Negative headlines about the biopharmaceutical industry have been more common in recent months, but the high cost of medication isn’t just a concern for consumers.Some biopharmaceutical companies are concerned with how they fit into the new equation for outcomes-based care, and how to help bring costs down for customers and themselves.

“Broadly speaking, I know that they are really looking at innovative clinical trial design and ways to make the process more efficient,” said Michael Ybarra, senior director of alliance development at the Pharmaceutical Research and Manufacturers of America.

Ybarra spoke at an event hosted by the HealthCare Institute of New Jersey on Tuesday in Monroe Township to address the cost of prescription drugs.

He explained that pharmaceutical companies are faced with tougher regulations, harder-to-find venture capital and fewer FDA approvals along with the public outcry over high health care costs.

A Tufts Center for the Study of Drug Development report in April this year showed the range in methods used by companies in the industry.

“Success rates in bringing a drug from discovery through to commercialization are low and getting worse,” according to Tufts. The cost to companies on average is about $2.6 billion to get a product to the market, and it can take up to 10 years.

As a result, companies are getting smarter about choosing which drugs to push through the pipeline, using green manufacturing methods, terminating trials earlier when safety issues arise, increased public-private partnerships, and using patient data — all to help lower costs internally, according to Tufts.

But that doesn’t solve the whole problem.  There are still external factors such as insurance companies and lack of education about assistance programs that can make drugs more affordable, Ybarra said.

A new roadblock is Insurance companies tiering drugs, which can be problematic for patients with bad health plans, Ybarra said. Out of pocket costs are going to vary greatly, depending on the type of coverage from the plan.

“Patients are being forced to pay more for medicines than for a doctors visit,” Ybarra said.

And if an insurance company simply will not negotiate a drug the doctor wants to prescribe, some physicians have found an innovative solution. Sometimes, a doctor will send their patient to an emergency room to bypass the insurance company’s roadblocks on certain medications, Ybarra said.

“One of the things companies are doing is prescription assistance programs,” Ybarra said, explaining he has personally used copay coupons to help pay for medication for his own children.

But not enough individuals know about these programs, and are therefore paying the higher prices for drugs.

Despite having launched in 2005, the Partnership for Prescription Assistance is still not as widely known among physicians and patients as it could be, Ybarra said.

At the end of the day, experts don’t disagree that medicines can save lives and have extended the lifespan of many. It is simply a question of access to these medicines at a price that isn’t going to simultaneously bankrupt the person who is trying to be treated or cured.

Some of the most common comments from health care experts in support of the value of medicines and their costs are:

• The cost of noncompliance is higher than the cost of the prescription, so you are saving yourself future bills by following directions and purchasing your prescription
• The cost of creating a drug is in the billions, so higher costs are justified to recoup costs.
• The R&D and clinical trials costs are the biggest cost drivers of the drug prices, and regulations have created a greater burden in recent years.
• Newer drugs tend to work more efficiently than older drugs and keep you well longer, justifying the greater expense.
• High costs are temporary. Patents run out, so eventually generic prescriptions will drive the costs down — the only aspect of health care where that phenomenon occurs.

And here are some of the fewer-known facts:

• Prescription assistance programs are available from the drug companies to help those in need.
• The total of health care dollars spent for prescription medicines in 2014 was equal to what it was in 1960 — about 10 percent.
• List prices of drugs from manufacturers can be negotiated, as is done with companies like Express Scripts, Walmart, CVS Caremark, Target and Walgreens, for example, who leverage their large customer bases.
• Hospitalization is more expensive than prescriptions, but, conversely, the total out-of-pocket for a doctor’s visit is cheaper than the cost of a prescription.
• Less than 12 percent of drugs are approved by the FDA each year.

The biopharmaceutical industry is a huge money-maker for the country and it turns around to invest in philanthropic endeavors, including resources for STEM education to support the future of the industry, said HINJ CEO and President Dean Paranicas

“According to the Conference Board, the pharmaceutical industry is the most philanthropic industry, and we take our role in helping patients very seriously.  Further, the industry is committed to investing in R&D for diseases where patients need help. The biopharmaceutical industry is the second-largest funder of research into neglected tropical diseases, following the National Institutes for Health. Last year alone, pharmaceutical industry investment into tropical diseases increased 28 percent,” a PhRMA spokesman said in an email to NJBIZ.

Paranicas said that headlines have shouted against, talking heads have criticized, presidential candidates have lambasted and policymakers at the state and local level have threatened legislation that will negatively impact the research and development in the biopharmaceutical industry.

Ybarra agreed, saying, “We want to make sure we are not having knee-jerk reactions that would chill the R&D ecosystem, because this is one of the most vibrant aspects of the U.S. economy.”