President Joe Biden speaks about how his Build Back Better agenda will lower prescription drug prices, in the East Room of the White House in Washington, DC, on August 12, 2021. © 2021 Oliver Contreras/Sipa USA/AP Images

Last week, the administration of US President Joe Biden released a much-anticipated policy agenda for addressing exorbitant prescription drug costs in the United States. Congress and the White House should seize this opportunity to implement reforms that will provide relief for millions of people in the US struggling to pay for lifesaving medicines.

Soaring medicine prices and inadequate health insurance coverage can result in unaffordable out-of-pocket costs that undermine the right to health, drive people into financial distress and debt, and disproportionately impact people who are socially and economically marginalized. One person I interviewed who had been diagnosed with type 1 diabetes summed up a common refrain I heard from medicine-dependent people with chronic illnesses: “You either afford it or you die.”

A forthcoming Human Rights Watch report documents this crisis, describing the human costs of unregulated insulin prices. In the US, the most prescribed forms of this lifesaving drug can cost someone without adequate health insurance coverage more than $300 for a single vial, easily adding up to more than $1,000 a month. Our interviews showed how the high cost of insulin in the US is not just paid in dollars, but with health, lives, and livelihoods.

But high prices for prescription medications like analog insulin are not the norm among high-income countries. Rather, they reflect an abdication of the US government’s obligation to ensure affordable access to essential medicines.

There is no system in the US to ensure people who need essential medicines can afford them before they enter the market, or restrict how much manufacturers or their intermediaries can increase prices once they do. In this unregulated market, drug prices are exceptionally high and people’s ability to access and use the drugs they are prescribed is dangerously low.

If implemented, the Biden administration’s Comprehensive Plan for Addressing High Drug Prices could upend this tragic status quo, creating a framework for setting fair prices for expensive essential medicines and increasing transparency throughout the industry.

The international human right to health includes equal and affordable access to essential medications. The US government can have a tremendous positive impact on the rights of millions of people in the US by reforming this drug pricing system and ensuring people don’t need to choose between their health, their finances, or death.