Washington D.C  -  Mortgages, car payments, prescription drugs.  Which of these household expenses doesn’t belong?  All three have the ability to dwarf other expenses in the family budget, but one – prescription drugs – doesn’t have to.

Missouri senior citizens are hopeful this is the year Congress finally unites to pass legislation to lower the high cost of prescription drugs.  Americans are the best customers of the pharmaceutical industry, purchasing more than half of the world’s supply of prescription drugs.  Yet the prices we pay for these medications are also the highest in the world.

Congress has been charged with creating a $400 billion prescription drug benefit to help seniors cope with these high costs over the next ten years.  During that same time, though, prescriptions will cost American senior citizens $1.8 trillion. 

I fully support using federal funds to help senior citizens, especially the poor, pay for their prescriptions.  I even support devoting billions of our tax dollars to this cause.  But to date, the emphasis of government efforts to solve this problem have been one-dimensional.

Instead of simply giving more benefits to senior citizens to offset the high cost of prescription drugs, we should also address one of the root causes of the problem: the high cost of prescription drugs in the first place.

Three policy measures could potentially double the positive effects of a $400 billion benefit and drastically reduce that $1.8 trillion cost estimate.  First, implement drug efficacy measures to ensure doctors are prescribing  the best, lowest cost medicines to their patients.  Second, increase access to effective generic alternatives to prescription drugs.  And third, allow licensed pharmacies and wholesalers in other countries to import medicines to America.  These steps would combine to save Americans billions of dollars in taxes, and even more in personal income.

Drug efficacy is a policy to develop scientific evidence regarding the cost-effectiveness, safety, and overall quality of prescription drugs used by Medicare and Medicaid participants.  Reference materials for health care professionals would compare expensive “name-brand” prescription drugs with identical, lower-cost generics.  Armed with this information, American doctors can see through the gimmickry, advertising, and incentives provided by drug companies and prescribe the medicine that will truly work best for the lowest cost.  Through reports for practitioners and consumers, drug efficacy would improve our system of  health care across the board.

Generic alternatives currently save consumers $8 billion to $10 billion every year, according to the Congressional Budget Office.  Yet the name-brand pharmaceutical industry takes advantage of loopholes in existing law to withhold lower-priced generics from senior citizens.  By changing the purpose of the pharmaceutical to extend their patent or paying generic companies not to go to manufacture, drug companies keep low-cost alternatives off the market.  These practices cost the American consumer and your government billions of dollars each year.

Finally, and most importantly, market access to imported prescriptions drugs would represent unprecedented savings in the American pharmaceutical markets.  For example, Premarin, used to prevent and manage osteoporosis, costs $97.99 from Walgreens and $37.36 (USD) from an online Canadian pharmacy.  The same scenario plays out for medicines to fight high cholesterol, cancer, depression, and other ailments that require an intensive treatment regimen including prescription drugs.

Overseas, the same medicines sold at home cost consumers an average of 35 percent less than they cost in the U.S.  Of that $1.8 trillion in expected prescription drug costs, a 35 percent savings would mean $630 billion back in the pockets of American senior citizens on fixed incomes. 

Despite the fact that, for individuals, crossing the border to bring back prescription drugs is illegal in the U.S. under a law unenforced by U.S. Customs, millions of Americans go to Canada or Mexico to see the pharmacist.  Even more purchase reimported medicines online.  A policy of market access would make legal for these Americans and for certified pharmacies and wholesalers in selected foreign nations what is now only permissible for large drug companies.  Supplemented by access to generics and better information for doctors, market access would be a powerful shift of purchasing power to the American consumer.

In combination, these measures provide the right prescription to put significant downward pressure on drug prices.  Drug companies spend millions of dollars each year on advertising, but it is not enough to make us forget the images of American senior citizens skipping months of medications, cutting pills in half, and forgoing good nutrition in favor of expensive prescription drugs. 

A bipartisan coalition in Congress is working to make these ideas into reality for Americans who rely on prescription drugs.  There is no better publicity for the value of good pharmaceuticals than lower prices.