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Pointing Fingers at Big Pharma Won't Solve Our Drug Cost Problem

<ѻý class="mpt-content-deck">— Policymakers must work together to overhaul systemic problems in the healthcare system
MedpageToday
 A photo of Bernie Sanders
Numerof is president of a global healthcare strategy consulting firm.

In his latest outcry , Sen. Bernie Sanders (I.-Vt.) and a group of other senators recently questioned three "Big Pharma" CEOs in an hours-long hearing about the cost of drugs in the U.S. Even the name of the committee -- Health, Education, Labor & Pensions, whose acronym is "HELP" -- drips with irony. The subliminal message was clear: Sanders and his colleagues were there to "help" the American people by addressing the high cost of pharmaceuticals in the U.S. and shed light on the drivers of cost.

Predictably and unfortunately, the hearing did neither in my opinion. What it did do was provide a platform for Sanders to press executives from three of the largest global industry leaders in a to place blame.

In order to truly solve the problems plaguing today's healthcare system, policymakers must widen their lens. The issues the hearing sought to address go much deeper than three pharmaceutical CEOs -- and our political leaders would better serve their constituents by working with healthcare stakeholders, not against them. Until policymakers are willing to have the larger conversation about how we got here and the complex factors at play, the American people will continue to shoulder high costs in a failing system with no meaningful "help" from their leaders.

In his prepared remarks for the hearing, his goal to "substantially reduce the price of prescription drugs in America." This priority is laudable and would likely be supported by most Americans who are aware of the price of drugs when they fill their prescriptions. But trying to blame pharma alone misses the mark.

While the committee is right that there are deep-seated issues with our current fee-for-service model -- and that often, the majority of the cost burden falls onto everyday Americans -- the narrow focus on three pharmaceutical CEOs stifled the much-needed conversation about the overarching problems with America's fee-for-service model. By honing in on one segment of the healthcare delivery ecosystem, "Big Pharma," the HELP Committee was able to skirt the more difficult questions and shift responsibility onto these CEOs to seemingly snap their fingers and fix everything.

If only it were that simple. Unfortunately, prescription drugs are only a fraction of the . Even if we reduced that segment to zero, healthcare costs would likely still be too high for many, and adverse health outcomes wouldn't suddenly be nil. Still, pharmacy benefit managers and other middlemen were not told they may be subjected to a subpoena for this hearing, nor did they have to face the same , even though they too bear some blame for today's soaring healthcare costs.

The most helpful thing that Sanders and the HELP committee can -- and should -- do is take a broader, constructive approach to the healthcare ecosystem, evaluating how the pieces fit together, understanding how we got here over decades, and outlining what's required to fix the massive issues we face: a system overhaul. Congress and current and prior administrations have played a significant role in getting us here, and they have an important part to play in fixing the current state.

Today's broken fee-for-service system has decoupled payment for services from quality outcomes and incented volume of procedures over prevention. Yet, leaders have failed to find a way to move on from this model. Every healthcare stakeholder is complicit in allowing this broken model and perverse incentives to keep going. And every stakeholder is responsible for breaking this cycle.

Some committee members seemed aware of this reality. Senator Bill Cassidy, MD (R.-La.), used his to call on his fellow senators to take a wider, "substantive" look at "insurance benefit design, price transparency, regulatory barriers, intellectual property barriers, and the perverse effect government discount programs have upon prices charged to commercial patients," in addition to the pharmaceutical industry. His apparent understanding of the entire ecosystem -- and the many players who benefit from high prescription costs, which goes far beyond a few pharmaceutical CEOs -- was refreshing. Yet, others appeared to have an overt political agenda and bulldozed right past him.

Repairing the decades-old problems that plague our healthcare industry will take a greater and more unified effort than Big Pharma can accomplish alone. Until policymakers are willing to engage in real collaborative efforts to overhaul decades-old, systemic problems, nothing will change. Pointing fingers at industry leaders is political theater; it is not a serious effort to solve serious problems. Consumers and the country deserve more.

Rita Numerof, PhD, is president of Numerof & Associates, a global healthcare strategy consulting firm, working in all areas of the healthcare industry. She has authored six books, including , and is a regular contributor to , where she writes about the business of healthcare and the need to move to a market-based model.

Editor's note: You can read an opposing perspective on this issue in another op-ed here.