1. Put in a federal pricing board for prescription drugs that requires each and every drug to be listed with the feds for sale, with a maximum price tag attached to the drug based on evidence of the cost to develop, market and create the drug.
2. Severely restrict patents for "copy cat" drugs to those only that have a change in an "active" ingredient of the drug. Slow release formulas, etc. which do not change the drug actions themselves, would be prohibited from patenting.
3. Negotiate drug prices for participants in big pharma's large markets such as Medicaid and Medicare.
5
When the private market fails to produce necessary goods at a "reasonable, affordable" price, it's time for the federal government to step in. It's perfectly orthodox capitalism, going back to Adam Smith and the Wealth of Nations. It's also called socialism - to either provide a good or service, and to assessing society as a whole for it, instead of assessing individuals in proportion to their use.
We already socialize the following:
K-12 education. We don't charge kids or parents; but socialize the cost among all property owners in a municipality.
Roads: Mostly built with state and federal taxes. The closest thing to assessing individual users per their use, the gas tax, is totally inadequate and continues to become less so.
National defense: Paid through federal taxes, entirely consistent with the basic function of the federal government.
Police and fire protection, public street snow plowing, public lighting for safety. Socialized at the community level through local taxes. You are not billed per your use of these services; the entire community pays.
Here are some things that -should- be socialized, because they are necessities, because metering and charging individuals for their use is either not feasible or makes them unaffordable:
Affordable housing. Let's get the government back in the housing business.
Drugs: Only fair; so much basic research is taxpayer funded.
Medical care for all: A basic necessity whose cost is increasingly out of reach.
4
Ten years ago, i had a surgical procedure to remove a GIST. I followed up the surgery with adjuvant therapy of taking Gleevic for four years. Just checked current prices of the drug as of 2016: "Generic imatinib is available in Canada for $8,800/year and Gleevec is available for $38,000/year. In the United States, Gleevec is priced today at about $146,000/year." Had a friend who also had to take imatinib. She paid $50 a month.
1
Nothing but pure greed with impunity
1
Is this a kind of socialism conservatives want ??
1
Moral outrage will not make pharmaceutical companies lower their prices. Government needs to regulate prices. Good luck with that.
1
I won't hold my breath waiting for drug prices to go down after pharmaceutical executives testify before the Senate Finance Committee. It's going to take a lot more public pressure to convince our elected officials to bite the hand that feeds them.
5
Here is what I have come to understand and better late than never. I used to believe that politicians would 'get' the inherent wrong in a system where citizens die because they can't afford medicine. The reality is that politicians don't care. They have no political will to care and in fact have managed to twist the message into 'healthcare is not a right.' (I'm sure healthcare lobbyists and certain vicious libertarians were delighted to help with messaging.)
Politicians do develop political will when citizens start speaking up. But even then we must be careful and strategic because well-financed forces are aligned against us.
Once we cross the Rubicon - and it needs to be crossed - there will be be no going back. Predatory capitalism that kills people is unacceptable. There are more of us. We need to remember this.
6
It's not just the prices, it's the SAFETY. Example: Lupron.
We are willing to spend almost anything to save our lives. Given monopolies, that's exactly what drug companies will charge us.
And they have done every thing they can to convince us that we will die, and die painfully, without their nostrums. They valiantly resist curing anything in favor of turning it into a chronic condition for which they can sell us drugs for life. They give us drugs to counteract the side effects of other drugs.
We are made to believe that we have a daily requirement for medicine greater than our need for fresh vegetables.
They experiment on us with weakly proven medicines--without ever testing long-term effects. They are insulated for liability for vaccines the long-term effects of which are unknown--'they will monitor consumer complaints.'
We are cash cows to them. Nothing more. They want to keep us alive only to milk us more.
3
Concerning some conditions - I don't mean the most serious ones -- I often wonder if doctors are too quick to propose an expensive prescription without checking closely as to whether a problem is happening because of something else. In a busy world, it seems to me that some things are far more widespread than we think: poor or mediocre nutrition, vitamin deficiencies, food sensitivities (such as wheat, dairy, factory-made meat, processed foods, preservatives), lack of sufficient exercise, insufficient sleep, workaholism-related stress, too much computing. Poor self-care is a pandemic in the world today. Do doctors rule out things like this first? Or do they go straight to a prescription? And do people too often believe that a prescription is the answer? I know a number of people who undertook aggressive programs of natural methods to improve their health and the results were astonishingly effective.
3
I agree absolutely with every complaint in this article, and I’d still ask folks three questions: a) ever wonder why you don’t polio, tetanus, diptheria, typhoid and a bunch of others any more? b) you know anybody being treated for Hep C or HIV that feels Quite as angry as you do about Big Pharma? c) you know anybody who’s got a long story about stomping into their doc’s office and demanding this or that new drug for this or that semi-imaginary complaint, being told they don’t need it, and stomping in down the street until they find their proper pusher?
2
There is a difference between making a living and making a killing. It sounds like pharmaceutical company bigwigs are doing the latter.
4
On another note, perhaps true reform with controlled pharmaceutical pricing will rid ourselves of that Doug Hirsch of GoodRx, and that smirk on his face, who is obviously laughing all the way to the bank, because of the inability to regulate prices!
2
If pharmaceutical companies are to have their "tobacco moment", surely the safety of the product - prescription drugs - needs to be considered along with the cost.. Over 100, 000 people a year die from the side effects of these drugs taken as prescribed. Companies - with lots of money at stake - do what they can to minimize side effects, push to have a drug originally approved for one thing expanded to be approved for other conditions to get a larger market, often with minimal clinical trial evidence of efficacy. The FDA's safety oversight has been effectively watered down over time due to industry pressure - corporate campaign donations to Congress do have an impact. This conversation needs to be expanded -if it were 100,000 deaths from malfunctioning cars, it would be.
3
I'm not a socialist but it's time to nationalize the pharmaceutical and insurance industries.
3
Is the exclusive use of pharmacologically active agents or physical interventions appropriate in an age where IBM is selling Quantum computers?
Is keeping us sick too profitable?
2
We need healthy pharma companies. We don't need tobacco companies.
2
I'm not optimistic that this hearing will prove as seminal as the 1994 hearing with the 7 leaders of cigarette companies in the US.
One reason is that the Pharmaceutical industry simply makes the greatest net profit of any industry (NET profit!). That money buys influence in the Senate. This will be an infomercial!
Another reason is that prices are not just set by the manufacturer! My wife's monthly cancer medicine costs $37,000 (per injection!) at Dana Farber and $17,000 (per injection!) at Indiana University's Simon Cancer Center. Both are outrageous, but you don't have to be a mathematician to see the difference!
4
The single largest purchaser of prescription drugs is the US Gov't via VA, Medicare, Medicaid and a number of other smaller programs. Each and every prescription drug purchase is funded with tax dollars provided by you and me.
Medicare and Medicaid are legally NOT allowed to negotiate prescription drug prices - this means WE pay full retail pricing. Only in America does such absurd and costly practice exist. Only in America.
This must stop - the US Taxpayers should not pay one cent more for these drugs than the lowest negotiated price. All Federal Gov't HC program purchases of prescription drugs should be based on best available pricing; which can be no more than the lowest price that drug is sold for. Period, Full Stop.
4
It seems to me that Pharma spends a lot more money on marketing relative to research than it did years ago. I really don't like paying for all the marketing.
5
This is a very biased article,catering to the populist whims of the moment. I would have expected a more balanced piece with some depth in it.
The comparison of the pharmaceutical industry, whose mission is to save lives, to the tobacco industry is a cheap shot and it is insulting. Not to recognize millions of lives saved through the successful treatment of many previously deadly diseases, is either due to ignorance or willful demagoguery, neither of which I would have associated with the Editorial Board of The New York Times.
3
@Ahmet Goksun Like any corporation, the sole "mission" of any pharmaceutical company is to maximize the wealth of its executives and shareholders. Saving lives is incidental at best. And that "mission" effectively demands that they take full advantage of the American market-- the only one in the world that isn't subject to government price controls-- by gouging Americans with prices significantly higher than anywhere else.
Without government restraining them, they can also manipulate the market to stifle or absorb competition, so they can keep increasing the prices even of old off-patent drugs. Rent seeking is easier and more lucrative than innovation!
With unregulated capitalism, wealth concentrates in the pockets of a few spectacularly wealthy people while everyone else becomes impoverished. Pharma CEOs may find that acceptable. And the politicians who take their campaign contributions may piously insist that the diabetics who are dying because they can't afford the increasing price of insulin just need to work harder. But gouging the world's only uncontrolled market is sacrificing an increasing number of American patients to enrich executives and shareholders. You might be willing to accept that, but an increasing number of us are not.
This isn't just about "populist whims." There's a good reason why every other country has rejected market capitalism for health care, and regulates drug prices. Why should Americans uniquely suffer to serve the greed of Big Pharma?
7
@Ted I totally agree with you. When I lived in Europe for a few years, I paid much less for a prescription drug I took, than I did for the same drug that I take in the USA. The drug is only manufactured in this country. This is how these drug companies treat their own citizens. They could not get away with it in other countries! We must stand up to them.
2
Republicans will surely do everything they can to ignore the elephant in the room: Prescription drug prices must be regulated by the government, as they are in every other "advanced" country. Without that regulation, pharmaceutical companies will continue to raise prices even for old drugs, because they believe their only imperative is to create more wealth for their executives and shareholders.
Yes, insurance companies, pharmaceutical benefit managers, wholesale distributors, and other parasites all contribute to the byzantine opacity of drug pricing in our American-Exceptional medical-industrial complex. But ultimately the problem is one of pure greed. Along with a campaign finance system that encourages our elected officials to put that greed ahead of people.
Pharma CEOs may whine that regulation will stifle innovation, and leave their impoverished shareholders to starve in the streets. But drug companies clearly make enough profit to be worth doing business in all those countries whose governments regulate prices. It's merely adequate profit rather then the stupendous profit they make from gouging Americans; but they have no automatic entitlement to more than that.
I suspect those CEOs are already running scared. More and more of us are outraged about the price of prescription drugs, even those of us who aren't diabetics dying because they can't afford insulin. How much suffering, death, and outrage will it take before our politicians do what's necessary?
4
The time for listening to these turkeys should be over. The time to tell pharma how it’s going to be would already be here if much of the Congress were not already bought and paid for buy pharma’s PACs. Solution will only come after we have over-ridden Citizens United. But, I guess to do that, we’d have to get the same members of Congress to walk away from even more money by approving a Constitutional amendment and sending it to the states. Catch 22.
1
One of the most frightening aspects of the drug industry is the compound side of it. A company may claim that their drugs are manufactured in the United States, but they leave out the fact that the ingredients are compounded in foreign countries with no sterling reputations for cleanliness or other quality controls.
Then of course Americans make up the difference in cost as compared to the lower cost of drugs abroad, because congress allows this practice.
The opiod crises is an example of poor pharma regulations.
Which one of the brave new legislator is going to go up against pharma?
4
I am married to someone who works in biotech in Silicon Valley. He makes an excellent salary but a whole lot less than many people seem to think. In almost 20 years in industry, he has made a grand total of about $30,000 in options. We have a large mortgage on our house and might have to sell and move elsewhere when we retire. The people who make the most money in the biotech industry are venture capitalists who would not put up the money for start up biotech companies without the chance of riches in a few years. The biggest problems are the generic drug makers who are trying to make fortunes without having to take any risks. The dramatic rise in the cost of insulin is sickening. But if the American people want to develop new drugs for less money, the US government will have to figure out how to develop drugs without private money. If venture capitalists do not see a way to make money in developing new drugs, they'll just go elsewhere.
1
I don’t think the pharmaceutical industry representatives are spending enough time with their patients.
Next time your doctor is meeting with the Rep that is peddling your life saving drug,
ask if you can come along.
Ditto with your member of congress.
4
@BBB
One good source to find out how much campaign money a Congressman/woman takes from the various corporate interests - including BigPharma - is Open Secrets. Might be good to check it out before the battle begins!
1
What a capitalistic irony depicted here: when a company sells a product that's terribly bad for you, like cigarettes, they make it as cheap and accessible as possible; but when a company's got the only product that you need to go on living and get healthy again, they raise it's price beyond affordability. Any question why there's a need for Democratic Socialism?
6
This is capitalism, and the drug companies can charge whatever they want for their private property. If you don't like it, move to Cuba or Russia.
Be sure and keep that in mind, when the wife goes on Humira or Gleevec, or the kid just needs a new six-pack of Epipens.
2
Get ready for expert-level equivocation, obfuscation, subterfuge, and even prevarication, for the stakes are obscenely high.
Like the seven tobacco executives before them, the seven pharmaceutical heads will be hell bent on protecting the most valuable products of their R & D divisions: billions of U.S. dollars. Make no mistake, nothing brings out deceit, doublespeak and lies quite like unadulterated greed.
6
After we bring in the pharmaceutical industry, can we bring in private colleges next?
Th
3
@Kelly
Everyone's in it for the money, not the people. It's the new American way (especially championed by Republicans). Bring every one in.
3
Sure, why not. That way you can confuse this issue hopelessly by yelling at liberals.
Drug prices are another example of how free market economics fail in Healthcare, while countries that have universal healthcare with tight Government control do better.
Of course for those over 65 we have universal single payer healthcare and we all know that if Medicare could negotiate drug prices they could be brought under control yet drug companies have been able to convince - or coerce - lawmakers to protect them from those negotiations.
4
Given that pharmaceuticals are the anti-matter to tobacco's matter this comparison seems poorly conceived. Pharmaceuticals help people lead longer healthier lives. The treatment of mental health disorders, diabetes, hypertension and many other disease states have been vastly improved by pharmaceuticals. The successes of the industry are talked about far more than the failures and yet failed drug candidates are a huge driver of cost.
For a many Americans, the price they pay for their medications is set by the copay amount from their insurance company. Given the discounts and rebates that giant pharmacy benefit managers demand list price becomes almost meaningless.
Far better to for congress to examine why United Healthcare, McKesson and CVS Caremark are numbers 5,6 & 7 in the Fortune 500
1
The pharmaceutical industry views that it is a sort of "Robin Hood". They charge as much as they can in America so that they can develop drugs for the rest of the world that either cannot afford them or has placed regulations on their prices and profits.
Are their solutions? Yes. Look at the methods used in the UK, France, Germany, the Netherlands, Belgium ....
In particular, the British approach is a voluntary agreement revised every five years. If the pharmaceutical companies can develop this agreement with in the UK, then they can develop it with Medicare, Medicaid, the VA and other government-funded insurance.
https://www.abpi.org.uk/what-we-do/medicine-pricing-in-the-uk/pprs-how-does-the-industry-help-the-nhs-manage-its-spend-on-medicines/
1
I am surprised that the New York Times opinionators are confused as to the cause of high drug prices. In a nutshell, its Obamacare fault, and any intelligent observer would have seen these rises coming long ago. It is not just pharma drug prices, its all medical devices, procedures and tests. Even the price of urine tests has gone up 1000% in the last 10 years. The only things that cost less today are things that bypass insurance, like botox, plastic surgury, lasik, hair enhancement, etc. Any surprise there?
Previously, as any pharmacist will tell you, there was actually a small cash market for drugs, which encouraged pharma companies to keep prices reasonable. But since the passage of Obamacare, more people have acquired insurance. Cash paying consumers have dwindled. With insurance now paying or the vast majority of drug costs, pharma companies can charge more for drugs from these deep pocketed entities.
Today, American pharma creates 75% of all new formularies globally. Socialist healthcare European countries simply do not innovate, all of the EU accounting for less than 15% of new drugs. American pharma companies must recoup the billions spent on R&D and they can only do it from the 300 million American consumers. Other countries do not enforce patents and steal American innovation. People all over the world enjoy the benefits of American drugs, but they do not pay their fair share, shifting the burden to American consumers.
2
So your answer, apparently, is to be sure less people have insurance with drug coverage.
5
I’d tell ya that correlation does not equal causation, that premiums and copays rose over ten percent a year each year between 1998 and 2009, that the cost of drugs has zippo to do with more people being insured in ways that any capitalist ought to be able to figure out for themselves, and that these price jumls have to do with market speculation and the real costs of development and advertising that encourages excessive demand, but you can’t spell words.
2
Unless you put a ban on health care related lobbying in Washington DC or, one of the parties in Congress takes a stand not to accept money from pharmaceutical companies, this is just a pipe dream.
3
If Big Pharma wants to advertise to consumers and lobby politicians, the format should be a public congressional question and answer session on C-SPAN. Let everyone in on what they want to tell your congressional representative in private.
1
The medical profession in general earns enormous sums from fees, ownership of labs, MRI facilities, referrals, drug company percs and lots more. Compare doctors' incomes in the USA to any other country and it's obscene in the USA. And I'm sure I'm unaware of some of their other advantages.
4
I know this hearing is before the Senate Finance Committee- but if the subject is profits over people - to put it in simple terms - I hope they will also get into the new findings from the internal industry documents that show how, with the help of the FDA- labeling changes on opiods were allowed which, in a large part, aided and abetted the current crisis. Remember the infamous tobacco execs who all raised their right hands and swore they did not think nicotine was addictive......... These guys should be put on the hot seat as well.
I now pay over $60,000 per year for Enbrel to treat rheumatoid arthritis, a severly crippling and life-shortening autoimmune disease if not treated. The drug is made and sold by Amgen. When I began taking the drug in 2001 it cost $12,000 annually. I thought the original price excessive. It is time for congress to investigate, expose, and to end the "your money or your life" pricing that has become prevalent in the case of many life-saving drugs. it is too bad that drug prices have to be regulated, but it's clear that the industry formerly known as the "ethical drug" industry no longer has any sense of ethics or social responsibility.
3
Let's hope that the "Tobacco Solution" is not the same as the Tobacco Solution. Too many states let the tobacco industry off with a wrist slap in exchange for hefty windfall bonuses for the states and taxes on tobacco products that states increasingly rely upon to meet their budgets--meaning these same states will never be able to maker any meaningful attempts to confront the dangers of smoking. A win-win for the tobacco industry. If the states sue the Pharmaceutical Companies to recoup a portion of the money they paid for overpriced medications for Medicaid recipients, they will declare this a big fat victory--and Pharmaceutical companies will continue to price gouge, with the blessing of states which know that they can turn to these companies whenever they are in financial need and get huge windfalls again--because Big Pharm will continue to be rolling in money.
1
Things will change for the better when politicians stop taking money from big pharma and the health insurance companies. Until then, big pharma will never reduce prices to affordability. In their for profit world, they want their customers to be sick for a very long time. They don't want us healthy or dead. No money in that.
All this discussion about lowering costs is wrong thinking - we need to triple all the costs.
Before I get into that, if Big Pharma really had their Big Tobacco moment they'd admit their pharmaceuticals kill people. Yes they do. Over 100,000 deaths each year from pharmaceuticals correctly prescribed by MDs in a hospital setting (AMA statistics). Year after year.
Additionally, research by Harvard's Safra Institute (Dr. Light) finds that 90% of pharmaceuticals are worthless, no better than a placebo. They're essentially patenting placebos! No wonder Big Pharma is the most profitable industry group on the stock exchange.
If you throw in avoidable medical errors, those deaths (all are people by the way, not just numbers) jump to 250,000 per year after year, which is underreported. That's the third leading cause of death after cancer and heart disease.
Our deadly healthcare system itself needs rethinking before considering costs. Why would you want to pay less for a system so broken it kills you.
Better that we triple the costs so we'd can't afford it. If you want to live - stay away from doctors and their killing grounds, the hospitals.
(I'm talking about chronic-care that comprises 75% of healthcare costs, not our acute-care, which is the best in the world.)
1
@FourteenAdditionally "research by Harvard's Safra Institute (Dr. Light) finds that 90% of pharmaceuticals are worthless"......A research colleague once told me that antibiotics were only 25% effective because 75% of the people who receive them would have gotten better anyway. But to the point, having spent 30 years in drug research, the above statement is a load of garbage. No greedy drug company would even consider spending $500 million + dollars on something that doesn't work. In fact the reverse is true. A lot of potentially valuable life-saving drugs never see the light of day because of concerns about safety and how their limited use under controlled conditions would affect profits.
2
Dr. Light’s degrees are in sociology and related fields, not medicine and not biology or anything similar. And he emphatically did not say anything remotely resembling “don’t take drugs, they’re worthless and dangerous.”
He said, and said very clearly, that the increased efficacy of the NEW drugs was well and truly open to question. The new lipid drugs are excellent examples: only about 10% of patients show improvement over older, cheaper drugs. You wanna complain about that—and you should—go for it.
So what axe are you grinding? Naturopathy? Megavitamins? Scientology?
Now THERE are some money-making scams that could use a little fresh air blowing through feom good clinical studies...
1
@W.A. Spitzer
"No greedy drug company would even consider..."
Sure they would. They do every day. I've seen them do it from far above the narrow perspective of a lowly researcher.
Just have to get through P3 testing and onto the market. And to do that, simply need to be a few percent better than a placebo or existing drug. And that's easy by jiggering the data sets and experimental design until it fits. Then they throw out all the results that did not work out for them. If your first cohort did not work, get another. If three months of data do not work do four, or two. The FDA and their revolving door gives them the stamp of approval. Now you got a Blockbuster. Stock shoots up and you print money. They do it every day.
2
The powers that be like to tell themselves (and us) that 'capitalism fosters innovation via competition', and yet this system is designed to prevent competition and stifle innovation. So, our illustrious leaders are lying through their teeth yet again. Big surprise!
3
It is easy to demonize Big Pharma but a lot of this demonization comes from ignorance of history. I strongly recommend an excellent book about the discovery of sulfa drugs “The Demon Under the Microscope” by Thomas Hager that documents, in stomach-churning details, what it was like to die of a scratch, burn in childbed fever, or rot alive with gas gangrene. Sulfa drugs were discovered when a big German pharmaceutical company “I. G. Farben” poured huge funds into creating and testing thousands of chemical compounds. And yes, the same company was put on trial in Nuremberg for manufacturing poison gas, so real history is much less tidy than our conventional narratives of vice and virtue. I don’t want medical research to dry out for lack of investments. I want anti-aging drugs. I want new antibiotics. I want new anti-cancer vaccines. All these things cost a lot of money, and somebody has to pay. This does not mean that some of the measures proposed in this article should not be implemented. But beware of throwing the baby out with the bath water. Modern medicine is the greatest miracle in the history of humanity, and I don’t want it jeopardized by populist demagoguery.
4
I remember the tobacco hearings 25 years ago and I remember that when the Republicans retook Congress they apologized to the tobacco executives (upstanding citizens selling a legal product in our free enterprise system) for their treatment at the hands of the congressional Democrats.
Why would anyone expect anything different from Republicans today?
6
Better late than never! Limiting price gouging, etc. will help. But we are facing a self-serving association on the scale of our military-industrial-complex. The pharmaceutical-medical care and research-academia-complex (or whatever you want to call it) is thriving, largely at the expense of the working poor. They would fair FAR better if the wealth and resources of society went toward public services, basic nutrition, disease prevention and protecting our agriculture and our environment, rather than toward corporate medicine and other needs of the educated/professional class.
4
Why do I, again, get the impression that our elected officials will go through the motions of a dog-and-pony hearing where Big Pharma will give the same old tired excuses and Congress will settle for the status quo? Has the Committee done its homework by studying what other countries pay for specific medications compared to what we pay? Have they studied the structural differences in healthcare/pharma systems that come into play for such cost differences? At the very least, the Committee should ask Big Pharma to explain how other countries pay far less for the same medications and to tell us what we need to do it have comparable prices. Will that most basic question even be raised?
5
Let’s not pretend that drug prices are some outlier in an otherwise prudent and fair healthcare system. America has a free market healthcare system. It costs twice as much as any other developed nation’s healthcare. That’s because having for-profit healthcare is obscene. The entire system needs to be dismantled. It’s not the drug prices, it’s the capitalism.
251
@John Ranta
What's so great about capitalism (not to be confused with markets) is that it can be manipulated to favor corporations and the rich. It really is the best system to accumulate wealth, money, and power - but for corporations, not the People.
The People's money, wealth, and power is what gets Hoovered into the capitalist's off-shore accounts.
These capitalists want you to believe they create the wealth.
No, it's the People who create wealth. The capitalists then steal it from us and say they made it.
We are the Makers, they're the Takers.
19
@John Ranta
If it just cost twice as much as top-ranked UK that would almost be okay. But it's also ranked dead last in the developed world. And below Costa Rica in the all countries ranking.
Remember the above to throw back at your MD (Malpractice Doctor) when he gets arrogant.
7
@John Ranta
John, you misunderstand what has happened here. What we have is far from what you claim to be a "free market healthcare system," and certainly not free market capitalism run amok. Rather, it is the worst of crony capitalism: patents stifle competition, politicians have been bought off by the drug and healthcare industry to create roadblocks to competition. Moreover, Medicare has been barred by congress from seeking the lowest price, but must pay for drugs of marginal value at full price without the ability to negotiate for lower prices. The FDA, with the blessing of Congress has encouraged advertising that goads the public to pressure doctors to prescribe costly drugs of little, if any, value. Our healthcare system is a Frankenstein created by Congress and the FDA. That's where the obscenity lies!
19
It is far past the time to talk, it is time to take action. The American Health Care System is broken and produces the highest costs for mediocre results in comparison to other western countries. Congress do your job for once and produce reform for the greater good and not for special interests!
4
There are a few problems with the automatic demonization of "the greedy Big Pharma companies" (where I worked in R& D for quite a while.) The problem is that about half of the arguments against these companies are legitimate and have real merit, while about half of the arguments the companies use in their defense are just as legitimate. The other half of the arguments against the industry are mostly based on misconceptions about the industry, about patents, and about R&D costs. The other half of the arguments by industry in their defense are unfortunately just the kind of arguments that a rapacious industry would use to justify activities that can't really be justified. Do taxpayers fund the basic research that underlies many very beneficial pharmaceutical products? Yes, but that just brings such potential products only to the starting line where the really big costs are incurred and really big risks must be undertaken. Is the patent system abused by companies extending protection on some trivial product "improvements?" Yes. But patents covering the initial discoveries may often expire before a commercial product can reach the market after a decade or more of the arduous and expensive development process. Do pharmaceutical companies spend as much on advertising as on R& D? Yes. But it doesn't have to be this way. When I went to work in the industry, direct-to-consumer advertising (those much-hated TV ads) was forbidden. My point: It's not so simple.
