• Keeping Drugs Affordable and Accessible

    Issue 

    Drug prices are part of a delicate balancing act. The Academy supports efforts to prevent sudden price spikes, but we are also aware that some proposals can threaten access to sight-saving treatments.

    Generic-drug price spikes

    Several of the drugs ophthalmologists use are on federal shortage lists. Several drugs spiked in price by more than 1,000 percent, seemingly overnight. This severely disrupted care, with some patients delaying or opting out of treatment because of costs. Since many ophthalmic drugs lack multiple manufacturers, the Academy wants to see greater competition in the market as an initial step to drive down costs.

    Payment reform for drugs administered in-office

    The president and Congress continue to oppose rising drug prices. Part B drugs, which physicians administer in-office, are among the most expensive. Independent advisors to Congress on Medicare issues have floated several solutions. However, these proposals are problematic because they could create access issue. Previous efforts by the federal government to test new Part B drug-reimbursement models inadvertently threatened to remove ophthalmologists’ ability to secure necessary treatments, especially for retina ailments.  

    What the Academy is doing

    We are one of Washington, D.C.’s leading physician voices in the fight to preserve fair prices for prescription drugs. The Senate Committee on Aging relies on the Academy for our expertise on the issue, and continually repeats our message of the need to preserve access to affordable medications. We compelled the Center for Medicare & Medicaid Services to scrap its proposed Medicare Part B drug demonstration. The agency wanted to investigate how alternative payment strategies would affect providers’ prescribing patterns. However, the demonstration could have adversely effected those with complex conditions, such as age-related macular degeneration. Our advocacy helped generate significant, bipartisan congressional opposition, which led CMS to abandon the proposal.  

    Next steps

    We’ll continue to work with federal stakeholders to develop solutions to this important issue. The Academy supports efforts in Congress to drive down generic drug prices by injecting more competition into the market. Two new proposals introduced over the past few months in the U.S. House of Representatives and the Senate seek to expedite the review process for generic drug applications when a drug shortage occurs or only one manufacturer exists. We’re also working with Congress and CMS to reform Part B Medicare drug pricing. We believe that this will provide a long-term solution to ophthalmology’s access issues.