Biopharma, we've got a problem.

In the wake of presidential hopeful Hillary Clinton unveiling her proposal to rein in prescription drug costs and Turing Pharmaceuticals LLC walking back a 5,000 percent price hike on a life-saving drug, the folks on social media are ramping up the rhetoric against biopharma, guaranteeing that high drug prices won't be just a flash-in-the-pan campaign issue. (See BioWorld Today, Sept. 23, 2015.)

Claiming Clinton's plan would hinder drug innovation, economic growth and competition, a Pharmaceutical Research and Manufacturers of America (PhRMA) tweet Tuesday generated dozens of responses, nearly all of which were negative and some not publishable. Most of them called out drugmakers for their greed, using hashtags such as #highwayrobbery.

"Stop profiteering and pretending it's in the public interest," one tweeter responded. Another said, "Big pharmaceutical companies are raping Americans." And yet another asked, "If you are so worried about the American ppl, where are the new antibiotics? Cheaper HIV meds? Cheaper BP/+lipids meds?"

Other tweets oozed even more disdain and lack of trust in the biopharma industry. "Lots of diseases that will never be researched, because the profit margin isn't high enough. Greed's the only impetus," someone wrote. "Big Pharm probably makes more profit then (sic) any other industry except for energy/oil!!!" one tweet shouted. "Their greed is out of control and prays (sic) on the sick and dying in the world," another replied.

Concerns over drug prices are not just the stuff of social media rants, as is evident in survey results PhRMA released Wednesday. The Morning Consult survey of more than 2,000 registered voters found that health care is the third most important issue this campaign season, falling only behind the economy and security.

For those responding to the PhRMA-sponsored survey conducted over the weekend, reducing patients' out-of-pocket costs for medicines was nearly as important as developing new drugs to treat or cure cancer, Alzheimer's and other debilitating diseases.

Fifty-eight percent of the respondents said encouraging the development of new treatments should be a very important priority for the next president and Congress, and 29 percent identified it as a somewhat important priority. Meanwhile, 55 percent said reducing out-of-pocket costs should be a very high priority, and 30 percent said reducing those costs is a somewhat important priority.

When it comes to controlling out-of-pocket costs, 36 percent said the priority should be capping the prices drugmakers can charge for prescription medicines and 52 percent said it should be reducing the amount insurance companies require patients to pay. But looking to insurance companies for the solution isn't that easy, thanks to the Affordable Care Act (ACA).

SHIFT IN WHO'S FOOTING THE BILL

Drug prices have jumped to the forefront of public discourse due to a renaissance in the biopharma industry and a transformative shift in who's paying for them, said Todd Evans, director of strategy, sales and marketing for the pharma/life sciences and health advisory industries at PricewaterhouseCoopers LLP.

Speaking at a recent webinar on escalating drug prices and the need for affordable alternatives, Evans noted that the FDA has opened an approval valve in new science, resulting in an "almost unprecedented level" of new drug approvals. Since 2010, specialty drugs, which command higher prices than traditional drugs, have made up the majority of the new approvals every year.

Consequently, spending on specialty drugs is expected to quadruple by 2020, Evans said. The specialty drug spend in 2012 was $81.7 billion. That's set to grow to $192.2 billion next year and to $401.7 billion by 2020.

In the past, consumers were pretty much shielded from high drug prices, as insurance companies picked up most of the tab. But because of insurance changes imposed by the ACA, consumers are now having to pay a bigger share of their drug bill through higher deductibles and out-of-pocket structures that have converted co-pays into a percentage-based co-insurance, Evans said.

The bottom line for drugmakers is they can no longer set drug prices based solely on negotiations with third-party payers. Instead, they're going to have to engage with patients, Evans said. That means establishing the value of their products to patients and educating the public about the sustainability of developing new treatments.

But first, they may have to work on that public perception problem. While the PhRMA survey didn't address trust issues or general perceptions of the industry, it did ask how well certain statements described biopharma companies.

While 82 percent of respondents answered at least somewhat positively, only 20 percent believed the phrase "Deliver and produce high-quality products and services" described biopharma "very well."

The same percentage agreed that "Play an important role in our country's economic success" described biopharma very well.