Dr. Cohen makes the case that knowing how patients pay for medications, and the extent to which patients can afford out-of-pocket drug costs, are essential parts of overall patient care.
Steep increases in prescription drug prices have been a topic of heated debate within advocacy groups, journalists, and policymakers among others. However, there are a number of complex aspects of how these increases affect patients that people so far removed from patient interaction may not understand all the specific nuances and options available to them.
Clinical Professor Sally S. Cohen, PhD, RN, FAAN, at the New York University Rory Meyers College of Nursing, argues in her editorial, “Soaring Prescription Drug Prices,” in Policy, Politics, & Nursing Practice (PPN), that nurses “..have an ethical responsibility to [their] patients and profession to learn about the economics and politics of prescription drug costs,” sounding the clarion call for nurses to get more involved in this conversation.
“We have an ethical responsibility to our patients and profession to learn about the economics and politics of prescription drug costs,” said Dr. Cohen. “Muting our voices in the deliberations on prescription drug pricing would be a serious policy and political oversight.”
Dr. Cohen emphasizes the importance of understanding that prescription drugs costs and policies are payer dependent, meaning that each payer has its own eligibility, copayments, deductibles, and covered drugs. Variations in options among each payer, and different state and federal laws also affect coverage scope and costs.
The levels of variation among the prescription drug prices and how they are priced, is a major concern.
Dr. Cohen notes that, “[g]eneric drugs comprise about 80% of all prescriptions. Their lower prices compared with brand drugs have been a major factor in controlling total health-care expenditures and patients’ out of pocket health care spending over the past 5 to 10 years. This is changing.”
“[C]ontroversial” tactics, which brand name drug companies use to maintain their monopoly over the market, is one of the bigger problems.
When placing this all in a political context, Dr. Cohen points out that new laws and regulations often prompt price increases because pharmaceutical executives worry about public policies on their company’s bottom line.
The important role nurses have a chance to play in this issue is Dr. Cohen’s main point.
“We see it when patients in primary care settings can’t afford to purchase medications and start to scrimp on dosages—taking half the prescribed amount and ending up with high blood pressure or undermedicated pain,” she notes.
As a result, Dr. Cohen is calling for nurses to get more involved in the patient’s payment process.
“Consider asking patients how they pay for prescription medications and what they do if they can’t afford them,” she counsels. “Ask other clinicians and social workers about their experience in this area. Demonstrate understanding of this issue from patients’ and family members’ perspectives to foster trust and patients’ willingness to discuss these issues with you.”
Finally, Dr. Cohen advocates for nurses to continue to educate themselves, stay informed about the issues, and communicate their concerns to members of Congress, either individually, or collectively, through advocacy groups such as AARP.
“It’s time for nursing organizations and nurses to join the national and state discussions on prescription drug costs and for nurses, individually, to be part of policy deliberations,” says Dr. Cohen. “We have much to offer and a window of opportunity for policy engagement.”