UH Study Highlights Problematic Drug Prices

Chien-Wen Tseng. Photo courtesy of University of Hawaiʻi at Mānoa.

A recent study co-authored by a John A. Burns School of Medicine (JABSOM) researcher at the University of Hawaiʻi at Mānoa highlights why new laws regarding price negotiation between government entities and pharmaceutical companies may be necessary to provide affordable healthcare to the segment of the nation’s elderly population dealing with heart problems.

The study has found an effective drug treatment for chronic heart failure may price out many senior citizens with a standard Medicare Part D drug plan, according to a university press release distributed Sunday, July 21, 2019.

The therapy is a combination of sacubitril and valsartan dubbed Entresto. Researchers found that, even with insurance, the cost to Medicare patients may be more than $1,600 a year.

“This drug is the standard of care for the people with significant congestive heart failure according to both the American Heart Association and American College of Cardiology guidelines, yet it’s priced so high that, even with insurance, patients may not be able to afford it,” said senior author Chien-Wen Tseng, HMSA endowed chair in Health Services and Quality Research at JABSOM and a physician investigator with Honolulu’s Pacific Health Research and Education Institute.

The study co-authors worry that, since Entresto is a pricey, brand-name drug, such high copayments may result in patients not taking it at all. And that comes with a potentially steeper price than the high cost of the drug itself.

“The science shows that this drug can help save lives,” said Tseng, pointing to clinical studies showing the therapy has reduced deaths from heart failure by 20%. “We need to figure out a way to deal with its $5,000 price tag, and how folks on Medicare can afford to pay $1,600 each year in copayments to benefit from it.”

Current laws prohibit the US Department of Health and Human Services from negotiating drug prices with pharmaceutical companies on behalf of Medicare Part D beneficiaries.

“Paying $1,600 per year for a single drug could be a huge hardship for many older adults who lived on an average income of less than $25,000 in 2017,” said lead researcher Colette DeJong of the University of California at San Francisco. “Changing the laws that prevent Medicare from negotiating drug prices on behalf of seniors and people living with disabilities would be one step toward curbing these skyrocketing out-of-pocket costs.”