The increasing cost of both brand-name and generic drugs isn’t just the fault of pharmaceutical companies, according to Jay Kaplan, MD, president of the American College of Emergency Physicians.
In a statement, Kaplan said patients who are angry about the rise in drug costs may not recognize the role health insurers have had in driving up prices, thanks to “high-deductible health insurance plans” that don’t shield customers from “exorbitant” costs.
“Those plans, which now account for nearly one-quarter of employer-sponsored health insurance, use words like 'out-of-network,' 'deductible,' 'co-insurance' and 'copay' to hide an ugly reality: more money coming out of your pocket to pay for your healthcare,” Kaplan said.
Kaplan specifically mentioned the controversy over the 400 percent jump in price for EpiPens, a potentially life-saving treatment for severe allergic reactions. The manufacturer of the autoinjector, Mylan, has promised to produce a less expensive generic version, as members of Congress and consumer advocacy groups continued to demand documentation justifying the increased prices since it acquired the device in 2007.
“The firestorm over drug prices is just another chapter in the ongoing story of 'surprise bills' which are more accurately characterized as 'surprise gaps in coverage,” Kaplan said. “Emergency physicians continue to fight for fair coverage for medical care, whether it is provided in the emergency department or by a bottle of pills. Physicians and patients must join together to fight back against the 'heads I win, tails you lose' strategy employed by health insurers."
Lawmakers at the state level have targeted those out-of-network costs, most recently in California, where legislation to tie those bills to Medicare reimbursement rates is awaiting action by the state’s governor.