The leading proposal in Congress to lower prescription drug costs would come at too high a price for patients with HIV and other chronic and life-threatening diseases.
Lawmakers are attempting to address a very real problem: Patients spend too much on medicines at the pharmacy. Their drug pricing proposal fights the right problem but goes about our shared goal in the wrong way. By imposing price controls, it ignores the systemic problems that are pushing up out-of-pocket costs — and will inevitably reduce access to advanced medicines and stifle innovation.
The plan thus poses a serious threat to our most vulnerable communities here in the Golden State and nationwide.
The prevalence of COVID-19 infections and death among underserved communities has mirrored the devastation of the HIV/AIDS epidemic a generation ago. Considering the two pandemics side by side illustrates both the urgent need for Congress to lower drug costs and to encourage the development of new, innovative treatments.
The toll the AIDS epidemic has taken since 1981 is hard to comprehend: Almost 40 million people died worldwide, including 500,000 in the United States. And the HIV/AIDS epidemic is still ongoing. Thousands of Americans contract HIV every year, and California is home to more patients than any other state.
Though not over, the HIV crisis has become more manageable in recent years for the same reason COVID-19 deaths have plummeted since their peak: Scientists developed medicines to fight back. Though no vaccine for HIV has yet made it all the way through clinical trials and to patients — as several have for COVID-19 — the basic trajectories of both epidemics were the same.
First, we were at the mercy of the disease. Then, thanks to researchers at government labs, universities and private drug companies, treatments were developed. The scientific community saved millions of lives.
But the differences between the two pandemics may be even more instructive. The COVID-19 vaccine took less than a year to develop. It took six years from the emergence of AIDS to the approval of AZT, the first antiretroviral drug to fight it. It took even longer to develop the treatments that today have downgraded HIV from a death sentence to a manageable chronic condition.
The lessons from COVID-19 and HIV are the same: We cannot approach drug prices and drug innovation as competing priorities. But this is the mistake that Congress is making right now.
Legislation in the current reconciliation bill will arbitrarily control the prices of dozens of branded medications. If their prices rise faster than inflation, financial penalties will be imposed. This will undoubtedly reduce the size and scope of biopharmaceutical innovation in the United States, as it would reduce the incentives for investors to back early-stage scientific research. Capping prices will also reduce access to the most advanced medicines.
So even if price control schemes are effective in lowering costs, patients with incurable diseases like HIV and AIDS will be left on the outside looking in.
Congress would do more to lower drug prices by capping patients’ out-of-pocket costs, or by better regulating all the middlemen in the health care industry. This would protect the pipeline of medical research that patients with chronic diseases are still counting on for their cure. Costs and cures must be seen as “yes/and” rather than “either/or” goals.
Our country’s leaders should apply the lessons of the most recent pandemic to finish the fight against the last one.
Richard Zaldivar is the founder and executive director of The Wall Las Memorias, a nonprofit organization dedicated to promoting wellness and preventing illness among Latino populations affected by HIV/AIDS by using the inspiration of the AIDS Monument as a catalyst for social change.