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Alyssa Lee
Mr. Rogers
Government 4
26 October 2016
The Stresses and Struggles of Obtaining Prescription Drugs
Current human beings, especially those living in the United States, are in the midst of a
rapidly developing world where one has access to numerous technological and scientific
advances, from iPhones, to medical scanners, to constantly updated search engines. Amongst
these breakthroughs include prescription drugs, which are continually progressing to treat both
new and old disorders and diseases. However, as these medications become more complex, as do
our health care systems, the prices of these drugs shoot up. The Accessible Pharmaceuticals Act
of 2016 includes a system that attempts to make prescription drugs more affordable for health
care patients who are struggling to fit prescription drugs into their spending. Said bill is more
than necessary for American citizens because of the increasing amount of money spent towards
medications, the over excessive expenditure by pharmaceutical companies on marketing, and the
major differences in prescription drug prices in the United States and other countries.
The rate of prescription drug spending and use in the United States is high and expected
to increase. As scientific research advances and develops new pharmaceuticals that can help with
numerous conditions, there is going to be an increase in the number of people who are prescribed
medication. To put it simply, the more drugs we produce, the more people will want to pay for
them in order to relieve symptoms and side effects. In the United States, almost 70% of
American citizens take at least one prescription drug, while over 50% are prescribed at least two
(mayonewsreleases). One in five Americans are on more than five drugs (mayonewsreleases).

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Those who are prescribed specialty drugs, such as those that help with symptoms of hepatitis C,
cancer, or osteoporosis, have a much higher cost than the basic generic drug, considering that
these often involve special research, administration, and handling. Think about it: the conditions
that are treated with specialty drugs are commonly the chronic and more serious diseases that
require medication. This means that the most expensive drugs are those that manufacturers and
physicians know people will buy. In the year of 2015, total expenditure on medicines reached
$310 billion in the United States (Constantino). Averaged out to the rounded 320 million
Americans (U.S. and World), the spending on prescription drugs equals almost $1000 per
person. That is an excessive amount of money for an individual to be spending on an item that
should succeed in easing pain and stress, not causing them. As a result of pharmaceutical prices,
about 8% of Americans did not take the correct amount of medication that was prescribed to
them (Cohen and Villarroel). Prescription drugs are administered to patients in order to help
them settle symptoms, improve disorders, and ameliorate health status. These pharmaceuticals
defeat the purpose if their costs are so unaffordable that patients are neglecting their doses. The
costs of prescription drugs are weighing down on the United States population, but why are these
prices so high?
In order to develop new products and market them to doctors and health insurance plan
providers, pharmaceutical companies spend a large amount of money on advertising for every
new drug that they produce. In the United States, there are those prescription drugs that a health
care patient cant obtain unless receiving a prescription. This concept plays a major role in
determining where pharmaceutical companies decide to distribute their spending. While a good
amount of money goes towards research, an extravagant amount is put towards advertising to
both doctors and patients since citizens can not directly acquire their medication. More than half

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of the Americans in a poll believed that too much money is spent on advertising prescription
drugs to the public rather than on research (DiJulio, et al.). Doctors are more aware of how much
money is spent on advertising to them, especially considering that they view first-hand the ads
that are directed towards physicians. However, it is significant that even the patients are aware of
just how much money is spent on marketing. The fact that patients see the pharmaceutical
companies expenditure on advertisements as excessive indicates a notable message to the
prescription drug companies. Pharmaceutical companies expenditure on marketing is in fact
almost two times the amount that they spend on research (Belk). It is perfectly logical for
pharmaceutical companies to spend money on advertisinghow else are they going to sell their
products? However, spending two times the amount of money on marketing than research is not
proportionate. It should be important for pharmaceutical companies to even out their spending
because the research behind the prescriptions that they manufacture is just as, if not more,
important as making sure that they are sold. This is even more significant when we look at the
fact that pharmaceutical companies spend $8000 to $13,000 on advertising to just one doctor
alone each year (Wazana). It makes sense that so much money is spent on just displaying
products to doctors: a patient needs permission from their doctor in order to be prescribed
medication. The advertisements that the public views serve as a link between a patient and their
motivation to ask their physicians about the ads they see on television. Pharmaceutical
companies know that they have to persuade doctors to prescribe their products in order for the
public to actually pay for them. This explains the large amount of money that drug companies
allocate to health care professionals. It is no lie that pharmaceutical companies are spending too
much money on broadcasting their products, therefore hurting the amount of money spent on

