As healthcare costs are set to be a key issue for voters in the upcoming US presidential election, PhRMA’s Robert Zirkelbach lays out why policymakers must abandon partisan solutions that do not address underlying access and affordability issues. Instead, Zirkelbach urges for greater protection of the USA’s world-leading biopharmaceutical R&D and greater accountability for insurers and pharmacy benefit managers.


With President Joe Biden and former President Donald Trump clinching their respective parties’ nominations for President, the 2024 U.S. election season is officially underway. While the economy and inflation remain leading issues for many Americans, voters are sending a clear message that lowering healthcare costs is also a top priority.


Concerns about inflation start at the gas station and grocery store and follow American families to the doctor’s office, emergency room and pharmacy counter. Roughly 80 percent of voters say it is “very important” for this year’s candidates to talk about healthcare affordability, which mirrors the number of voters (83 percent) who feel the same about inflation, according to a recent KFF Health Tracking Poll.


The challenge is identifying the real pain points people experience when it comes to healthcare costs, which is critical to finding the right solutions. Fortunately, public opinion research offers some important insights on both accounts.


A Morning Consult/PhRMA survey found that nearly 90 percent of insured Americans want policymakers to make lowering out-of-pocket healthcare costs a priority. An Ipsos/PhRMA survey found that more than 90 percent of Americans believe health insurance should provide affordable access to all, but only 34 percent think the current system does.


With premiums and other out-of-pocket costs skyrocketing, the current system isn’t working for American families. Voters support changes to the status quo, and policymakers have several ways to provide them with meaningful relief.


First, abandon bumper-sticker, partisan ideas that don’t address the systemic problems facing patients. Out-of-pocket costs drive voter anxiety far more than medicine list prices. Yet with each new election cycle, politicians offer the same old policies disconnected from people’s real-world experiences.


For example, the Inflation Reduction Act lets politicians set medicine prices in Medicare but leaves in place everything people hate about their health insurance, such as burdensome prior authorization and fail first requirements that result in delays in care. Furthermore, government price setting could increase costs over time by putting access to new treatments and lower-cost generics and biosimilars at risk. That’s why, when presented with the likely tradeoffs of less access and fewer new treatments, public support for government price-setting plummets.


Instead, policymakers should focusing on holding middlemen accountable to lower out-of-pocket expenses and protect patients’ access to medicines. An overwhelming majority of voters lay the blame for rising healthcare costs with insurers and their pharmacy benefit managers (PBMs), the entities who decide which medicines are covered, how much patients have to pay and what hoops they have to jump through to access the medicine their doctor prescribed.


There is strong public support for bipartisan proposals that would rein in abuses by these middlemen Nearly nine out of 10 voters believe insurers and PBMs should be required to pass the rebates they negotiate directly to patients, which would ensure no one pays more for a medicine than his or her insurance company pays. They also want lawmakers to end financial incentives in the system that encourage PBMs to prefer higher-priced medicines and stick patients with higher costs.


The cost of medicines matters to voters but making medicines accessible matters too. Roughly 1 in 5 voters say a medicine their doctor prescribed wasn’t covered by their insurance, according to a recent Harris survey. It’s not surprising then that more than 80 percent of the American people believe Congress should rein in tactics used by middlemen and insurers that delay or deny access to medicines. People are tired of waiting while insurance bureaucrats meddle in decisions that should be left between patients and doctors.


Finally, making healthcare more affordable shouldn’t come at the expense of new treatments or American leadership in medical innovation. Breakthrough therapies generate excitement across party lines and the American research ecosystem is critical to the development of new medicines and cures. A recent survey from Research America found that three-quarters of Americans want the country to lead the world in medical and health research (73 percent).


What does this mean for policymakers? It’s a reality check for those who are tempted to raid biopharmaceutical R&D and use it as a piggy bank to fund other political priorities. Upending our existing ecosystem under the guise of lowering healthcare costs would stymie medical progress, inflicting lasting harm on patients, caregivers and our healthcare system, and risk triggering a backlash at the ballot box. Voters understand the value innovative cures and treatments bring to patients and society, and they want to protect it.


This election will be consequential. Voters are clear about the healthcare challenges they’re experiencing and the solutions they want to see. Policymakers who can address these concerns with practical solutions would enjoy broad public support and help deliver a better, more affordable healthcare system.


Robert Zirkelbach serves as Chief Public Affairs Officer & Head of Strategic Initiatives at the Pharmaceutical Research and Manufacturers of America (PhRMA).