Dr Jennifer Sturgill Addresses IRA Drug Price Negotiations and the Current Drug Shortage

Jennifer Sturgill, DO, inpatient medical director of population health, Central Ohio Primary Care, discusses how shortages of antibiotics and medications for attention-deficit/hyperactivity disorder have affected primary care, as well as addresses the impact of CMS’ recent announcement of the first 10 drugs up for price negotiation in 2026 on heart failure care.

She presented on value-based care at our recent Institute for Value-Based Medicine® event held with the Zangmeister Cancer Center of Columbus, Ohio.

Transcript

Can you provide insight into how the current drug shortage has affected primary care for patients?

You know, the drug shortages have mostly been on antibiotics and ADHD [attention-deficit/hyperactivity disorder] medications. The antibiotics are a little bit easier to deal with because we can provide alternatives. And I think it really has kind of forced providers to maybe get out of their comfort zone instead of just always prescribing that one antibiotic they're comfortable with; they can pull up the guidelines and see what's the first, second line and change it to something different.

The ADHD medications have been a little bit more difficult, and that really has been the pressure put on the patient. They're the ones having to go to different pharmacies to find out if the medication is available. We really don't have a great solution or workaround to this. I think it's getting a little bit better, but it's still a huge burden on the patients.

How might CMS’ announcement of the 10 drugs subject to price negotiation under the Inflation Reduction Act affect primary care when negotiated prices take effect?

I'd say not just primary care, but for patients in general, looking at the list, in particular, the SGLT-2 [sodium-glucose cotransporter-2] inhibitors, they are hugely important now in the treatment of CHF. And, you know, we have an aging population, and people are developing congestive heart failure, they're living longer, and they're living longer chronically ill. And now when we're starting patients on medications, we can give them a coupon and hope that they're able to get that first month supply. But it really takes a lot of effort on the patient's behalf and on the primary care provider to make sure that their patient is able to stay on the medication, that there's no interruption in care.

We know that CHF is one of the leading readmission diagnoses for patients. These patients decompensate quickly and often, and it's not helping their medical condition if they're not able to stay on a medication. So, it's very exciting to see that these medications are going to be addressed.

And then the other medications, the anticoagulants with Eliquis [apixaban] and Xarelto [rivaroxaban], we know that these are safer, [have] fewer interactions, require less monitoring than Coumadin [warfarin]. These are the medications we are prescribing for patients, and a lot of patients are on them. And again, it's going to be very helpful to know that we don't necessarily have to jump through a lot of hoops to make sure the patient can initially fill the medication, but then also stay on it.