1
@John....I also worked in drug research for a major pharmaceutical company for 30 years. I am in complete agreement with your post. There is one correction I would make. Drug companies spend more money on marketing (MARKETING) than they do on R&D, but advertising to the public is only a small fraction of the marketing budget. However, I agree completely with the conclusion that marketing directly to the public should be eliminated.
2
These questions are easy to answer. Why do all of these things happen? Because they can get away with it. There is no rationale, no justification for these horrific prices except, we do it because we can.
For some reason, Americans keep clinging to this romantic notion that the healthcare industry is some kind of a humanitarian activity that exists to help people in need. No it is not. Healthcare is a profit centered business that exists to make as much money for itself as it can. It's all about the money. Always was. If they can get away with charging 100 times what they do in Britain, they will.
The excuse that the money is needed for future drugs is just that. Do we really need all of those drugs? Why do they advertise sophisticated cancer drugs on TV? To get desperate people to make their doctors prescribe them at high profit.
The drug industry operates no differently than a cartel. This cartel wears lab coats and has bought off the cops, the FDA and Congress.
What I would do is open up the US drug market to foreign competition. Let people get their scripts filled overseas. Amazon already has the pipeline set up. If that reduces the number of new drugs on the market, great! We would save so much money that university and government scientists would have ample funding to develop truly lifesaving saving drugs the world needs. And the world would be able to afford them.
269
@Bruce Rozenblit
Right on the money as usual. I would add that the pharmacies are doing the same thing these days, by pushing the consumers to get multiple months supply of drugs at once--and if your prescription changes you are stuck with hundreds of pills that you have pad for and will now have to dispose of, hopefully not down the drain. I have stopped using my local CVS over this issue--only to find that Rite Aid is doing the same thing. I was told that the insurance companies "require this." So many job creators ...
19
@Bruce Rozenblit
" .. Let people get their scripts filled overseas .."
You must be joking. In China, patients have been killed by poor quality pharms.
The wrong pharm can kill you. You want cheap, be my guest .. just don't expect me to pay for your mistakes and errors.
5
@Bang Ding Ow
Europe is also overseas.
30
Many of the most impressive and helpful drugs were almost entirely developed by research for which we all paid via our taxes.
Big pharma then takes this tax supported research and patents it and sells us the results at steadily rising prices.
They also work overtime to make sure that when the patents on their medications expire , no one will be able to offer the drugs at a reasonable price.
Many of the medications that they are pushing, for they are drug pushers, make no mistake about that, not only have horrible side effects, for which they will give you even more drugs, but are not even helpful for what they claim they do.
A prime example are statins which are so horrible with side effects especially musculoskeletal issues, that patients cannot tolerate them.
Yet the very issue they are touted to treat, cholesterol elevation, has little if any proven relationship to cardiovascular disease.
The drug companies sponsor research that creates the mythology of "diseases" that were never a problem in the first place so we will take their drugs until we die.
If we are dying then they have a drug for that, too.
I write all of this as a physician who has steadily seen the drug and insurance companies over the years strangle the medical system in their greed and need to wring every last dollar out of us so their investors will grow even richer.
These people have so many skeletons in their closets that the doors are about to explode.
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@simon sez
Fact: U.S. govt does NOT pay for clinical trials required before pharms are issued to public.
Fact: the failure rate of basic research in clinical trials is 90-plus percent.
Basic facts that real medical doctors know. Then again, on the Web, no one knows if you're a dog.
7
@simon sez
As to side effects, there's a reason Public Citizen recommends not taking a new drug for seven years - only then does the real (as opposed to what the drug company chooses to reveal) side effect profile come clear.
4
@simon sez..."Many of the most impressive and helpful drugs were almost entirely developed by research for which we all paid via our taxes."....This is a total misconception. Before the gasoline engine goods were delivered by horse and wagon. Imagine basic research as the horse and applied research as the wagon. Taxes do indeed support basic research, the horse. But without the applied research, the wagon, not very much would ever get delivered. And sometimes a good wagon will cost several times more than the horse.
5
Here is my most recent experience with a needed prescription of Nexium.
I called the five major pharmacy chains in my area to compare prices. For a 90 day supply of the prescription the cash cost (no insurance) ranged from $324.00 to $575.00. That is 90 pills
I ended up having the 90 day prescription broken down into 30 days at a time.
A friend told me I should call a Hospital Pharmacy and see if the cost would be any different.
I then called a Hospital pharmacy. The cash cost was $50.00 for the same 90 day supply. I had my prescription transferred to this pharmacy.
When I returned home I compared the bottles. Much to my surprise, both prescriptions came from India and were distributed through two different United States companies..
Astra- Seneca is the Company that has the patent. They are a Swedish Company.
So this begs the question. How can Nexium (prescription generic formula) be so far apart in price? And why are the major drug stores allowed to charge these ridiculous prices? And furthermore, how come they can buy from India, but we are not even allowed to buy from Canada, our next door neighborhood.
Something is really rotten.
3
@Jean...If the drug is made in India it is very likely off patent and generic. There is nothing to prevent you from buying the drugs you need from Canada. But remember, the U.S. is ten times the size of Canada. There is no way the drug companies are going to sell Canada ten times more drug than they need so they can resell to the U.S.
@W.A. Spitzer
The 30 day supply that i got from a CVS pharmacy was also generic and it cost 116.00 for 30 pills as compared to the 90 day supply from the hospital pharmacy. Both were generic from India.
I just question that the CVS company has to charge such an outrageous price for the very same medicine that I got a 90 day supply of for $50.00
The medication my son needs to walk went from free to more than half a million dollars after it received FDA approval in November. My son has a rare neuromuscular disease called LEMS. For decades LEMS patients had been receiving an investigational drug called DAP for free under an FDA compassionate use program. Another company, Catalyst Pharmaceuticals bought the US rights to another lightly modified version of DAP and recently won FDA approval. Little risk and zero innovation on Catalyst’s part. Now it to charge whatever it wants for it’s Firdapse. Drug makers must be forced to justify their prices.
These companies spend far more on marketing than R&D. We can lower their costs for them.
Ronald Reagan got rid of the ban on advertising prescription drugs on the grounds that patients had a right to know what was out there. We now have the Internet. Reinstate that ban, while allowing companies to describe on their pages (and thus findable by search engines) every drug they make--but require them to post with each one every single finding from the studies that got those drugs through approval and every follow-up finding since. Let the patients who want to be informed be truly informed.
When I was on an experimental med to save my life I had to read and okay everything, every lab rat that sneezed. Once that med got approved, all of that information vanished, and how would patients know the risks they were taking? All they get now is the price hikes. That's wrong.
My suggestion will also help with the tort reform the companies are always arguing about: the patients will bear some responsibility for knowingly taking the risks of each drug.
I have no doubt that Congress and the big pharmaceutical companies will put on a wonderful show of strong arming by the Congress and contriteness from the pharmaceutical executives. Much will be said about controlling prices, unfair pricing, the high cost of research for new drugs. Then everyone will go home and nothing will change. Excuse me for being cynical, but I have seen this rodeo before. I watched tobacco companies work it for years before law suits got the best of them. The same will have to happen to the big pharmaceutical companies. Unless lawsuits brought by citizens cost them real money, they won't change, and Congress won't do a thing. Both are making way too much money on this game, and we are paying the toll.
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@Patrick Stevens Lawsuits won't work against companies that don't do anything illegal. This is a policy and political issue, and instead of putting on a show with the hearings, Congress should regulate pricing, or at least allow Medicare to negotiate prices.
21
@Larry Figdill Seems to me false advertising would play a part in this. My insurance company just got through paying $10,000.00 a month for two of the new "miracle" drugs for the treatment of stage 4 lung cancer. All I see on TV are smiling old folks playing with their grandkids while the soft music plays and the side effects are orally listed for a couple of minutes. All these drugs really do is pick our pockets and allow the cancer to kill more slowly. No a whole lots of smiling in that!
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@Patrick Stevens
Of course. The Pharma execs actually understand their business. The congress-people don't. Few (if any) have done the extensive homework necessary. In testimony, put up someone who knows the businesslike the back of his hand against someone who just glanced at a briefing paper on his way into the room? Guess who wins?
What's needed is an investigative commission with subpoena power that can hire knowledgeable people who can devote the time necessary to dig into the unholy mess that is drug pricing. It will take a year or two, but the results will be worth it.
4
I have worked in the drug industry for almost 35 years. I used to be very proud of this industry for things like the response to the AIDS crisis and the advances in immuno oncology which have or will save millions of lives. But when I see what happened in the insulin market over the past ten years I am ashamed of the industry. When I started in the laboratory the drug companies were mostly interested in science and innovation but starting around 1990 things changed and they became extensions of Wall Street with MBA running the companies instead of scientists. The MBAs are really only interested in one thing and that is growing earnings. They have no dedication to their customers, their employees or their home countries. Of course, the same can be said of IT and most other industries today. Price controls are needed but I hope that they are applied smartly so that new drug development is not harmed.
3
Asthma inhalers with CFC were banned in the US after considerable lobbying by Big Pharma under the false pretext that the CFC content was dangerous to the atmosphere. The quantities are so minuscule as to be completely insignificant.
Using this pretext, generic albuterol with CFC was replaced by albuterol HFA formulations under patent. Prices at least doubled and for many asthma sufferers the HFA formulation is far less effective. Profits first, patient care last.
3
Xarelto, that bloodclot-preventing pill Arnold Palmer pushes on TV, is a modern replacement for Warfarin, a blood-thinning pill "derived from rat poison," to quote my cardiologist.
My friend in Mexico, with a history of strokes, pays $2.50 per pill over the counter down there. Those pills are imported from Bayer in Germany.
She eventually made her way up to the States and got her American cardiologist to prescribe them here to get her insurance to pay for them. The EOB for the "American" Xarelto bills her insurance at over $7 per pill. The bottle containing the pills states, "Made from components manufactured in Germany." The difference is sucked up by the pharmacy distribution system and the PBMs involved.
1
don the con has made hundreds if not thousands of claims, distortions, and outright lies about the border and is now trying to grab $8B for a useless wall.
Meanwhile ALL Americans and American companies which provide health care are being gouged by pharma pricing strategies that are at best idiotic and at worst evil and destructive to the American economy.
clearly this administration's priorities are lunatic
Corrected: Pharmaceutical companies have been raking huge profits during past 20+ years. Prior to that they were still making money but probably not that much as evident in the share prices of their stocks.
Pfizer's share prices followed a fairly typical path as those of others. In 1972, it traded, split-adjusted, under $1. It didn't rise for about 10 yrs. It crept up then to reach $2 by 1985, then to $3 by 1990. Soon it reached $7. It split for the last time as 3 for 1 in 1999 when the share price zoomed to $50! It stayed around there for a few years. Then it dropped to reach about $20 by 2005. It even dropped further. After several more years of trading at or below $20, it gradually crept up, somewhat steadily to pass $30, then $40-43; it hasn’t yet reached the peak price of 1999.
The balance-sheet of Pfizer is excellent: Revenue $53.6B; gross profit is $42.5B, i.e., the cost of their products is only about $11B!? Net profit margin >20%, some 4-fold of average Fortune500 companies. Their R&D budget is about $8B https://www.marketwatch.com/story/pfizer-to-raise-rd-spending-to-bolster-pipeline-2018-07-31
Who benefited from the exorbitant prices of drugs patented by Pfizer? Not stock-holders; many must have lost money. The CEO is not making that much more. Many Drug-reps have lost jobs during mergers & acquisitions.
The extreme contrast between Pharmaceutical and Airline companies illustrates how distorted capitalism can be, operating in the same free-market mode.
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ask Corey Booker why he supports these pharmas? Is it because many are located in his home state of New Jersey or because they give lots of $$$ to his political war chest. Booker smells bad.
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I am growing weary of outrage. Tooth and claw. Devil take the hindmost. Predator and prey. Wolf and sheep.
It is a Republican Senate. Hypocrisy rules. Nothing will happen.
Tobacco causes cancer, Bio techs are curing it. Gilead paid about 11 Billion dollars for Kite Pharmaceuticals in order to improve their blood cancer drug pipeline, How much would you like them to cut their prices on drugs they already sell? Do you think Chuck Grassley or Ron Wyden is qualified to make such an assessment? Can they cure cancer?
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Two problems: greed and Congress. Maybe add in the presidents!!. Party doesn't matter here.
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Over Weight.
And while you are at it, why not ask the Hospital orgs about the fat profits?
Half the time I see a bright shiny, ultra-modern building going up its a medical building & I think "Yep. There's my insurance premiums going towards another not so necessary building.
The entire US MD system is bloated and fat off our $$$$.
Having experienced first-hand how other developed countries manage better healthcare for far far less money, the US just might implode under its own weight.
Make that Over Weight!
1
The pharma industry has saved lives and made remarkable progress because there is the chance that if successful there is a payoff. Editors at the NYT and their ilk wishing for drugs in the absence of significant returns are foolish. I work in the biotech industry and have lost my job several times because my company ran out of money due to the risk and cost of drug development. One of my companies just got its first product approved, after 15 years of efforts, multiple failures and $1B in investment. First year sales are less than $10M, and it will take several years to be about $200M per year. You don't know what you are writing about and you risk lives by doing so.
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@No
There is no question that successful drug discovery efforts should be appropriately rewarded. Without such incentives their would be no important clinical efforts made to develop drugs for rare disorders. However, there is no reason these important considerations cannot be fairly covered under regulations that prevent price gouging.
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"What the market will bear", used as the excuse for inhumanly expensive, and inhumane, drug prices, is simply raw greed, nothing more. That the U.S. Patent Office colludes with these companies to wall off competition (used to bolster their greed) is, in itself, WRONG, and should be revised in LAW.
"Do no harm' has NOTHING to do with the ROI these thieves expect. They need to be chopped down, in no uncertain terms.
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Having had the need on occasion to purchase pharmaceuticals in Europe and India at a fraction of the cost that I would have paid here, I've often wondered why the US consumer must fund the cost of R&D for drugs that the rest of the world will purchase at a fraction of what they will cost in the US?
The Pharmaceutical companies in the US have displayed for decades conspicuous greed in pricing at the cost of the health of very many in this country who could just not afford them. It is immoral and just plain wrong.
@Mike US Consumers contribute disproportionately to pharma profits, but that's just one part of the picture.
Biotech R&D is concentrated in places like Belgium, which have excellent tuition free education with a high STEM output and colleges with government funded fundamental research.
Speaking of education, a big chunk of physicians in the US were trained for free by foreign countries before they came here to make the big bucks.
Considering that Big Pharma pays more money to politicians and has more lobbyists handing out campaign "contributions" I don't expect anything but softball questions and prepared answers. Wii anyone from Purdue Pharma or the Spackler family be testifying? They're responsible for almost the entire opioid epidemic going on today. I expect prepared answers, 50 or 60 lawyers and a lot of lawmakers thinking about those fat checks.
1
Like with tobacco, drug companies should be banned from running any commercials on TV. Pretty obvious that's where their money goes and not to "research and development."
Anyone who watches any TV can attest to the mountains of drug ads proliferating for the last decade or so. Those ads should not be aimed at the public. Drug advice should be given by doctors to their patients, not from endless expensive ads on TV.
Why did the NYT ignore this topic? I hope the senators don't.
Greed, greed, greed, it is that simple.
Proof in the insane profits of the drug companies and I am sure the executive compensation does a great job of placing those executives into the top 1%.
Control the drug prices. Clean up the patent laws. End advertising of any kind for drugs.
Another question to ask is: What are the top salaries of your CEO's and Executive management?
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@freshginger....And that goes for all CEO salaries not just those of the pharmaceutical industry. If actually practiced capitalism would pay CEOs the minimum required for the value of their contribution. CEO's and the corporate board system more closely resemble a feudal system where the lords of the manor take as much as they can get.
What about the obvious question: Why can you sell drugs in other countries for so much less?
Forget about “getting answers” the pharmaceutical are paying corporate lawyers $900 an hour to compose “answers” for its theft. Our lawmakers need to enact laws and impose tax sanctions on these companies,that are abusing the most vulnerable people. They can start by outlawing patent manipulation. They can continue by revoking patent protection given to companies that abuse this.
Banning medical advertising would go a long way to lowering drug prices and self diagnosing.
As evil as drug companies are, they are still better than banks. They at least make products of value that do save and transform lives. Unlike banks that just steal.
I can guarantee that if drug prices collapse, innovation will grind to a halt. Biotech sector will tank. Businesses that rely on the hundreds of thousands and millions of families that rely on a paycheck from those industries, will suffer and Congress will have to answer that. Jobs in NYC, NJ, CA, Democrat strongholds, will be lost.
The problem is Americans subsidize low drug prices for the rest of the world. Just like we subsidize their military costs so they can all have nice lives while we suffer. But part of Trump's plan is putting America first, make other countries put in their fair share. And on drug pricing, Trump has a lot of allies in Democrats oddly enough.
Definitely the marketing and advertising are a complete waste. If that can be cut so prices can go down, that would be great.
But we have to get out of mindset that drug insurance is for expensive, life-saving drugs. Drugs like statins, diabetes, are really cheap, pennies, as they should be.
“Drug prices are soaring in a way that defies reason.”
To the contrary, the reason drug prices are soaring is obvious. The market will bear the price increases. Pharmaceutical companies cannot be expected to or shamed into foregoing enormous profits when the market allows them, and Wall Street rewards Big Pharma for the price increases. There are only two solutions; aggressive regulation of drug prices, and/or allowing the federal government, the only entity with sufficient bargaining power, to bargain down drug prices.
Nothing will change until our Federal Government is allowed to get back on it's feet and it's employees are given the political tools they need in written policy to negotiate (regulate) prices for all drugs.
Until we vote for leaders, be they R or D, who will work on behalf of all Americans, not just the wealthy top tier who are truly the ones who own the lock on current free market pricing while guarding their golden keys with ruthless behind the curtain back room deals to lobbyists, Pharma, big and small, will continue to pile up the cash and the influence at everyone who needs healthcare's expense.
For me, the problems begin and end with both parties playing the American people for suckers when it comes to finally accepting the fact that the US needs some form of Medicare for All, universal basic coverage and care. A rare few do get it. For Pete's sake. If poor LBJ was able to enact Medicare and FDR was able to give us Social Security, the least we can do is bring ourselves up to developed world standards and enact a basic universal medical coverage system. The money is most certainly there (hidden away in these corporate and Pharma windbag's tax havens) and I challenge anyone to say it isn't. It is.
Time for Pharma to face the same cost scrutiny the rest of the developed world faced and managed to survived long ago. We're just twenty years behind schedule.
It's not just high prices. It's concocting studies that are "legitimate" in the eyes of the FDA, but are actually a scam. It's called relative risk v. absolute risk.
The best example is statins. Pfizer alone has sold over $110 billion of Lipitor. The company claims that it reduces heart attacks by 35%. So Average Joe assumes that instead of 1,000 heart attack victims who took a placebo, there would be only 650 heart attack victims who took Lipitor. Far from perfect, but a huge reduction nonetheless.
But what it actually means is that 1,000 people are given a placebo over a certain time period and 35 have heart attacks, while 1,000 people are given Lipitor over the same time period and 23 have heart attacks. The math? (35-23)/35 = 35%+/-.
So for 2,000 people, there will be (allegedly) 12 fewer heart attacks, not 350 fewer heart attacks.
In my opinion, the methodology is an absolute disgrace.
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@Erik....Except that the protocol of the clinical trials and review of the data is controlled by the FDA; and whether you want to believe it or not, the FDA is rigorous and independent.
Congress controls the patent laws which permit Big Pharma to price as it does.
Americans who lobby for a sane health care structure are routinely labelled "socialist". Few politicians care to incur the wrath of any wealthy and powerful interests.
As for Actimmune at $26,000 per month; the important question is not the "Why?" which the public may ask. It's the "Why not?" which the board of directors and executives of the manufacturer ask when making that decision.
There are all natural outcomes and perfectly legal under the laws which Congress has chosen to rule America.
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Cost of Insulin continues to rise.
Conclusion.: There must be no competition, rather a cartel sets prices for insulin.
Insulin is still under patent protection. After one hundred years of production? Why is this possible? Collusion between big drug manufacturers and national leadership, both civic and governmental?
One solution is to forget the latest patent tweak and just offer to buy an earlier version that is no longer under patent protection from the generic manufacturers.
Comment. It is tough to negotiate lower prices with a cartel since their purpose is to keep prices high.
So, look for an alternative solution. Such as government spending that funds a federal laboratory to foster new competitive drug manufacturers making low priced insulin. The cost of today’s insulin is most likely so high that it would be worth spending a few billion to accomplish the following:
Congress would enable a federal lab to issue Requests for Proposal, RFP, to the general market requesting development and construction of a low cost insulin manufacturing line. The lab would award contracts to more than one contractor, with the stipulation that the contract requires the contractor to build a certified operating insulin production line.
Once such entities are up and running, drug purchasers could submit offers for purchase of large insulin quantities in the realm of an auction market.
Talking to drug companies is a political dead horse Find a new horse.
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Unregulated health care costs driven strictly by the profit motive. Welcome to the USA.
4
Greed rules the pharmaceutical companies just as greed rules our entire health care system. Greed rules Wall Street investment firms that develop new ways to make money that stand to have the same impact as real estate investment did when it caused the last recession. Greed rules the oil companies which is one reason why we haven't made greater advancements to reduce Global Warming. Capitalism and profit are great; however, it needs rules and regulations to control greed and unbridled profits. Every sport needs rules to keep the game fair. Capitalism is the same.
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@Linda Bell I agree. Just like big oil, insurance companies, Wall Street, Energy, weapons manufacturing etc., pharmaceutical companies are unlawfully organized.
Their joint lobby forces buy political power through campaign financing, which results in deliberate government inaction against obvious price fixing (e.g. lockstep price hikes of insulin), a lack of central price negotiation, insufficiently available generic drugs, no Chinese wall between prescribing doctors and drug companies etc.
Without tackling the root of most problems in the US, money in politics, a push against rising drug prices is Sisyphus work. There will always be politicians ready to bargain with the devil, to get money for (re-)election.
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As a person who did for two years have a tier exemption to help with the cost of a drug I in particular need, I went to Humana Clinical Pharmacy review board as to why I was refused for 2019. Humana blames Medicare:
"This application was denied because Medicare Prescription Drug Manual rule (Ch.18, Section 30.2.1) says that because there is no lower cost brand name or biological drug for my condition on my plan’s formulary (drug list), you don’t qualify for a tier exemption."
Can anyone make sense of this? It sounds like a rule lobbied
into being that grants a monopoly pricing just because they are the only ones to make this suitable drug. Why would Medicare promote this ruling?
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It's like a junkie and his connection, when you have to have it you will pay anything. 1. Their advertising costs are many times their development costs. 2. Many drugs are developed with government grants, and the government does not take its rightful snare of the profits. 3. There is the same rotation of government employees to industry as the defense department. 4. They have legislators in their pockets.
They have had their chance. They need to be regulated. But, who will stand up?
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This discussion is starting at the wrong point. The implicit assumption is that pharma drugs are critical and are the only avenue for treatment of medical conditions; they are not. There are people who actually do need them, but anyone with a chronic (versus urgent) condition will be harmed by pharmaceuticals that are taken long term. Pharmaceuticals do not address the cause of conditions; they only address symptoms. If you have scurvy, you take Vitamin C, not some pharmaceutical. If you have beriberi, you take B vitamins. You don't cure high blood pressure by taking a drug that slows down your heart. Furthermore every pharmaceutical, being synthetic is toxic to the liver. That's why longer term use of these drugs is harmful if not deadly.
If we want to lower drug prices, let's eat nutritious food and take fewer drugs. I take none and am healthy.
Yesterday, I found out I will not receive a sufficient cost adjustment for a drug I have taken for 10 years. It started out at $15 a month. Now it is priced nearly $1000 per month and my insurance company, who lied to me before I signed up with them this year, say they cannot lower the price beyond $150 per month. On average, my insured price is ten times the original price -- I can't afford it. Now I will have to use the generic, which I know from past experience, does not work as well. More money, lower quality life. On YouTube, find some of economist Dean Baker's suggestions to control rising pharmaceutical costs.
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The op-Ed didn’t mention the expose on 60 Minutes last night of the opioid addiction crisis caused when the FDA knuckled under to Big Pharma to add a few words allowing opioids to be used forever and anywhere for chronic pain.
After champagne toasts in pharma board rooms they went on aggressive marketing campaigns to get doctors to prescribe them for everything from ingrown toenails to itchy scalps. Result: the opioid crisis Trump promised to fix and billions to big pharma.
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Several commenters have suggested that the federal government, through grants to universities, pays for the cost of drug development. This is fundamentally incorrect. Basic research carried out at universities, medical schools and research institutes will often reveal important biological signaling pathways and potential drug targets. Much of this work is funded by the NIH. However, detailed drug discovery and clinical trials are performed by pharmaceutical companies. This is phenomenally expensive and most potential drugs fail to reach phase 3 trials, where final efficacy is determined. This does not justify the many tricks used by pharma to charge exorbitant prices or chemical tricks to extend patents. Nevertheless, an informed discussion requires an honest accounting of the cost of drug development.
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Well said. This is a great answer to at least one of the many problems relating to the high cost of pharmaceutical products. Most people are poorly informed on this topic.
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Again the core problem is money in politics, why are drugs bought overseas cost much less than the same drug bought in the USA. The opioid problem was the result of greed and money as political oversight was absent as drug lobbyist pumped money into politicians cofers. Seniors unable to cover the co-pay for drugs as social security of $800 per month is not enough to cover rent and food let alone chronic illnesses requiring drugs to stay alive. Billionaire drug company owners and ceos' are making more money than ever and Medicare is unable to negotiate pricing as a deal was reached by politicians that would prohibit any such negotiations as the VA does. Time to act and stop the spin that feeds their campaign coffers .
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As an engineer who has worked in pharmaceuticals and other industries I can you tell you that waste takes on a whole new character in pharma. It's the only industry in my field of chemical engineering where waste is ignored so completely. "Pass it along to the consumer," that's what I was told.
