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Navigating the Dermatological Drug Cost Curve.

Increasing costs of brand-name prescription drugs are causing concern for patients, physicians, and policy makers alike.1 What should be done? Some in the pharmaceutical industry suggest that concerns are overblown because overall retail spending on prescription drugs has remained less than 12% of overall health care spending over the past 30 years.2 But this perspective overlooks the fact that the use of lower-cost generic drugs has increased from 20% to more than 85% of all prescriptions dispensed during that time.3 In addition, spiraling brand-name drug prices are substantially affecting the economy and patient care. Retail drug spending now accounts for 19% of employer-provided insurance benefits,4 and nearly a quarter of respondents to a national survey currently taking a prescription drug reported that they or a family member did not fill a prescription in the last year due to cost.5 The first step in developing solutions to address high drug prices is to get a better handle on the problem. In the February 2016 issue of JAMA Dermatology, Rosenberg and Rosenberg6 provide such insight. Based on a survey of 4 national chain pharmacy stores, the authors documented changes in the cash price for a full course or month of treatment with 19 brand-name dermatological drugs in West Palm Beach, Florida, between 2009 and 2015. These drugs, selected from among 72 brand-name medications on the basis of “frequency of prescription, diseases treated, or unusual price increase during the survey period,” included 5 corticosteroids, 4 products for acne and rosacea, 4 anti-infective agents, 3 antineoplastic drugs, and 3 products for psoriasis. Even when accounting for selection bias—namely, a focus on drugs with the greatest price change—the study revealed troubling data. From 2009 to 2015, the cost of each drug increased substantially (range, 60%-1698%), far greater than the consumer price JAMA DERMATOLOGY