College students are experiencing the realities of the high cost of healthcare in the United States this spring. Oral contraceptive prices — along with those of a host of other medications — are on the rise on campuses across the country, the result of a seemingly unrelated deficit-reduction act passed by Congress over two years ago. Women who obtain their birth control through student health centers, including Colgate’s, are already seeing increases of $10 to $30 per cycle, depending on the brand.
“For years, college health centers have been able to buy many medicines at reduced rates,” Adjunct Professor of the Health Sciences and Director of Student Health Services Dr. Merrill Miller said, “But things are changing.”
According to Miller, pharmaceutical companies sell drugs at special “clinic rates” to hospitals and doctors’ offices, which are then able to immediately start patients on a prescription. In the college environment, the arrangement is particularly beneficial.
“We know that not everybody would go to the pharmacy, and [students] don’t have to worry about choosing between textbooks and medications,” Miller said. “I see it as part of the ‘transition services’ that colleges provide to students.”
Contraceptive medicines and devices have been part of this equation for years. Availability at student health centers means that students can obtain such products at a reasonable cost in a more familiar setting. Students’ health insurance arrangements also play a role, as not all are comfortable sending a monthly birth control bill home. For drug makers, the scheme provided an opportunity to instill brand loyalty in patients, especially in the case of birth control.
Miller said that, beginning a few years ago, drug companies began scaling back clinic rate discounts and the number of free drug samples distributed, but that health centers were generally still able to obtain the medicines and pricing they desired.
“Everything changed with the 2005 Deficit Reduction Act,” Miller said.
Part of the bill attempted to trim the costs of the nation’s publicly subsidized health insurance programs by requiring drug companies that offered preferential pricing to pay more to participate in Medicaid. The bill did allow companies to continue discounts for a few groups, but colleges were not on the list.
The American College Health Association (ACHA), the primary college-health lobbying organization, began efforts to obtain an exemption for colleges and universities almost immediately, but price changes came sooner than were expected.
“Because of a two-year delay in the bill, everybody thought we had until this summer,” she said. “And then companies started raising prices this winter.”
The change is beginning to be felt at Colgate’s Student Health Services (SHS), which stocks three brands of birth control. Despite earlier assurances that some of these would not be subject to price increases, Miller now reports that all three will see an increase – to $15 per cycle – at the end of this week.
“I’m optimistic that some sort of compromise will be made,” Miller said, adding that a time frame for such a compromise is uncertain.
Regardless of a potential return to lower prices for students, Miller said the loss of this financial cushion has provided an unexpected dose of reality for affected students.
“College is a transition in a lot of different ways,” she said. “That clearly includes learning about healthcare.”