Federal drug policies raise concerns over access, stability | Opinion

For the millions of Americans living with depression or bipolar disorder, the path to wellness isn’t a straight line; it is a journey.

At Depression & Bipolar Support Alliance, a national organization born in Chicago and rooted in Illinois, our mission is built on the power of lived experience.

We know that mental health care is individual, and for many in our community, finding the right medication can be a life-changing breakthrough that provides the stability needed to work, care for families, and lead self-directed lives. 

In reality, federal policies like the Most Favored Nation drug pricing model and provisions of the 2022 Inflation Reduction Act risk disrupting that stability.

By prioritizing government-imposed price controls over the unique needs of people living with mood disorders (peers), these policies threaten to narrow the range of treatment options for those who need them.

According to IQVIA, the U.S. has access to all 53 new first-launched central nervous system medicines over the last 10 years. On average, 24 of these new medicines are unavailable in the EU, and 19 are unavailable in the countries referenced by the proposed MFN policy. In other words, only 1 in 5 new innovative treatments for neurological and psychiatric conditions are available in these countries, where pricing is artificially set low.

U.S. Rep. Darin LaHood, a Republican from Illinois, has been a steadfast advocate for keeping the government out of the exam room, and we share his skepticism of these federal overreaches. Healthcare decisions should be driven by peers and their providers, not government mandates.

The MFN model is particularly concerning for our community. Tying U.S. drug prices to those set by foreign governments fails to account for key differences in healthcare systems, many of which operate under single-payer models that rely on strict access controls.

Trying to emulate this system domestically would have significant impacts on mental healthcare. Psychiatric medications are among the first services to face cuts or coverage restrictions when budgets tighten. We cannot import these restrictive models and expect anything other than reduced access.

For someone who has finally found a medication that works, losing access or facing new barriers to that treatment due to policy changes is not just disruptive, it can destabilize care and force them to restart the difficult process of finding an effective option. In some cases, they may even consider abandoning their treatment altogether.

The same logic applies to the IRA’s “Pill Penalty,” which has become a point of contention for patients and advocates concerned about health equity across Illinois. By creating a shorter lifespan for price negotiations on everyday medications (or ‘small molecule’ drugs) compared to complex infusions (or large molecule drugs), the policy risks discouraging investment in the very treatments on which many patients rely.

For those living in rural or underserved regions of Illinois, a daily pill is often the only realistic way to stay on a treatment plan.

Expecting a senior or a rural resident to travel long distances to a specialized clinic for a complex infusion can create a barrier to care that our system should work to tear down. Policies should expand access to all effective treatments, not limit them.

Barriers to access to medication are a dangerous challenge in mental health, long linked by federal health experts and researchers to higher rates of recurrence, hospitalization, and poorer outcomes. When medications are harder to obtain or choices are limited, people skip doses, and the results can be life-threatening. Protecting a full spectrum of treatment options is essential to ensure continuity of care.

All Illinoisans deserve a healthcare system that values their lives and honors their journey toward recovery rather than settling for the limitations of foreign reference pricing.

We ask Rep. LaHood and other lawmakers to continue fighting for patient autonomy, quality access to care, and the development of future breakthroughs.

Andrew Smith is the director for peer and policy engagement at the Depression and Bipolar Support Alliance.