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@Rocketscientist
Interesting comment.
I don’t presume to mind your business, but has it occurred you that an essay or a book revealing specific cases of the waste you mentioned might help us in our efforts to restore our health care system to sanity?
Just a thought.
Thank you for your comment.
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Agree, agree. When I first read the title, I thought the editorial board was going to call to task the Sackler family for continuing to promote Oxycontin even when they knew the addictive nature of it. The outcome of the aggressive pushing of this drug has left hundreds of communities at the brink of bankruptcy, let alone the extensive loss of life due to former oxycontin users turning to heroin to stave off the withdrawal from the opiate that was originally prescribed to them legally by a doctor. When does the Sackler family get called by congress to answer for their negligence? The amount of money that is being spent on emergency services is decimating communities across the country. A "tobacco lawsuit" of the Sackler family should be funneled into drug treatment programs and to all the communities that are spending millions to fight the tide of overdoses that now have outnumbered the U.S. soldiers we lost in Vietnam. When are they going to be held accountable?
2
Excuse me while I don't hold my breath. A topical medication that only worked so-so and cost me about $8 a few years ago is now $175. I don't use it any more. Another medication that was $400 per year for several years is now $24,000. Needless to say I can't afford that now either. Too bad the replacement drug doesn't work very well. And that's just one person. With prices like this, Big Pharma ain't gonna budge. Congress will do their shrugging thing while they get Big Pharma checks in their mail box, and we're all over a barrel.
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Their "Tobacco Moment"? What exactly would that be? I don't think that the tobacco companies had a tobacco moment, so I have no idea what you have in mind. How many tobacco companies have been held liable for the deaths that they caused? Doesn't tobacco still cause 450,000 or so deaths a year in this country? And what about vaping, billed as a healthy alternative?
A tobacco moment would be a complete ban on all tobacco products, including vaping. Tobacco is and remains the only product that, when used as intended, may well kill you. How come tobacco products are still available at all?
A ban--THAT would be a tobacco moment worth having.
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The problem is that many aspects of healthcare are fundamentally incompatible with capitalism.
Injured and sick people often need care right away and sometimes even without their prior consent, which creates a situation primed for abuse.
All other Western countries understand this.
The US is like a wrong-way driver wondering why all the other vehicles are in the wrong lane.
There is no need for a tobacco moment. We need to expand Medicare and let private insurance evolve naturally to a healthcare extension providing things like a private hospital room or repatriation from abroad when injured.
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Our leaders have been complicit in this gouging for years. Congress and the presidency have been controlled by both parties entirely at one time or another in the past decade. Neither party did anything about drug prices. Neither party did anything to speak of about many things the American people have indicated they want addressed.
It is a bit childish to think that high prices are anything but greed. The pharmaceutical companies have influenced enough politicians in both parties to protect their huge profits.
We are not in this predicament because our leaders have been working for the people. We are here, in this place, because they work for the wealthy who have the money to buy them.
I know there are some like Wyden who are on our side, but they are too few in number.
Today’s pharmaceutical companies are a modern day pyramid scheme. Much like others, the Sachs family, makers of Oxycodone, pushed the narcotic like candy, giving doctors kick backs for writing prescriptions and rakng in cash that did nothing for health but a great deal for personal wealth. The same can be said for other big pharma companies who are less drug manufacturers and developers and more like drug pushers and patent trolls. Patients pay the unjustifiable costs at the bottom of the pyramid and investors and CEOs at the top reap the benefits.
Will this change? No, because members of Congress are beholden to pharmaceutical companies and their lobbiests. Elected officials have decided it is much more advantageuos to accept what are essentiaaly bribes to stay in office, or forego the perks and have big pharma fund someone else’s campaign.
This COULD stop if campaign finance reform, which Republicans have torpedoed several times, were enacted AND enforced, rather than being ignored and gutted at every opportunity.
Pharmaceutical drugs almost never address the root cause. Doctors are not trained in wellness. They are trained in symptom alleviation. Most Americans have no idea how to be healthy. The typical doctor knows little about the use of food to heal disease. The idea, which dates back to Carnegie's hijacking of the medical school content, is that we all have a shortage of synthetic pills. Depression: Pill. Heart Disease: Pill. Arthritis: Pill. Anxiety: Pill. Diabetes: Pill. Cancer: Have some Poison. We are a sick nation. I'd say we should all throw our pills down the drain, but then the water supply would be toxic - because our pills are poisonous to the human body, and to the world at large. We need FAR more than lower priced pills. We need a reeducation around health and well being. Until our grocery stores have no sugared waters (typically an entire aisle), we are going to be unwell. Choices.
2
"A new analysis from U.S. federal government actuaries say that Americans spent $3.65 trillion on health care in 2018 ... larger than the GDPs of such countries as Brazil, the U.K., Mexico, Spain, and Canada ... The level of spending is by far the highest in the developed world ... With such a level of economic increase, people will increasingly face difficulty in obtaining medical care ... While spending is highest, the United States ranks 27th in the world for its levels of health care." (Fortune, 21Feb2019) Corner office types extorting money from our society using our health care system.
Equating pharma with tobacco companies is a terrible way to come at this problem. It is true that drugs costs are high. In some cases, there may be good reasons for this. Some drugs are incredibly expensive to do research on and to produce. Some drugs have been available for decades and pharma often repackages them as combinations and drastically hikes prices in ways that are unjustified and harmful to patients. But the bottom line is that pharma is in the business of creating chemicals that save people's lives and/or make them better. Tobacco is in the business of using a natural substance that is addictive and causes cancer, heart disease, etc. Editorial board loses credibility by making this analogy.
@EZ, Agreed. It's a false equivalence, and a few bad players are being used to tarnish an entire industry. Most lay people seem to equate the development and manufacture of drugs with the manufacturing of anything else, and nothing can be farther from the truth.
I have two basic suggestions:
First, repeal that ridiculous prohibition against government competitive bidding for Medicare covered drugs. That, by itself, will result in dramatically plummeting prices.
Second, prohibit campaign donations from patent holders. They pay and politicians play - with our lives and health not even thought of.
2
Tobacco advertising in print and on TV was a huge source of revenue for media. I assume the same is true for prescribed medicines, given the plethora of such commercials and the ad pages in publications. I have seen very little media coverage of this issue, despite fact AMA came out against direct-to-consumer advertising two or three years ago and New Zealand and US are the only developed countries that allow it. How about an editorial or article or op-ed or column on the cost (in the billions, I believe) of direct-to-consumer advertising?
1
Ike could have said, "Beware the pharmaceutical industrial complex". Or any of the other "industrial complexes" that seem to run the Nation.
60 Minute's examination last night on Oxycotin and the opioid crisis shows the real culprits to be in the industry, not coming across the border.
This state of corporate welfare must stop or the people will rise again. Or they will die. Either way the industries will not have any more customers.
Congress will waste how much time with this charade inquisition?
All the House and Senate need do is pass a law stating that no drug may be sold in the United States for more than its average retail price in the European Union, Canada and South America.
The could do that in less time than it takes for the introductory remarks (read: lies) by the representatives of PHARMA, and still have time to get in 18 holes before it's too dark to swing a club. But that would run counter to the real reason for this "investigation," the grandstanding that will be on display.
Campaign season is only months away and our elected officials will not permit anything to stand between them and the camera.
@Glen Although that suggestion has some merit, if implemented, it would likely result in many drugs being sold only in the USA.
The pharmaceutical industry operates on a lottery model. Enormous amounts of time and money are spent on fruitless research, in the hopes that one successful drug candidate will emerge that can be turned into a jackpot. The U.S. market provides a decent jackpot, and producers are happy to accept much smaller margins in other countries to marginally increase that jackpot.
If you force a choice between (U.S. jackpot + marginal gain) and (U.S. marginal gain + marginal gain), the result in many cases will be to take the U.S. jackpot and give up on the rest of the world. Maybe other countries will accept higher prices rather than lose access. Or maybe they won't, and producers will be incentivized to raise prices in the U.S. even further. It simply depends on the market size and margins for each drug in each reference country.
How much extra is is costing to have some celebrity push these drugs on national TV every five minutes? Turn on the TV, and you are likely to see several brand-name prescription drug ads in the space of a half-hour. It's the same if you open any magazine. My mother takes Xarelto, a brand name anti-clotting medication, for which we were told there isn't a good generic option. Her copay is about $175 for a 30-day, 30-tablet supply. The insurance pays $2,000. To add insult to injury, the high cost of the prescription pushes her into the Medicare "donut hole" towards the latter half of the year, so we have to pay even more once that happens. I would really like to understand why the pharma companies need to charge so much in order to make a profit and why they can't exercise a little cost control instead? How they can possibly justify maintaining high profit margins at the expense of old people living on Social Security, I just don't know.
2
big pharma sells its products all over the world and many firms are based outside the US. a key attraction of the large, wealthy American market is that there are no price regulations here, compared with other markets. therefore, pharma will charge a little more than what the traffic will bear here, essentially forcing Americans to subsidize their international costs, including R&D. how is this different from President Trump's complaint that our allies are hoodwinking America into paying for their fair share of defense expenses? those wiley Republicans want it both ways because they are on the take from both sides, and sick Americans get snookered. imagine the imposition of "Socialist" anti-price gouging drug regulations here, where even Medicare is legally enjoined from pharmaceutical price negotiations. perhaps you would need some strong drug to make such a fantasy seem possible.
1
A number of drugs are used to treat the same inflammatory conditions like Enbrel, Humira, Remicade, Otezla, Xeljanz, Stelara, Cosentyx, Taltz and others. I know about these as I have been on several of them. What is striking to me is that regardless of dosing schedule or clearly different formulation is that the monthly cost is nearly identical for all of them. The cost is obviously independent from the true cost of research (typically borne by the taxpayer through basic research), clinical trial or manufacturing. This would appear to be obvious collusion and price fixing by pharmaceutical companies and the companies managing prescriptions for insurance companies to the detriment of the country.
@Tony The cost of e.g. tax preparation software is also roughly comparable among competing products, regardless of development costs, and despite the fact that the "manufacturing cost" of software is nearly zero. This is because development and manufacturing cost are not the basis of how companies typically set prices in most industries, and certainly not in industries where you are essentially selling intellectual property. Price is set relative to perceived benefit of the product and payor acceptance. If this were not the case, then Microsoft Windows would only cost 5 cents. Of course, if Microsoft Windows only cost 5 cents, no one would bother to develop it or update it.
1
Congress must allow bargaining with Big Pharma for drug prices. An example of how Big Pharma gouges Americans while pricing in other countries is affordable: The brand name drug, Janumet that is used to treat diabetes, cost $500 for a one-month supply in the US but can be bought from Canada for less than half that for a three-month supply. I now spend more on prescriptions than on my car note.
How about addressing the fact that drug companies pay politicians to not do anything about high prices, legal bribery. Oh congress will put on a big show of concern and then vote against any price restrictions. Canadians get the exact same drugs from us and pay much less.
though I am not advocating anyone doing this as I am not a doctor, there are natural remedies for some of our leading health problems that the drug companies do their best to cover up. because they cannot make a profit. What I do and again do this at your own risk is research natural remedies and read what research has been done. Our ancestors somehow managed to cure many problems with remedies they found in nature. And they are out there. Of course it is a risk, but honestly have you ever studied the side effects and dangers of prescribed medications?
I even have cured my cats of certain ailments by holistic means. Going to the vet is horribly expensive and there are websites that offer first hand accounts of using things like organic cider vineagar and colloidial silver and coconut oil,that at least in my uneducated opinion and experience work, and do no harm to the body. I really wish doctors were trained in the use of natural cures, but alas big pharma grabs them young and never lets go of them and profit is everything who cares if people sometimes die or get addicted.
1
I think painting all pharmaceutical companies with the same brush as tobacco companies is wrong...not all companies are guilty of price gouging, and the ones that are should be called out. But to demonize a whole industry based on several bad players is not helpful. About 70% of the drugs prescribed in the US are generic, but this fact seems to get lost in the rush to demonize drug companies.
@Steve
Yes, but the price of many generics has also skyrocketed.
@Grennan.....The two (generic and non-generic) should be considered separate issues. Many of the major pharmaceutical companies do not engage in the generic market.
The editorial board is barking up the wrong tree. The issue is not the tantalizing details of how pharma companies try to maximize profit. Face it, the primary job of any private company is to return shareholder value, and this will continue, no matter what details we know. Rather, Congress should focus on it's role to be a regulator, representing the people of the country. Set the right rules, and industry will respond. All the rest is just click-bait distraction.
4
When most of the rest of the developed world negotiates lower drug prices in their respective countries and the United States doesn't, where do you think Big Pharma is going to make up its lowered profits? Yes, in the good old U.S. of A. Because of the immense lobbying pressure here, our government does not negotiate lower drug prices, and the market's "invisible hand" to ensure competitive pricing becomes more of a "veiled fist" forcing higher prices on everyone. Medicare would be a good place to start negotiating or just legalize Canadian pharmacy prescription purchases.
3
ProPublica, Public Citizen, Worst Pills Best Pills, MedWatch PharmedOUT, Kaiser Health News - are organizations free of Big Pharma's funding/greed. Staffed by ppl passionately dedicated to protecting American public from ravages of Big Pharma. The GOP in Congress (yes Dems too) are "all in" for their benefactors in the pharmaceutical industry. The money flows like water between Congress and Pharma and tributaries flow into the pockets of unscrupulous physicians and researchers. Sloan Kettering is just one of the more recent examples of a high profile doctor making millions of dollars from pharma. Dr. Baselgá never disclosed ties to pharma in his medical journal articles. Patients look to their good doctors to provide the best possible medications. Those same people are dying because of the greed of Big Pharma. Ghostwriters in medical journals, DTC ads, drug trials are discarded & never published because they don't fit the marketing plan or worse proved the drug was harmful or of no value compared to placebo,"me too" drugs - patents that are about to expire are kept ongoing by changing 1 tiny ingredient. CME's paid for by Pharma are nothing more than marketing meetings for doctors to hear a KOL (key opinion leader) give his/her pharma written lecture on their featured drug. PBM's! We must stop the insanity. People will march in the streets soon! Bring Big Pharma into a real congressional hearing. Tobacco was killing people - Congress changed that. Change Big Pharma!
1
Elisabeth Rosenthal wrote about all this price gouging two years ago in “American Sickness. “ Not only for pharmaceuticals and medical devices, but insurance practices, hospital stays, and, sadly, even physician billing.
Now patients can’t afford life-saving drugs, while medical suppliers rake in billions.
Is this Democracy?
Yes, market forces provide some efficiency, but in areas with inelastic demand (as in insulin—patients have no choice), the market becomes a monopoly. The free market does not have the interest of patients at heart.
We need to reconsider the relationship between democracy and capitalism, and the out-sized influence of lobbyists on Capitol Hill.
The job of government is to protect its citizens, not the pocketbooks of Big Pharma.
3
THANK YOU, NY Times!! Another question for Big Pharma: how much money is spent on advertising?
3
Wonderful editorial but I am dubious that a Senate hearing dominated by Republicans will produce anything worthwhile. Please prove me wrong.
3
You wrote: "Industry critics, however, note that a good deal of basic research is funded by the federal government, through the National Institutes of Health, and not by the drug makers."
It should say "...funded by taxpayers,..." It's the same thing, but the average citizen needs this point made often, and with clarity.
Also, since these companies will sing the praises of the so-called free market when it benefits them, why not ask this:
"If the market is the best way to get these drugs to consumers and patients, will you all agree now to never again receive any public support or subsidy from any publicly funded institution, whether that is government or a university? I mean, we'd hate to mess with the market, right?"
Finally, I can see absolutely no reason why any profit should be made off these drugs, or any health care expense. It's disgusting and inhumane.
2
*** The question I would like answered is why these same drugs are cheaper to purchase in other westernized countries?
Why is America footing the bill at the expense of our own people?
Profit does not justify gauging on price. Its shameful
3
We already know that Trump wants to destroy the middle class. Not giving them access to crucial medication is part of his evil plan to ruin our society.
1
@Walter
Unfortunately, that's not too much more unbelievable than the idea that a U.S. president could have a corrupt relationship with Russia.
really, he is not that smart and the gradual destruction of the middle class is merely a handy byproduct of the main objective of enrichig himself and his spawn.
@Grennan The problem with your comment is that he's a complete puppet of the ruler of Russia. Trump is disgusting.
Elected officials in Congress have had years to address the pharmaceutical companies price gouging and have done nothing. This looks like more show boating to look good for 2020. I hope I am wrong.
6
There is no mystery to high pharmaceutical prices. We have a free market healthcare system. In a free market, sellers are free to charge whatever the market will bear. The market will bear a lot to avoid pain, sickness, and death.
We also have privately funded political campaigns. Politicians need corporate campaign contributions to get elected, and therefore put their contributors' interests before their constituents when voting for legislation, all while paying lip service to their constituents' plight.
3
Perhaps now is a very good time because big pharma, tobacco, and food manufacturers are going to take over the cannabis industry. Of course, if that is successful, they will have a monopoly on medical cannabis. Then what?
dp not jp
As a prescriber, I want to know why pharmacies are running out of commonly used medications- even ones that have long ago gone off patent? The last 1-2 years many patients are unable to fill prescriptions because the pharmacy is out of the med. This situation can last days to a month. Stopping some medications abruptly can range from very dangerous (i.e seizures, rebound high blood pressure...) to feeling very very uncomfortable(i.e flu-like symptoms. headaches...). Most prescribers warn patients to not abruptly stop medications. Pharmacists tell me their "manufacturer is out of the medication," they "get the medications from overseas and tariffs are causing these shortages..." Also, it appears that pharmacies are decreasing the number of dose sizes they carry. A medication made in 10mg, 20mg, 40mg.. can now only be found in 40mg tab requiring patients to cut tab in fourths to get 10mg dose prescribed-this can be dangerous- more so if a capsule! Cost of many generic medications has greatly increased. In past they were relatively inexpensive. Insurance companies are increasingly requiring "prior authorization" (PA) for medications previously available without PA's and requiring that patients first have tried other medications for same purpose that are not as effective, not appropriate for particular patient, has many more side effects, etc. ? Pharmaceutical and Insurance industries are controlling medical care at high costs in so many ways. Why? Has to stop!
2
A suggestion -
Post the price of drugs for-
1.a consumer
2. Medicare
3. Military- VA
4. Canada
And see what happens.
This will also work for Healthcare (surgery, doctors appointments0
2
@swenk
This has actually been attempted for several decades, and while it might be informative, it doesn't address the underlying issues.
Congress needs to ask the drug companies to cough up production records of DES diethylstilbestrol which they supplied en masse to Planned Parenthood between 1939-1947 for experimentation on the poor. These companies used DES coal tar drugs on women at the Black colleges and at the maternal health clinics in coal mining towns while developing a "safe" birth control pill. DES was widely distributed in mining and farming areas, an estimated 1 in 10 Americans have epigenetic damages from when their mother or Grandmother was given DES during pregnancy before 1971.
DES is the cause of illness in 35-45 million Americans. The political protection supplied to Planned Parenthood has killed 100's of thousands and maimed millions more.
Men didn't damage women's health with apathy, the majority of health problems today in America and Europe are the result of fake estrogens Planned Parenthood gave out like candy until it was banned a a carcinogen.
Consumer protections cease to exist in a meaningful way when legislators are making beaucoup bucks from corporations. Until this changes, we can expect lots of faux outrage and promises that amount to nothing.
5
No mention here of how much the drug companies spend on advertising. Why should there be any advertising to the public on TV and in newspapers and magazines? Lay people are hardly qualified to judge the safety and efficacy of medications.
3
And we must include the FDA.
1
@Same Asylum As Before
Yes, FDA, in effect is "prostituting" for Big Pharma, as many physicians, accepting a free lunch naively do so; some taking big pay for brainwashing other physicians, in Big Pharma's push to prescribe fancier high-priced drugs.
1
If the drug executives testifying on Tuesday were honest, they would tell the Senators that "We're not in business to make drugs, we're in business to make money." (Don't hold your breath!)
2
Excellent wake-up call by the Editorial Board! The evidence against immoral and even criminal abuses by most pharmaceutical companies has been painfully evident for way to long. It is time to reeducate them to fulfill their original goal: to save and improve lives, not to ruin them!
2
For decades — since the first significant congressional hearings on drug pricing and marketing, in 1960 — the industry's main argument for high prices has been the need to recoup R&D costs. In the age of Shkreli, that no longer holds water. One drug — a hormone called Acthar, introduced in the early 1950s, which surely must have made back its research costs many times over — has undergone a 97,000% price hike, according to CNN.
2
In 2007 the very same Republicans block a democratic move to allow Medicare to negotiate drug prices. So I suspect these same Republicans will soft ball their questions and do little more than offer a "shame on you" response. This is what "winning" looks like in the trump world.
2
opensecrets.org indicates the entire Healthcare Industry spent $580M on lobbying, and $280M (more than half) was from pharmaceutical companies.
Lobbying efforts by each firm are listed here: https://www.opensecrets.org/lobby/indusclient.php?id=H04&year=2018
You can drill down through the data to see exactly which firms are being paid by each company - to drive you into bankruptcy and death.
No one is killing and bankrupting you for free; they are being paid to do it.
The same site will allow you to research your House and Senate reps to see where they are being funded.
Let's get that sunshine out, and start disinfecting the lobbying industry.
3
Drug companies have no incentive-none- to control costs, since they can pass that on as costs of drug development. So, flying execs around, when a simple computer hookup would work just as well, putting them up in posh hotels, paying outrageous salaries and bonuses, (outrageous bonuses), It can all be chalked up to development costs-that and good old fashioned greed- add to the extortionate cost of drugs in this country.
1
Many of these drugs are made in other countries to keep costs down and huge prices are charged in the US for patients.Where does research come into this picture.India exports a lot of generic drugs at low prices to US and yet the patients are charged high prices.
1
In business, if you are a big customer of a manufacturer you require them to give you "most favored customer" status -- that no other buyer of their product gets a better price that you do. The USA should do the same --"most favored nation" status. If a drug can be had for $300 in Britain, it must be $300 in the USA.
2
I wish the committee members good luck at eliciting even one honest answer from the drug company folks. They make double-talking politicians sound downright open and forthright in comparison.
4
You open with "With seven pharmaceutical executives set to testify before the Senate Finance Committee on Tuesday, one can only hope for a similarly pivotal moment for prescription drug prices." A Senate Finance Committee run by Republicans is not going to bite the hand that feeds them. A quick google search turned up that drug companies spent $240 million on lobbying efforts alone last year.
5
Also, time to ban advertising of prescription drugs especially on TV. It's ridiculous to have to listen to all the possible side effects! Let a doctor choose the appropriate drug for a patient.
Will never happen but would be good to ban lobbying by drug companies as well.
518
@EJ
A radical measure OUGHT to be undertaken to curb drug-prices. What I suggest may appear impractical. Actually if we apply simple logic, it's not impractical:
I would suggest to get rid of the patent system for life-saving drugs, one after another. Let the respective manufacturer submit the entire R&D cost, including for related failures, of a life-saving drug that patients can't afford if bought at retail price, without insurance. Taxpayers foot the bill. Generic versions are produced & sold at affordable prices, right away.
Total R&D budget of Pfizer is $8B https://www.marketwatch.com/story/pfizer-to-raise-rd-spending-to-bolster-pipeline-2018-07-31
This means, the total R&D budgets for all US based pharmaceutical companies would be no more $100B. The annual cost of drugs to Americans is about $375B. If no patent system, drug prices should be <$275.
Something similar happened with AIDS drugs in 2000. There was a law-suit in South Africa. Clinton administration decided not to back that lawsuit. Finally, with enormous pressure from activists, the company(ies) withdrew the lawsuit. Generic versions, which were already in the pipeline, began to flood the market for Sub-Saharan Africa & other Third-world countries at a fraction of the cost, of >$10K, like around $100 in another few years. Millions of lives were saved. Though GW Bush caused so much havoc in the Middle East, he announced $15B grant in 2003, thereby saving perhaps millions of lives!
14
@EJ
A few relevant thoughts:
1) Compare and match the campaign contributions from the Big Pharma industry to the members sitting on both the HR and Sen oversight committees, and to various Presidential candidates.
2) Medicare patients are always required to use the generic form of drugs when available, and of course, are required to fund their co-pays. Why is this not the case for Medicaid patients, who can request and obtain a prescription for a name brand drug, the cost of which is fully covered by Medicaid?
3) It's long past due time that the Federal Govt. negotiate quantity volume discount pricing on behalf of Medicare recipients from Big Pharma.
4) Why is there no drug advertising on European TV?
5) Since we live in a global world, it seems like it's time for Big Pharma to be required to charge exactly the same prices for drugs in the US as they do in Africa and all other countries.
6) If the GOP hadn't blocked FDR's national health insurance legislation back in the 1930s, just imagine how much consumer wealth could have been used for other purposes such as education, retirement, etc.
Far too many members of what was formerly the middle class live in fear of the one bad medical diagnosis that will completely wipe us out financially. This is no way to live for 99% of Americans.
53
@EJ
Exactly right. Obviously the drug companies have determined that the ads increase demand for the drugs, even for serious conditions such as cancer and diabetes for which most consumers have no knowledge of appropriate treatment protocols. But the ads cost money and you know who ends up paying.
26
I think the problem is clearly illustrated by a "lecture" given in my high school psychology classroom. When studying the use of pharmaceuticals for mental illnesses we had a guest who was a retired CEO of a major pharma company. He told my class that, for example, he and his wife should have access to a cancer treatment that would only extend life for several months because they could afford it but that taxpayers should not be expected to pay for such a drug for people of lesser means. What a lesson! The wealthy, who accumulated their wealth from selling medications, deserve to live longer because they jack up prices and hoard profits.
3
As a physician, the reimbursements i Receive from medicare are prescribed by law.
There is absolutely no valid public policy reason why drug prices should not be regulated.
In 30 years of practice as a Neurologist, I have seen the advent of disease modifying drugs for multiple sclerosis start out at around $800/month. Initially one drug was joined by 3 and now there are about 10 different drugs. Has this competition driven down the prices you may ask. NO! All of the drugs, including the ones that have been around for almost 20 years generation 1B+ in revenue per year, are now around $5,000 per month. See how well competition works!
