Virginians struggle with rising prescription drug prices
A House of Delegates panel last week rejected a proposed drug affordability board.
The pandemic brought about widespread increases in prescription drug prices. For VCU graduate student Jenaya Moore, that’s meant choosing between her monthly supply of asthma medication and keeping the lights on.
“It is so far out of my budget to the point where my medication is costing as much as my electricity bill,” Moore told VPM News. “I honestly have not been able to get my inhaler medication like how I used to.”
Sometime in 2020, she said she noticed her prescription for Symbicort, a powdered steroid inhaler, triple in price to about $300 a month. For Moore, who supports herself financially and is putting herself through college in public administration, that often means choosing to go without her medications.
“I basically called my physician and said, ‘Just cut off my refill for right now until I'm able to actually afford it,’” Moore said. “And I'll basically get it right now on an as-needed basis.”
In 2021, she took on an additional part-time job — bumping up her hours from 40 per week to around 60-65 on top of school. Even with the extra income, she said she can only afford to purchase her medications occasionally.
Moore was hoping legislation would pass during this year’s General Assembly session to create a prescription drug affordability board in Virginia, which could then review medications like hers and decide if prices should be capped.
While she said she’s mostly been able to manage her asthma without significant flare-ups so far, she’s worried it could get worse at any point if she can’t access her medicine regularly. Her first flare-up — when she was diagnosed with chronic asthma in her teens — was so bad she said it landed her in the emergency room.
“It just kind of came out of nowhere, and it hit me really hard,” Moore said. “Just being able to have my supply at an affordable cost like I need to on a regular basis will help alleviate a lot of my worries.”
The legislation, SB 957 sponsored by state Sen. Chap Peterson (D–Fairfax), cleared the Democrat-controlled Senate but didn’t make it out of a House panel. VPM News reached out to the offices of House Republicans who ultimately voted the bill down — Dels. Kathy Byron of Bedford, Joseph McNamara of Roanoke, Amanda Batten of James City County and Michael Webert of Fauquier — but didn’t receive any comments by deadline.
James Williams, the state’s deputy secretary of health and human resources, told a Senate panel hearing in January that the Youngkin administration “strongly opposes” the bill, because he said it was “really broad in its reach.” He added that “we don’t think a part-time board should be the one to actually make these recommendations.” The governor and the General Assembly would have shared responsibility in appointing members to the board.
Rhena Hicks, executive director for Freedom Virginia — an advocacy organization dedicated to issues of financial security — noted the bill specified the board would have consisted of health care experts with no ties to pharmaceutical companies, and that companies would’ve had the opportunity to justify the reasoning for significant drug price increases to the board before a ruling on potential price caps.
“I think the governor wants to stand with big pharma,” Hicks told VPM News, noting that the Youngkin Inaugural Committee 2022 received a $10,000 campaign contribution from Pharmaceutical Research & Manufacturers of America. The House Republican Campaign Committee also received a $10,000 donation from the same group — as did Speaker of the House Todd Gilbert (R–Shenandoah).
The pharmaceutical group also donated $2,500 each to the Virginia Senate Republican Caucus and the Democratic caucuses for both chambers, in addition to numerous donations to other lawmakers from both parties.
“He [Youngkin] ran on lowering costs for Virginians and these kitchen table issues. I don't know how much more kitchen table you get than someone's medicine that they take to survive,” Hicks said.
She said a number of other states like Maryland, Colorado and Oregon have already taken steps to implement similar drug review boards — which she said are a fairly new concept. Hicks hopes Virginia will soon follow in their footsteps.
“We've got to start somewhere, and these drugs are hitting the market at just an unattainable price,” Hicks said.
In a 2019 survey of Virginia residents conducted by Altarum Healthcare Value Hub, more than 1 in 4 respondents said they were not regularly filling their prescriptions because of cost concerns. A 2021 Virginia law required health insurance carriers, pharmacy benefits managers and pharmaceutical manufacturers to annually report on specific prescription drug pricing information.
Dr. Micha Joffee, a primary care doctor in Vienna, told VPM News he polled his patients about which drugs they struggle to pay for. The most common concern he heard was about steroid inhalers, which are for asthma.
“Inhaled steroids are medicines that calm down inflammation in the lungs and make it easier to breathe, and there's no generics for those,” Joffee said. “So, they're really expensive and a lot of times patients will do without them and just kind of put up with not breathing well and coughing.”
He also pointed to a new diabetes medicine called Ozempic, which costs about $1,000 per month without insurance.
Even for drugs that do have a generic option, he said some people need to be on a brand-name medication because the generic version doesn’t work very well for them. He pointed to a 2017 study that found an 8% increase in negative side effects when switching from a brand-name to a generic drug.
Joffee said he has a patient with depression and anxiety whose insurance company told her she had to switch from a brand name drug to the generic version because it was less expensive.
“She said within two weeks, that depression became out of control and she started feeling thoughts of suicide,” Joffee said.
She eventually had to get back on the branded drug, which Joffee said cost her about $4,500 in out-of-pocket costs last year — and insurance authorization, which requires jumping through a lot of hoops.
Joffee said another patient, a 75-year-old woman, has to work full-time in order to afford her $600-per-month cardiac drug to address atrial fibrillation, an irregular heartbeat. He thinks both political parties should support a drug affordability board in Virginia because it will cost the state more in the long run.
“[Patients will] forgo a treatment rather than take a medicine that's more expensive,” Joffee said.