Health Care Cost: A Case Study

The utilization of prescription drugs has increased across all age groups in the US, with 50% of Americans taking at least one prescription drug (Rice & Unruh, 2016). This can be attributed to physician-induced demand, substitution of pharmaceuticals for other medical regimens, commercialization of the products, increase in the aging population and drug insurance coverage, and also the increase in chronic conditions. Lathan discusses the startling fact that the rate increase of prescription drugs purchased was considerably higher in contrast to the US population growth - 71% and 9% respectively (Rice & Unruh, 2016, p. 264).

Imagine this: you are tragically diagnosed with a chronic life-threatening illness. Your only hope to survive is through medication to treat your disorder. The medicine is pricy but you can work out the costs each month. One day, you go to fill your prescriptions and realize the cost of a $13 pill has jumped to an astounding $750. You need this patented medication to survive and to afford it you end up losing your home, filing for bankruptcy, and sleeping in your car. This story sounds fictional but it is the reality for many Americans who can no longer afford their grossly overpriced medications.

As we advance in our healthcare system and continue to find cure for the deadly diseases we are also faced with prescription drug prices rising much faster than they were a few years back. Drug prices are increasing at an unmaintainable rate without any sign of reduction. People who are heavily affected by this rise are mostly elderly citizens and also the poor of this country because they can barely afford these expenses. These people either have no money to pay for their copays or no health insurances at all.

The prices of prescription drugs in the United States are by far the highest in the world. [1] On average, Europeans pay 40% less than Americans for the same medications. [2] Consumers have been resorting to several ways, sometimes putting themselves in harm’s way, to alleviate the burden of high prescription drug costs. Some buy their medications online or cross the borders to neighboring countries so they would be able to afford buying their needed medications. Others have resorted to the illegal act of selling their unused medications in online forums just to recover part of their expenses. Many factors contribute to the increased drug prices in the United States including research and

The cost of health care has been at the forefront of politics for years. It is one of the most talked about topics not just in political venues but also country wide. Every American has an opinion on how our economy can be fixed and they are passionate about health care reform. The price of insurance alone causes many Americans to not have coverage. For those that can afford coverage, the struggle to pay co pays is immensely crippling their bank accounts. Of these burdens on Americans today, the most frightening fact lies in the cost of prescription medications.

25% or more of one’s income going toward health care is too much for today’s economy this

Many patients are finding it more difficult to afford their prescription medications. Comparing health care expenditures in the United States, prescription drug costs rank third compared to hospital expenses and physician services (Omojasola, Hernandez, Sansgiry, & Jones, 2012, p. 479). The rising cost of prescription drugs is concerning to many patients. “The high out-of-pocket prescription drug cost is associated with medication non-adherence and adverse health outcomes” Omojasola, et al., 2012, p. 480).

As of 2008, the Center for Medicare and Medicaid Services (CMS) identified falls as a Hospital Acquired Condition (HAC). HAC is a complication or comorbidity that occurs as a consequence of hospitalization and is high volume and/or high cost, and be reasonably prevented using evidence-based guidelines (Radey & LaBresh, 2012). The Center for Medicare and Medicaid Services will no longer cover the cost of care as a consequence of an inpatient fall based on the presumption that falls are preventable by the organization (CMS,

The state of does California does participates in the Healthcare Cost and Utilization Project. The contact person is Amy Peterson the manager and her contact information is Healthcare Information Resource Center/Data Analysis Unit. California Office of Statewide Health Planning and Development. Her address is 400 R Street Room 250 Sacramento, CA 95811-6213. Her phone contact is (916) 326-3869 and fax is (916) 324-9242. Her e-mail address is amy.peterson@oshpd.ca.gov and website is http:// www.oshpd.ca.gov.

The rise in costs of prescription medicines affects all sectors of the health care industry, including private insurers, public programs, and patients. Spending on prescription drugs continues to be an important health care concern, particularly in light of rising pharmaceutical costs, the aging population, and increased use of costly specialty drugs. In recent history, increases in prescription drug costs have outpaced other categories of health care spending, rising rapidly throughout the latter half of the 1990s and early 2000s. (Kaiseredu.org, 2012).

For anyone growing older or anyone with aging parents, long-term care planning should be a priority. Matthew L. Darpel, PSC, is an elder law attorney and financial planning expert serving clients throughout the Fort Mitchell, Kentucky, area. He understands how important it is to have long-term care plans in place and works with clients to achieve this end.

Recently, there has been a debate about the high prescription drug prices in the United States. Accounting for 9.7% of the national health expenditure, $329.2 billion was spent on prescription medications ($931 per person) in 2011 (Linton, 2014). So what exactly is the average American getting with their $931? Well, because there is an extraordinary amount of time, effort, and energy that goes into creating, manufacturing, and distributing a new drug, it’s no wonder the prices are so high. But what other costs are folded into the prices of your prescribed medications? This review looks beyond just the research and development costs needed to take a new drug from idea to shelf by examining several journals and other credible, secondary sources, to shed some light on how much pharmaceutical companies are spending to develop, advertise, and sell their drugs.

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Pharmaceutical companies are one of the fastest growing businesses in the United States, because individuals want to be healthy and live longer. In order to stay healthy, individuals are more likely to have multiple prescriptions or over-the-counter medication, especially the elderly. Every month, about half of the population of Americans take different forms of medication such as, vitamins, birth control or antibiotics. These different forms of medication help millions of people in different ways and save lives. The article, “High drug prices,” states that the “U.S. now spends approximately 15.0 percent of its GDP on health care” (Okunade). The prescription drug cost is one of the major concerns in the United States because of the fluctuating prices. Another article stated, “The challenge here is that drug prices are growing astronomically and becoming not only unaffordable to health-care system, but to consumers as well” (Mangan). The cost of medication is not only a burden on the government, but also to individuals that have various medications, and especially those who pay out of pocket cost. There are different reasons to explain the increase in prescription drug cost; the high demand for medication due to the baby boomers, patent protection on most drugs, the use of drugs instead utilizing preventive measures.

The spending on prescription drugs is on the rise. The United States spending on prescription drugs reached $329.2 billion in 2013, up 3.2 percent on a nominal basis and a rebound from the 1.0 percent decline in 2012 (Aitken et al, 2014). Furthermore, prescription drugs spending growth is anticipated to accelerate through 2019 due to increases in drug prices, as well as increases in the number of new drug approvals (Truffer et al, 2010). According to the recent report of EvaluatePharma’s World Preview: “For the first time in the pharmaceutical industry’s history, the consensus forecast of worldwide prescription drug sales is set to exceed one trillion dollars, reaching $1,017bn by 2020, equating to an average growth of 5.1% per year from 2013 to 2020.”