Drugs are getting more expensive, threatening the affordability and accessibility of much-needed therapies for patients, a new report says.

An American Heart Association presidential advisory issued Thursday said the current and projected costs of drugs and biologics have raised serious concerns among policymakers, health care providers, insurers and patient groups about the risks of passing on these costs to patients.

In 2015, net U.S. spending on pharmaceuticals reached $309.5 billion, an 8.5 percent increase from the year before, according to IMS Health, which tracks prescriptions. Annual spending is expected to reach $370 billion to $400 billion by 2020.

The advisory, published in Circulation, outlines eight areas, including patient access, pharmaceutical advances and the cost of treatment, to address rising drug costs and their harmful impact on health.

Elliott Antman, M.D., coauthored the advisory and said the purpose is to ensure medical progress is shared by all while continuing to promote innovation in medical therapeutics.

“We want to make sure that [effective] medications and promising new treatments are accessible to the people who need them,” said Antman, associate dean for clinical/translational research at Harvard Medical School and a past AHA president.

Juddson Rupp was aware of the rising cost of health care. But he had health insurance through his employer and didn’t worry too much about it.

Then he had a cardiac arrest at age 35, followed by a heart transplant 14 years later.

Rupp said he was concerned about “burdening” his family with the high cost of his health care, which includes expensive medication to prevent his immune system from attacking the transplanted heart. He and his wife have had to make financial sacrifices. Every year, he said, they pay “thousands of dollars” out of pocket before their health insurance covers everything he needs.

Rupp isn’t alone.

An October 2015 telephone poll from the Kaiser Family Foundation revealed that 42 percent of roughly 1,200 U.S. adults found it difficult to afford health care — more difficult than other expenses such as utilities at 38 percent and housing at 35 percent. In a separate Kaiser telephone poll in August 2015, one in four respondents said they or a family member opted not to fill a prescription within the past year because of cost.

But not filling prescriptions ends up being costly to the economy.

Nonadherence costs the U.S. health care system an estimated $100 billion to $289 billion annually, according to a 2012 study in the Annals of Internal Medicine.

Antman stressed that accessibility is a key part of health care delivery. “If the price [of drugs and biologics] is preventing access, then it is imperative that we develop solutions that address this problem,” he said.

The advisory pinpoints the various forces at play in the drug and biologic markets, namely the market entry price of innovative drug products and the rapid increase in the cost of generics drugs. Federal regulators may need to change requirements for how drugs are tested or approved, and the process by which drug prices are set should be transparent, the advisory said.

But medications are often only one component of a patient’s larger treatment regimen, the advisory points out. The authors note that making drugs and biologics accessible to more people will therefore require a comprehensive and critical look at the nation’s complex health care system.

The AHA publishes presidential advisories at the request of its president and other volunteer officers. Advisories are issued for health topics that require additional attention or clarification, and are written by a group of volunteer experts.

Read full presidential advisory for more details.

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(EDITOR’S NOTE: The headline of this article was revised Nov. 11 to include additional details about the presidential advisory.)