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research, but how do the numbers spent on and for pharmaceuticals in the United States compare
to those in other countries?
The United States is the number one spender on prescription drugs. Our nation is
fortunate enough to have the technology and innovation to create new and life-saving
medications, but along with that comes a large cost for the patients that need these drugs. In
comparison to other countries around the world, the United States spends the most on
pharmaceuticals by far. Medicare, which serves as one of pharmaceutical companies highest
buyers, is not allowed to negotiate prescription drug prices with those companies (Gokhale, et
al.). This is significant because it highlights the fact that the pharmaceutical companies are the
only people who really have a say in how much the public pays for its products. In European
countries, the governments utilize a method known as external reference pricing (Brennan). Not
only do government health systems, not pharmaceutical companies, set prescription prices, but
the external reference pricing works to observe prices for certain drugs in other countries in order
to set the prices in that particular country (Brennan). The viewing of costs in other nations allows
for a benchmark price that will be used to determine the price of the drug in whichever country is
utilizing external reference pricing. One of the biggest reasons for such high prices in the United
States is based on how prices are actually set. The manufacturers who produce the prescriptions
consider the market exclusivity rights that are granted to them by the Food and Drug
Administration and by patents (Avorn J, et al.). This means that the Food and Drug
Administration grants pharmaceutical companies the ability to set their own prices for the drugs
they sell. There are no limits when they have the monopoly. In Canada, though, there exists the
Patented Medicine Prices Review Board. This Board succeeds in restraining pharmaceutical
companies in the country from making their prices too excessively expensive (Shulman Sr.). Our

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country also has a more complex and expensive system of simply prescribing a medication to a
patient than do others. Making an appointment with a doctor is already a strenuous process, but
on top of that, patients are often forced to pay a fee for the doctor, for the visit itself, and for the
examination. The bill will reach the patient in the form of a bill from their health insurance
company. This person hasnt even paid for the drug yet (Merino 75). In France, on the other
hand, patients looking for a prescription only need to stop by their local pharmacist, ask for their
medication, and pay the person at the counter (75). It is clear that, not only are prescription prices
themselves much higher than those in other countries, but even the simple action of going to
obtain those prescriptions is more difficult in the United States than in other places. This is
where the Accessible Pharmaceuticals Act aims to make medication more easily attainable by
altering the pharmaceuticals system in the United States. Not all Americans are on board for this
idea though.
A majority of opponents against the Accessible Pharmaceuticals Act are most likely
health insurance plan providers and pharmaceutical companies who argue that this Act will hurt
them economically. Health insurance companies might state that, by creating more tiers for
drugs, they are losing money because patients arent forced to pay such high copayments on
generic drugs. Pharmaceutical companies will most likely also oppose this bill because they are
losing money by being cut on the amount that they are allowed to spend on marketing. However,
one must look at these two situations from the point of view of a health care patient. $2.6 million
is spent on every new prescription drug that a pharmaceutical company develops (News). Not all
of these drugs, however, make it to the market for patients to purchase. As a result, the
pharmaceutical companies have to make up for the losses through the patients. Prices for
prescriptions increase to accommodate for the pharmaceutical companies losses. The Accessible

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Pharmaceuticals Act will limit the amount of money spent on marketing in order to supply
pharmaceutical companies with more money to spend on research so that there is an increased
likelihood in more drugs making it to market. If this is the case, then a decrease in medication
spending will occur because patients do not have to accommodate such a large amount for losses.
Health insurance companies are always considering the amount of money that they owe
manufacturers for prescribing their prescriptions to patients (Barlas). It is logical to assume that
not all health care insurance plan providers will be happy that the tiered drug system is
decreasing their profit by lowering the costs of some medications. These providers have good
reason to object this Act. However, health care patients are struggling to fit pharmaceuticals into
their spending when costs are towering so high. It should become the priority of a health
insurance plan provider to make prescriptions as accessible as possible for those under their
health insurance policies. Those that oppose the Accessible Pharmaceuticals Act must take into
account the difficulties that a health care patient has in simply obtaining what will help them
with their conditions.
In the United States, there are numerous people who are in need of prescription drugs, the
pharmaceutical companies are not spending their money on the right ethical purposes, and the
country itself has more complex and expensive methods of obtaining medication. The costs of
pharmaceuticals should not be the issue when the patient is already suffering from other
maladies. That person needs the prescription for a reason, and their condition, disorder, or
disease should not warrant the added stresses and struggles of being able to access and afford
what will help. The Accessible Pharmaceuticals Act is a necessity in making the prescription
drug obtaining, spending, and taking processes as anxiety-free as possible. This Act should be

