Pharmaceutical drug costs are a workers’ rights issue

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OPINION — The average California worker did everything right.

They budgeted carefully, planned for their family’s future and relied on the health coverage they had earned on the job. But after a medical emergency, the cost of their prescription medication surged, forcing them into debt just to stay on treatment.

Their story reflects a growing reality for working families across California: even people with stable jobs and solid benefits are struggling to afford the medications they need to survive.

Prescription drug prices are often framed as a healthcare issue, but increasingly they are a worker’s rights issue.

For working families, rising pharmaceutical prices don’t just show up at the pharmacy counter.

They ripple through the entire system — driving up insurance premiums, increasing coinsurance and straining the union health trusts that help maintain high-quality benefits that many working people and families depend on. Over time, that pressure erodes hard-won benefits and leaves families financially exposed.

What makes this more frustrating is that lower-cost alternatives exist, but patient access to them is not guaranteed.

Biosimilars — safe, effective alternatives to high-cost biologic drugs used to treat complex illnesses like cancer — have generated $56.2 billion in savings for America’s patients, employers and the U.S. healthcare system since 2015, according to the Association for Accessible Medicines. In other countries, these medications are far more widely used, generating billions in savings for patients (Biosimilars Council).

In the United States, however, adoption has been much slower.

The reasons are well documented. Brand name drug companies build dense webs of overlapping patents, known as “patent thickets,” to delay lower-cost rivals from entering the market.

These thickets are constructed not at the time of invention, but strategically after a drug is already on the market: one analysis found that 72% of supposedly novel patents examined were filed only after the FDA had already approved the drug, suggesting the goal is extending market exclusivity rather than protecting genuine innovation.

Brand-name biologics also remain remarkably expensive: often more than $100,000 per patient each year. Biologics account for 38%-40% of all pharmaceutical spending while fewer than 2% of Americans use them (Health Affairs).

Drug companies say all these protections are about paying for new cures. But that’s not what it looks like from the ground.

Over the last 13 years, they’ve filed 84 lawsuits to block lower-cost biosimilars from coming to market — and not one of those cases claimed the drugs were unsafe. If safety were really the issue, they’d say so. Instead, they’re using the courts to stall competition from would-be competitors and keep prices high.

For union workers, that hits close to home. It means higher premiums, higher co-pays and harder fights at the bargaining table just to keep decent health coverage. It means standing at the pharmacy counter and hoping the price hasn’t jumped again.

At the end of the day, it’s pretty simple: the longer drug companies are able to keep cheaper options off the market, the more money they make — and the more the rest of us pay for it.

From a worker’s perspective, it’s not always clear who’s fighting to lower costs. Big drug companies spent $31 million on lobbying in 2024. Meanwhile, organizations like the California Chronic Care Coalition say they’re pushing for a better healthcare system.

But when so much industry money is in the mix, it’s fair to ask whether “better” means more affordable for patients — or more profitable for drug companies.

The result is a system where cheaper options do exist, but the people who need them most cannot access them.

For California’s labor movement, this is very real. Union health plans face rising drug costs every year, and workers and employers often must cover the gap through higher costs or fewer benefits.

That dynamic puts pressure on wages, bargaining power and long-term economic stability for working families.

There is a better path forward.

Policymakers can take steps to expand access to biosimilars, increase transparency around the pharmaceutical industry and promote fair competition in the drug supply chain. Doing so would not only lower costs, but help ensure that innovation serves the public—not just drug company executives and shareholders.

Breakthrough medicines should be rewarded. But no one should be priced out of care as a result.

If California is serious about protecting workers’ rights, it must address rising drug prices and ensure access to affordable medication.

Al Austin is the political and legislative Director for AFSCME Council 5.