Prescription Drugs Cost More Here Than Anywhere Else

What the issue is

Americans pay more for the exact same medication than people in almost any other developed country. Same drug, same manufacturer, sometimes the same factory — a higher price here.

Then there's what happens inside the doctor's office. Too often the answer to pain is another prescription rather than fixing the thing causing it. Part of that is cost: a procedure that solves the problem is expensive, and a prescription that manages it is cheap. The cheaper path gets taken, over and over, and people end up dependent on medication that was never meant to be permanent.

"Doctors need to start treating what is the root cause of a person's pain and not constantly running to prescription drugs to issue to people." — Kevin Martin

And most of these medicines aren't made here anymore. We depend on other countries for drugs Americans need to stay alive.

What Congress actually controls

Nearly every lever on this one is federal.

The federal government is the largest purchaser of prescription drugs in the country through Medicare and Medicaid, and Congress sets the terms of that purchasing. Congress writes patent and exclusivity law, which determines how long a drug stays free of competition. It controls the FDA's approval pathway for generics and biosimilars. It sets trade and tax policy that determines where manufacturing happens.

And federal antitrust law — written by Congress and enforced by federal agencies — is what governs whether an insurance company is allowed to own the practice that treats you and the pharmacy that fills your prescription.

What needs to change

Stop paying more than everyone else. If other developed countries pay a lower price for the same medication, that should be the ceiling for what the federal government pays. There is no defensible reason American taxpayers and patients subsidize the rest of the world's prescription costs.

Bring critical drug manufacturing home. Medications Americans depend on should be made in the United States. That is a supply chain question and a national security question at the same time, and the levers — trade policy, tax treatment, FDA approval timelines — are all federal. It has to be done without driving the price back up.

Break up the arrangement. When an insurance company owns the doctor's practice and has a stake in the pharmacy, the person deciding your treatment is working inside a system with its own financial interest in the answer. Congress has broken up concentrated industries before — the phone company being the example Kevin reaches for — and this one warrants it.

Let doctors treat the cause. When fixing the underlying problem is the right medical answer, that should be the option, not the one denied because managing it is cheaper.

Why it matters

This is a bill nearly every family in the district pays, and most people never see why it's so high.

It also connects to something bigger. A great deal of what we call an addiction crisis started in a doctor's office with a legitimate prescription for real pain, written because it was the affordable option rather than the right one.

Nobody should be choosing between a prescription and a grocery bill, and no American should pay triple what someone in another country pays for the same pill.