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enacted, and for the sake of health care patients, it should be enacted now. To all members of the
Senate: vote for the passing of the Accessible Pharmaceuticals Act.

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Works Cited
Avorn J, et al. The High Cost of Prescription Drugs in the United States: Origins and Prospects
for Reform. National Center for Biotechnology Information, 23-30 August 2016,
www.ncbi.nlm.nih.gov/pubmed/27552619. Accessed 10 October 2016.
Barlas, Stephen. Are Specialty Drug Prices Destroying Insurers and Hurting Consumers?
National Center for Biotechnology Information, August 2014,
www.ncbi.nlm.nih.gov/pmc/articles/PMC4123806/. Accessed 13 October 2016.
Belk, David. The Pharmaceutical Industry. True Cost of Health Care,
truecostofhealthcare.net/the_pharmaceutical_industry/. Accessed 12 September 2013.
Brennan, Zachary. European Drug Prices: New Commission Report on What Policies Work and
What Could Work. Regulatory Affairs Professionals Society, 25 February 2016,
raps.org/Regulatory-Focus/News/2016/02/25/24409/European-Drug-Prices-NewCommission-Report-on-What-Policies-Work-and-What-Could-Work/. Accessed 17
October 2016.
Cohen, Robin A. and Maria A. Villarroel. Strategies Used by Adults to Reduce Their
Prescription Drug Costs: United States, 2013. U.S. Department of Health and Human
Services, January 2015, www.cdc.gov/nchs/data/databriefs/db184.pdf. Accessed 16
October 2016.
Constantino, Tor. IMS Health Study: U.S. Drug Spending Growth Reaches 8.5 Percent in
2015. Quintiles IMS, 14 April 2016, www.imshealth.com/en/about-us/news/ims-healthstudy-us-drug-spending-growth-reaches-8.5-percent-in-2015. Accessed 4 October 2016.

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DiJulio, Bianca, et al. Kaiser Health Tracking Poll: October 2015. Kaiser Family Foundation,
28 October 2015, kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-october2015/. Accessed 16 October 2016.
Gokhale, Ketaki, et al. The U.S. Pays a Lot More for Top Drugs Than Other Countries.
Bloomberg, 18 December 2015, www.bloomberg.com/graphics/2015-drug-prices/.
Accessed 17 October 2016.
mayonewsreleases. Nearly 7 in 10 Americans Take Prescription Drugs, Mayo Clinic, Olmsted
Medical Center Find. Mayo Clinic, 19 June 2013,
newsnetwork.mayoclinic.org/discussion/nearly-7-in-10-americans-take-prescriptiondrugs-mayo-clinic-olmsted-medical-center-find/. Accessed 4 October 2016.
Merino, Nol. Health Care. Greenhaven Press, 2012.
News. Tufts Center for the Study of Drug Development, 18 November 2014,
csdd.tufts.edu/news/complete_story/pr_tufts_csdd_2014_cost_study. Accessed 13
October 2016.
Shulman SR. The Canadian Patented Medicine Prices Review Board. New rules and new
status. National Center for Biotechnology Information,
www.ncbi.nlm.nih.gov/pubmed/10155589. Accessed 16 October 2016.
U.S. and World Population Clock. U.S. Department of Commerce,
www.census.gov/popclock/. Accessed 10 October 2016.
Wazana, Ashley. Physicians and the Pharmaceutical Industry. Stanford University Medical
Center, 30 March 2011, med.stanford.edu/coi/journal%20articles/Wazana_AIs_A_Gift_Ever_Just_A_Gift.pdf. Accessed 20 October 2016.