Another call shift at my hospital brought in another appendicitis case, a 49-year-old mother of three, writhing in pain. She had appendicitis but also another issue. Her blood sugar was higher than 300 and she had a severe condition diabetics can suffer known as diabetic ketoacidosis, a condition typically preventable with close adherence to medication.
When I asked if she had been taking her medication, her answer was direct: “No, I cannot afford it.”
After caring for her, I spoke with my father, who is also a diabetic. He told me about a newer medication that his doctor had prescribed called Jardiance that cost him $660 a month to fill. Fortunately for him, the doctor’s office had enough samples of the medication to get him started. After the samples ran out, he had a candid conversation with his physician about the drug’s high cost and was switched to a less effective medication.
After these experiences, I started noticing and asking the patients I cared for about their ability to afford the medications I was prescribing.
The responses were devastating.
People were enduring debilitating pain, failing to fill life-sustaining medications, taking their medications every other day instead of as directed, and were cutting pills in half to wait longer to get a refill they couldn’t afford.
People were choosing rent, utilities, school supplies, child care and car notes over medications that were critical to their health. This is unfortunately not unique to my patients. A recent study showed almost 30% of Illinoisans were cutting their pills in half or skipping doses because of cost.
During this state legislative session, our lawmakers have an opportunity to pass a bill (HB4472) to create a prescription drug affordability board that could review the cost and affordability of prescription drugs and set maximum limits for what Illinoisans would pay. Illinois would join Colorado, Maine, Maryland, Minnesota, New Hampshire, Washington, Oregon and Ohio in setting payment limits and making drug therapies more affordable.
America: No. 1 in drug prices
Medications in America, brand-name and generics, cost significantly more than drugs in all comparison countries, such as Canada, Mexico, Germany and France. The discrepancy in drug prices led Florida to start importing prescription drugs from Canada. The pharmaceutical industry has utilized the wallets of everyday Americans to subsidize the low prices of drugs in other nations. If the pharmaceutical industry won’t prioritize the health of Americans over its huge profit margins, then we must.
Drug costs have become particularly overwhelming for retirees and middle- to low-income communities that are financially spread thin. People who don’t qualify for Medicaid and can’t afford private insurance are especially affected. Without insurance, individuals are more likely to pay the full price of prescription drugs, without any assistance.
In marginalized minority communities, which experience disproportionate rates of unemployment and where many are uninsured, the prevalence of chronic diseases increases the necessity of pharmaceutical drugs, worsens financial burdens and leads to poor health outcomes.
Every day I see people juggling the weight of financial pressures and the costs of drug therapies with keeping a job to afford the therapy and staying healthy enough to feed their families. We have the highest prevalence of chronic diseases compared to all other high-income countries. Therefore, affordable drugs are crucial to the health of our nation.
Drug companies would like you to believe that lowering the costs of prescriptions would hurt funding for research and the innovation of new drugs — that they would have to pull drugs off the market to stay afloat. The truth is large pharmaceutical companies spend considerably more money on advertising than they do on research. The U.S. is one of only two countries — along with New Zealand — that allows the pharmaceutical industry to advertise directly to consumers. The billions of dollars these corporations spend on advertising could easily stem losses from making drugs more affordable.
As a physician at the University of Chicago, I care for the rich, poor and everyone in between. I cannot effectively care for patients if they cannot afford the therapies necessary to keep them well. Drugs don’t work if people can’t afford them. A prescription drug affordability board is the first step to making medications accessible and affordable for all, and it is a step I encourage our state legislators to take during this session.
Dr. Anthony D. Douglas II is a general surgery resident physician at the University of Chicago who studies socioeconomic and historical factors that impact trauma in urban communities.
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