This is just outrageous!
Another pharma strategy is to take an old generic drug, put it in a slow release pill form, do a few clinical trials on it and now it is a branded medication. One that I will specifically call out is Gocovri, an extended release form of an old medication called amantadine that is marginally effective for variable response to treatment in Parkinson's disease. A month supply of the Gocovri costs $2,500 whereas the generic can be had for 12 bucks. I kicked the rep out of my office. More docs should do the same
587
@LRW
Good for you for "kicking the drug rep" out of your office. It's tough enough to get accurate efficacy information and safety profiles on pharmaceutical drugs listening to the "airbrushed" version the reps want to present, or the sanitized version of a drug's benefits presented by physician "thought leaders" at medical conferences. Then there are those questionable journal articles, often ghost-written by industry types.
94
@LRW
" .. There is absolutely no valid public policy reason why drug prices should not be regulated .."
Google "commerce clause." You will find it informative. Good luck.
3
The Commerce Clause gives sweeping power to Congress to ban any and all economic disparities between states.
43
Want a solution to the high cost of drugs? Do what Canada does, and cut drug prices roughly in half.
Let's implement Medicare for All, and give Medicare the ability to negotiate drug prices, much the same way Canada does.
MFA will provide overall net cost savings in the hundreds of billions of dollars annually. Don't let anyone try to tell you anything different.
3
The question which each company should answer is over the last ten years has the number of research and development Phd's at your company increased. The answer is no. These companies do not conduct basic research but instead identify other small start up biotech/pharmaceutical companies to purchase. The venture capital and M&A divisions of theses companies have all grown over the last ten years while R&D staff has been cut. Pharmaceutical companies have become financial service companies with large marketing divisions. There are, however, two very simple solutions. Medicare, effectively the largest insurance company in the world, should be allowed to negotiate all drug prices and in some cases, not cover a drug if its efficacy is nominal (yes, this is a death panel, too bad). Second, as one of only three countries that allow direct to consumer marketing of perscription drugs (the others are those health care destinations New Zealand and Hong Kong) this practice should end. There is no evidence to suggest we are healthier since this law was changed but the explosion in health care spending is undeniable. Congress should ask these CEO's to justify this law. For the last 15 years I have watched my wife, a physician, deal with falling reimbursements and rising office expenses despite a professional investment and risk that far exceeds any other profession. While the vast majority of physicians enjoy their work at some point talented physicians will choose something else.
3
It is not enough that drug advertising costs not be tax deductible to pharma companies. Such advertising should be prohibited. What logic supports decision making by consumers of pharmaceuticals? Not only is the average consumer untrained to make such decisions, but the data on which even physicians must base decisions is unavailable in to the consumer. Even advertising in medical journals ('direct to physician') has been notoriously inflated, insufficient or both.
You can (and will) bet your life that lobbyists wrote and paid for the regulation allowing direct to consumer prescription ads.
5
@TLJ
There is more than one big-pharma detail-man (or sometimes woman) assigned to every doctor in the United States. "Teachers," or pushers, outnumber people on the receiving end.
Look at it the other way around. If you're a doctor there is more than one person whose full-time job is following you and working on the questions of what you think and do. And that person doesn't also have to run a medical practice. You are their full-time occupation.
3
I’m not a regular viewer of television, so when I do, I simply can’t but notice the number of advertisements for prescription drugs. In many cases I have little to no idea what condition they are suggesting the drug itself solves (well, ok, not the ED ones). Is the thought that I see the suggestion on the television and rush out to my doctor with a request? Not likely.
Don’t get me started on the magazine ads with the 2-4 pages of disclaimers. Those are downright scary.
7
The biggest single change that Congress can make is to allow Medicare and Medicaid to negotiate for, and publish, drug prices. That's the elephant in the room. This should have been from the beginning of the part D benefit. The drug companies are counting on Congress being too timid to take them on. So far, it's working. Trump could get behind this; his base would love it.
5
Come on. We know the answers. Making insulin today carries zero risk. Most ofhe procedures have been refined over the last century. The cost of production certainly has not gone up. Add in that lots of production has moved to India where technicians earn a few dollars a day.
The answer is called "price gouging".
The price goes up and up because the government does not put an end to it.
There is no need for so-called questions. The pharma executives have been practicing their answers for weeks now - moot court as it were.
Even if (its not but let's indulge in some fantasy fiction) this is the cost of new invention, why does Europe pay 20% (if that) of what the US does?
Congress should pass a law limiting the highest price of any individual drug to US distributors to be not higher that the average price of the same drug to European distributors. Then do the same for distributors.
If the companies create workarounds, if the price to consumers does not drop to European/Canadian levels - then simply remove patent protections from them and solicit manufactures to produce the medicines.
Just recently, carcinogens were found in the "sartan" family of BP meds - cause a precursor compound from China (not the US) was contaminated. Production has moved to low cost countries, prices have skyrocketed, pharma execs earn tens and hundreds of millions per year and Congress holds ridiculous hearings "to determine" why.
What a farce.
10
The more obvious anything is in the US, the more ludicrously the media and politicians will dissimulate about it.
While I certainly agree with the board, I wonder if they have ever seen the Senate in action? Over the past two years I've seen quite a few hearings, questionings and committees. If what I saw was representative about all that will come out of this is a lot of grandstanding by the Senators (both sides of the aisle). Questions will be long, rambling and without a point (or they will have forgotten their own point long before they actually get to the question). The Senators will appear to have done little, or no homework. They probably won't even have read the briefs painstakingly prepared by their own staff. And every single Senator that gets money from a company even remotely associated with the drug industry will handle these guys with kid gloves. No one's feet are going to be held to the fire and no one is going to be on the hot seat. Ho hum, another day of ineffectual government.
10
Indeed. Why is it that US drug prices are so much higher than drug prices in other countries, Canada for example? If you want to obtain drugs from foreign countries you can run into FDA problems about unapproved drugs. The one thing Trump is right about is that there's too much regulation in the US but to me, only for some categories like prescription drugs. The drugs you can get from Canada are every bit as good as those you can purchase in the US and the consumer doesn't get raked over the coals.
2
@Mike You may be too young to know that the regulations against importing medications from other countries were imposed by Republicans in Congress, pushed to do so by industry lobbyists. Just as we need to go after the industry, we also need to root out members of Congress who have refused to take any kind of bold initiatives in favor of average Americans. The culprits are mainly Republicans.
10
Possible solutions for our current drug pricing disaster range from letting Medicare negotiate prices to nationalizing the large drug companies. At the moment, I favor the latter, but could be convinced that something less drastic might work. What amazes me is that Democrats who now control the House are not already making a noisy push to allow Medicare and Medicaid to bargain about prices. It might not pass the Republican Senate, but Democrats are blowing the opportunity to show the American people who stands with them--assuming Democrats actually stand with citizens and not big pharma.
2
American universities are also complacent in this large scale corruption, if I may say so. They now mass manufacturing not only very mediocre people (who are less capable to invent/innovate but call themselves scientists or managers, hardly any leader though), but also criminals who are more than happy to collude with other criminals in big industries like Pharma & Biotech or anyone who can pay. That picture became clearer from the book- Tailspin.
Now research shows that 78 percent of patents approved by the FDA correspond to medications already on the market, while those disease areas not considered growth markets are ignored. It's reported that 90 percent of American doctors take "favor" (read, bribe) from these pharma and medical device manufacturing companies (source:Brit. Medical Journal).
These big pharma companies, along with most big companies in Biotech and software also having the same issues. They all prevent US Govt to reform its patent rule. Part of its huge profit is given to politicians and various political parties for lobbying. It has a huge impact on new entrepreneurs as well as small and medium scale businesses and industries. That help more consolidation of industries, less job creation, declining social mobility and more concentrated income and wealth.
3
@bonku...."Now research shows that 78 percent of patents approved by the FDA correspond to medications already on the market,"....The FDA has nothing to do with patents.
1
@W.A. Spitzer I know but FDA is the agency that approve new drugs. Having patients means nothing so long it have any economic value. Most patents granted are basically useless even in terms of basic/academic research. That's why FDA approved drugs are mentioned as they have huge commercial value.
https://www.washingtonpost.com/news/theworldpost/wp/2018/10/17/pharmaceutical/?utm_term=.d97ea9789be1
I’ve spent more than 30-years in Pharma in various roles in small and medium sized companies, including global supply chain and distribution. I’ve worked on both product and company acquisitions. EVERYTHING is a money play, especially for C-suite bonuses tied to stock price.
The insulin issue is near criminal. A 100 year-old, life-sustaining drug owned by major pharmaceutical companies with many branded and cash-cow (not-actively promoted) products, should be in the public domain at the marginal costs of manufacturing plus distribution as the price of doing business with their other branded products.
7
@Last Moderate Standing....The issue with cost of insulin is criminal, but the fact is that Humulin has been off patent since 2000. Humulin is in the public domain. You and your neighbors could get together and manufacture it at marginal cost. Why isn't that happening?
@W.A. Spitzer because there is no such thing as marginal cost in the biologics manuafafring world, and to think otherwise is being a tad glib.
You need bioreactors, media, stocks of cells, filters, GMP environments, document control, a sterile bottling line, an temperature controlled storage and distribution system, and you have to pass state and federal oversight and manufacturing regulations.
Even if the biological entity is in the public domain, safe manufacturing is exceptionally expensive and cost-prohibitive.
That’s why you’re not seeing it happen.
In a functional, competitive, free-market economy, profits are limited by competition: i.e. inordinately high profits will draw new players into the marketplace.
On the other hand, when you have a government that intervenes on behalf of the cartels and rent-seekers--as we have in the US--inordinately high profits and income inequality are inevitable.
3
I'm tired of all the "negotiating," which to me is another way of saying drug companies are stonewalling for guaranteed mega-profits.
The answer is simple: health care in the US can no longer be for-profit. All this would stop immediately.
4
It seems more than coincidental that the enormous surge in drug prices has followed the proliferation of billionaires in the tech industry. Where drug manufacturers and their shareholders used to be content to accrue millions of dollars, they have seen that vastly more is possible. Their personal goal now is billions of dollars. To achieve that end, they overlook their price gouging and the fact that they are offering no added value, simply draining the lifeblood of patients in dire need of medications that were once affordable, sometimes at the cost of their lives. This pattern is not about recouping R&D investments: It is about greed, pure and simple.
1
@Susan Wensley.....I agree with your premise. But the big drug companies compete on Wall Street for your investment dollar every day against Disney and Pepsico.
@Susan Wensley, wait, what? Big Pharma makes billions keeping Americans addicted to drugs and you blame......the tech industry?
Scratches head.
Here are some issues to consider:
First we have a capitalist system and it seems, the capitalist system is the only one that produces innovations.
Second, investing in medical companies has not been an especially good investment. Facebook and Amazon have the same combined value as all the publicly traded drug companies.
Subtract the questionable things that drug companies do, like advertising, unethical pricing, and patent games and no one will invest in new medical technology.
It is easy to state the problem, not so easy to come up with a solution.
Extending patent life while at the same time curbing some of the questionable things might be an answer. Why a copyright for Mickey Mouse should last longer than a drug patent makes no sense.
No doubt we over pay for new drugs while others under pay.
The price gaming of generic drugs ought to be an easy fix.
My bottom line is we have to pay for innovation while ensuring everyone has access to it.
6
The extreme cost of pharmaceuticals goes well beyond the cost of reasearch & development. The other major cost to the pharmaceutical companies is the promotion of their drugs. That includes all the TV ads we endure when watching commercial tv. But IMHO the biggest cost, not mentioned in this opinion, is the cost of all the pharmaceutical representatives! They drive from doctor to doctor with samples and to take orders for the pharmaceutical they have the responsibility for. If one company has many different drugs for different medical issues there is a separate representative for each drug. So one company could have several of their reps visit a Doctor to sell their particular pharmaceutical.
Addditionally these pharmaceutical representatives are paid very well. The company also provides them with a car. Some of these representatives drive a few thousand miles a week, so those reps get a new car once a year. The reps also receive bonuses from their company for “ doing a good job”. The pharmaceutical company may reward a representative with an all expense paid vacation to Europe for the reps and their partner for a week or more.
All theses representative and TV & print advertising costs are on top of the cost of research & development.
I have no problem with research & development. I do have an issue with the volume of advertising and the huge cost of all the pharmaceutical representatives.
Ever notice the drug reps who walk in and walk out while you wait to see the doctor?
5
@KenK...I worked in research for a major pharmaceutical company for 30 years and I can assure you that most everyone in research agrees with you that marketing is the tail that wags the dog. So what is the solution? If company A improves their profits by marketing, company B and C will follow suit and it just escalates from there.
2
I lived in Europe for a few years where I saved hundreds of dollars on my eyes drops for glaucoma. The irony of this is that the eye drops are made in the USA - then exported to other countries where people pay less than we do here at home. With Medicare and supplementary insurance, I still pay more for my prescriptions here than I did while living abroad. Why?
6
Congress needs to pass a law banning pharmaceutical commercials on TV to consumers. My 89year old mother watches a lot of TV and she sees a relentless array of drug commercials, with each drug 'returning the patient to a wonderful life' just 'ask your doctor'. Take the dollars saved on advertising to consumers and lower the price of the drugs. I've traveled internationally and haven't noticed drug commercials anywhere else but the good ol' USA.
20
@Linda The ads are disgusting. As is the whole Pharma industry.
1
The parallel with tobacco makers is unfair: the latter were knowingly making a product that kills; pharma companies make products that save. Being guilty of not saving enough people is not the same as being guilty of killing too many.
4
@Ilya Shlyakhter, you are confused. They saw the path to profit in OVER-prescribing good stuff. Then, when addiction rates went sky high, they pushed for MORE, using addiction for profit.
Your argument that they are being punished for failing to save enough people with their drug? Super naive. Read the emails between Perdue execs. https://www.statnews.com/2019/02/22/a-secretive-billionaires-role-in-promoting-oxycontin-emerges-in-new-documents/
1
Price gouging by Big Pharma must stop.
3
It’s all about the money and publicly traded companies. We need to stop the insanity and legalized corruption by;
1. capping compensations and packages for all C-level that publicaly traded. No one should earn more than 500k in a publicly traded company or govt. funded entity.
2. Stock options should not be given at 0.00 cost but rather should be tied to current stock price
3. The board of directors should not make decision on money matters without getting 80% of all shareholders. 10% stakeholders should NOT make decision for 90%.
4. Grants received from the govt. should be considered as a loan with some ROI to the “investors”, taxpayers.
5. We need to hold everyone accountable and transparency especially if it is a publicly traded company.
Institute CPRA, Brown Act for all publicly traded companies.
6. Hold personally accountable those deliberately cover up, mislead, deceive, and harm others. No legal representation paid by the corporation.
Drug prices will drop when these insane and legalized corruption policies end.
5
"Like their predecessors in the tobacco industry, the drug makers will testify at a time of near-universal anger over industry antics."
Antics are Lucy and Ethel at the candy factory. I think the word y'all were looking for is MALFEASANCE
6
Corruption starts with the first wink. Congress and our media companies stand to lose cash when they offend. Not standing up to the damaging of our system begins the end of that system. The pharmaceutical corruption mess is one of many that threaten the success our nation. Temerity at calling this out serves only to make corruption the new America.
4
So long as we have a bunch of politicians willing to sell their services to big money donors, nothing will change.
Go Justice Democrats!
10
I recently had surgery and was completely constipated from the opioid pain-killer I was given. Several friends said, "easy...just get a package of Dulcolax." It worked, problem solved. The cost...about $5 for a package of 25 pills.
On the flip side, we're inundated with glossy TV commercials featuring attractive, opioid-induced constipated people praising the benefits of "Movantik." The cost for 30 pills...neary $400!
It doesn't matter that insurance may pay for all or part of it. You're still introducing an unnecessary $400 cost into the system that SOMEBODY - ultimately consumers - will have to pay for through higher insurance premiums. And of course, AstaZeneca could care less whether the you pay out of pocket, or through your insurance company or Medicare...they'll ALWAYS get their $400 one way or another!
Is it really necessary to be creating new, expensive drugs, complete with multi-million dollar advertising campaigns, when perfectly safe, effective and CHEAPER, over-the-counter products already exist?
Our system is really screwed up.
103
@Mike Schmidt. Like you, I suffered from constipation when taking opioids. The best laxative I found was a brand I bought at Dollar Tree for $1. Even the more expensive over-the -counter medications didn't work as well. Now I see the commercials for that expensive prescription brand and wonder about the ethics of doctors who prescribe it. I guess the old saying is true. "There's a sucker born every minute."
There is a simple if radical solution:
Change patent protection for drugs to resemble long term service contracts where the manufacturer makes promises in exchange for (initially) exclusive permission to sell a particular medicine. Here is how it would work:
1) Protection for a drug would run for a fixed period of years from the first sale (as long as the patent was held at the time of initial sale).
2) It would be conditional on a price cap with modest price increases over time and stable supply.
3) Near the end of this period the supplier could apply for extended protection by publishing its cost basis and detailed manufacturing protocols in exchange for an exclusive contract to guarantee national supply at a reduced (yet still profitable) maximum cost.
4) After this second period the manufacturer would face a competitive rebid, again disclosing manufacturing costs as well as the usual quality metrics with licenses issued for a limited time conditional on cost and supply stability. Licenses would be limited based on projected need. This would be the model that all FDA regulated drugs would fall under.
You would jump to step 4 if the initial producer declined to take step 3.
Innovation would be rewarded, stable supply and lower prices for older drugs would be guaranteed and increased transparency would help to curb future costs.
2
Welcome to unadulterated Capitalism (Ref: The Grapes of Wrath)
Need medical care or drugs? Head to Mexico or Canada. If you're spending enough you could easily fly to Europe and enjoy a brief break from American greed.
Best of luck to you all.
13
If you want examples of obscene drug pricing, look no further than Spark Therpeutics' new drug Luxturna. It costs $850,000.00 for a one-time treatment. (Oh, and the drug has a long list of frightening possible side-effects.) But, hey, what's your sight worth to you? It's a medical mugging.
17
I recently got a from COSTCO that said "We negotiate prices with suppliers so you don't have to." Maybe not the exact wording but that was the pitch. Volume purchasing in a free market system gets the attention of suppliers and manufacturers who want the business.
So why can't Medicare negotiate prices with drug manufacturers? Because for all the hot air expended claiming otherwise, we do not have a free market here. Big Pharma bought themselves legislation prohibiting Medicare from engaging in free market negotiating. And that's called a rigged system. It's also called hypocrisy.
114
@Edward
I notice that you don't blame the politicians that allow themselves to be bought.
Why is that?
1
@Edward
Other countries with single-payer or nationalized health care negotiate prices. As a result, one suspects the industry (including foreign pharma companies) relies on the US market as a cash cow.
Another factor in high US drug prices is the huge amount of money spent on promoting Rx drugs to consumers, who do not make the decision to use them — their doctors do. They, not patients, are capable of making informed decisions (hopefully not informed by misleading marketing or payola). This kind of advertising is relatively new (since the mid-1990s) and permitted only in the US and New Zealand! Getting rid of it would eliminate at least some of the costs of marketing a drug.
8
@WTK
Unfortunately, it's a lot harder than you would think for physicians to get real clinical trial information - held on to by BigPharma as "proprietary information".
5
This opinion piece is irresponsible. The pharma industry has saved lives and made remarkable progress because there is the chance that if successful there is a payoff. Editors at the NYT and their ilk wishing for drugs in the absence of significant returns are foolish. I work in the biotech industry and have lost my job several times because my company ran out of money due to the risk and cost of drug development. One of my companies just got its first product approved, after 15 years of efforts, multiple failures and $1B in investment. First year sales are less than $10M, and it will take several years to be about $200M per year. You don't know what you are writing about and you risk lives by doing so.
1
@No Any free market business has risks and takes chances, why should we treat the pharma industry any different from any other small business or big business? Lots of business have risked $1 Billion in development costs and seen it go down the drain, that is capitalism.
Have you ever thought about a US based manufacturing business that can't be competitive anymore because Health Care costs in the US are double or triple of other developed countries?
Ultimately the profitability of the US pharma industry is greatly underwritten by the trillion dollar deficit the US government is running and the contribution of Medicare to that deficit.
4
Sorry, but you appear to be the exception to the rule...either that or you are lying, but I will give you the benefit of the doubt. At its simplest, take insulin. Why after one hundred years in existence is the cost continuing to rise in double digit numbers? Why isn't it in the same essential category as penicillin? Costing literally pennies, except maybe for some higher manufacturing costs? How much of your research was funded by the government? What other drugs is your company making and profiting in that allowed you to "spend " a billion dollars?
5
@No Irresponsible? There is nothing that you have written here that can even begin to answer why insulin should now cost over $1000/vial. Insulin was first successfully injected back in 1922, brother. Is the high price of it now due to research and development? Seriously?
I do not believe that you can entirely justify the cost of research and development for new drugs as driving up the cost of the old. This would seem to be a grave ethical oversight, to force potential bankruptcy on patients who need substances that should be reasonably priced.
I just watched my father die of a glioblastoma -- a tumor for which there is no cure -- and at most, his life was extended for just over a year. But the drugs cost a mint -- liquid antibiotics, Humalog, infusions...Granted, my father could have chosen not to take anything, and thank goodness for Medicare. But in the end, it all seemed a dumb show, with a heavy price tag.
That the industry is profit-driven is obvious. And no doubt that some drugs are expensive to develop. But one need only look at the current opioid crisis and how prescription opioids were pushed onto patients, regardless of consequences, to have a heavy dose of skepticism regarding R&D and its motives.
BTW, I am a sociologist who studies drugs and society. True irresponsibility lies with not questioning institutions of power, especially when the bottom-line literally affects the ordinary American consumer's life and death.
4
“If the members of the Senate Finance Committee want to make use of that spotlight, here’s what to ask executives on Tuesday:”
1) How much money have you given my campaign, my colleagues’ campaign and my party?
2) And, what six-figure position will you offer me after my “government service"?”
60 Minutes ran a segment about drug companies’ institutionalized corruption of Congress forcing Medicare (that largest purchaser of drugs in the world) to pay retail prices – costing taxpayers hundreds of billions extra.
Lobbyists showering money and employment opportunities, middle of the night backroom deals, arm twisting, etc. You got the picture. Apparently, little has changed.
https://www.youtube.com/watch?v=Hhtrcs8njNQ&t=24s
We must find a way to hold self-interested and self-enriching Elected Politicians, government officials, their staffers and operatives from both parties personally and financially liable, responsible and accountable for the lies and half-truths they have told US, their gross mismanagement of our county, our $22 T and growing national debt (105% of GDP), and our $80 T in future, unfunded liabilities jeopardizing our economic and national security, while benefiting themselves.
12
Get their fear mongering and obnoxious medicine advertisements Off Television!!!
14
@Counter Measures
also: if the "new" product isn't better than existing, FDA should not approve.
If the "new" is just an isomer of the original (Prylosec & Nexium) then FDA should not approve
and NO Doctor should benefit from prescribing a particular drug
6
@Counter Measures i can't reach the TV remote fast enough when a drug commercial comes on, to mute the lies and greed that comes with each commercial. i watch the NBC news every night, and i'm astonished when lester holt has a story on outrageously high drug prices, then goes to commercial, it appears 75% of which are drug commercials. it sickens me.
1
It is osteopetrosis, not osteoperosis. Different diseases.
We have a national health crisis ... Americans are dying intentionally because the big pharmaceuticals are allowed to hold peoples lives hostage for criminal greed. Epi pens are even criminally priced ... parents can’t afford or even get them to keep their children from dying. There are too many accounts where working young people can’t afford their life saving insulin and have died !! We don’t have a national crisis on the border ... we have a national health crisis inside our borders ... Americans are dying needlessly because they can’t afford their life saving drugs. If they lived in “ SOCIALIST “ Britain, France, Germany, Japan, Switzerland, Australia ... Americans would be able to afford their insulin !
9
One of the members should ask the CEO of Sanofi how insulin is made and how much a vial costs to produce. I doubt much is made any more from hogs. Most is likely made by genetically engineered bacteria. As a microbiologist I can tell you that process, even on a commercial scale, is reasonable. How much can it cost to package?
Do you know how to spell Ripoff?
16
I am neither shy nor easily intimidated. So when presented with a medical bill or charge for prescription that seems outlandish, I ask questions.
Doctors, surgeons, specialists, hospital administrators and, on more than one occasion, pharmaceutical company employees probably view me as a loud trouble maker. I couldn’t care less.
Something I read in this well-written op-ed piece, reminded me of the number of times the person I was questioning tried to justify the ridiculously high bill I’d been presented, by focusing on the VALUE of the services or pharmaceutical drug I’d received.
“Yes, Tom, you were only here at our emergency room for five hours. And the bill for services you’re waving in my face IS for $17,600.
“However, what you fail to understand is the value of what we did for you. Without the repairs our doctors made to your hand, you would have permanently lost the use of two fingers on your left hand. Index and middle finger! What is value of those two fingers to you? How would you like to go through life with just eight usable fingers?
“When you look at this that way, $17,000 is very reasonable.”
So many times I’ve been assaulted with this sort of maddening excuse-logic!
It is not the reasoning of a healer, not of someone dedicated to easing human suffering. It better fits a kidnapper or a thug extorting “protection services” from small businessmen.
Raised in Pittsburgh, I respond with one of the most powerful insults I know.
“You should be ashamed of yourself.”
10
As a Primary Care Physician who sees many patients daily that are burdened with high drug prices, I say—get rid of $$$ TV ads and pass that savings to the consumer, otherwise known as the patient!!! Christopher D Stanton MD
15
I'm so glad to hear that the Editorial Board has taken the time out to rail against this massive machine which offers absolutely no good to society and exists only to suck money from our pockets. Who will stand up to them?
Controlling Big Pharma should be part of the Green New Deal. Pharma companies have so much sway over us, we cannot be trusted to make our own decisions. Sure they have created life altering medications which have eradicated such diseases like Measles, Mumps, Rubella, Polio, Small Pox, etc. and make medications to treat such small conditions like Cancer, and HIV. But honestly, what are they good for?
Oh wait, they make opioids.
They price gouge the consumer
They are publicly traded companies.
