- Medicare prescription-drugs have skyrocketed 89% in Georgia from 2013 to 2019.
- Prices for common medications in Georgia have also ballooned during that time.
- Cost transparency is lacking even from state government as key prescription-drug players blame each other.
Costs for prescription drugs have risen dramatically over the past decade in Georgia while people struggling to pay for medications have little idea as to why.
In recent years, Georgia residents and their insurers have spent more on prescription drugs and for out-of-pocket medication costs not covered by health plans than most states in the U.S., according to several studies. Georgia joined every other state in the country in witnessing a trend of both more people filling prescriptions under Medicare and steep cost increases for those drugs between 2013 and 2019, rounding out to an 89% hike in Georgia's drug costs during that time, according to federal data.
Medicare and other health plans cover most prescription-drug costs to keep them affordable, but many low-income Georgia residents and seniors on fixed incomes still struggle to make up the difference for what’s not covered – leaving many people to choose between paying for medications or buying groceries.
Meanwhile, the root causes for why drug prices have soared in recent years remains largely unknown, shielded behind certain carve-outs in state law and a complex system of behind-the-scenes price negotiations that many patient advocates blame for the rising costs. The intricate causes for Georgia's rising medication costs have left many people in the lurch like Nicola Jackson, whose monthly battle to pay for her medications poses a constant challenge for her family's budget.
In this five-part story, State Affairs tells the stories of several Georgia residents like Jackson who struggle to afford their medications, as well as the forces at play that make tracking the rise in costs – and who exactly is to blame – a difficult task.
Costs for prescription drugs under Medicare in Georgia shot up between 2013 and 2019. (Credit: Brittney Phan for State Affairs)
Part I: The Search for Answers
Georgia is among the highest spending states in the U.S. when it comes prescription drugs and out-of-pocket costs, according to national researchers.
Part II: A Window into Drug Costs
Seeing her monthly bills for prescription drugs on paper is bad enough for Nicola Jackson. Having to tell her husband about it makes the stress even worse.
Part III: Choosing Drugs over Groceries
While Medicare data hint at rising medication costs across the board in Georgia, research by NiceRx shows prices for many high-demand prescription drugs have also ballooned – including for several drugs that Jackson needs.
Part IV: Prescription-Drug Blame Game
Critics trace rising drug costs largely to intermediary companies called pharmacy benefit managers that have pointed the finger right back at drugmakers, pharmacies and other key players.
Part V: Lawmakers Push for Transparency
State regulations and a law firm's investigation into prescription drugs under Georgia's Medicaid programs have kept the focus on pharmacy benefit managers in recent years.
Read this story for free.Create Account
Read this story for free
Already a member? Login here
Food insecurity in Georgia is huge, and a Senate bill hopes to bring parties together to figure out how to fix it
A two-year effort to tackle food insecurity in Georgia may be coming to fruition. The General Assembly is now moving on SB 177, a bill to create a Food Security Advisory Council that would find ways to get more healthy food to economically disadvantaged people in underserved areas. It began in early 2021, when Sen. Harold …
Q&A: Georgia’s new ag commissioner says agriculture is more than ‘cows, sows & plows’
Tyler Harper makes no apologies for vigorously preserving and guarding Georgia’s farmland. “Agriculture at the end of the day is national security,” Georgia’s newest agriculture commissioner told State Affairs. “We’ve got to ensure that we’re protecting our food supply and providing the food, the fiber, the shelter for ourselves right here at home.” Harper became …
Q&A: New Department of Labor commissioner is taking stock and making changes, aiming for a better experience for Georgians
When Bruce Thompson says he has an open-door policy, he means it. Literally. The badge-only elevator access to his sixth-floor executive suite in downtown Atlanta is gone, removed shortly after his arrival in January as Georgia labor commissioner. “We’re treating it like any other floor now. The doors are wide open,” Thompson told State Affairs. …
COMMENTARY: Uncovering the truth: The role Freedom of Information laws play in student journalism
Editor’s note: The New Leaders Association (NLA), formerly the American Society of News Editors, created Sunshine Week 17 years ago to promote open government. NLA and the Society of Professional Journalists host the national celebration of access to public information and what it means to citizens across the country. We asked Rohan Movva, a high …