#1. Prescription Drug Costs Set to Become a Leading Cause of Death for Elderly Americans

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More than 1.1 million seniors in the federal government’s Medicare program could die prematurely over the next decade because they will be unable to afford the high prices of their prescription medications, according to a November 2020 study issued by the West Health Policy Center, a nonprofit and nonpartisan policy research group, and Xcenda, the research arm of AmerisourceBergen, a drug distributor. As Kenny Stancil reported for Common Dreams, West Health projects that, with the continuation of current drug pricing trends, “cost-related nonadherence” will become “a leading cause of death in the U.S., ahead of diabetes, influenza, pneumonia, and kidney disease” by 2030.

According to the West Health/Xcenda study, the rising cost of prescription medicines will lead to an estimated 112,000 premature deaths annually, due to elderly Americans being unable to afford necessary medications, a situation referred to as “cost-related nonadherence.” Explaining that “medication adherence” is a term used to describe how well patients follow healthcare professionals’ instructions for taking medications, the study stated, “unaffordable drug prices can significantly impair medication adherence.” As medicines become increasingly expensive, patients skip doses, ration prescriptions, or quit treatment altogether. According to the president of the West Health Policy Center, Timothy Lash, “One of the biggest contributors to poor health, hospital admissions, higher healthcare costs and preventable death is patients failing to take their medications as prescribed.”

A separate study, published in March 2020 by JAMA, one of the leading peer-reviewed medical journals, found that list prices on branded pharmaceutical products in the United States increased by 159 percent from 2007 to 2018. The high cost of medicine will raise Medicare expenses by an estimated $17.7 billion each year from 2021 to 2031, the West Health/Xcenda study reported. Established in 1965, Medicare is the national health insurance program that serves as the primary provider for Americans aged 65 and older.

The West Health/Xcenda study examined the impact of cost-related nonadherence on the general Medicare population, with a focus on five medical conditions that “significantly affect seniors and for which effective pharmaceutical treatments are available,” including several types of heart disease, chronic kidney disease, and type 2 diabetes.

Medicare beneficiaries are responsible for 25 percent of a prescription drug’s cost, until their expenses reach the out-of-pocket maximum. For this reason, “even with Medicare insurance, what seniors pay is linked to a drug’s price,” and patients are likely to experience “a significant increase” in their prescription costs as drug companies continue to raise list prices, according to the West Health/Xcenda study. A June 2021 AARP study found that, between 2019 and 2020, the retail prices for 260 widely-used brand name prescription drugs increased by 2.9 percent, more than twice the general inflation rate of 1.3 percent. AARP reported that, “[f]or the average older American taking 4.7 prescription drugs per month, the annual cost of therapy would have been more than $31,000 for 2020”—a figure that exceeded the median annual income for individual Medicare beneficiaries in 2019 ($29,650).

Stancil’s Common Dreams report reviewed policy changes that could lower the cost of prescription drugs and “curb the power of Big Pharma, resulting in far fewer avoidable deaths.” The West Health/Xcenda study recommended that limits on drug price increases and empowering Medicare to negotiate directly with drug companies on behalf of patients could prevent 93,900 deaths per year and reduce Medicare spending by $475.9 billion by 2030. As a model for policymakers, the study pointed specifically to the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3), which had been passed by House Democrats in December 2019 but was stalled in the Senate by Republican majority leader Mitch McConnell at the time of the Common Dreams report. Since then, the newly elected president, Joe Biden, has declined to include Medicare negotiation in his $1.8 trillion American Families Plan proposal, but House Democrats, led by Energy and Commerce Committee chairman Frank Pallone Jr. (D-NJ), have reintroduced the Elijah E. Cummings Lower Drug Costs Now Act.

Soaring prescription drug costs have been widely reported by corporate news outlets. Corporate coverage typically highlights the rising costs of the most expensive branded medications, as exemplified by a January 2021 CBS News report. In April 2019, the New York Times reported that Americans had “borrowed an estimated $88 billion over the last year to pay for health care,” according to a survey conducted by West Health and Gallup. But corporate news outlets appear to have entirely ignored the subsequent West Health/Xcenda study on the consequences of rising drug prices for elderly Americans enrolled in Medicare. In May 2021, Rep. Peter Welch, a Democrat from Vermont, and David Mitchell, the founder of Patients For Affordable Drugs, co-authored an opinion piece for The Hill, advocating for H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, and cited figures about preventable deaths from the West Health/Xcenda study.

The public’s understanding of the debate surrounding H.R. 3 and other proposed legislation designed to control inflation in prescription drug prices ought to be informed by accurate information about the grim repercussions of continuing the status quo. Sadly, the corporate media have failed to provide the public with such information for far too long, and the consequences could turn out to be deadly for millions of seniors.

Kenny Stancil, “High Drug Prices Could Result in Premature Deaths of More Than 1.1 Million Seniors in Next Decade: Analysis,” Common Dreams, November 23, 2020.

Student Researcher: Silvia Morales (Sonoma State University)

Faculty Evaluator: Peter Phillips (Sonoma State University)

Illustration by Anson Stevens-Bollen.