In recent weeks, top health officials have floated an idea for bringing down prescription drug costs in the United States: getting Americans to take fewer medications. <\/p>\n\n\n\n
Health policy experts say that while the goal is reasonable, the approach places too much blame on patients and overlooks key issues with drug pricing. <\/p>\n\n\n\n
\u201cWe need new approaches,\u201d Food and Drug Administration Commissioner Dr. Marty Makary said last week at an event on food dyes, discussing the \u201calarming\u201d rate of cancer and diabetes in young people. \u201cLet\u2019s not forget that the best way to lower drug prices is to stop taking drugs we don\u2019t need.\u201d <\/p>\n\n\n\n
Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, made a similar point at a White House event celebrating his confirmation. \u201cHealthy people don\u2019t consume health care resources,\u201d Oz said. \u201cThe best way to reduce drug spending is to use less drugs because you don\u2019t need them, because you\u2019re healthy.\u201d <\/p>\n\n\n\n
Chronic disease has been a particular focus for Health Secretary Robert F. Kennedy Jr., who is planning to launch an ad campaign called \u201cTake Back Your Health.\u201d\u2002<\/a>One part of the campaign will ask Americans to pledge to eat healthier and exercise as a way to address the country\u2019s chronic health problems. Beyond the anticipated campaign, the White House hasn\u2019t yet publicly laid out a strategy for lowering chronic disease rates. <\/p>\n\n\n\n About 3 in 4 adults in the U.S. had at least one chronic disease in 2023, according to the Centers for Disease Control and Prevention<\/a>. The prevalence of chronic conditions among young adults, in particular, has risen sharply over the last decade, from 52.5% in 2013 to 59.5% in 2023. Chronic diseases, such as obesity, heart disease and diabetes, cost the U.S. trillions of dollars a year<\/a> in medical care and prescription drugs. <\/p>\n\n\n\n Studies show that healthier people with fewer chronic conditions typically have lower medical costs<\/a>. However, experts argue that health officials are missing two key points: many people rely on prescription drugs for conditions that have nothing to do with lifestyle choices, and drug prices are much higher in the U.S. than in other countries. <\/p>\n\n\n\n \u201cWe have the highest drug prices in the world, and when that\u2019s the case, you\u2019re going to be spending a lot on drugs, regardless of whether you\u2019re healthier or sicker,\u201d said Dr. Adam Gaffney, a critical care physician and\u202fassistant professor of medicine at Harvard Medical School. <\/p>\n\n\n\n Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee, said that even if people in the U.S. had \u201cevery tool at their disposal\u201d to live healthier lives, they would still get sick. <\/p>\n\n\n\n \u201cPeople should not be blamed for their need of medication,\u201d she said. <\/p>\n\n\n\n Soaring prescription drug costs <\/strong><\/strong><\/p>\n\n\n\n The pronouncements, experts say, echo Kennedy\u2019s view that Americans are overmedicated. <\/p>\n\n\n\n Kennedy has questioned the safety and effectiveness of antidepressants, referring to them as potentially more difficult to stop taking than heroin<\/a>\u2014 a claim that isn\u2019t supported by research. He\u2019s also been critical of the extremely popular diabetes and weight loss drugs such as Ozempic and Wegovy, telling\u202f Fox News in October<\/a> that companies are \u201ccounting on selling it to Americans because we\u2019re so stupid and so addicted to drugs.\u201d (He later walked back those comments, telling CNBC in December, \u201cthe first line of response should be lifestyle, it should be eating well, making sure that you don\u2019t get obese, and that those GLP drugs have a place.\u201d) Earlier this month, the Trump administration said it wouldn\u2019t move forward with a proposal by the Biden administration<\/a> for Medicare to cover weight loss drugs. <\/p>\n\n\n\n While the push to make Americans healthier isn\u2019t \u201ca bad motivation,\u201d Dusetzina questioned whether people using fewer drugs would indeed lower costs. <\/p>\n\n\n\n \u201cWe wouldn\u2019t be changing how pharma prices their medications specifically,\u201d she said. \u201cIf we stopped using as many drugs, there\u2019s nothing necessarily to say that companies won\u2019t just re-price their drugs.\u201d <\/p>\n\n\n\n Dusetzina noted the Trump administration\u2019s self-responsibility approach to lower drug costs is a shift from the Biden administration\u2019s strategy, which focused on going after drugmakers through policies targeting their pricing or the out-of-pocket costs that consumers pay. <\/p>\n\n\n\n Then-President Joe Biden, through the Inflation Reduction Act, lowered the out-of-pocket cost of insulin to $35 a month for people on Medicare \u2014 a move that pressured drug companies to do the same for those on private insurance<\/a>. <\/p>\n\n\n\n The law also required drug companies to pay a fee if they raised the prices of their drugs faster than the rate of inflation. <\/p>\n\n\n\n Most notably, it allowed Medicare to negotiate prices on the costliest prescription drugs<\/a> people take directly with drugmakers. (It remains unclear whether the Trump administration will ramp up the negotiations or scale them back.) <\/p>\n\n\n\n Larry Levitt, executive vice president for health policy at KFF, a health policy research group, said few would disagree with the idea that lifestyle changes \u2014 such as better nutrition and more exercise \u2014 would make Americans healthier and reduce health care costs. <\/p>\n\n\n\n \u201cBut,\u201d he added, \u201cthe anti-pharma rhetoric threatens to obscure the fact that there are chronic illnesses that people can\u2019t control through behavior change,\u201d including Type 1 diabetes, asthma, rheumatoid arthritis and certain cancers. <\/p>\n\n\n\n Gaffney, of Harvard Medical School, said the idea that high drug costs in the U.S. are mainly due to American\u2019s poor health choices is \u201cjust not true.\u201d <\/p>\n\n\n\n