and Florida, have not implemented Medicaid expansion. 

The (VHA) is  the largest integrated health care system in the United States, providing care at 1,293 health care facilities, including 171 VA Medical Centers and 1,112 outpatient locations. Over 60% veterans are eligible for healthcare through the VHA but fewer than half enroll. One reason is that many veterans have other sources of coverage including private insurance. Veterans who depend on private insurance or Medicare Part D coverage are subject to the same problems with prescription drug affordability as the rest of us even though their health care needs may be greater than those of the general population. About 40% of people with private insurance still can’t afford prescriptions, including millions of veterans who need treatment for common service related health issues described above.

The price of prescription medicines is increasing faster than any other medical good or service, largely because drug corporations have monopoly power to set and keep prices high. Drug corporporations charge patients in the United States three times as much as people in other countries for the same drugs. Already in 2021, drug corporations have raised prices on over 830 drugs by an average of 4.5%. More price increases are expected in July since drug corporations typically increase prices twice a year. Congressional action to lower drug prices would benefit taxpayers, businesses, families and veterans, who largely get their health care from the same sources as the rest of us. 

Congress Must Lower Drug Prices to Make Medicines More Affordable and Improve Health

Nearly 9 out of 10 voters named lowering prescription drug prices as a top health care issue leading into the 2020 election. Current federal programs like the VHA and Medicaid provide guidance on how Congress can lower prescription drug prices for everyone and increase accessibility to affordable medicines, particularly by adopting price negotiations that exist in these programs but are prohibited in Medicare Part D.  

  • A comparison by the nonpartisan Congressional Budget Office (CBO) of prices for brand-name drugs in government programs and agencies including Veterans, Department of Defense, Medicaid, and Medicare Part D found that Medicare Part D’s prices were significantly higher than the other programs where direct purchasing and negotiations were used. 
  • A recent Government Accountability Office (GAO) report found that the Department of Veterans Affairs (VA) paid, on average, 54 percent less per unit for a sample of 399 brand-name and generic prescription drugs in 2017 as did Medicare Part D, even after accounting for applicable rebates and price concessions in the Part D program

Experts affirm that being able to afford prescriptions is a key reason why people skip doses or forgo medicine rather than comply with doctors’ orders to take it. Research shows for instance, that one in four diabetics skip insulin doses because they can’t afford the medicine.  There are dangerous health risks to skipping medicines and negative impacts on health outcomes that can even include death as we’ve seen in several cases of insulin rationing. But for people who can’t afford medicines, there is no choice until Congress takes action to ensure increased affordability and access. 

A 2020 study in Health Affairs shows that veterans who get their health care through the VHA, including low-cost prescription medicines, are more likely to take their medicines as directed because of the improved access. Researchers concluded that although veterans with VHA health coverage were older and in worse health and had lower incomes than those with other kinds of  coverage, VHA patients had lower rates of cost-related medication nonadherence: 6.1 percent versus 10.9 percent for non-VHA patients.

Here in Wisconsin, veteran Roger Punswick receives prescription drugs through the VHA. As a Vietnam veteran, he was exposed to agent orange, and currently receives a lot of medications with no co-pay because the prescriptions are service related.  He is currently on 7 medications, including Metforman, Metolpral, Hydrolozen, Certroline, and Ferosomide, among others. Roger says “Everyone should be able to afford the prescription drugs they need – even if they did not serve.” 

Congress Should Implement  Negotiations in Medicare and Extend Discounted Prices to Everyone 

H.R. 3, the Lower Drug Costs Now Act and the newly-released Senate Finance Committee principles for prescription drug reform both include proposals for Medicare negotiations that would lower prices and then extend those discounts beyond Part D enrollees so that people with private insurance or no insurance can also benefit from more affordable medicines. Congresswoman Gwen Moore voted in support of HR 3 in the 116th Congress and is a co-sponsor of the bill in the current Congress.

Negotiating drug prices in Medicare is a popular and bipartisan proposal that would save patients and taxpayers money and increase access to medicines that people need, including many veterans. 

Senator Tammy Baldwin has openly supported price negotiations, and Wisconsinites are still waiting on Senator Ron Johnson to sign on to negotiations. 

A new study by West Health shows that Under H.R. 3, employers could save $195 billion on health care spending, while employees would save $61 billion in lower premiums and out-of-pocket costs). Costs in the ACA market could fall by $58 billion, including $34 billion in premiums and patient cost-sharing. Overall, the CBO predicts that the bill would save taxpayers nearly half a trillion dollars that could be invested to improve benefits and services in other areas of Medicare.

Although the pharmaceutical industry is objecting to these proposals with false claims about dangers to innovation, a June survey shows that 8 in 10 Americans still prefer major government action to lower prices notwithstanding the industry’s fear mongering over innovation.

Americans Have Waiting Long Enough for Fair and Affordable Drug Prices–It’s Time for Action

After decades of lip service from both parties, Americans can’t wait anymore for Congressional action to lower drug prices and ensure that medicines are affordable for everyone who needs them. There are ample models thanks to the VHA, Department of Defense, and Medicaid to demonstrate that negotiating prices directly with drug corporations and putting in place rules to ensure consumer protections against drug corporations’ monopoly pricing of medicines works. 

The prescription drug industry has the highest profit margins of any sector in the nation. Continuing to put those profits ahead of patients’ health, particularly the veterans who have sacrificed and contributed in countless ways to protect the security and well-being of the nation, is fundamentally wrong.

“No matter where we live, what we look like, or how much money we make, high prescription drug prices affect us all,” said Robert Kraig, Executive Director of Citizen Action of Wisconsin. “For too long, Big Pharma executives have lined their own pockets at the expense of Wisconsinites’ health – aided by the lack of transparency in drug pricing. Citizen Action of Wisconsin and our members call on Wisconsin’s Congressional delegation to support the Lower Drug Costs Now Act.”  

“Wisconsinites – and all Americans – need to be able to afford medically necessary medications” said Gary Mitchell, President of the Wisconsin Alliance for Retired Americans, “it’s time for Congress to at least pass HR. 3.” 

It’s time for Congress to honor the peace, freedom and prosperity that veterans have fought for across generations by taking action to ensure everyone in America has access to affordable healthcare and medicines they need to take care of themselves and their families. 

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