The Causes of Rising Prescription Costs

PBIRx®

Intelligent Solutions in Pharmacy Benefits

612 Wheelers Farms Road, Milford, CT 06461

(888) 797-2479

You certainly do not need to be a patient that relies on a prescription or a professional in the pharmaceutical industry to know that the cost of prescription drugs is still on the rise. But considering that this is a reality we all face, the real question here is why - why is the cost of drugs still not showing any sign of slowing down? Although there are various factors that go into the cost of a drug, there are a few possible reasons that can be directly pinpointed to explain this trend; we have outlined three of them below:

1. Lack of control: While other countries are very particular about the way drugs are priced, the United States government does not have a policy when it comes to the regulation of drug prices. Ultimately, drugs are given their value based on what other drugs cost after they are compared to one another, not by what the government says they should be priced at.
2. Scarce competition: The more competition, the more likely it is to see a drop in prescription drug costs. However, competition is something that is often lacking when it comes to new drug treatments. As a result, those very few companies who produce a valuable drug tend to offer them at an extremely high cost - it is not until more hit the market that you can potentially expect to see a slight decrease.
3. Cost of research: The process of developing and seeking approval for a new drug is incredibly costly for drug manufacturers. Therefore, it is only natural that they first enter the market with a price that seems over the top. As the cost of manufacturing new drugs continues to rise, it is only natural to see a rise in the cost of the final product too.

While we may not be able to escape the fact that the cost of prescription drugs is continuing to skyrocket, one thing providing entities can do is have their pharmacy benefit audited to ensure that all contract language accurately reflects the actual claims adjudication, including the discounts, dispensing fees, rebates and guarantees stated in your current Agreement. Auditing your pharmacy benefit by an expert like PBIRx can also provide you with the information to know if your current financial model is competitive or how much money you are leaving on the table of the PBM.

If you have yet to meet with an expert team about your pharmacy benefit contract, start by calling PBIRx at (888) 797-2479. Through our comprehensive approach, you can start to get more control over your health care costs at a time when it matters most.