Hospitals charge double for specialty drugs compared to pharmacies, AHIP finds – Healthcare Finance News

 
Photo: Jeff Lagasse/Healthcare Finance News
On average, hospitals charge twice the price for certain drugs when compared to specialty pharmacies, demanding approaches that shield patients, families and employers from high drug costs, according to a new study released by AHIP.
The study focused on drugs that are administered in a hospital or physician’s office, which the insurer advocacy group claimed is an often-overlooked opportunity to improve healthcare affordability while ensuring patient safety.
WHAT’S THE IMPACT
AHIP researchers analyzed the cost of 10 drugs that are purchased, stored and administered in a healthcare setting, such as a hospital, but could also be safely and securely delivered directly through a specialty pharmacy for provider administration.
The study examined data from 2018-2020 and found that costs per single treatment for drugs administered in hospitals were an average of $7,000 more than those purchased through specialty pharmacies.
Drugs administered in physician offices were an average of $1,400 higher, the data showed. And hospitals, on average, charged double the prices for the same drugs compared to specialty pharmacies.
Prices were 22% higher in physicians’ offices for the exact same drugs, on average, results showed.
High drug prices and costs for hospitals and physicians aim to produce higher reimbursement rates and higher payments, according to AHIP. And these costs are in addition to the fees hospitals and physicians are paid to administer the drug to the patient.
THE LARGER TREND
While prescription medication prices are no longer the fastest-growing commodity or service, prescription drug costs have still increased 2.5% since the beginning of the COVID-19 pandemic, according to new data from GoodRx.
In 2021, the cost of car rentals, tobacco, beef, and moving expenses all outpaced the cost of prescription drugs. Yet drug prices have also historically grown faster than the rate of inflation: Since 2014, drug prices have increased 35%, while the cost of all items and services has increased 19%.
Linking the cost of prescription drugs in the U.S. to the prices paid in other high-income nations could have reduced American spending for the drugs by at least half in 2020, a RAND study found this past September.
Modeling a proposal that would cap U.S. prices at 120% of what is paid in six other nations, researchers found that such a move would have cut U.S. spending on insulins and 50 top brand-name drugs by 52% during 2020 – a savings of $83.5 billion. These savings are on top of already-lower U.S. “net” prices after rebates negotiated between drug companies and insurers.
According to data from the U.S. Department of Health and Human Services, Americans pay more than $1,500 per person for prescription drugs, far higher than other comparable nations. Since prices for brand name drugs are rising faster than the rate of inflation, it has led many to not take their medications as prescribed due to their cost. HHS has identified lack of competition as a key driver of these rising drug costs.
 
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com



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