WASHINGTON, D.C. – (February 16, 2022) – Everyone should be able to get the medications they need at a cost they can afford. But drug prices are out of control, demanding solutions to shield patients, families and employers from high costs and make health care more affordable for them. A new study from AHIP focuses on an often-overlooked opportunity to improve health care affordability while ensuring patient safety: drugs that are administered in a hospital or physician’s office.
AHIP researchers analyzed the cost of 10 drugs that are purchased, stored, and administered in a health care setting, such as a hospital, but could also be safely and securely delivered directly through a specialty pharmacy for provider administration. The study examined data from 2018-2020 and found:
- Costs per single treatment for drugs administered in hospitals were an average of $7,000 more than those purchased through specialty pharmacies.
- Drugs administered in physician offices were an average of $1,400 higher.
- Hospitals, on average, charged double the prices for the exact same drugs, compared to specialty pharmacies.
- Prices were 22% higher in physicians’ offices for the exact same drugs, on average.
High drug prices and costs for hospitals and physicians aim to produce higher reimbursement rates and higher payments. Moreover, these costs are in addition to the fees hospitals and physicians are paid to administer the drug to the patient.
“Now more than ever, Americans deserve more affordable solutions, and we all need to work together to deliver for them,” said Matt Eyles, President and CEO of AHIP. “Health insurance providers are developing solutions to improve affordability while protecting patient safety and access. The data are clear, specialty pharmacies lower patient costs by preventing hospitals and physicians from charging patients, families, and employers excessively high prices to buy and store specialty medicines themselves. Secure, direct delivery is a safe and smart competitive alternative that improves affordability and access for everyone.”
AHIP is the national association whose members provide health care coverage, services, and solutions to hundreds of millions of Americans every day. We are committed to market-based solutions and public-private partnerships that make health care better and coverage more affordable and accessible for everyone. Visit www.ahip.org to learn how working together, we are Guiding Greater Health.