They market their medications to doctors who are to stupid to realize they are being used.
I wish there was someone would tell me what to think
22
Try the Upshot, here on the Times, and Kaiser Family Foundation’s various excellent studies.
3
@Chris
I understand your frustration but would recommend avoiding the view that everything is all good or all bad. The price gouging is unacceptable--including for generic drugs, which in so many cases are not generically-priced anymore.
But as someone who has worked in the industry, there are a lot of people making good medications that have changed people's lives. So the noble pursuit has to go on. It just should not go on with markedly escalating the charges.
27
@David
This post is a microcosm of our current state of affairs being broadcast to us by many politicians, academics and dare I say the media. Makes me weep as a progressive because we fail to see all the good we have done and only report on the negative.
3
To the Editorial Board headline writer (and editor):
There is a material difference between "moments" about over-priced products and about deadly products.
The pharma industry has saved lives and made remarkable progress because there is the chance that if successful there is a payoff. Editors at the NYT and their ilk wishing for drugs in the absence of significant returns are foolish. I work in the biotech industry and have lost my job several times because my company ran out of money due to the risk and cost of drug development. One of my companies just got its first product approved, after 15 years of efforts, multiple failures and $1B in investment. First year sales are less than $10M, and it will take several years to be about $200M per year. You don't know what you are writing about and you risk lives by doing so.
@No
You, apparently, do not understand business, and have not been listening to the deafening adoration of executives and investors drowning out sane conversation in America for the past few decades.
You put a "Queen for a Day" spin on business doing exactly what it is supposed to do.
Somebody had an idea that merits development. Some other bodies thought there was potential there and ponied up the cash to make it happen.
The government, in an increasingly rare burst of concern for its citizens, imposed a few rules and demands of proof of concept.
In a few years (or 15) this crew of smart guys and moneymen come up with a promising product with acceptable risk. If its any good, profits will ultimately be running to the billions, everybody will be rewarded, and it will time to start filing near-fraudulent applications for patent and copyright extensions.
What's wrong with that? It is exactly the American way, except for the part where the price steadily rises beyond rational and patients' lives begin to fall apart, your company sells the same drug in Africa for $10 a pop, and you have to spend your days fighting off generics seeking to make your drug available to people who need it.
This is the whole myth of American capitalism. That risk, that time invested, are the rational for a trillion dollar gift bag now wrecking our economy and forcing rich people to search out even bigger basements to hide their cash.
And you're complaining?
4
@No
While I’m sure what you say is true, as long as we see Epipens, plastics delivery devices for a chemical which has been around for many years, expires in about a year, and probably can be manufactured for a few bucks rise to $700, we will not be persuaded.,
And as long as we see insulin suddenly esperience exorbitant rises, we will not be persuaded.
As long as we hear the stories of drug reps showering doctors and their office staffs with gifts to promote their products, we will not be persuaded.
5
Oh. So we cover your losses, and you get the profits.
That’s maybe fine for some advanced, gene-engineered drug....but insulin? Epinephrine? Are you kidding?
2
The hearing ushered in a public health victory for the ages. In its wake, lawmakers and health officials enacted measures that would ultimately bring smoking rates in the United States to an all-time low.
http://rawalpindi.pakistanjobs.pk/3-s-pharmaceutical-pvt-ltd-jobs-o8518
1
I daresay expenditures for advertising far outstrip those of R&D. Time to rid the airwaves and print media of this nonsense.
12
Finally an article in the opinion section worth reading, one with a clear identification of a substantial issue, understandable evidence supporting the controversy at hand, and a rational conclusion with an optomistic outlook. Wow.
If this standard of writing isn't associated with the Times Op-Ed section's other pieces, it darn well ought to be.
It's a shame the rest of the Op-Ed section writers have been honing skills that are giving Roger Ailes enough adrenaline to pop right up out of the ground and take a parade lap around whatever cemetary he's buried in, high fiving Papa Bear Bill O'Reilly along the way over the lack of sanity and reason they've clearly infected most Times Op-Ed writers with.
It's either that, or Paul Krugman's pieces are such well thought out jewels no one cares to even try to reach his standard, or the Boards' in this one.
Oh well.
Bring out the banner ads and the smiling blonds, the Op-Ed section's clearly called it quits on strategy and admitted if you can't beat Murdoch, join him.
So, when exactly do the red 'Breaking Controversy' banners start running?
2
@angry veteran
So...the failing New York Times finally, thank God, produces something that meets with your approval, and use the occasion beat them bloody and prove your manliness?
You think that's gonna work? Or does it just feel real good?
Ask the CEOs why a friend of mine has for years been able to get the same meds for a fraction of the U.S. cost by ordering them from Canada or even New Zealand or Australia. Same brand name drug, vastly different prices.
Ask the CEOs why they don’t put the drug prices in their endless TV and print ads. After all, prices are shown in ads for cars, appliances, cell phone services, etc. why not products that can save someone’s life?
Look hard at C-level compensation plans at the pharma companies (salaries, stock and benefits). It’s bound to be rather high.
Then look at R&D costs on a per drug basis and spread it out per dose over the typical market life of a drug. Then compare it to the market cost of the drug. See how much trickles to the bottom line and stock dividends.
I’m 69 and am fortunate to only take an occasional Advil, but lots of people take all kinds of meds. I exercise, eat healthy foods, and take decent care of myself. Still, after a career in marketing, I do wonder how many of the drugs out there are really needed and how much is pure bull cookies.
4
In understanding the problem, the first thing the public needs to understand is the difference between the high cost of drugs under patent and the high cost of generic drugs. These are two rather different problems that should not be lumped together as a single issue.
1
Recently Genentech released a new drug to treat (not cure) multiple sclerosis. The cost is well over $300,000 per year. Desperate sufferers of the disease have little choice but to try the treatment, especially when their Neurologist insists that its the best course.
Insurance companies may cover the main expense but the co-pay can easily run into the thousands. Genentech offers a credit card to help spread out the payments. That means patients are in serious debt should the credit card option be the only way the average household can afford the co-pay. Oh by the way, even if you’re in a group insurance companies will find a way to dramatically increase the premium or drop you by finding a loophole in existing regulation.
Doctors seem all to eager to move toward the most expensive option. Their actions make you wonder what their financial motivations really are.
This is just another example of the U.S. “Health Care Inustrial Complex”. Its 17-18% of this country’s GDP today and its growing at alarming rates. Unless something is done it will eat us alive.
2
A company dropping you like that is illegal, as would be changing your premium, unless you’re dumb enough or rich enough to buy in the individual market.
A simple partial solution -- Require Medicare to negotiate, using global pricing, the price for the medication. Then use reference based pricing for the private sector purchasers (who really are the employers, not the insurers or the PBMs). Those familiar with system with understand this easily, and the Pharma companies and PBMs will resist with all their might.
Ignore the claims the sky will fall.
5
Having worked in research and development jobs in the Pharma industry for three decades, I am appalled by drug pricing policies. Their only justification is sheer greed.
It is also appalling that Pharma spends more money in marketing than in research. It is about time that, like in Europe, drug prices be negotiated with Medicare for their real added value.
The insulin crisis is unforgivable.
17
"Elected officials have made a lot of noise" and received a lot of campaign contributions from pharmaceutical companies.
7
When is comes to big pharma, the modern GOP has spent decades enabling the worst kind of unbridled, socially parasitic greed.
For so many Americans, their political actions have created a visceral and very real "death panel".
3
Oh, so we're suddenly waking up to see that giant, hugely profitable corporations can endlessly, steadily, powerfully tilt the playing field ever more in the direction of their profits. What could possibly go wrong?
Labor, citizens, and the ever-elusive public interest are simply left out of the equation, as if they don't even matter.
Executives being paid in stocks and stock options is a powerful corrupting influence -- as if the money floating around in this swamp wasn't enough to corrupt -- on the "business" "leaders" who act only for the bottom line and with harry a nod in the direction of the public interest, a concept that seems to have vacated the minds of the sociopathic elite (David Brooks's favorite word to slam left-leaning folk, never the right) who inhabit the upper echelons of the business and political world in the USA.
Not holding my breath, even with a Democratic controlled House, to see any swamp drainage here. Until we have publicly financed political campaigns with actual policy debates -- and no stupid advertising -- starting say 8 weeks before a general election, I have no hope that anything will ever change. And what percentage of the electorate would even tune in to watch a policy debate? We're toast in the long run.
8
How weird is it that for the same medication I can buy affordably in Australia, and American family may have to do without. They are holding you guys all hostage. How can you stand it?
14
@EC too many of us do without. this is the hypocrisy of our representatives, all of whom speak out of 2 sides of their mouths. we have a bought and paid-for congress, by campaign contributions. the first thing that needs to happen is public financing of elections.
1
To the New York Times Opinion Section:
You wouldn't believe the cost of buying a U.S. Senator these days! And the cost of buying the biggies like McConnell and Graham has gone through the roof.
And have you looked at what a single Presidential Inauguration costs? It's in the hundred$ of million$ and that's just for the fraud and waste.
Then the Pharmaceuticals have to buy Governors, Legislators, and Big City Mayors who have really jacked their prices through the roof.
That doesn't leave but a few billion$ for research and development at posh resorts in the Caymans or the French Riviera.
12
Power in Congress is strictly determined by capacity to raise money for the party.
7
An appropriate question would be:
What are you going to do now that we’re allowing Americans to buy their prescriptions from Canada, Japan, and the UK?
Another appropriate question would be:
Since your corporate policies have maliciously addicted, bankrupted, and killed Americans for the sole purpose of enriching yourselves, are you ready to be prosecuted under RICO statutes?
12
Another question for the executives: When was the last time you produced a cure?
3
Hep C drugs.
Every word of Dr. Marcia Angell’s 2004 shocking book “The Truth About the Drug Companies” is still true today and needs to be reviewed by everyone in Congress
4
Follow the money. Just as you can line up legislators opposition to gun regulation directly to the amount of “contributions/bribes” received from the NRA, one can do the same with big Pharma and medical device manufacturers. People should know which of their representatives have sold them out.
11
Yes by all means let's follow the big tobacco strategy. When big tobacco lost what did they lose exactly? We found out during the decades of legal fighting that they put poisons and chemical in their cigarettes to make them even more addictive. So they just bribed their way out, nothing changed you'd think at least Congress would have prohibited arsenic but no money rules everything and big pharma is the worst of the bunch. How come with our stupid war on drugs there were no SWAT team raiding the homes of Purdue executives easily the biggest drug dealers of all time? Our nation is gone it's been sold to the lowest bidder
3
A couple of quotes:
“We try never to forget that medicine is for the people. It is not for the profits. The profits follow, and if we have remembered that, they have never failed to appear.”
George W. Merck, president of Merck & Co., 1925-1950
“My primary responsibility is to Valeant shareholders. We can do anything we want to do.”
J. Michael Pearson, CEO of Valeant Pharmaceuticals, 2015
7
Big Pharma's motto: "Your money or your life."
13
Very easy solution.
1. Medicare for all. individuals can still purchase extra private insurance--but all private insurance must be non-profit..
2. Tell drug manufacturers--and hospitals and clinics and etc., etc.-- they can charge whatever they want, but that if they want access to US public health system $, they must negotiate prices with Medicare.
3. Extend initial patent to 25 years. Disallow subsequent patents on the same medicine to promote competition. That should be a sufficient profit motive to develop new drugs. If not, maybe overseas companies would be happy to fill the gap.
4. Force all employees of Federal Government to take the public option--including Congress and the President--as their ONLY health insurance for their time in office.
9
Congress already must use the Obamacare exchanges. And no, MFA wouldn’t wave a wand and fix this.
I love the thought of Congress lecturing the private industry about cost containment. Nothing hypocritical there.
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@John
You do realize that "Congress" (eew...) makes the policies private industry wants it to make? That our courts sit motionless until private industry tells them what to do?
That some cities, not as wise as New York, pay billions of dollars for private industry to maybe step in and hopefully employ a few people and with any luck not leave to pull the same scam elsewhere?
You boys love this business vs. government stuff. You seem to think it means something. Its stupid.
When was the last time a cure was found for anything? No profit in peace or cures, truly evil people are in complete control.
4
This is why there is little incentive to develop new antibiotics. Blockbuster drugs do not cure, they just palliate.
3
NYT - please write an article on how Big Pharma funds most of the members of our wonderful Congress. Start at the top, list each candidate, how much they've been funded now and through the years and then list how they have voted on each legislation affecting Big Pharma. The results won't be shocking. Nothing will change until this is fixed for good.
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And in addition to politicians, a comprehensive assessment of marketing to physicians. (It will not be declared as marketing, rather as consultation and education.)
8
I'm a doc. Your analogy to tobacco is misguided: there is no beneficial use for tobacco products, except maybe to look chic in an old movie. Bogart looks great smoking away in Casablanca: dead fifteen years later of the big C. The tobacco companies got us hooked and played us until they were stopped, or at least slowed.
Medicines are largely necessary and needed, often life-saving. The ancients knew that people would pay any price for health, pain relief and looking better. The healthcare industry knows it too. What we need is cost containment without killing the golden-egg-laying goose. No one wants Venezuela here.
What to do?
Competition and negotiation.
Let me offer an anecdote. My patient sorely needed a med the local druggist wanted $200 to dispense. GoodRx site revealed it was $30 at Costco.
The druggist reluctantly agreed to match it!
9
The Times is a funny organization. They think big Pharma has a conscience and the Congress has any interest in helping the American people. America has become a country that has no interest in intruding into profit making. No matter who gets hurt in the process. Monopolies? they no longer exist. Price fixing and gouging? Not in America. Negotiate drug prices for the people? Not here we don't. It used to be, you developed a new drug, got a patent, made back the cost of discovery ( and a lot of research for new drugs is paid for by the taxpayer, by the way) and a nice profit cushion, then the price was scaled back or generics were allowed on the market. Now it's the bean under the cup game. Oh and by the way....if you need those drugs, who are we to stand in the way of insurance companies raising your premiums? Why do all these companies sing the exact same tune? Think they coordinate? And you were all worried about death panels and rationing of care...Nope, doesn't happen here. You are just subsidizing other countries who say to big Pharma....We will tell you what we are willing to pay....Oh yes and the answer Democrats offer is socialized medicine.. We reject that. We prefer paying through the nose or going without. We have principles here in America. Trump and Mitch have my back. The next line you here..."Tough hearing, Senator. What say you to going out for a drink and dinner? Love to hear about your family".
10
Let's get Joe Manchin (D-WV) to ask Mylan those questions. Mylan, manufacturer of the EpiPen, is run by Manchin's daughter, Heather Bresch. Mrs. Bresch went on television and got away with justifying the outrageous price increases of the EpiPen. Where would she find the nerve to do that without knowing that Congress would never give her a tough hearing?
12
Drugs sell in other countries for a tenth, or sometimes nearly a hundredth of what the same meds cost in the U.S. Clearly you aren’t losing money on any of those sales, so why should we have to pay more than everywhere else in the world?
Pharma spends more on advertising than on R&D. It’s hypocritical to argue that doesn’t impact pricing.
8
How about the real culprit of rising healthcare costs? The Insurance companies. Please do an article on the salaries of the CEOs and have them come to Congress. Pharma might have a few pricing issues but nothing compared to the parasites of insurance companies who produce literally nothing but judgements and out of control costs. Pharma at least provides medicine and it can cost billions to bring new drugs to the market. But this darn crazy rich unregulated insurance companies have really gotten away with what is practically murder.
2
Big Pharma's undisclosed and undeserved fortunes are a product of lack of sensible regulation, and public supervision, and morals, of a savage capitalistic system devoid of ethics, hence, disallowing the freedom to become relevant to patient's needs, and become a license to exercise selfishness and avarice...to the deep detriment of patient's life and disease control. This situation is not sustainable, and voluntary restrain is a joke and non-enforceable. Can't we see we humans are corruptible when given the chance? Let's help these poor rich Pharma executives a hand, so they can exercise their prudent behavior...by doing what's right for a change.
1
It is time for Americans to be able to access foreign medications. The manufacturers have gamed the system in the US so that they are restricting competition with generics and raping the public with prices on brand name products. They spend more on advertising than they do on drug research.
2
How about we charge them with murder, or battery if the prices of the drugs are so high that people who can't afford them die or are injured due to pill splitting?
1
A number of years ago my wife was in the US. She got a cold sore. No big deal. Cream for this is sold in Israel over the counter, a small vial for the equivalent of $10 or so. It is not subsidized. That is market price.
She went into a NYC drugstore. Firstly this required a prescription. Ok. Legitimate. Then they asked for her insurance? Insurance? How expensive could this be? It turned out to be $400 (!). Why? Who knows. She did not buy it.
Now if she visits the US she has a vial of cold sore medicine with her, just in case.
The irony for residents of the US is that generic brands of your drugs sell for much cheaper abroad.
4
Tough call on this one.
We live near the largest Pharma companies headquarters.
Because or their location their are thousands of newer homes, new shipping centers, new schools, new roads, the revitalization of old towns, and new hospitals.
If it weren't for these companies this would not exist.
They have provided excellent paying jobs, taxes for new good schools that send kids to college and the cycle continues.
Provided thousands of construction jobs. Created demand for materials to build all the new buildings and roads.
Landscapers are busy.
Hispanic immigrants make money here and send it back to their home countries helping those economies.
These companies use lots of electricity and fuel for their buildings and laboratories.
The area is flush with money....and for no other reason.
This area would be a depressed area if not for big Pharma.
Those that read and post around here that hate this success, what is your replacement plan?
You stand on wooden boxes and talk about good new jobs, what do you have in mind?
Yes there are big executives that make big money there, but there are also janitors with no education that make good money cleaning the bathrooms.....and thousands of in between good paying jobs.
Tell me your plan.
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@Joe Paper
From the New Testament, Mark 8:36. For what good does it a man to gain the whole world but lose his own soul.
@Joe Paper
As I see it, the main discussion is on how the rules of the game should change so drug prices go down in the US, and people can afford taking medication. No one is saying pharma companies should completely disappear.
As an example, the drug Humira makes about 19B$ revenue per year in the US alone. That is over 1B$ per month. Think about this number, and how much money comes in every day on the US Humira bank account...
No doubt you can have great janitor jobs at the headquarters from these profits (as well as sales reps that push the product), but is it fair that everyone pays for these through their inflated health insurance? Or should we force the company to set a lower price? (Humira costs $5-6000 per month, people use this for chronic diseases all year round). In other countries, Humira is a lot cheaper. At half of the price, you would still have great jobs in your region.
@Mark
No,,, if most in your party had their way the companies would be shut down and the people would rely on a government check to live....while living in silly little houses and walking for a small bag of groceries every day.
This is what your party has planned for us.
This may be a stretch too far for today's propagandists t the NY Times and other East Coast news outlets.
Cigarette smokers going back over a century knew full well that tobacco harmed them. The line that consumers were fooled may fool the completely ignorant but average America has always known better.
The crisis today with prescription drugs includes some things that can be fixed by government, like a drug maker buying ALL the raw material sources for plant-based compounds that can be made into important drugs - which HAS happened.
But if you are serious about lowering drug prices, the tort system will have to be reformed so that it loses the casino efect of some fast-talking lawyer fooling a jury into defunding a drug company over the one person in ten million who suffered from a beneficial drug.
How about a clearing committee that will review judgments and jury decisions with an eye to the public's need for some drug companies to be sheltered from the most outlandish damage?
The drug companies are paying the Republicans in congress payoffs to keep every thing the same so they can keep over pricing the drugs. That needs to stop but with the greed within those companies at an all time high I don't expect cooperation. The government needs to take them over. Capitalism only works for the rich not the 99 percent.
1
Our non-transparent grossly overpriced military purchases, our criminal jack up of cheap life giving medicines-- these are criminal, banana republic acts. Big Pharma can get what it wants, and Big Pharma also mixes meds, changes one molecule to a cheap generic drug, then makes the entire over worked GP and Internal medicine docs parrot what they say and give only the expensive kind- (maybe free samples for the first 10). This is criminal behavior. The millionaires in Congress don't know the vicious actions of Big Pharma.
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Don't kid yourself. Our lawmakers are also gaming the system...who else lets these pharma lobbyists get away with these shenanigans. Then we expect them investigate the industry. What a system!
1
The pharma industry has found a very effective marketing strategy: “Your money or your life!” The people running it should be treated the same as anyone else who tries that approach, and locked away for a very long time
Kudos, and now how about the other tobacco industry analog...addiction.
Drug ads, like for humira are 30% of drug costs. Humira will bring in twenty billion dollars this year. Many drugs are really stolen from university research labs when the researchers figure out it is effective they take off with the drug and patent it. We should not pay more than the average cost charged in the ten most developed countries in the world. We are underwriting drug costs for the rest of the world while many many people go without because they cannot afford the drugs. Forty percent of prescriptions are never filled because of high costs. Medicare should be allowed to negotiate prices like the VA does. Leave this up to Congress? There are three drug lobbyists for every congressman in Washington and drug companies contribute five million dollars to each on average every year. Drug ads have bought off the press. Seventy percent of network revenue comes from drug ads. They bought us out folks. Drug patents should be rolled back from twenty years to ten in two year ratchets. This industry is morally corrupt. People have a right to health care. In France, Italy, Great Britain, Canada, Japan they get drugs at reasonable affordable cost. We are sleeping our way to diseases and death.
2
It's a disgrace and an insult, a slap in the face, if you will, to those Americans who are sick and need some relief. All solid questions you pose in your excellent editorial. If they aren't asked by the committee, what other recourse do people have?
How about the editorial boards of like minded major newspapers issuing a united editorial? Pressure has to be applied to these drug companies in various and unexpected ways. Maybe some radical means need to be considered? Although I'm fortunately not one of them, desperate people take desperate actions.
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Congress doesn’t control Big Pharma. Big Pharma controls Congress.
If people want Big Pharma reigned in, they need to stop electing Republicans and Corporate Democrats. These legislators have spent decades ignoring Pharma racketeering in return for massive injections of cash.
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One very simple fix make advertising drugs illegal. That will reduce costs.
3
Congress and the NY Times should demand to know more about the huge number of drug shortages. There are currently 219 drugs “in shortage” (https://www.ashp.org/Drug-Shortages/Current-Shortages/Drug-Shortages-List?page=CurrentShortages). These are not exotic compounds but include things like Normal saline (sterile salt water), D50 (sterile sugar water) and cheap but essential medications that have been off patent for years.
I have been on our hospital’s pharmacy committee for 25 years and these drug shortage problems have been escalating over the last decade. Through these shortages, drug companies deny patients access to life saving chemotherapy and they also contribute to higher prices as pharmacies scramble to find substitutes, for which prices can then be escalated.
In some instances, shortages result when the FDA keeps companies with poor manufacturing practices from producing drugs. However, regulations need to be in place so that there are always at least 2 manufacturers of any generic drug and that manufacturers are fined for every day that an approved product is in shortage. Also the FDA should have regulatory mechanisms in place to keep manufacturers from stopping production of an approved drug on supply/profit reasons alone. (Obviously the FDA could still shut down production on safety grounds.)
Patient safety is too important for price inflating drug shortages and overal price gouging to be allowed to continue. Action is needed NOW! Enough is enough!!!
1
I recall that the cigarette company executives stood up before the congressional committee, took an oath, and lied one after the other. I also remembered that none of the executives suffered any consequences for their bald faced lies. That day exposed congress as week-kneed paper tiger.
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If anyone thinks that the kabuki theatre is going to bring about real change, you are really just kidding yourselves.
M4A is probably the only thing that works. And you have visionless policymakers like Dianne Feinstein on its path. She is not only visionless; she also seems to forget she is a public servant.
Despite what the Times continues to write, the vast majority of the work required to develop molecules and study a drug occurs after the basic science is elucidated. Further, as documented in several venues, the funding of research by NIH is dwarfed by that spent by Pharma and biotech, and NIH does very little translational and development work. Crediting NIH for the development of drugs is like saying the makers of pigment are responsible for the Mona Lisa.
1
@LTJ
"Developing molecules" almost always refers to making small changes to molecular structures of existing drugs that "get around" existing patents belonging to other companies. These small changes have no effect on the drug's efficacy, but open the market to competition. This is a waste of scientific talent and development money. Very rarely does increased competition lead to lower drug prices.
"Study a drug" involves animal testing and Phase I and II clinical trials in humans. The clinical trials use up most of the money, paying MDs in med-school-associated hospitals to plan the trials and do the work. Cutting corners on getting "informed consent" from patients is a great temptation for these MDs, whose present employment and professional advancement depend upon fulfilling these drug company contracts.
This whole system is rotten. Nationalizing "ethical pharmaceutical companies" could restore ethics to the process.
Many of our elected officials who are going to question drug companies obscene increase in drug prices are the ones colluding to keep prices high. Citizens United helped to elect and corrupt our Congress. Trump promised to reign in drug prices and names Alex Azar, to be his Secretary of Health. When Azar was CEO of Lilly, the price of insulin they produced tripled!
To stop this travesty we need to have single payer Medicare for all and enable Medicare to negotiate fair drug pricing. We need to stop TV advertising of drugs. We are one of only 2 countries that advertise drugs on TV. We stopped tobacco companies from advertising on TV.
We need to get rid of Citizens United as part of campaign finance reform and elect a government that represents their constituents, not corporations.
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What? “Trump hasn’t kept his campaign promise to “negotiate like crazy” with drug makers.”?
But why does America have to depend on the whims of campaign promises to make such a basic human right as medicine affordable---especially by a Trump who lies like crazy?
It’s amazing the Times could editorialize on high drug and medical costs without focusing on who finances our lawmakers' run for office. Why is that such a taboo?
Sure the companies “need to take meaningful steps”. What’s going to require them to do it?
What will compel our lawmakers to compel corporations to lower drug prices, make insurance premiums affordable, to deal with climate change, or to take any steps to benefit society and not profits?
In other world democracies, they are compelled to ‘take steps--- with L-A-W-S, passed by their legislatures. Why are their legislatures free to regulate drug and medical costs, to represent the interests of their citizens who elect them?
Could a major factor be freedom from the need for campaign funding from their medical industry, and other corporate mega donors----which our laws allow and even encourage?
It’s the corporations who regulate our govt, compelling lawmakers to do their bidding. Lawmakers and the media lament the abuse Americans have to put up with. We vote and hope for the best.
