Revenue Cycle
and Billing

2022’s Prescription Drug Price Hikes (So Far)

by | Jan 6, 2022 | ACA Enrollment, Enrollment, Health Cost, Medicare, Open Enrollment

As we welcome in the new year, so do pharmaceutical companies with new increased prices on their prescription medications.   

Unfortunately, as we all know, this is nothing new, and this year’s median increase according to GoodRx is 5.0% on over 450 drugs so far. However, it is worth noting that some increases on individual drugs are much higher than others.   

For instance, Pfizer’s insomnia drug Halcion only jumped .5% in price as opposed to the immunology medication they offer, Solu-Cortef, which took a 16.8% hike in price.   

GoodRx has adamantly tracked price increases across the industry for the public over the past several years and compiled a running list of all the price hikes that went into effect on Jan. 1. So far, the price increases seem to fall below a 10% threshold that many companies have pledged to observe in previous years. Although, clearly, there are some outliers that have gone over that number.  

What Does This Mean for You  

Although the prices GoodRx provides for us are listed or retail prices, they are a strong indicator of future drug pricing trends, which ultimately affect almost every aspect of your healthcare coverage. These increases every year influence cash prices, insurance premiums, and copayments.  

When these price increases continue year after year, it puts people in a position where they are making the tough choice of, do I pay for this prescription drug, or do I eat this month? That is not a situation anyone should be in, but unfortunately, that is exactly where we are.  

“It’s unfair that drug prices keep rising, even for medications that have been on the market for decades,” says Leigh Purvis, director of health care costs and access at AARP. According to a June 7 report, total retail prescription drug costs for the typical older American who takes four to five prescription drugs per month would be $31,000 per year — more than the $29,650 average annual income for Medicare beneficiaries.  

Does This Affect 340B Beneficiaries?

We help sponsor a lot people that make use of programs such as these, along with Ryan White and simply put, it does not.

A manufacturer may not charge more than the 340B ceiling price to covered entities regardless of whether the covered entity purchases pharmaceuticals through a wholesaler or directly from the manufacturer. The 340B ceiling price is the average manufacturer price (AMP) reduced by the unit rebate amount (URA). The URA is a minimum rebate percentage of 23.1 percent for most brand-name prescription drugs, 17.1 percent for brand-name pediatric drugs and clotting factor, and 13 percent for generic and over-the-counter drugs. Manufacturers must offer greater discounts on brand-name drugs if the manufacturer’s best price for a drug is lower than AMP minus 23.1 percent for that drug and/or the price of the brand-name drug has increased more quickly than the rate of inflation. 

Other Ways to Reduce Prescription Costs  

An advisable way to save money on your medications is to consider a prescription discount card. A slew of vendors provide these services, such as GoodRx, US Pharmacy Card, Discount Drug Network, et cetera, that can reduce prescription costs and usually don’t cost you a penny to get.   

Coupons are another great way to save money on brand-name drugs for people who may not qualify for any kind of federal or state subsidies but meet other qualifications, such as providing medical information or being insured. Some retail pharmacies will even offer coupons to entice customers to fill prescriptions with them.  

Alternatively, you can buy your prescriptions online. Nearly everything else you order is online; why should your prescription medications be any different? Although it can be incredibly easy to buy counterfeit pills online accidentally, so you should always confirm that you are getting your drugs through an accredited pharmacy. Also, make sure they require a prescription to purchase your medications and are part of the Verified Internet Pharmacy Practice Sites (VIPPS) program.  

What Can American Exchange Do for You  

Our licensed enrollment specialists can thoroughly compare tens of hundreds of plans available to you to see which prescription drug plan works best for your prescription needs. It’s always important to review your health care coverage for the upcoming year due to severe changes in cost such as this. On one plan, it is quite possible your needed medication can cost $20 per 30 days, and on another plan, it won’t even be covered, and you will have to pay out of pocket.   

Subsequently, we can help you discover any state or federal subsidies you may qualify for that may reduce the cost of your prescription drugs. With the additional resources at our disposal, we can quickly and accurately identify whether or not you will be able to receive a subsidy. 

Call American Exchange today at 888.995.1674 or email us at