Runaway drug costs, surprise billing subject of new legislation

One in two Pennsylvanians struggle to afford prescription drugs

HARRISBURG, July 13 – As prices for life-saving medicine continue to increase year-over-year, Allegheny state Reps. Dan Frankel and Emily Kinkead today introduced legislation to lower costs for prescription drugs and prevent surprise billing for “facility fees” to keep health care affordable and accessible for Pennsylvanians.

“Together, these bills would protect consumers from the kind of sudden expenses that are derailing families who are already struggling to stay afloat,” said Frankel, who is the Democratic chair of the House Health Committee. “This legislation would not only help to ensure health care is affordable but would increase the quality of life for families and individuals across the state.”

Frankel’s legislation (H.B. 1722) would create a prescription drug advisory board to set limits on what pharmacies, providers, patients, health plans and wholesalers pay for some medications, similar to boards in other states. Separate legislation (H.B. 1723) would prohibit the billing of surprise “covid fees” and other unreasonable facility fees, which are not covered by typical health insurance.

“In every other industry, consumers have the information to understand the cost of the goods and services they receive,” Kinkead said. “In health care, we have allowed for too long pharmaceutical companies and insurance companies and healthcare CEOs to set prices that are completely divorced from the cost to provide the care. More troubling is that patients and providers rarely know the cost until the bill comes. I am proud to support this legislation and say enough is enough.”

Nationally, the cost of prescription drugs has risen by 30% since 2010, with the most common brand-name drugs outpacing inflation, on average, by nearly eight-fold and with double-digit increases between 2012 and 2016. According to news reports, the prices of more than 400 prescription drugs increased by an average of 5% in 2020.

"After a year and a half of unprecedented unemployment, uncertainty and income loss, Pennsylvanians continue to struggle with high healthcare costs,” said Patrick Keenan, policy director of the Pennsylvania Health Access Network. “One in two Pennsylvanians are struggling to afford the prescription drugs they need, and one in every five are cutting pills in half, skipping doses or leaving unfilled prescriptions at the pharmacy. Others are struggling to pay for unexpected fees, like facility fees, after seeking care. We applaud Representative Frankel for continuing to push for solutions to unacceptable high healthcare costs, and we urge Pennsylvania's General Assembly to move swiftly to pass this legislation and provide much-needed relief for Pennsylvanians."

Older Pennsylvanians are particularly hard-hit by rising drug costs. The average older Pennsylvanian takes between four and five brand-name prescription drugs regularly, the average annual retail cost of which exceeds the average senior’s median income by 20%. 

“Alarmingly, one out of three Americans do not take their prescriptions as prescribed because they cannot afford them,” said Bill Johnston-Walsh, director of AARP Pennsylvania. “Medications do not work if patients cannot afford to take them. AARP strongly supports policies that will help individuals and families afford their medications.”