Next editorial, please.
1
Big Pharma and the rest of corporate ghouls have high jacked health care in the USA, transforming our health care system into one that exploits the sick and dying instead of caring for them.
"...critics, however, note that a good deal of basic research is funded by the federal government, through the National Institutes of Health, and not by the drug makers."
This reality that negates Big Pharma's main argument for their price gouging has been ignored by the press and politicians for years.
Enough of this madness. Government has a bigger role in pharmaceuticals than just being free R&D for profiteering drug companies. It should strictly regulate the prices of drugs, ALL drugs, but especially those that owe their existence in part or whole to taxpayer funding.
The companies that make medications in the USA are on a trajectory that is purely insane .
I will note this - the price of Ventolin inhalers in Australia are about 7 Australian dollars - about 5.8 USD and the price in the US market around 65 dollars .
That is for a medication that has been around for a very very long time and went generic a long time ago .
Insane .
1
I’m not getting the analogy. Cigarette companies kill people...for money. Drug companies save lives...for money.
This editorial equating the two diminishes the point you are trying to make here. If there is a problem (and there probably is) you make it extremely unlikely that people will take your point seriously.
@Timmy F lack of money kills. Drug companies are charging extremely high prices for some of their products or have raised prices to unconscionable levels. Oh, and some drugs do not benefit people more than the older drugs or placebos. The tobacco moment is that drug companies lie about what it costs to bring a drug to market when it comes to the science side of things.
@Timmy F
RE: Sackler Purdue Pharma
In 2017, opioids killed 43,036 Americans
What adds insult to death, is that Medicare Part D has funded this at a premium. The U.S. Congress has had a law that states we cannot negotiate the price of drugs.
1
It's obvious. You can't allow unlimited profiteering of the sick — it's immoral. But that's what we've been doing for decades in this country. Our system is immoral.
Why pretend that suddenly there's some drama in the moment? It's logical for for profit companies to continue to gouge the sick up to and until they're dead. Unless we limit the level of profit like civilized countries do — why present this fantasy that we are addressing some unknown enemy at soem crisis moment.
The time for Universal Healthcare was in 1950 when the rest of the western world got it. Our status quo has just been so morally reprehensible for so long we can't even feel pangs of conscience anymore.
4
I'd like to add that drug commercials should be illegal.
How much does Big Pharma spend on research and developement? Is it less, or more than they spend on Marketing?
How many drugs are invented in OUR public institutions, whose patents are handed over to Big Pharma?
And why, oh WHY, are they allowed to manipulate the Market by (barely) altering a drug (by about half a molecule) when one of their drugs is about to enter the public domain/ be open to being generically made at Substatially less cost to Citizens?
I know, I know, it's 'just Business,' but since when has Greed Over Profits become the new American mantra?
1
And this article doesn't even address the opioid crisis created by the Sackler family of Purdue Pharma in Stamford CT that is killing more of us than the so called smuggled drugs Trump is citing as coming across the border.
Ok
Here is a question I wish the NYT would ask.
If Humira does not need over 100 patents (and surely it does not), and it's just a way to extend the money making machine, why does the US patent office grant the patents? I'm having trouble blaming AbbVie here. I mean, if I ask my boss for a raise every month, and he gives me a raise every month, am I bad for asking?
Here are 2 simple solutions:
1. America/Americans buy its drugs from those countries where the prices are cheaper (which is ALL of them)
2.The Government negotiate the price of all Drugs.*
*As the Government has already and is "allowed" to negotiate the prices of drugs for the V.A, it does not involve creating extra costs or administration than already exists and therefore is a very simple fix.
Implementing either 1 or 2 or Both will guarantee Americans a far fairer and better price for drugs than they currently endure.
By now you’d have to live in a bubble not to know that Pharma is run by a bunch of crooks. They get away with price gauging because we let them. And we let them by electing people who take their bribes and campaign ‘contributions ‘. What a system. And anyone who does try to fight against all this is labeled as a socialist. How helpful is that?
Too bad there’s nothing on the market to improve general intelligence.
There is no reason to expect Trump a rich Republican to go after the drug companies and demand lower prices . With there lack of morals the GOP are taking payoffs from their lobbyist to keep the prices high so they can continue their ripping off the people in the world their product was suppose to help. His GOP supporter are not smart enough to see this . Very sad
Government must subsidize cost of election if we are to truly have members of congress address the issues facing us. It would be foolish to expect them to bite the hand that feeds them.
The malfeasance of the pharmaceutical industry makes my blood boil.
Industries whose products or services directly impact public health and well-being should not have a free hand in setting prices. The "invisible hand" of the marketplace doesn't care if an insulin user's life is cut short. But we should.
In my angrier moments I think that a stake and a pile of tinder and wood in the agora should be reserved for industry leaders whose products cause addiction and death. But life imprisonment for second degree murder would suffice.
1
The industry that is actually most similar to Pharma is Oil Exploration. Out of 100 dry wells, a company finds one gusher to pay for all the failures. The same is true in Pharma. I know scientists who have spent their entire careers in drug companies without a single successful program to their name. Discovering new drugs is not easy, and the NIH doesn't have much to show in this area either.
On a related topic, the FDA has questions to answer about its role in the opioid epidemic and its meetings with big pharma prior to allowing opioids for long term use. Those responsible should be grilled over that. But just as we saw in the financial crisis, those responsible will escape accountability for the pain they cause so many.
1
High drug prices here subsidize low drug costs in the EU and elsewhere. How thoughtful and generous our Congress is to the EU.
5
Having worked on the scientific research side of a few pharmaceutical companies I can state that they are not concerned with the science research as much as they care about the market research. When cuts are made they affect the science side far more than the marketing side. Data that does not support the company's wish to sell a drug or highlights unpleasant side effects is often ignored. These companies are not the angels they masquerade as. They are as profit driven and greedy as any other company. Their true allegiance is not to the people who might use their product but to the bottom line, the CEOs salary, and whatever else is necessary to keep a popular drug popular.
2
We do not allow the electrical utilities or the natural gas utilities to charge whatever they want to charge. We fix prices because these services are so critical to life. We should do the same with drug pricing.
1
@Hubert Nash....Not true. We fix utility prices because they have been granted a monopoly to operate in a given area of the country.
1
@Hubert Nash Va Power OWNS the government in the state of Virginia. They call the shots.
Like many giant problems Americans face, profit must be addressed before public good. Guns are more important than regulations, dividends before clean water and profit before health. It’s not ironic we have a washed up flim-flam steak salesman as President, it’s a perfect representation. Medicare cannot negotiate drug prices by law. And patients can’t go outside the US market. There is nothing free about this market, market forces don’t lower prices - it’s just a legislated, monopolistic rip off. And Americans die so the pharma execs can buy a bigger boat next year. That’s who we are. We are very exceptional in that we regulate profits over people and make our country less livable by the day.
8
Congressional Democrats will be fighting a battle with one hand tied behind its back. Republican legislators are in the back pockets of big pharma lobbyists and care far more about free market capitalism even if the consequences are price gouging. The outrage over this should be bipartisan but sadly it is not.
4
@nzierler I agree with your point generally but both parties are beholden to Big Pharma. ObamaCare did little if anything to address predatory pricing in pharma and neither party appears willing to allow the Federal government negotiate drug prices for Medicare or the VA on behalf of patients. The notorious Epipen pricing and blocking of competitive products by Mylan (and the relocation of their HQ from the US to the Netherlands) was aided by the CEO's father, Senator Joe Manchin (D - WVA). If you want to point fingers, there are plenty of folks in both parties to blame. This is more indicative of the influence of lobbying money on both parties.
@nzierler The Democrats are in bed with Big Pharma too. If not, then why didn't they pass Medicare pricing while the Dems owned the House and the Senate when Obama was President?
This problem can be solved, but it will take strong, fearless leadership from the top levels of our government. Trump made some big claims during the campaign about fighting soaring drug prices, but he immediately shoved the work off to his HHS, FDA and CMS folks. That won't do the job. I have spoken with many physicians and specialty pharmacists over the past few years through my job, and I've asked them about this issue. One, drug pricing is a deliberately secretive matter. The drug companies, pharmacy chains, insurance companies and PBMs have used this system for years to justify huge price hikes that bring them juicy profits. The only "reason" for the rise is that it's "what the market will bear." For too long, patients have been lulled into accepting this system because their insurance companies would pick up so much of the tab. When they don't, for a particular drug or if your insurance coverage changes, you'll see a huge increase. "Sticker shock." And there is no end in sight. Patients (citizens, voters) need to DEMAND that their elected officials do more.
4
This is why health care should not be left to unfettered capitalism. Insurers and pharmaceutical companies must be regulated. Period.
6
Every business enterprise takes financial risks on its product or service. What drug companies know, and what is unique about their products, is that they have special leverage with consumers. People's lives or their quality of life is usually at stake, and consumers of medicines are especially vulnerable to overcharging, even extortion.
1
@JR80304.....What is also unique is in the discovery and development of a new drug is that almost all of the very significant cost comes before the first unit of their product is ever sold.
I agree with all of the comments, especially those who correctly label big pharm as part of the MedicalPharmInsurance Industrial Complex. Notice I added one more culprit to the mix: Insurance Companies. Yes, those folks who “cover” for all those prescriptions and then turn around and deny them unless the prescribed meds are not the “generic” form. Generics are often NOT identical to the original. But between high pricing, lobbying and noshing with MD’s, insurance companies have convinced patients that they are. The local pharmacist is caught in the middle. We would not HAVE to have “generics” if the patents for drugs developed with tax payer dollars BELONGED TO THE TAX PAYERS in perpetuity. Secondly every medicine sold through any government agency, i.e., VA, Medicare, Medicaid, Children's Health Insurance Program, Public Health centers, Planned Parenthood, prisons, AD military and state funded hospitals, be priced according to pool pricing, not in isolation. Then why stop there, why not the whole nation based on ability to pay. The MPI Industrial Complex has too many tentacles and too much to lose if the US adopts a national health care system. Just ask your congressional reps.
The primary purpose of government is to protect citizens. The MPI Industrial Complex has come between the government fulfilling that purpose and those it is supposed to serve.
3
The pharmaceutical companies claim that they can't reduce their prices to the levels seen in Europe, Canada and elsewhere for the same medications, because then they would lose money, or couldn't afford research and development. It could be that they are just simply lying.
However, to the extent there is any truth in what they are saying, then effectively US consumers are subsidizing consumers in other countries. Don't take this the wrong way, Europe, but we can't afford to do that.
2
Qui Tam: "protect the crown"
As I read the White Papers on Healthcare by PwC, Deloitte, and others and listen to politicians who claim to be "fiscal conservatives" speak of preserving Medicare in the face of campaign finance efforts by Big Pharma to keep the politicians in line with keeping the Medicare Part D "cookie jar"; I feel a deep sense of; Taxation without representation.
3
It is simple story to understand. Even Congress can understand. Big pharma can't legally price gouge in the EU but they can in the US. Thus the current drug price crisis in the US. Congress has not been duped. Congress has been a willing, long time, hand maiden to the drug cartel pricing scheme. All in return for its political action dollars.
15
No, it is not a fair point that without enough profit from one drug, companies can’t afford to make the next one. If this were true it would also be true for all other products. There are many startups that work on new products while they have no existing product. They propose a new product idea and seek to get funding for it.
3
I used in my youth to be a cigarette smoker who switched to pipe and then to cigars.
While I fully believe in the evil of cigarettes and their adulteration by tobacco companies, I ask myself whether the throwing into one basket of all natural tobacco products is justified? The enjoyment of pure tobacco smoke from a pipe, hookah or cigars is too deeply rooted in human habits. I have no opinion on the use of snuff and chewing tobacco.
The Federal government is the only body with the power to control the oligopolistic practices of the pharmaceutical industry. Of course the rest of the developed world figured this out decades ago which is why drug prices in France, Britain, Japan, Canada et al are a fraction of those in the US. Until the government seriously take control of this process this situation will continue.
6
And much of the research is done in taxpayer funded universities and academic medical centers. Our tax dollars pay for this research. We should not then be gouged for the lifesaving medication. I urge Senate Finance Committee to hold the Pharma executives accountable. Americans know that consumers in other nations pay far less for the same medication.
12
@Kate Sweeny, RN...."And much of the research is done in taxpayer funded universities and academic medical centers. Our tax dollars pay for this research.".....This seems to be one of the biggest misconceptions in the public domain. Universities and academic medical centers are engaged in basic research. They do not do, nor are they capable of doing, applied research. For new drugs, both basic and applied research is essential, and neither is trivial. You can't substitute one for other.
Advertising should be included in this list of top questions. Direct-to-consumer ads are annoying and inane as they have become more prolific. Let's explore these numbers, as well, shall we?
18
@Nancy Ellis -There are only 2 countries in the world where DTC advertising is allowed. One is the US and the other, I believe, is New Zealand. More is spent on advertising and marketing than on development and research.
2
@MegWright..."More is spent on advertising and marketing than on development and research.".....The correct statement is that more is spent on marketing than on development and research. Advertising to the public, although unnecessary and dubious, represents a relatively small part of the marketing costs. In fact the marketing costs includes giving away free drugs which is nearly as much as their public advertising budget.
1
How do you write about pharmaceutical companies having their "tobacco moment" without discussing the problem of the pervasive television advertising the companies are doing? While tobacco was forced off television because of the widespread belief in the harms of their products, all of the pharmaceutical products are only forced to announce their potential harms and risks during television advertisements and that is exactly the problem. The masses of viewers are being constantly exposed to the fact that people around them are having to make life or death choices in double bind conflictive conditions. Many of the new pharmaceutical advertisements offer relief from medical conditions, but warn that the medicines may kill them or make breathing difficult or may cause other frightening side effects. The effects of such constant double approach-avoidance messages on television all day and all night long need to be studied and discussed. I think the messages themselves hurt American society.
9
The only way we can prevent unfair pharmaceutical pricing, is by ending lobbying. How can we depend on politicians to stand up to these corporations, when these companies are funding their campaigns? Look at how much Novartis paid off Michael Cohen. Its all there for everyone to see, but nothing will stop this unless corporate lobbying is ended.
13
@Jess One of my students from China asked me recently -- how is lobbying different from bribery...? He asked tentatively and sincerely but he had a point...
3
It's not just the drug companies, it's the entire medical industrial complex that must change -- the doctors pushing drugs when simpler lifestyle changes might truly heal a problem, the insurers pushing drugs over other such options, a government run by and for these companies, not the general public... As an example, a dermatologist once tried to prescribe oxycodone to me for a slight skin rash! Turned out, I was allergic to toothpaste. Meanwhile, a friend in Denmark got a prescription for a health club to exercise as treatment for a heart condition. We really are up against the limits of capitalism on so many levels in the US today...
8
@sue denim: Of course, but this article is about what drug companies are doing and what they need to do to bring down the costs of drugs. Also, what government can do to lower drug prices. That is part of changing the system, and an important part.
@sue denim
Actually, your friend who was prescribed a health club membership for heart disease, was prescribed the correct treatment. Diet and exercise are what matter the most for heart health, not statins.
Yes, the healthcare industry is full of many problems. But the pharma companies are the root of these issues, as they have embedded themselves fully into the healthcare practice. i.e. paying off doctors in order to prescribe their products, etc..
6
I worked for many years for several multinational drug companies in France, dealing with doctors, pharmacists, marketing people and top executives. I well remember the tension in the air whenever the time came around for the tough negotiations with the government medical authorities (l’AFSAAPS) concerning drug pricing, but I don’t remember anyone ever saying that these negotiations were not normal and necessary for a fair functioning health system. The fact that the American government is not involved in drug pricing negotiations with drug manufacturers is utter insanity.
19
@Susan
And no advertisements running on TV. Way to go France! If one needs drug info, speak to doctor.
2
It isn't just the manufacturers of drugs that are running up the prices. It's chain "drug stores" like Walgreens that are soaking those in need of medication too.
Seems to me that a little "truth in advertising" aimed at Pharma advertising on TV is needed also. But they are spending millions on TV adds that has the backing of advertising companies and the Networks that are raking in those millions.
Where is congress on this issue ? Sitting on their hands and getting paid off with campaign funds.
8
@USMC1954....I have heard that the drug store mark up is nearly 50% of the price they pay for the drugs they sell.
The global market for pharmaceuticals is around a trillion dollars. The US market for pharmaceuticals is around 500 billion. In effect, we are subsidizing the entire planet. Obviously, the “America first” ethos that has crept into our politics lately, doesn’t apply to big pharma!
3
I work in pharmaceutical pricing, and can guarantee there is no complex hidden formula to set the drug prices. It is pure market dynamics.
The way this works is that prices are determined by how much insurers are willing to reimburse. For any new drug, the market access team will have discussions with insurers where they test target profiles of the product at different price levels. Typically the optimal price in the US is the one where insurers will say they reimburse at minimal restrictions. The fragmented insurer market and the fact that Medicare/Medicaid are not allowed to negotiate drug prices, lead to the inflated prices we have today.
On top of that, every company takes price increases on their product (typically 3-10%) every year, for the simple reason no insurer will stop reimbursing if you increase the price marginally, as they will have to explain this to their patients, who might then switch over to competitor plans.
In all my work over the past ten year, I have never seen the cost to produce a drug come into the equation. Generally that is way below the price insurers are willing to reimburse.
To deal with this, the trump administration is implementing a pilot with reference pricing (this proposal is similar to a Bernie Sanders proposal), where they look at the prices in other countries, and limit the price Medicare/Medicaid will pay for this drug to prices in for example Greece.
2
A hearing on drug prices in this Republican Senate? I'm not sure how they'll do it, but somehow they'll manage to look good on camera and end up preserving Big Pharma's profits. It's what Republicans do. They all know who subsidizes their next campaign.
Citizens United: the gift that keeps on giving.
29
The drug companies are obviously going to charge as much for their products as the traffic will bear. The only institution that can counter this situation is government. Our government is too invested in capitalism to do anything that would benefit the general welfare so we wind up with the highest drug prices in the world.
15
@Clark Landrum But, but, socialism!
1
@Terry
Exactly.
1
I don't know what is happening in the world but corruption in the Indian Pharmaceutical Industry is booming leaps and bound.
After working as a sales representative in this industry for 12 years I can say that companies and doctors are doing all the wrong things together without bothering about patients.
Every year new guidelines come to control these malpractices but ended up at failure as policymakers are primary beneficiaries of all kind of pharma sponsorships.
3
"...one can only hope for a similarly pivotal moment for prescription drug prices"
No, one cannot.
Its different world out there. Washington, from the legislature to the courts, is supine before business, unwilling even to contemplate anything more than another Susan Collins weep-fest before voting to honor the nobility, the purity of purpose of the rich and the corporate, and yet again wrecking the system to feed them ever more financial bon-bons.
There will be stern, even angry speechifying; there will be Lucy from Des Moines whose mother died for lack of medication, there might be some vague invocation of God or somebody equally hefty. There will be no meaningful action.
In twenty-five years America has lost its way, tossed aside the compass, and gone whole hog into the "money is all that matters"slough, capped with "if you have it, you must be a very, very good person; the rest of you sit down".
I imagine it would be a profitable exercise to to observe this show trial with the tobacco scorecard on your lap, comparing the games directly. A good sociological proxy for the degradation of a once great nation and a once-promising economic experiment.
The signal phenomenon defining our current desperate situation: "applying for dozens of patents for minor technical tweaks that provide little clinical benefit".
You're flagrantly generous: patents are extended for colorful packaging, new colors for capsules, wee changes in dosing information.
18
Does anyone watch television? Those ads are costly.
Probably more so than the $$ spent on testing, development and manufacturing the drug.
Ask your doctor.
15
@NLG Stop advertising drugs on television. Allow doctors to recommend medications to their patients. It must drive doctors crazy when their patients come in and ask for a drug they saw on TV.
1
@NLG.....Advertising drugs directly to the public should be eliminated. However it is also true that advertising to the public represents only a small fraction of the drug discovery and development cost.
But who we're not going to see , the big gap in the picture--is the PBMs, the Pharmaceutical Benefit Managers. The PBM is the black box where rebate deals are struck between the pharmaceutical makers and the insurance companies. Essentially it's the same process as billing fraud, where the inflated price shows on the books but a cheaper price is actually paid, and the middleman and supplier pocket the difference. Until this dark link in the supply chain is fully exposed to the light, the scam will go on.
12
The analogy is imperfect.
Pharmaceutical companies sell hope to people seeking cures.
As long as they do that, they will prosper.
4
Congress needs to look no farther than its own allegiance to pharma lobbyist donations for the current state of drug pricing. Medicare, the single largest payor of prescription pharmaceuticals in the country, is forbidden by law to negotiate drug prices with manufacturers. If congress overturned this practice, we would have a true drug market based on supply, demand, and competition, instead of the uneven playing field that exists today.
41
Congress needs to get its own house in order here, too. By legally preventing Medicare to negotiate prices and denying citizens the ability to buy drugs from Canada or elsewhere they have engaged in protectionist, anti competitive practices to the potentially fatal detriment of the people they pretend to serve. The hundreds of thousands of dollars poured into the campaign coffers (that I am sure is passed on to the consumer) of these "public" servants is more than suspect when it comes to examining the problem. Perhaps at some point they should put a mirror in the witness seat.
30
This is a subject that needs close examination. Eliminating price gouging practices of this part of healthcare is essential. One good interim step toward correction would be to authorize Medicare to negotiate all drug prices.
In my early fifties I began to have two new health issues, high blood pressure and asthma. Both are well controlled with certain medications. The cost of the generic HBP medications is reasonable. The asthma medication — in my case, Advair, is very expensive. According to my doctor, the combined medications it involves have been around a long time, but the patents have been extended for years with minor changes to the delivery inhaler.
7
@James
I was treated for asthma in my 50s, which turned out to have been caused by an allergy to egg whites!! (two a day for breakfast was more than my body could handle.) .Self-diagnosed!! I also had hives -- ran out of eggs and the hives and the asthma disappeared! Also pay attention to air quality. Crack a window open summer and winter!! Good luck.
More and more, I like the idea of taking some of those patents by eminent domain, as I recall being suggested a few months ago in an op-Ed.
And start building, operating state-owned drug companies.
Capitalism is good, but when it fails to provide what a nation, state, community needs, its fair that we step in and make it ourselves.
20
Comparing companies that work to improve health with those that never did dumbs down a complex issue. Many of the comments highlight this complexity: basic elements emerging are that 1) research for improved medical outcomes are part of a larger poorly understood system. Acting on one element of that system alone may not yield the intended outcome. 2) The values in the US are mainly those of capitalism and individual empowerment. To enact some of the control mechanisms that some advocate for would fly in the face of one or another of thee these values and not be immediately acceptable to Americans.
While it is easy to be more inflammatory in our editorials, individual commentaries, discussions with those who have had direct positive or negative impact in one or another complement of the complex system, the first and most important step is to clarify our goals for health as a society. How important is health to us? How does it compare to our desires for economic opportunity, defense spending, individual rights, social safety nets.... Once this country is clear on what it chooses to achieve, I can think of no better place to find smart solutions.
1
@Nevine Zariffa
"The values in the US are mainly those of capitalism and individual empowerment. "
No, that's not right. Maybe more like: The rhetoric in the US is mainly that of capitalism and individual empowerment.
Business around here loves to talk free market and capitalism and individualism. And democracy.
But they lust after socialism at the corporate level. They spend billions every assuring themselves they are safe from anything like the free market. And they conveniently ignore all the help, money, and special treatment that accompanies the long, lonely, hellishly difficult process of creating the next half-trillion dollar wonder drug.
Of course that gives the lie to everything you just said, because that long, lonely, hellishly difficult process is exactly what the free market is about. You work, you invest, you get rewarded. That's how it works.
American capitalism just skips to the 'get rewarded' part, and then uses all that money to keep the cash coming in without additional effort, not even a legitimate stab at maintenance.
The number of people commenting here who clearly adjudge themselves brilliant beyond the ken of their American peers, and sophisticated in finance and politics in ways no common man can appreciate, are living on hype, lies and a seventy-year-old picture of what business actually does.
American business is broken. American business broke it. Politicians abandoned their citizens and allowed, even encouraged, it to happen.
Having had a major mental illness for the past 25 years, I remember many conversations with my prescribing psychiatrist each time a "new" mental health drug came on the market. Frequently he explained that the drug company had added an ingredient which extended the patent and marketed it to another segment of the population.
1
Publically traded pharmaceutical companies attract interest from activist traders who see the lack of U.S. market pricing controls as a means to grow their wealth fast. These companies cannot be shamed into pricing their products fairly, especially if their pricing index is beholden to shareholder interests. It will take regulation to bting drug pricing in line.
4
The good thing about capitalism is that competition keeps prices reasonable. It seems to work at the gas pump, as we drive down a highway with many gas stations we see a range of prices which change frequently; Adam Smith would tell us it's the market determining fair prices, no need for the government intervening. I believe that. With pharmaceuticals it's an entirely different story, competition is difficult to discern; the government must intervene. Regulations tend to have two sides, but what if it were illegal to lobby congress on drug issues ? What if the life of drug patents were much shorter ? We might need to experiment with such remedies and observe the results.
5
@eclectico
"Adam Smith would tell us it's the market determining fair prices, no need for the government intervening"
You are deceived, or willfully wrong.
Adam Smith, as every other significant theorist of the free market, insists repeatedly and forcefully that capitalism requires regular and rigorous regulation or the system will collapse in a miasma of greed, dishonesty, self-dealing, and thievery.
We are currently proving him right.
Alexis de Tocqueville, that great describer of democracy and capitalism, spent the larger part of his brilliant work warning of the depravity of business without wise and meaningful regulation, and the absolute requirement to hold in check exactly the destructive forces wrecking society today.
'Capitalism' was never intended to describe unrestrained plunder and destruction.
This, "We might need to experiment with such remedies and observe the results", is a cruel joke. As you experiment lives are destroyed, misery spreads, and the "we" you mention are the very people who bought us to this horrid pass.
The FDA is not in the business of controlling business practice yet they could help. First, stop approving drugs that are redundant in therapeutic benefits. There are several disease states that have too many drugs to treat the same indication. Take MS, how many therapies are need that do not prove to be an improvement in outcomes? Too many options equates to shrinking market shares for each product which encourages unnecessary price increases to keep up profits. We cannot allow any one or a few companies to monopolize a indication-but we can impact it.
