$11 Prescriptions: What U.S. Health Care Can Learn From Germany

With Meghna Chakrabarti

Germany has a private health care system like the U.S., but even the sickest patients rarely pay more than $11 for a prescription. How?

Guests

Noam Levey, writes about national health care policy out of Washington, D.C., for the Los Angeles Times. (@NoamLevey)

Leigh Purvis, director of health services research at the AARP Public Policy Institute. (@leighdrugwonk)

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Los Angeles Times: “German patients get the latest drugs for just $11. Can such a model work in the U.S.?” — “Patients who come to the Havelhöhe cancer clinic in the leafy outskirts of Germany’s capital are often very sick.

“Struggling with advanced-stage cancers, many need strong doses of expensive, cutting-edge chemotherapy that can run into the hundreds of thousands of dollars.

“But like all Germans, none of the patients sitting quietly in the infusion ward here pay more than 10 euros a prescription, or about $11. ‘We never talk about costs,’ said Dr. Burkhard Matthes, a senior oncologist at the clinic.

“Germany’s ability to provide citizens access to the latest drugs while keeping patients’ costs so low is made possible by a novel strategy launched in 2011 to rein in exploding prices that were threatening to bankrupt the nation’s healthcare system.

“Mixing free-market incentives to encourage innovation with regulation and lots of transparency, Germany’s drug review process gives manufacturers the chance to bring new products to market and charge higher prices — but only if they can show the new medications are better than existing ones.

“Nearly the entire process is open to the public, giving doctors, hospitals and patients access to not only new drugs, but also independent evaluations of how well they work.

“And it’s kept drugs accessible. Just 7% of Germans reported cost-related problems getting medical care in the last year, compared to a third of Americans, an international survey found.”

The Economist: “American drugmakers are raising prices. Again” — “‘If you think the cost of your drug will scare people from buying your drugs, then lower your prices.’ That blunt warning was issued recently by Alex Azar, America’s health secretary, to global pharmaceutical giants. A new report by ubs, an investment bank, finds that Americans spent nearly two-thirds of all money spent globally on new drugs from 2012 to 2017. On June 14th Bluebird Bio unveiled a gene therapy to treat an inherited blood disorder that will cost nearly $1.8m per treatment. Shortly before, Novartis, a Swiss giant, priced its gene therapy for spinal muscular atrophy at $2.1m, making it the world’s most expensive medication.

“Outrage over such headlines is a rare thing to unite President Donald Trump and his Democratic detractors. Many cheered the administration’s latest effort to force drugmakers to disclose the list price of drugs in television advertisements.”

Washington Post: “White House is reviewing a new index to cut Medicare drug spending” — “Eight months ago, President Trump vowed to bring federal payments for some Medicare-covered drugs more in line with lower prices for the medicines in other countries. It was a move that struck many as especially aggressive for a GOP administration but meshed with Trump’s vow to lower the price of prescription drugs.

“A proposed rule for the experimental international pricing index is being reviewed by the White House Office of Management and Budget as of Thursday, indicating the Department of Health and Human Services is finally moving forward on it after some delay.

“There’s enthusiasm inside HHS for the index, which would tie the prices for drugs covered by Medicare and distributed by doctors to an average of lower prices paid in 16 other countries, where the government plays a much more active role in setting prices. But the drug industry and some conservative groups are fighting hard against it, and Sen. Chuck Grassley (R-Iowa), head of the powerful Finance Committee, poured cold water on the proposal after holding his fire for months.”

Stefano Kotsonis produced this hour for broadcast.

This article was originally published on WBUR.org. [Copyright 2019 NPR]