The Epilepsy Foundation works to ensure access to and affordability of care, especially prescription drugs because epilepsy medications are the most common and cost effective treatment for controlling and/or reducing seizures.
Like many of our partners in the patient advocacy community, we are concerned about high cost-sharing that makes it hard for people living with epilepsy and other chronic conditions to access the medications and services they need. Concerns around drug prices are significantly influenced by cost-sharing requirements from patients, like copayment and coinsurance.
We support policies that create greater transparency in the health care system overall and that reduce or limit cost-sharing for the medications and services that our community relies on to maintain their quality of life.
We are supportive of transparency requirements that truly give health care consumers information they need to make decisions. An individual patient’s cost-sharing burden for medications is determined by a complex process and structure. Policies to address the cost of prescription medications should take into account all stakeholders, not just pharmaceutical manufacturers, which have been the focus on many recent proposals, but also pharmacy benefit managers (PBMs), insurers, and pharmacies.
Further, it is important when considering proposals to address the costs of prescription medications to acknowledge the value of medications and the cost associated with medical discovery. Prescription medications make up only about 10 percent of health care spending but lead to significant improvements in quality of life. Medications play a critical role in reducing unnecessary hospitalizations and surgeries; lost productivity and wages; and decreased quality of life for the patients and their family and caregivers.
Any proposals to address the cost of prescription medications also should not threaten the progress of biomedical innovation, which is exceptionally important to the epilepsy community because no cure exists for epilepsy and one third of people with epilepsy live with uncontrollable or intractable seizures – and many more live with debilitating side-effects from medications. The Epilepsy Foundation is committed to accelerating the development and approval of new therapies, especially to benefit those in our community with difficult to control seizures and those who experience significant side effects from existing therapies. Manufacturers spend millions of dollars over several years on research and development of potential therapies, many of which never make it to the market. We need an environment that encourages investment in biomedical innovation.
Lastly, bringing the patient experience and perspective to this dialogue is critical. Patients need to have a voice in the conversation on the value of health care.