1
All prescription drugs have side effects and are poisons. If people ate a healthy diet and lived a healthy lifestyle, we would not need ANY of these drugs! Nature Cure naturopaths have been telling us this for more than a hundred years. Drugs hurt our bodies but they make huge fortunes for a lot of people, unfortunately. I am 78 and my husband is 82 and we do not take ANY drugs at all!
7
@jimfaye - There are many, many diseases with no known lifestyle component. MS, Parkinson's, many different cancers . . . the list goes on and on. Yes, lifestyle changes can have a positive effect on SOME diseases, but if you claim everything can be cured by lifestyle changes, then you're just wrong. What you're benefiting from at your ages is good genetics. I know, I'm almost as old as you are and I, too, take no medications. But I know that I got lucky in the genetic lottery. Other people aren't so lucky.
1
I'm very skeptical that there are enough people in congress to force any real change. Big money controls the government. Why else has nothing been done?
30
They spend billions trying to hawk their products in advertising. Ask your doctor about some wildly over priced product. Why is it that so many people cannot afford the medicines they are prescribed? Its because it is a capitalist market profit driven system that is out of whack. The pharmaceutical companies want to pretend that they are not a part of a winner take all system. They use insulin and epi-pins to rake in huge profits. They sold physicians on the notion that addiction to OxyContin was manageable problem. Medicare for all is their worst nightmare.
15
Please call Pharma out for relentless marketing on television, where they dominate ad time. These ads appeal to uninformed consumers, who are prompted to self-diagnose and to see the need for drugs as a normative relation. We have an opiod epidemic that is a crisis. Marketing drugs directly to the public is about profit, not health care.
37
@WIS Gal
Fair ask. The core of the problem is that there is not enough fair-balance between the efficacy of the therapy and the glamour the ad represents. If one believes we need to see fewer ads, then full disclosure will reduce the number of ads.
2
@WIS Gal. Yes, I agree. In fact, I think all drug advertising should be prohibited: Television watchers' brains go into the slower alpha waves, making critical thinking (beta waves) drop. It's kind of a meditative state. So the ads also hypnotize people into believing they are sick as well. And now these stupid ads are all over our computers too! Do you have COPD?
Finally, a lot of pharma drugs overwhelm the body - yes, sometimes that is needed, but many times, a more gentle (and cheaper) remedy can be found that works with the body instead of overwhelming it. Our bodies are our best friends, not enemies to be conquered!
1
A tobacco moment for big pharma? One way to bring it about would be to legislate against physicians owning stock in pharmaceutical companies: a conflict of interest.
24
@Joe Not to mention congresspersons.
2
i just looked up the profit margin of United Healthcare and it's significantly more than 20%. What gives? Profit margin is a bit of a weird metric anyway - it varies naturaly by sector. If profit margin is all you care about the biggest villain would be gas station convenience stores rather than companies trying to get lifesaving new medicines on the market. If you look at CEO salaries the insurance sector is doing awfully well off of their business model of competing to be the company that denies the most claims and thus keeps the most premiums.
7
To our representatives - Please do something. No more just talk. My type I diabetic son - a hard working laborer - his whole life revolves around his diabetic illness - and the premiums the copays, the anticipation of the next insurance rate hike.
At the ground level a day to day life. A mother here observing his attention to good diet, exercise, emotional stability.
Can see the benefit of more accurate insulin delivery pens, glucose monitoring and delivery devices. But to see the cost of life-saving basic ingredient insulin go up and up puts a knot in one's stomach. Lives are in your hands. Think about it.
15
@Glad Even better than better drugs and devices would be finding cures. In general, the large pharma companies are not interested in developing cures because of loss of revenue. Most drugs temporarily take the edge off of the worst symptoms but don't address root causes. Directing Federal money to address root causes and funding manufacturing might be a partial solution. Some U.S. leadership on this would be welcomed--now.
3
Don't forget to examine the role of Pharmacy Benefit Managers (PBMs) in the economic equation. The price of the drug is hiked by the manufacturer so that it can offer "rebates" to the PBMs to allow their drug to be on its formularies. Where do these rebates go, after the PBMs get them? Hint: look at yahoo finance and examine the financials of the big three PBMs. They have posted record profitability.
19
Is lobbying still legal? End of conversation.
11
@Michael Yes. It is a 1st Amendment right: "...to petition the government for a redress of grievances." Get a group of your fellow North Carolinans together, make an appointment to see your congressman or woman during an in-district work week, go meet with them and have specific examples of your concern and describe what a good outcome would do to improve that congressional district. Bonus points if you can recommend legislative language.
1
@Ask4JD
And bring money?
Insurance companies have a cap of 15 to 20 percent on profits is the problem. fifteen percent of $1,000 is a lot more profit than 15 percent of $100.
6
There seems to be no limits on what big Pharma will charge. I am aware of an oral treatment, using a commonly used supplement, that has just been approved for a rare disease that will cost $30,000+ a year. Anyone could go to any nutrition store and buy the same supply of the compound for less than $3,000. Of course that would not be by prescription so I assume that insurance companies will not cover it. The high cost is not due to development costs, all the work was done in university and it appears that most of it was funded by the federal government. And in this case the cost was not due to massive advertising costs, so it must be greed. (By the way the one thing these type of articles ignore is that many pharmaceutical companies spend as much on advertising as on research).
20
I don't think you need an expert to explain how the drug prices are set or why they keep rising. Its called greed.
39
What is needed is not answers but mechanisms preventing the price escalation. Pharmaceutical executive can provide answers for hours and days.
Congress should tackle one by one reasons that allow for the price escalation. Patent laws were bent in corporate favor, they should be bent back. Generic drugs face difficulties of entry, this should be reformed, perhaps even with "cost + fee" model that was applied to utilities. Then there is a question if balkanized health care system can match bargaining power of national systems, perhaps we are doomed without a "single payer" model.
10
They also need to be stripped of their immunity for vaccine injuries and restore the principle of due process of law, instead of placing the burden on the taxpayer and the corruption of an administrative government Court.
11
It's simple. The pharmaceutical companies charge outrageous prices because our health insurance companies are happy to pay them and pass the costs to us by jacking up our insurance premiums.
20
Lowering drug costs in the U.S. should be pretty simple: Just look at what almost every other country in the world has done. If they can do it so can we!
19
@RF
What other country in the world has ever developed any new drug?
@Nevine Zariffa I didn't say anything about developing drugs. My post was about lowering costs. Why change the subject?
And thanks to the 2017 GOP tax bill which adopts territorial taxation, US based multinationals like AbbVie no longer have to move to a foreign country to avoid US taxes. Now all they have to do is move their intangibles/IP/patents to a tax haven and shift pre-tax profits there - hiding in plain sight escaping taxation indefinitely.
16
Mitt Romney, if Corporations are people, why doesn’t territorial taxation now apply for actual people?
"The hearing ushered in a public health victory for the ages. In its wake, lawmakers and health officials enacted measures that would ultimately bring smoking rates in the United States to an all-time low."
And they lived happily ever after. That is, the lawyers lived happily ever after. Why are smoking rates at an all time low? Because a pack of smokes went from $1 to as much as $8 per pack.
When everyday meds go from expensive, to really expensive there will only be one clear choice. The government takes over pharmaceutical distribution. What's so bad about that?
Remember the phrase, "means testing". The more you make, the more you pay. Poor people won't have to pay anything. At first. Just wait until the US government goes full Venezuela.
@Mike Real world experience would inform you that there are many options between vulture capitalism and "Venezuela". I have lived for the past year in Costa Rica, hardly a Venezuela. For a mandatory fee, based on means that for us is $200 dollars a month, my wife and I receive complete health care coverage that includes pharmacy. If we don't wish to use that system we carry an added private insurance of which there are a number of options from government operated to private. Again at significantly lower cost. By any worldwide gauge their health care is very highly rated. Generic medications are readily available at a fraction of the U.S. price. I can walk into any Pharmacy here and, outside of a small list such as antibiotics and narcotics, buy any medication I need from a knowledgeable pharmacist, and in some cases get advice from a physician who works for the pharmacy, eliminating costly visits to the doctor or emergency room. In case you are wondering Costa Rica is a healthy, one person one vote democracy.
1
@Mike You could check out one of today's stories on CNBC.com, for an example.
"Social Security expansion bill poised to gain traction in Congress, targeting those who earn over $400,000."
And let's not forget the billions they spend pushing their wares on television, radio and print. It's not as if they don't have enough sales people on the ground pushing drugs directly to the doctors.
39
I've been living in Norway for almost thirteen years, and work as a health economist doing cost-effectiveness evaluations for the Norwegian health system.
It is clear that Europeans have found ways to keep prices down by negotiating at a country level. Some people have said that the ability to do this is facilitated by the high drug prices that Americans pay, but it seems like those outrageous prices only add to the high profit margins in the industry.
Wake up, Congress! The pharmaceutical companies will continue to charge as much as they possibly can until you decide to act.
73
@ASD
Somewhat simplistic and poorly thought out. The question, from an economics standpoint, is not just how much the drugs cost, but what benefit is being procured for that cost and is it enough to warrant the cost? Please tell us what drug has been developed in Norway or any other European country with a "cost effective" drug pricing system?
1
Big Pharma sells drugs. Some are wonderful, live-saving compounds that have revolutionized humankind's existence and led to longer, healthier lives.
Others, however, are little better than tobacco, intended to bring short term relief (or even pleasure) at the expense of addiction. Like tobacco companies, Big Pharma has found that addicts are reliable and profitable customers.
But Big Pharma has one big advantage Big Tobacco never had--medical insurance. How great it is when your addict can keep buying because somebody else (the government or an insurance company) is footing most or all of the bill.
And another Big Pharma advantage--unlike tobacco products, politicians would never put "sin taxes" on drugs intended to cure people's illnesses. It would look terrible from a political perspective.
The key policy decision is how we use subsidize the research and prices of the life-altering, life-saving, drugs people need. Perhaps tax policy plays a role--tax credits for R&D on drugs with true health benefits, other than mere cosmetic ones (e.g., Botox). But this is so difficult. Most people would agree that taxpayers should not subsidize Viagra for use by adult film actors. But Viagra may also help a wounded veteran regain intimacy with his wife--a laudable goal that can help save a man's self-esteem and his marriage.
The usual wails from pure capitalists aside, eventually Big Pharma is going to have to be more regulated, to protect the rest of us from its excesses.
10
The USA is one of only two countries that allows direct-to-consumer advertising of pharmaceuticals. Americans are inundated with ads - expensive ads - for these products, and doctors are hectored on a daily basis by patients who demand that they be prescribed that latest 'tweaked' drug.
If this advertising tsunami were restricted - as cigarette ads are - a new prescription and pricing model could eventually emerge, with less incentive to push minor tweaks (now known as 'exciting new products') on patients, and with doctors (professionals) being more in control of what drugs their patients get. As well, tens of billions of dollars spent on marketing could be redirected to R&D to develop real improvements and new drugs.
28
@Chris H
Agreed. I'm old enough to remember when drugs were not advertised (except for over the counter). It was better for the public.
13
@Chris H
But then what would we watch at dinner time? Hasn't everyone noticed all the prescription drug ads between 6 and 7 every night?
Time to turn the TV off during dinner, folks.
2
@bdk6973
That's when the evening news is on. I, and many other people, watch the news
2
Good luck! The difference between Big Tobacco and Big Pharma is that you can prevent the former to sell their products, which are really poison, but you cannot force the latter to sell their products, which is medicine.
But more importantly, what to do with Small Pharma? We are not talking about Pharma Bro buying old drugs and running up the price 7000% overnight Fake Pharma but those who have sunk tens if not hundreds of millions in some miracle cure. Every one success story is matched with perhaps a hundred failures. Just how do you calculate that?
A single provision cannot solve this high cost of healthcare conundrum. It has to be holistic, starting with basic research and ending with sensible regulations and partnerships. By supporting basic research, government should lay claim to part of the medicine benefitting from it. FDA has doled out goodies along the way like orphan drug status, fast track and priority review. Do you know you can resell a company's priority review ticket for millions? If companies cash out on their prize before realizing their stated goal of bringing medicine to market, there should be crawl back.
Elected officials need not only to learn the intricacies of how the medicines are brought to market but also some patent reform. You need more than just a simpleminded solution. Perhaps the NYT Editorial Board should also learn about the complexity as well
1
Even if all prescription drugs were free our healthcare costs would still be climbing. Millennials are on track to be the most obese generation in American history and 40% of all cancers are preventable. Drug companies do have to answer for raising prices but let’s not overlook the fact that we are not eating right or getting enough exercise which in turn leads to hundreds of billions in healthcare costs.
5
@Richard Meyer
This is true but not germane.
Simples, if a drug is protected by a patent its retail price is regulated by the federal government.
No patent, no price regulation.
The airlines’ profits were once regulated by the federal government. A 14% return on Investment was the cap. No reason why this couldn’t apply for Big Pharma, although 10% is probably better.
15
Cost is the least of the big pharma problem. See Vanity Fair ‘Deadly Medicine’ and then do more reporting on how pharma is taking sketchy and deadly clinical trials abroad. Also, they have all but become mob-like in pushing more drugs with dangerous ‘side’ effects on more people, with laughable FDA oversight.
14
The trouble is that the agencies that should regulate pharmaceuticals, as well as politicians are so politically sensitive that nothing is done to really regulate them. In the case of politicians, the sensitiveness spells money. The first thing that can be done is refuse to give 270 patents to the same medicine. The original patent should last whatever the law allows, but further refinements should not be patented. After all if the medicine requires improvement it means that it was not that effective to begin with. Second, Democrats should now give Medicare and Medicaid the ability to negotiate prices. And then let theSenate show which side they are on. Let's start with these two doable actions and then consider their effect.
18
It is nothing short of criminal that in a country that prides itself as one of the most prosperous in the world, a significant percentage of the population struggles to pay for pharmaceuticals, being forced to choose between eating or buying medications.
While some of the conditions people struggle to buy medications for are controllable by diet and lifestyle, such as high blood pressure and diabetes, in other cases pharmaceuticals are needed to control life-threatening illnesses, some of them hereditary, and of no fault of the individual.
As a business school graduate we are indeed taught that a public company's first responsibility is to its shareholders. However, where the well-being, or even the potential lives of a people are at stake, there needs to be some sort of regulation.
After all, if If Nike wants to charge outrageous amounts for its shoes, there are numerous more affordable options, albeit not necessarily name brand ones. Not always so in the case of pharmaceuticals. If the drug companies have no collective conscience, it is the responsibility of our elected officials in Congress to hold their feet to the fire.
Beyond that, if all these costly drugs are doing something to improve our health, it certainly doesn't show. According to the Bloomberg Healthiest Country Index 2019, out of 169 countries, the U.S. comes in a pitiful 35th place, almost last among rich nations. Seems we're not doing something right.
16
@JHM While I agree with most of your comment here but I am compelled to correct something specific you wrote which is a common lack of awareness about diabetes. There are several types of diabetes. You, like many, lump them together as one disease or condition. This is wrong. The two most common types of diabetes are Type2 and Type1 and are very different. While Type2, for some, MAY be controlled by diet and lifestyle, that is NEVER the case with Type1 diabetes. Type 1 diabetes is an autoimmune disease which can not be prevented and for which there is no cure. It is life threatening EVERY SINGLE DAY without the proper amount of insulin. Without the correct amount of insulin(which requires carbohydrate counting, an understanding of emotions, hormone levels, prior and future activity level and more) the Type1 diabetic becomes either hypoglycemic (an immediate medical emergency) or hyperglycemic which leads to various long term complications over time. Without insulin, a Type1 diabetic is dead within days. Dead. Insulin is like oxygen. Insulin is not a cure it is a treatment. Insulin should be dirt cheap. The original patent for insulin was sold by Charles Banting who discovered it in 1921 to the University of Toronto for about $1. He wanted his discovery to be affordable to everyone who needs it. How far we have fallen. Please do not generalize and imply that diabetes is not a life threatening condition. Otherwise, good comment.
11
the patent system has been a festering sore for decades. some even argue it is doing more to stifle innovation than support it. the big pharma companies are egregiously abusing patent protection, and it will take a dedicated, years-long cleanup effort to fix. it requires a president capable of understanding the problem and dedicating the political capital to solve it.
one possible quick-fix would be to somehow incentivize and authorize private law firms to litigate the worst abuses and reward them with a portion of the savings the government realizes from protected medications getting generic competition. this could be supplemental to similar in-house efforts by DOJ.
4
Patents are only standing to sue alleged infringers in courts where settlements are usually won by the deepest pocketed litigant.
1
In Canada, our government has the Patented Medicine Prices Review Board that regulates drug pricing. In addition, there is a law about new breakthrough medications, which cannot exceed its median price around the world.
Canadians do not receive free drug perscriptions... Working men & women get prescription drug coverage as an employee benefit, or pay out of pocket... Regardless, the same 'cheap' pricing exists for all Canadians, regardless of how the drugs are paid for.
The lack of pharmaceutical price controls in America is yet another case of US lawmakers acting only in the best interest of corporations who lobby with cash, not citizens whom mostly just bote.
23
British Columbia's pharmacare covers prescription drugs after one pays a very reasonable income-based yearly deductible.
11
So it seems now established that American people pay much more to their medicines than other peoples. There aren't many reasons to this. 1) Foreigners are free riding on this; not just on national securities! (as those prices are mostly managed by governments). 2) American pharmaceutical executives are much greedier than foreign ones (as, I think, the existing drugs are destined to become cheaper here).
5
How to explain the tripling of the price of a simple drug, Estrogen, in ten years in the USA?
Can pols in foreign countries accept $$$ from pharma corps for their campaigns?
Foreigners are
not freeloading off lower pharmaceutical prices negotiated by their governments, forcing Americans to pay more. This is a myth.
The cost of doing business is so much lower in countries that actually regulate the pharmaceutical industry.
Americans pay more because the pharmaceutical industry is funding Congress through campaign donations and the high cost of lobbying to keep the status quo.
Change how elections are funded and politicians would have a better understanding about who they represent.
I'm sad that this editorial didn't mention the Unapproved Drugs Initiative, a well-intentioned effort by the FDA to encourage medicines that existed long before there was an FDA to undergo the sort of safety and effectiveness study that is required for new drugs. Unfortunately, the then Republican-controlled government passed a law requiring that the studies couldn't be funded by the government itself, but instead would be funded by private businesses, rewarded by patent protection as if they had invented the drug itself.
I suffer from gout. While not life-threatening, it is an excruciatingly painful disease, and there is only one drug that prevents gout attacks for me and many other patients: colchicine, a medicine that has been used for gout for 2,000 years. One colchicine pill costs 9 cents everywhere in the world except the US, where it costs $4.85, a fiftyfold increase.
I'm very lucky; my health insurance pays most of this cost. But my out-of-pocket cost is $30 per month, ten times what I'd pay in Canada.
Again, this medicine has been known to be safe and effective for thousands of years. There has been no benefit to society from new research to confirm what everyone already knew. Alternatively, if Congress hadn't gotten in the act, the FDA could have sponsored the research for far less that what US government health programs such as Medicare and the VA have paid to Takeda Pharmaceutical because of the company's absolute ability to set the price.
17
We must break the Republican lock on Congress to make the changes necessary to reduce drug prices. The trademark laws must be changed to facilitate price cutting on drugs.
31
@DENOTE MORDANT, problem is most democrat's are bought off too, all problems stem from the legalized bribery that is our government.
2
I think it's time for a bit of realism on this issue. Treatments for cancer in particular are not developed from NIH-discovered molecules, 99% of all drug trials end in failure and most bio-pharma companies go bankrupt because the process of discovering, formulating and sending drugs to trial is so rife with failure. So please explain to me again why pharmaceutical executives, many of whom are physicians who moved into industry from practice because they were sick of dealing with insurance companies, should be dragged in front of Congress to answer spurious charges designed to make them look like bad people?
2
@Shane If they are not developing new treatments, then what is the National Cancer Institute and NIH doing with their $40 billion budgets? They are certainly testing medications on human patients who agree to be test animals.
10
Because they place no value on human life. The only thing they care about is collecting more of Lucifer’s Silver. They ARE the enemy of the people. And should be treated as such.
NIH and university medical centers are more than capable of developing drugs and running clinical trials. Basic formulary manufacturing processes should be multi sourced without patents interfering with market driven competition. As a society we have the answers to everything accept why we love rich big pharma executives and their lobbyists. Hmmm, maybe beholding congressmen and good ol boy Mitch could explain it to us mere common folk.
17
It’s also time for the members of the Sackler family to forfeit their ill-gotten billions, spend some quality jail time and pay a heavy price for the tens of thousands of lives lost and devastated as a result of the aggressive marketing of opioid pain medications for everything from a hangnail to end of life palliative care.
76
@chambolle We could clear a cell by letting out a non violent pothead who's in there mere possession.
The US government should have the best science labs in the world in all areas, for our national well being against foreign competition. Furthermore certain technologies should be considered vital and strategic to the national security, and therefore not necessarily subject to the avarice, vagaries, and whims of investors in the free market. This should include medicines, utilities like the Internet, and transportation.
The idea you cannot do better for Americans because it disrespects some theoretical capitalist ethic is an oxymoron, capitalism exists relatively unregulated only because people are willing to allow much private gain for much public good. When the private gain buries the public good, it's time to change the rules.
23
The only way to lower drug prices is to eliminate our third party, insurance system. Cash only , and you would see prices plummet.
15
@Hb
This is not true. The pharmaceutical industry has raised the prices of a number of drugs manyfold (up to 50-fold) within a short space of time. Sometimes insurers have adapted, sometimes they have pushed the cost to the consumer. Pharma has also stopped making some drugs because their profit was too small. Again, insurers have then supported alternatives at much greater cost. One problem in this is that there is no recourse when the pharmaceutical industry decides to stop manufacturing low-profit drugs. It almost seems time for government to support a not-for-profit manufacturer of orphan drugs. That is, if pharma decides not to manufacture a drug, all patents to it are revoked and the drug is manufactured at cost.
7
I very much favor reducing pharmaceutical prices substantially, but I find two aspects of this editorial off target. The comparison to the tobacco companies is not justified; they were selling a highly toxic product of no significant value otherwise and denying it. Although they charge too much, the pharmaceutical companies generally tried to bring things to market that improve peoples' lives. Second, the problem with pricing is as much or more a political and policy issue in the US than it is bad corporate behavior. The GOP has has not allowed Medicare to negotiate prices, a practice that would be a major driver for pricing. Why else do you think that these same drugs cost so much less in the UK. This is not to excuse the pharmaceutical companies, but the congressional hearings is a bit of an empty show, not unlike Trump's tweets.
13
A career in biopharma Sales & marketing here. The price increases are because they can—there is no cap on profits in capitalism.
They always claim innovation will end if they don’t have this level of profits. That’s a deep pile. Innovation was equal or better when price increases were annually instead of quarterly—look at the volume of new drugs that hit the market in 1970 versus today.
Used to be the average “formula” per dollar was: 20% to R&D, 40% goes to Sales & marketing. It was a great career, and I would love to get in this hunt.
25
I speak with gratitude for the many health care professionals and workers who bring healing to the ill, injured, crippled. From the person delivering food who takes time to open containers or cut food to the doctors and nurses and therapists who touch us in a multitude of ways to help us heal we are blessed by a host of caring individuals. And yes, there are numerous medications that protect and heal and reduce pain. But, as the Times’ editorial articulates the pharmaceutical industry has much to explain regarding the pricing of many drugs. As there was far too much evidence that cigarettes caused many ills now we see ridiculous price increases and drug charges by the pharmaceutical industry that far exceed any reasonable explanation. The outrageous prices are cruel, even verging on criminal. The pricing can easily require the complete savings of an individual/family. The healing provided by so many in health care is harmed by the unreasonable profit sought by the pharmaceutical industry.
4
Apologists for the status quo routinely denounce Democratic proposals for a more just system of health care as "socialism" or worse. They like to proclaim their concern for individual rights -- by which they must surely mean the right of Americans to be endlessly ripped off by Big Pharma, at a cost so extreme that no other advanced nation puts up with it. Research and development in itself hardly explains it (on average 20% of total revenues). And other products or services don't have such vulnerable and desperate customers, literally a matter of life and death.
19
US Government contracts to supply GSA for many years included a clause which guaranteed that the product would be available to the US Government (via GSA) for the lowest price for similar or lower quantities of the product anywhere in the world to any customer.
Given that the US Government and taxpayers are the true payees of most drugs today via Medicare, Medicaid (subsidies) or VA provided care, this seems reasonable to ask.
The "tweaked product" patents should be challenged with major abuses charged as the fraud and theft it is.
Drug companies are not the only reason the US manages to spend about 2 times the money per person of health care as other wealthy nations for worse outcomes measured in life expectancy and perceived healthiness,-but they are certainly a major cause.
FYI--this is only a place to start. As a cancer survivor with ongoing medical needs, my total medical spending in 2018 was billed by providers at $96,655.53 "rack rate", negotiated to $25021.37 by my provider, with 22045.79 paid by Medicare and my Insurance, leaving me 2975.58 out of pocket. "Rack rate" is the amount I would have owed without Medicare and supplemental insurance.
That bill is pretty typical for me 5 years post cancer--and includes only about $500 of drugs--all generic. The cost problems are widespread.
When opaque billings are 4 times actual payments (and profits were still made on my services), this is not capitalism, it is attempted theft.
9
The problem also extends to the insurance companies that conspire with big pharma. Case in point, a twelve week course of Harvoni for Hep C (HCV) costs $95k. Harvoni has a 95% effective cure rate. The insurance companies that cover Harvoni treatment (some don't) routinely will deny the claim initially. Doctors that specialize in liver disease now have staffs of nurses who's sole job is dealing with the insurance companies to get prescription approvals. Meanwhile, nearly 400,000 people die annually worldwide from complications of HCV according the World Health Organization. HCV could be virtually eliminated if the world population had access to Harvoni and Gilead could be the hero. Gilead is advertising extensively on television however large portions of the population does not have access due to the cost.
