In my years working as an ICU nurse, I witnessed firsthand how medications save lives every day. I cared for a patient readmitted in cardiac failure simply because he couldn’t afford his medications after discharge. Without them, his condition quickly deteriorated despite prior stabilization.
It was a stark reminder that access, not just treatment, determines outcomes. Medications often make the difference between life and death, but across hospitals, there is a common pattern underlying many readmissions. Either patients can’t afford necessary but expensive drugs, or accidentally use drugs to mask long-term health issues until something else puts them back in the hospital.
That’s why the Texas House hearing this week about healthcare costs must include how pharmaceutical companies’ prices drive overall spending. It’s not just about overly expensive drugs, but the common misconception that they are the only solution to health problems.
And the solutions need to come quickly. At 15.4%, Texas hospital readmission rates are higher than the national average. It also has the highest national prescription drug spending and one of the highest uninsured rates in the U.S. (4.8 million Texas residents). This means that too many Texans are paying out of pocket, putting them in dire financial straits due to drug companies’ cruel pricing decisions.
When patients can’t afford medications, recoveries stall, and conditions worsen. Hospital readmission — through emergency departments or inpatient readmission — costs more for patients, taxpayers, and the system itself than a simple prescription.
Health professionals effectively treat and stabilize patients. But as our system is so focused on medications being the cure-all, other important recovery and health maintenance programs are too often overlooked outside hospital doors.
As a nurse, I know prescription drugs can reverse what would be a deadly medical outcome even 20 years ago, and that is a scientific blessing. But drugs should not be relied on as a singular solution when many other modalities outside the institutional setting can assist.
These include physical therapy, smoking and addiction cessation, mental health counseling, regular exercise programs, healthier eating habits, education on diagnoses, and other lifestyle changes that can decrease the need for expensive drugs. High cholesterol and type 2 diabetes come immediately to mind, as diet and exercise can lower medication needs and, in some cases, eliminate them.
Lack of lifestyle changes can add to hospital readmissions, often because patients are spellbound by endless pharmaceutical ads on TV, or because so many in our medical community recommend drugs not just as the first solution, but the only one. Roughly half of all doctors saw a pharmaceutical rep once a week a few years ago.
They were not lobbied by the local gym or farmer’s market.
Outcomes are the same for those with or without insurance — exorbitant and sometimes unnecessary costs for drugs that leave long-term physical and financial health in the ditch.
The April 30th Texas House hearing will cover many important healthcare issues, including the cost of regulation and fraud, and choices for Texans in the healthcare marketplace.
What lawmakers must also address is the cost vs. the value of medications for patients, and what steps they are willing to take to publicly urge Big Pharma to reform many of its pricing policies and lower costs for consumers.
In the ICU, we saved patients, but the failed system sent them back to us. If we want better outcomes, we need to close the gap between treatment and recovery by recognizing that affordability is central to healthcare.
A life-saving drug works only if the patient can afford to take it — and if it’s the right solution in the first place.
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