Legislators Address Concerns About Rising Drug Costs


Prohibitive cost to Medicaid for hepatitis C medications and high prices of generic and off-patent drugs evaluated.

A recent summary of US Congressional and regulatory concerns published in the Journal of the American Medical Association addressed a number of drug pricing concerns.

The prohibitive cost to Medicaid for hepatitis C medications, high prices of generic and off-patent drugs, and the lack of a national policy to prevent infectious disease spread via air travel were among the specific areas are among the issues raised in the report.

Hepatitis C Drugs Top State Medicaid Pharmaceutical Expenditures

Sofosbuvir (Sovaldi) ranks among the top 5 expenditures for Medicaid programs in 33 states, according to data for 2014 released by the Senate Finance Committee. Sovaldi (Gilead Sciences) is used to treat hepatitis C virus (HCV).

Medicaid programs in 14 states spent more on Sovaldi than on any other drug, according to the new data. A course of treatment with Sovaldi costs $84,000 and Medicaid programs in those states were able to treat only 2.4% of approximately 700,000 enrollees infected with HCV.

Ten states indicated that the prohibitive cost of Sovaldi could have a negative impact on their overall budgets. As an example, the state of Washington indicated that the cost to treat all Medicaid patients infected with HCV would be 3 times the current state pharmacy budget.

Senate Committee Investigates Price Hikes for Off-Patent Drugs

Sudden price increases for drugs going off-patent have triggered a series of hearings by the Senate Special Committee on Aging. Prices began to increase in the past 5 to 10 years as mergers and acquisitions by manufacturers resulted in less price competition and increased shortages of generic drugs.

Additionally, many generic manufacturers are choosing not to enter certain drug markets. In one hearing, the committee was advised to investigate whether the decreasing numbers of generic drug companies are reducing competition by dividing the market among themselves.

Congress Seeks FDA Documents About Generic Drug Approvals

Citing that “recent significant price increases for certain generic drugs…will make health care more expensive for patients,” the House Committee on Oversight and Government Reform has requested information from the FDA about that agency’s process for reviewing generic drugs.

The request was made to the acting commissioner of the FDA, Stephen Ostroff, PhD.

Nearly 86% of all prescriptions filled in the United States are for generic drugs, and their average cost is typically 80% to 85% lower than brand equivalents.

The letter also noted that the FDA, under the Generic Drug User Fee Amendments of 2012, would receive approximately $1.5 billion in industry fees over the next 5 years to speed the public’s access to generic drugs.

Plan Needed to Prevent Infectious Disease Spread via Air Travel

While nearly 300 billion people board airplanes each year, there is no comprehensive plan in the US to prevent and contain the spread of infectious diseases.

A recent report from the Government Accountability Office (GAO) concludes, “US airports and airlines are not required to have individual preparedness plans, and no federal agency tracks which airports and airlines have them.”

While the Department of Transportation and the CDC state that parts of a national plan already exist, the Federal Aviation Administration has reported that individual airport plans are not aimed at handling an epidemic, the GAO said.

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