Roughly 30 percent of Americans say they’re struggling to pay for prescription drugs.

These costs can be even more expensive for patients with severe health conditions.

“My doctors have me on a four drug combination with a list price of more than one million dollars a year,” said David Mitchell, a cancer patient.

David Mitchell has multiple myeloma which is a type of blood cancer without a cure. Tuesday, he told Congress the only thing keeping him alive are those expensive prescription drugs.

“Just one of my oral drugs, a drug called Pomalystis is priced at $22,000 for just 21 capsules in this little bottle that I have to buy 13 times a year,” said Mitchell who is also president and founder of the national organization, Patients for Affordable Drugs.

Mitchell said there’s been some relief. He credits the inflation reduction act for significantly capping his out-of-pocket costs. But Mitchell said Congress has to do more.

“Please don’t let this opportunity to help millions of Americans slip away,” said Mitchell.

Medical experts say competition is key. They say big pharma has a limited period to sell a new drug before a generic version of it can hit the market too.

But doctors allege that isn’t happening.

“Many brand name firms now engage in strategies designed to game the system and extend the periods of market exclusivity to the detriment of patients,” said Dr. William Feldman, associate physician at Brigham and Women’s Hospital in Boston, Ma.

PhRMA represents nearly three dozen pharmaceutical firms.

Jocelyn Ulrich, PhRMA’s VP of policy & research, said this industry spends more than $100 billion every year researching and developing new medicines.

“No company has a monopoly on treating a disease, companies compete to develop the most effective treatment options for patients,” said Ulrich.

When it comes to lowering prices, Ulrich argues that insurance companies play a role too.

“Insurance companies and their pharmacy benefit managers determine what medicines are covered, what patients pay out of pocket and what hoops they have to jump throughout to access the medicine their doctors prescribe,” she said.

Democrats and Republicans are working together on a series of bipartisan bills aimed at lowering prices. One proposal would prohibit larger brand name drugmakers from paying other companies to delay releasing generic versions of their drugs.

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