Understanding the chronic disease epidemic in America

President Biden and lawmakers from both parties recently put forward proposals to cut Americans’ spending on insulin, which millions of patients — particularly the elderly — rely on to treat their diabetes. Diabetes affects approximately one in four US adults over the age of 65, and access to insulin is a matter of life and death for many of these patients. So these proposals could literally bring life-saving relief to many Americans.

These insulin cost-cutting measures hold immense promise. But they raise a key question: Why limit co-payment price caps to just insulin? Six out of 10 adults in the US live with at least one chronic disease, and four out of 10 have two or more. Chronic disease prevalence is even higher among seniors on Medicare, and out-of-pocket costs are becoming an increasing concern for millions of people on a regular income.

If the proposed $35-per-month co-payment cap on insulin makes sense — and it does — why not roll out the same policies for drugs used to treat asthma, high blood pressure, and other common chronic conditions, and focus on Medicare, where chronic conditions are so far are common?

Too many seniors struggle to afford the medications they need to stay healthy. According to a recent survey by the Kaiser Family Foundation, about one in three Americans with a serious medical condition has trouble paying for their medication. Not to mention how such struggles affect compliance with the courses of treatment prescribed by the doctor, the state of health and general well-being. This drives up Medicare spending and increases the burden on beneficiaries and their families.

When people deviate from their prescribed medication schedule, the health consequences can be devastating. It is estimated that medication non-compliance causes 125,000 deaths each year in the US and accounts for 10% of all hospital admissions.

Efforts to limit the cost of insulin to $35 are a step in the right direction. But given the magnitude of the affordability crisis, confining this type of response to a single class of drugs to treat a single disease undermines both human and economic savings potential. Starting with Medicare, it makes sense to limit the out-of-pocket costs of medications that people rely on to avoid the development and progression of chronic diseases.

The most direct and effective way to help the millions of Medicare beneficiaries living with chronic illnesses afford their medications is to limit the cost price of common chronic illness medications. Lawmakers could begin imposing a hard co-payment cap on the cost of out-of-pocket chronic disease medications for Medicare Part D participants, as many have suggested.

There are several reasons why legislators should support this approach. It would save countless lives and potentially reduce other Medicare health care expenses like hospitalizations as well. By one estimate, medication non-compliance alone costs our healthcare system as much as $289 billion annually. The policy would also provide seniors with much-needed and visible financial relief at the pharmacy counter at a time of record-high inflation.

More than half of Americans agree that a $35 insulin cap is a top priority in a recent Kaiser Family Foundation poll, and a strict cap on the cost of insulin for patients is a commendable start. A more comprehensive version of this policy to support Medicare beneficiaries is likely to gain even broader support. By offering the same support to people on Medicare living with diabetes and other common chronic diseases, lawmakers can save even more lives and give seniors and their families the kind of bold prescription drug action they want.

Michael Mandel, PhD, is Chief Economist and Vice President of the Progressive Policy Institute. Kenneth E. Thorpe, PhD, is Professor of Health Policy at Emory University and Chair of the Partnership to Fight Chronic Disease. Understanding the chronic disease epidemic in America

Fry Electronics Team

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