Prescription drug prices are hitting Americans hard. The average American now spends approximately $1,200 per year on medication – more than anyone else in the world. Prescription drug spending and price increases have surged more in the U.S. in the last decade than in other countries. Price surges for insulin have particularly attracted interest because it is so widely used and because the price in the U.S. for this century-old medicine has doubled, and in some cases tripled, in the last decade.

Several factors contribute to rapidly rising drug prices in the America. Most countries control or negotiate drug prices. The U.S. government does not. There are unique challenges to bringing generic drugs to market in America. Pricing and business practices in the pharmaceutical industry are less transparent in the U.S. than in other countries.

Many in Congress on both the left and right and both former President Trump and President Biden have called for measures to address the surging costs of prescription drugs. Still, congressional action has been repeatedly frustrated. Strong partisan differences remain on how to address the problem and powerful interest groups oppose many measures. Most lawmakers believe that the obstacles to passing bold drug price legislation are even greater now that we are approaching the 2022 mid-term elections. Still, some more targeted legislation may yet be possible. Perhaps the leading example is legislation that would address high insulin prices.