The high cost of prescription drugs creates an enormous barrier to treatment. According to the U.S. Department of Health and Human Services, more than 5 million Medicare beneficiaries had difficulty affording their medications in 2019; Black and Latino beneficiaries were more likely than white beneficiaries to face cost-related barriers.

A report from the Congressional Budget Office (CBO) found that both the Medicare and Medicaid programs have paid significantly higher prices since 2008 for brand-name prescription drugs. One silver lining is the downward trend in the average net price of prescription drugs overall, due in part to the increased use of generic drugs.

According to the CBO analysis, the average net price of all prescription drugs decreased from $57 in 2009 to $50 in 2018 in Medicare Part D and from $63 to $48 in Medicaid. However, generic drugs’ tempering effect on drug spending may be limited going forward because of already high generic dispensing rates — 90 percent of all drugs dispensed are already generics. The report also notes the challenges associated with making generic forms of newer, high-cost brand-name drugs, particularly biologic drugs.

Access to generic drugs has been a bright spot in the nation’s efforts to hold down pharmaceutical spending. Whether it starts to fade will depend in part on the industry’s ability to bring new products to market through a well-defined and well-functioning regulatory process. Continued implementation of the FDA’s Drug Competition Action Plan and renewal of the Generic Drug User Fee Amendments are important steps to maintaining success.