Taking Action to Lower Costs of Prescription Drugs

Health care’s affordability crisis is deepening as services and prescription drug prices grow at unsustainable rates. Studies have shown that patients may ration their prescriptions, or even forgo filling them because their medication is too expensive – nearly one-in-three Americans are not taking their medicines as prescribed due to costs.

Yesterday, I had the honor of moderating a conversation on actions needed to lower the cost of prescription drugs at ViVE with Jarrod Henshaw , CEO of Synergie Medication Collective and Gina Guinasso, J.D. , president at CivicaScript – two leaders that are taking real and meaningful action in this space.

I’m proud to say Blue Cross Blue Shield Association has been a founding partner of both Synergie and CivicaScript – finding innovative ways to challenge the status quo and lower cost of prescription drugs at a time when urgent relief is needed most.

The Case for Ensuring Affordable Prescriptions for Americans

Prescription drug spending has increased 60% over the last decade. A new analysis conducted by Oliver Wyman Actuarial Consulting shows that health insurers, like Blue Cross and Blue Shield companies, are protecting members from inflating prices by taking on the additional costs, though it’s not enough to solve the root problem.

We need disruption – action that makes it clear there are more affordable ways to deliver essential medicines to people. This was our key takeaway from the discussion onstage at ViVE.

Whether that disruption is from partnering with drug manufacturers directly, leading the industry by focusing on impact, or finding new ways to increase competition to lower cost; here is how we’re taking action:

Actions to Address Rising Rx Costs

To address rising costs of medical benefit drugs, Blue Plans have come together to form Synergie Medication Collective.

Through its reach and engagement with pharmaceutical manufacturers and other industry stakeholders, Synergie will reduce costs through greater competition. Synergie and 33 Blue Plans are working with drug manufacturers to disrupt the current medication landscape.

Jarrod highlighted this during our conversation at ViVE: the real opportunity is the scale of this partnership. Cost transparency that forces competition for high price medical benefit drugs is rare, but now Synergie is doing this alongside 33 BCBS companies with the ability to positively impact over 100 million lives. That scale alone is market disruption.

The lack of affordable options for common but high-priced medicines is another unique challenge in the complicated prescription drug market. CivicaScript was created to tackle this problem by developing and distributing generic drugs for high-cost medicines that have little competition today. In 2022, CivicaScript launched its first product – Abiraterone, a metastatic prostate cancer treatment drug – costing about $3,000 less per month than the average cost for someone with Medicare Part D. Sister company Civica Rx also announced intent to manufacture and distribute generic insulin – at no more than $30 a vial?– with first FDA filing planned for 2024.

Something Gina highlighted during our discussion, there is so much opportunity to expand the Civica model – focused on market impact vs. market share – throughout the pharmacy space. Civica’s goal is to bring true competition to the generic market, ensuring stable and predictable supply of essential generic drugs and ultimately serving as a check against aggressive pricing behavior. And the market interest is there because Civica is partnering with representatives from nearly all corners of the health care system that want to lower costs for the individuals they serve.?

The goal of our founding Synergie and co-founding CivicaScript is to create a system where Americans do not have to choose between life-sustaining medications and rent, groceries and other essential living expenses.

Disrupting an Industry, Together

While Blue Cross and Blue Shield companies are working to drive down the cost of prescription drugs, building a better system of health involves leveraging the ingenuity of many and being courageous enough to challenge the status quo.

Disrupting the industry is possible, but we must continue to find innovative ways to deliver on our shared mission of improving health care affordability.?