By John M. O’Brien, NPC President and CEO
One evening in June, I saw something I hadn’t seen in a while: a roller hockey game on Pennsylvania Avenue. Seeing maskless hockey players on a formerly fenced-in part of our nation’s capital made me grateful for progress and returning to activities we’ve missed in Washington during the last year.
Shortly thereafter, I saw something I didn’t miss about Washington: biased coverage of health care spending data, seemingly ignoring facts to generate controversy. Progress, it seems, is not spread evenly.
The 2021 Milliman Medical Index, which was published earlier this month, showed that annual per-family medical spending dropped for the first time ever. This was not a surprise: the pandemic walloped all non-urgent, in-person medical care, so it’s not a shock that spending went down.
Still, much of the attention – and nearly all of the errors and misinterpretation -- was focused on a second finding: that spending on medicines continued to rise despite the overall drop.
To critics, this was a smoking gun: proof that drugs were getting more expensive. Some news articles and tweets went so far as to suggest this was a result of drug prices increasing, despite a total lack of any data on drug prices in this report.
Not only did the Milliman report not look at prices, but the other experts that did examine pricing found that net prices fell amidst the pandemic. IQVIA found net manufacturer prices for protected brands declined 2.9% last year, even as demand spiked.
It turns out, that’s a conclusion that’s off-base by a mile. Not only did the Milliman report not look at prices, but the other experts that did examine pricing found that net prices fell amidst the pandemic. IQVIA found net manufacturer prices for protected brands declined 2.9% last year, even as demand spiked.
A more accurate discussion of the Milliman report, then, would highlight the extraordinary reality that lower-cost prescription medicines – and the pharmacists who provided them – helped people get well and stay healthy at home when hospitals were overwhelmed and medical practices were shuttered. When it comes to drugs, the Milliman report documents a triumph, not a failure.
Consider this in the context of our families: my Mom had many canceled medical appointments in 2020, but her Florida pharmacists did whatever it took to prevent an interruption in drug regimens. While some pharmacy data suggested a slowdown early on in the pandemic, pharmacies – in Florida and nationwide – innovated quickly. Using plastic wrap, plexiglass, and impromptu pickup window and delivery services, they (and pharmacists nationwide) likely prevented the serious complications that could have been caused by prolonged medication non-adherence. Others successfully transitioned patients to mail delivery.
That medicine use didn’t dip should be celebrated alongside the growth in telemedicine and telepharmacy. It’s no wonder so many people felt comfortable being vaccinated at a community pharmacy. For much of the past year, their pharmacist was the only health care professional they could access.
We also should celebrate the resiliency of the pharmaceutical supply chain. Drug manufacturers, wholesalers, and pharmacies prevented many predicted shortages, even while working to develop or distribute vaccines in what was accurately described as warp speed.
My Dad’s pre-pandemic imaging results identified a “shadow” worthy of investigating. Because he was unable to schedule a colonoscopy soon after and concerned about being exposed to COVID-19 at a doctor’s office, the mass had grown larger when we were able to schedule the procedure in September and necessary surgery in October.
Thanks to his doctors, my Dad is doing well today, but it pains me to consider how many people’s health worsened when COVID-19 interrupted their access to health care.
Decades of advancement in pharmaceutical research has turned life-threatening illnesses into chronic conditions and allowed people to be treated more conveniently at home. Prescription drugs also have led to a decrease in more costly forms of care.
We should appreciate that, in 2020, prescription drug spending followed historical trends, not the slow-rolling catastrophe of foregone care that plagued the rest of the health care system. That’s a dynamic that is now playing out in reverse this year as Americans head back to their doctors’ offices, sending spending skyward.
And we should also be thankful for the pharmacists, pharmaceutical companies and wholesalers who did whatever it took to keep this part of the health care system open, ensuring that we hung on to our progress in at least one sector.