On a general note: If our government leaders were as worried about microscopic invaders as they were about migrants looking for a better life, perhaps there would be a policy shift. But the insurance and pharma lobbies are effective in preventing this. Campaign finance reform would be a good start.
9
Why has the price of insulin soared?
Because it can!
There isn't really anything to investigate it. Industry runs this country so $$$ are all that matter to them and ultimately legislators. Healthcare costs will always be a problem as long as the healthcare industry is a for profit business. Look at big pharma profits, spending on the pharma lobby, campaign contributions, and how the pharma industry snows the public about research costs. The NRA isn't the only segment that buys politicians.
20
It's real simple.
Cap drug costs via government regulation and tell them that if they're not satisfied making $100 billion a year instead of $200 billion a year, they can try finding another line of work that pays more. Do the same with every other part of the health care so-called system. If doctors and hospital executives aren't satisfied being millionaires instead of multi-millionaires, tell them to find another line of work that pays more. My guess is, they'll stay on the job.
Medicare for everyone. It's a beautiful thing, even for doctors and pharmaceutical executives who'd still be rich while the rest of us would be a bit less poor.
16
Our patent system is broken. Blaming the people who play by the rules distracts from the failure of the representatives who should be fixing the rules.
7
I'm not holding my breath on anything being done by the Senators on the Finance panel. Their role in this theatrical production is to play the part of "doing something" while doing nothing (wink, wink).
If they play their cards right they'll get an outrageous quote to tickle a news cycle or two. But doing anything to get in the way of billions of profits - that is not what the Senate Finance Committee is set up to do.
11
It's not just about drug prices, it's also about drug efficacy and negative effects on health. Real medicine comes from healthy food and daily exercise, not drugs.
1
@PE Not exactly.
Part of the answer to the soaring drug prices is simply math based. Medicare D provides the pharmaceutical industry with about $3500 dollars per Medicare beneficiary per year in taxpayer funded drug coverage. In order to maximize profit off each and every beneficiary only requires hiking the price for as many drugs as possible and that wide net has enriched them at the taxpayers expense. Add the republican mandate that prohibits price negotiation for Medicare D and the economist working for the pharmaceutical industry calculated that broad price increases would maximize profits. So the price of every drug had gone up without justification.
8
In addition to the US being one of two countries that allow ads on TV, there are other schemes to contribute to effective drug dealing/pricing. According to a suit brought against the Sackler Family as board members of their privately owned Purdue Pharma, makers of the pain killer oxycontin, the increase of use of sales representatives is a direct correlation to overdose deaths.
Sales representatives were pushed to make more than seven visits a day at the cost to Purdue of $200 per visit - and still allowing for huge profits. These visits to 'high prescribers' would then yield millions for the Sackler family.
The marketing and advertising are one of hundreds of actions that need to be taken to get this industry under control before we have to file for bankruptcy as a country due to their greed and gouging. Purdue also spent large sums to fight legislation in Mass. that would cap the number of oxycontin pills that could be prescribed The bill never passed, thus the money well spent for the Sacklers.
We can thank the state of Mass. and their Attorney General for filing the suit against Purdue, because god knows, our legislators/lobbyists are just another cost of doing business for the industry. No legislation or meaningful change will come out of Congress. We appreciate the attorneys.
17
My suggestion: make patent protections hinge on pricing oversight. You want certain privileges? Earn them with good behavior.
6
Actually the more relevant question that your article should have posed is “Why does a bottle of insulin presently cost $25.00 in Canada and hundreds of dollars in the USA?” The insulin is identical. Type I diabetics CANNOT live without insulin and attempts at rationing have very serious short and long term health negative consequences.
19
The pharmaceutical industry is out of control and while we are at it, time to pull the plug on direct-to-consumer marketing on TV. Why is appropriate to market cancer drugs on TV? Only to put pressure on prescribing physicians. Very inappropriate to say the least and confusing to patients.
21
The price of drug in this country is perhaps the best example of a capitalist system running amok. The same drug manufactured by a U.S. company costs less in Europe and Canada than in the U.S. I hope that the members of the Senate in this committee do their homework and come prepared. I would like to know the precise amount of taxpayer money that goes in developing these drugs by means of collaboration between federal research agencies (NIH, NSF, etc) and commercial companies.
I hope that the Congress organizes another committee addressing the same issues.
14
I am so glad to see this editorially oriented article and the ensuing discussion. The high cost of most all medications is now in the silly-sphere, except for the simple fact the costs go beyond anyone's everyday means.
It has seemed to me that the increasing cost of pharmaceuticals parallels the advent of medicare and other required insurance covering medication. Perhaps I am mistaken but I certainly wish someone or two would look into the curious and disturbing coincidence.
Often as not I cannot take most prescription medications because they mess up my GI tract or neuro-muscular stability ... so I have spent out of pocket a tidy amount for nothing. Now I seldom fill prescriptions because the stuff works in ways unintended for me. hmmm. How can it be that I feel better and have saved money all in the same breath.
Corporate dollars and lobbying should be completely banned from the government. It’s the only way the government will ever work for the people.
29
@GN And how will That happen? There are two presidential candidates whose top platform planks are about ending corporate and financial elite corruption of our government. Vote for them like your life depends on it. Because is very well may.
8
In Mandalay a package of Sumatriptan (ten tablets) costs $2.00 or 20 cents a tablet. Retail in the U.S. is up to $20 a tablet--a markup of 100 times.
In Dhaka a package of Zomig (ten tablets) costs $0.50 or 5 cents a tablet. Retail in the U.S. is up to $20 a tablet--a markup of 400 times.
As Milton Friedman asserted, Are we "free to choose"?
Solution to outrageous US drug prices" allow (free) competition in the U.S. market place.
That is, allow Americans to buy drugs from Myanmar and Bangladesh and other countries. Drug manufacturers in many other countries already meet GMP standards.
And allow new pharma startups in the U.S. Reliable and safe drug manufacturing only requires standard competence that is widely available.
6
It is indeed true that pharmaceutical companies commonly perform research aimed at establishing that existing drugs can be put to new uses (used to treat new "indications"). But, a pharmaceutical company is not permitted to market a drug for a new indication without FDA approval, and that comes only upon submission of the results of clinical trials in humans that prove safety and efficacy for the new indication. Such trials are very costly and also risky in that they often fail to prove efficacy for the new indication. While physicians are legally permitted to prescribe "off label", to employ a drug approved for indication A to treat unapproved indication B, this is highly problematic for both doctor and patient. Who wants to be treated with a drug that has never been proven effective for one's condition? Yes, the market for a drug does expand when it is approved for a new indication, and that enhances the revenue of the drug company. But patients benefit as well. Yes, the new indication can be patented, but generic copies of the drug are permitted to avoid such patent by simply omitting the new indication from their labeling (skinny labeling). Such patents are not really an issue. So, spending money to research new uses for existing drugs is beneficial and probably not a major cause of excessive drug pricing. There is a problem, but this likely is not its cause.
2
I share the overall concerns expressed about prescription drug pricing. At the same time, however, I am the beneficiary of a drug that was approved just a year before my diagnosis which has amazingly reversed my condition and kept it under control. I thank the stars every day that this drug exists. The retail cost is something like $12,000 a month, but on Medicare it costs me $600 a month. Would I like it to be cheaper? Sure. But I’m still glad that it exists and that enough people have my condition that a pharma company invested the necessary R&D money to develop it. So I don’t begrudge the pharma manufacturer making a profit, and maybe even an outsized profit. We must keep in mind that many drugs are responsible for keeping us alive and well.
5
@RMM I'm glad you have been helped, but you miss the point. Overall the R&D being spent is far less than what would justify the price. Everyone pays into medicare and the drug company is ripping off medicare, which is you and me and your neighbor and family, everyone, ripped off. Do not thank people who steal from you and everyone else.
There are far better ways to develop drugs than our greed based system. Cheaper faster and more effective. But as long as we are in a morally reprehensible for-profit healthcare system, it must be rigorously regulated.
7
@Trebor As I said, I totally support getting the cost of prescription drugs down. I was trying to point out that the combination of a large enough pool of patients with a particular condition, combined with the profit motivation of our economic system, does foster the development of miracle cures and therapies by the pharmas. We cannot begrudge them making a profit. The discussion must be regarding the parameters of that profit.
It's a much tougher discussion for those of us who have so-called "orphan" conditions, where the patient pool is not large enough to motivate the pharmas to spend the time and money to develop drug cures. Anyone in that situation would probably gladly spend whatever it took to encourage the pharmas to develop drugs and therapies for their condition.
The point is that there is a delicate balance between the need and benefit of the drugs produced, and a fair profit for the pharmas who are developing them.
If producing drugs is a business, then profitability is the measure of success and a well-run business uses rules and regulations and patents to maximize profitability. If producing drugs is a business, then the family that runs Purdue Pharma are very good businessmen who have creatively overcome obstacles thrown up both by prevalent physician beliefs (that opioids present dangers of addiction) and by attempted government regulation. Their products have been gateways to hundreds of thousands of deaths, and the money they made funds wings and exhibits at major museums.
If we cannot demonize free enterprise, then we cannot demonize them or other pharmaceutical companies. And, in order not to demonize free enterprise, we do not demonize them. Critical portrayals of them give their excuses, such as that they spend so much on research, and the Times has the resources to pry into their finances and report on how accurate this claim is. If such research disclosed that these claims were misleading at best, and that much of their research is the search for a competitor to another company's blockbuster drug (which is not really research), this should be reported and their claims of funding so much research classified as fake news.
The Times does not take the usual sorts of climate change denial seriously, although it is a serious matter that these claims are made. Pharmaceutical company claims should be similarly handled.
5
@sdavidc9 Are you confirming that we SHOULD demonize free enterprise for the very reasons you pointed out?
@Ann
Definitely, free enterprise should be demonized. Free enterprise is a useful bunch of demons that we do not know how to live without. But they have bad habits that they cannot be trained out of, so they always need to be watched and distrusted, especially since they are very good at hiding what they are up to under piles of bull. We are drowning in bull and much of it comes directly or indirectly from them; some of it is found on these op-ed pages.
As a person with Type 1 Diabetes, I am very sensitive to the high cost of insulin, a hormone I inject daily to survive. Currently, I am using insulin purchased in Mexico for 1/10th the cost of the same insulin in the U.S. Our system is clearly broken and people are dying because they cannot afford insulin.
While it is true that the cost of insulin has skyrocketed over the past decade, I am unaware of any insulin that currently costs $2,200 a vial. If that were the case, I would require $80,000 worth of insulin annually to stay alive.
Living with Type 1 Diabetes is enough of a challenge without having to constantly worry about how to pay for life sustaining drugs.
I support Medicare for all and allowing the federal government to negotiate drug prices.
20
Australia not only has a very good universal health scheme, we also have an advanced, government regulated and controlled, prescribed benefits scheme which controls the price of prescribed medicines to the general public. Our scheme might not be suited to the USA system but it might be worth having a look at to see if there are bits of it you could use.
15
While Congress hopefully sheds lights on deceptive-yet-legal pharmaceutical industry practices, next on their docket should be the nutriceutical/supplement industry that peddles useless concoctions with deceptive advertising and false validation on product packaging.
3
There are no words for this kind of price-gouging. I’m sorry, there ARE words: Big Pharma, Lobbyists, and Health Insurance companies.
15
It’s been said that these companies spend nearly as much on marketing as they do on advertising.
There is waste in pharmaceutical marketing that seemingly rivals the waste seen in the Pentagon. I for the life of me cannot understand why I see a Humira ad every half hour when I am watching the news on tv, but that’s really the least of it. I know because I worked in the industry off and on and have seen some of the excess first hand.
Questions to be asked:
In order to lower drug costs, should DTC (pharmaceutical advertising trade lingo for “direct to consumer”) television ads be banned? The practice started in the 1990s and the justification was that they educate the public but how much of that really happens given the dollars spent? Shouldn’t drug selection be a conversation between the doctor and the patient in the doctors office? Should DTC be limited to print and web materials that the doctor can send the patient home with to study?
Two other areas to look at:
The huge amounts of research that is targeted not to lifesaving or extending drugs but to highly profitable lifestyle drugs. Do these deserve patent protection?
“Me too” drugs - a product for a disease state for which there are already a half dozen or more effective remedies, just so the company can be in that market.
18
@unreceivedogma
Humira advertises constantly.
1
Thanks to pharmaceutical companies advances during the past hundred years - you now have an extra 28 years of lifespan to spend complaining about them.
3
And those Big Pharma companies are very profitable despite the costs of R&D, clinical studies, etc...especially in the USA. Patients in the USA are subsidizing patients around the world because of the ‘Niemens’ prices we pay for drugs!
@Jason. I hope your gratitude for all those advances of the last hundred years can survive if you or a loved one ever needs medication whose cost soars out of reach due to the bottomless greed of the industry.
1
@Jason
Not if I can't pay several thousand a month for each of them.
1
If things keep going the way they are, eventually only rich people will be able to afford drugs and treatments for diseases. The rest of us will die.
Is that the kind of country we want? Are people with lots of money the only ones worthy to stay alive? Is that the ultimate moral standard?
25
@Kristen Rigney
"Take two tax cuts and call me from the morgue"
GOP 2019: "Drop dead, America !"
32
"Actimmune, a drug that treats malignant osteoporosis and sells for less than $350 for a one-month supply in Britain, costs $26,000 for a one-month supply in the United States."
This travesty didn't happen overnight - it's been going on for a long time now, and should have been dealt with back in 2003, when Medicare's prescription drug law was being debated. Instead, one of the first things to be taken off the shelf was Medicare's right to negotiate for lower drug prices. Then the ACA came along, and again no one dared tamper with the golden calf. Is it any surprise we're seeing these exorbitant rate hikes?
I'm sure the senators will put on a very good show, ask very tough questions, and convince all of us that they are doing everything in their power to protect the consumer. Sorry, I'm not buying it. When it comes time to vote on the next seemingly innocuous bill or rider that will actually allow more of this outrageous greed, the senators all know that if they want to be reelected, they'll vote the way they have been voting for the past few decades: and that is a "yes" vote to just about anything the drug companies want.
Apparently, the American consumer is just fine with these drug prices - otherwise, why do these Senators keep getting reelected?
35
@TM
“...why do these Senators keep getting re-elected?”
Well, what with the water heater making strange noises and finding a bag of pot in their daughter’s underwear drawer, folks generally don’t have a lot of time to keep track of what their senators are up to.
Where I live, many voters subscibe to the rule of thumb that if an elected official has managed to avoid being jailed, he or she is more than likely holding up their end of the deal reasonably well.
Re-elect him!
Also, their is a prevalent fear of strangers, of things unfamiliar, and people with either too many or too few vowels in their surname.
3
Have you not seen the little text on the back of every $100 bill? "There's a sucker born every minute."
1
One strategy would be for the DHHS or the FDA to buy up voting majority shares in drug companies. Then at shareholder meetings demand accountability for fair pricing. The same for executive compensation. Congress should also investigate how drug companies get a lot of basic research for free from public universities that are funded by taxpayers!
9
@Ultramayan
Good strategy, but a bit complex.
I myself like to go with more straight-forward schemes, such as the motto of Germany’s World
War I submariner training officers: “Kill one, make an example for the rest.”
1
The explosion in Pharma prices coincides with Medicare Part D.
Haul the pharma executives up to Capital Hill and threaten them with taking that away and see what they do.
The more money you throw at things, the higher the prices go. The best way to lower the cost of a college education is to get the government out of the loan business. We should try it.
16
Don’t senators and congressmen take prescription drugs?
I’m in my late sixties and as the years pass, I only become more dependent on prescription pharmaceuticals.
On my television, most of our national legislators apperar to be older than me. And I am acutely aware of the cost of prescriptions.
How is it possible that those elected officials playing with rubber bands and paper clips in the senate and house are blissfully ignorant of the struggles of those of us out here in real world?
11
Elected officials take prescription drugs, but are also "on the take" for the drug money that finances re-election or else goes to competitors. For elected drug-money addicts to question the source of their funding is simply not the way they do and stay in business.
Also, of course, you the taxpayer pay for all their medications.
13
@Tom W - all the senators and representatives have excellent insurance, much better than you or me.
3
@Tom W
Because they have top-of-the-line health insurance with low deductibles.
3
As long as drug development and pricing are corporate enterprises it will be very difficult to control prices
Unfortunately,with corporations he pecuniary motive dominates.
This has led to the proliferation of many new products that are no better than cheaper alternatives. Many of thee drugs barely beat placebo in clinical trials. Indeed, it typically requires only two studies that show a statistically significant difference between drug and placebo to gain FDA approval.Whether this difference is clinically meaningful is beside the point. Once approval is obtained hundreds of millions of dollars will be spent advertising the drug to the public and trying to convince doctors to prescribe it. Most doctors are at the mercy of drug reps and other doctors who have been bribed by the drug companies to hawk the latest and most expensive medication. Even the Universities and Medical journals are part of the cabal. A substantial amount of the research published in these journals is financed by the drug companies and is designed to promote the drug rather than advance scientific understanding.
What can be done. Eliminate the profit motive. Establish tax payer funded Institutes to develop and evaluate new drugs.. None of these products would be patented and would be available at no or nominal charge. Researchers would be well paid and honored for any discoveries but would not become multi-millionaires. Would excellent people apply for this kind of work. You bet.
4
I am always suspect of profitability "limits" such as those outlined for the insurers. If anything, maximum margins create an incentive to drive up spending - if only so administrative costs (including executive salaries and marketing budgets) can continue to increase.
3
VOX article says that abroad, it’s normal for govt agencies to regulate and haggle with pharma over price, and evaluate if new drugs are improvements over old.
It's also normal for govts abroad with insurance mandates to regulate premium prices for citizens. Here that would be abnormal for govt. So Americans are burdened by costs under ACA.
VOX-- “Other countries see drugs as a public utility.
Countries like Australia, Canada, and Britain don’t regulate the price of other things that consumers buy, like computers or clothing. But they and dozens of other countries regulate drug prices to be affordable for all citizens, regardless of their income.
In the US, there are thousands of health insurance plans. Each has to negotiate its own prices with drugmakers separately.
Because Americans are fragmented across all these different health insurers, plans have much less bargaining power to demand lower prices.”
American citizens are fragmented and lacking political power, while the drug and insurance companies are concentrated monopolies with huge political power.
This actually contradicts the purpose of democracy. And if our news media doesn’t prominently discuss this cause/effect, it contradicts the purpose of the free press in a democracy---to inform voters on the issues affecting their lives.
12
The members of the Senate Finance Committee have to come to this hearing extremely well prepared.The pharmaceutical companies will talk in technical terms about the chemical formulas of drugs and try to impress the Senators with their costs and the years of research that it takes to produce blockbuster drugs.The Senators need to refute these exaggerated claims in order to discredit the drug companies for their long running excuse that it takes years to recoup their expense for developing blockbuster drugs.The best solution would be for Medicare to negotiate directly with the drug companies for the millions they pay each year.Doctors bill Medicare by code for procedures whose price is set by Medicare.Why do the drug companies get way with exorbitant prices- their day of reckoning needs to come now!
12
@Janet Michael
Agreed. One biologic maker is raking in close to $20B a year. What do they have to show for this?
All the companies will claim a huge investment in R&D. What they don't like to talk about is how much of that is actually for "marketing" style clinical trials and R&D staff that support the marketing of a product. You strip that out and the real R&D cost is about 10% of the number that will be given.
9
This is what should you need to ask:
1. How much do you spend on marketing?
2. How much of that do you spend on direct-to-consumer marketing?
3. How much do you spend on lobbying?
3. Wouldn’t it be better to spend a good portion of that marketing and lobbying money on actual R&D?
7
What they are doing should be criminal. If it isn't, we need to change that.
12
The profit motive is a poor basis for an effective and efficient health care system. Every other developed country has long figured this out.
17
All of the drugs used by all of the countries in the world are made by companies with a profit motive. You do not imagine there are nonprofit companies supplying drugs to countries with universal health care do you? The only difference is the leverage that a single-payer system can bring to a negotiation with a drug company. But that leverage has to include the threat that the drug will not be covered at all and sometimes it isn't.
5
@JerseyGirl Not true. Look at the history of the discovery and development of insulin as a medicine. Or penicilln, for that matter. There are many strong motivators for human creativity and endeavor beyond financial profit. Do you really think everyone making a career in scientific research are primarily looking to maximise their financial incomes? Science and Wall St attract fundamentally different sorts of people, thank goodness.
The best metric for heath care is efficient resource allocation: How can we use our finite resources to the maximum benefit for all? This is the basis of effective and efficient health care systems worldwide. And by and large, it works.
10
Something overlooked is that when those tobacco company executives testified they said that they had no knowledge about the potential health risks of smoking. Later documents were made public that they had known about these for years.
Curiously, Congress never held them in contempt for perjuring themselves.
17
The article has many good points, but one idea struck me as illogical:
"Many leading drug makers spend most of their research dollars looking for new uses of existing drugs, not on risky innovations."
Why does it matter if patients are helped by an existing drug vs. helped by a new one? In fact, I would think it would be more efficient in the former case. Yes, the latter situation would be more costly for the drug company - or is that in fact the main goal?
6
@Connecticut Yankee
"By applying for dozens of patents for minor technical tweaks that provide little clinical benefit, they stave off competition for decades."
It's a rentier class monopoly scam. They develop a minor new use for the existing drug and re-patent it for a small number of people who do in fact benefit from the 'new drug' which is largely identical to the old drug, but the 'new drug' allows for the old drug's expiring patent to be extended for years, thereby allowing monopoly profits to be extended for years and generic competition to be killed.
It's pure evil Robber Baronism.
56
@Connecticut Yankee
When companies spend 25-50 million on a head-to-head study against a competitor, it is not innovative. It's just to sell more drug.
When companies do studies to justify small packaging changes, it is not innovative. Same thing.
When companies do studies to show their drug works on a disease that some other company already demonstrated in the same treatment class, it is not innovative. However, not all drugs work the same so this can help a bit.
Where the lack of investment hurts is that the medical team that makes new treatments is so under-resourced compared to the medical team that helps support the big blockbuster.
4
@Socrates -- That is a defect of the patent laws. It was not always that way, it was made that way by lobbying of those who now abuse it.
A major goal of our trade deals has been to extend this abusive "intellectual property" regime to more countries. What we should be doing is ending it here.
8
There's only one question that each pharmaceutical executive extortionist needs to be asked by the Senate Finance Committee:
"Have you no sense of decency, sir, at long last? Have you left no sense of decency?"
101
@Socrates... sounds so old fashioned now--- "have you no sense of decency, Sir?" Compared to the 1950s how challenging would that Q be in today's big money, show biz, political culture? Do we have a Welch, and Ed Murrow?
4
@Socrates
Isn't that the pot calling the kettle black? Congress calling out pharma companies for lack of decency?
Bear in mind that your 401(k) is invested, in substantial part, in these pharma companies, and you, like all the rest of us, benefit when those companies make huge profits. I wouldn't blame the CEOs that are doing what we (the investors) ask of them, I would blame our representatives (Congress) for not setting the rules so that running a company isn't in conflict with great good of society.
1
@Socrates
We all know the answer and decency has different definitions.
There are three questions which Big Pharma cannot answer without indicting themselves as the rapacious vultures they are:
1. How can they spend so much on advertising directed at consumers who aren't even allowed to prescribe these medicines themselves?
2. Why don't they charge all other countries besides the U.S. the prices they charge Americans?
3. Why must Americans subsidize the rest of the world and pay for all of the costs of drug development. manufacturing, and advertising?
Big Pharma has bought and paid for Congress for decades, and as such has been given free rein to prey on Americans who are sick, disabled, and infirm. It's long past time that these vultures were made extinct. The only question is: do those in Congress who have feasted at the trough of money from Big Pharma have the stomach to go on a diet?
5
I thought drugs in some other countries were cheaper because the government subsidizes them.
1
Sorry, Charlie.
Other countries regulate the extortion out of drug prices; that's why they're cheaper.
Our Congress sits on its hands, swallows its PhRMA campaign bribes and let's drug prices go to the moon.
Not only do we need single-payer healthcare; we need single-payer campaign financing to eliminate the fatal cancer of unfettered corporate greed and sociopathy.
19
@Kingfish52
Agreed, I hope they do have the guts to be blunt. And I hope they revisit how one company set up a useless consulting agreement with Michael Cohen and then did their backpedaling about how they really care so much about patients.
Time for talk is over. These Congressional hearings only exist to give grandstanding speech opportunities to members of Congress that go out of the meeting and ask for donations from the drug companies. It's time to pass into law something significant like the drug cost index Trump has proposed for Medicare so Americans aren't paying more than the average of all other industrialized countries. PS Comparing drugs to cigarettes is not appropriate. At least drugs have some degree of social good while cigarettes have none
6
Here is a question I think should be submitted to these executives: "How much money has your corporation spent directly or indirectly on lobbying federal representatives since the last presidential election and what is the rationale for these expenses?" The question should include a preface that lists these totals for each corporation by and independent/watchdog source.
8
Most of the suggested treatments for inflated drug pricing are addressing the symptoms and not the cause. This issue of corporate greed above the interests of the community could be addressed in the following 3 ways: 1) publicly finance elections so candidates can make informed community decisions not connected to their own personal success or failure. 2) create a national health plan by expanding Medi-care and negotiate pricing 3) start treating food as medicine which means re-thinking the cheap food philosophy of the Farm Bill and taxing junk food which has made Americans the fattest people in the world and the ones most dependent on pharmaceuticals and health care.
11
The cost of medications, treatments, regular testing and monitoring for side effects and for recurrence has become totally unaffordable, not just for some, but for everyone.
I have metastatic breast cancer. The cost of my infusions alone (drug cost) is $640,000 per year, for standard treatment for a relatively common subset of the disease. And don't forget the costs of quarterly CT scans, echocardiograms, blood tests and other treatments.
These costs would bankrupt any American family.
While I have been fortunate that Medicare and supplemental insurance have been paying for the bulk of the costs, there is still a substantial copayment. I still live in constant fear of changes to health insurance that will leave me unable to afford these life-saving medications.
Why do drug companies charge so much in the United States for their drugs? Because they can!!! The only constraints are what insurance companies are willing to pay. Medicare is not allowed by law to negotiate drug prices.
This is not a "free market". Drug companies are given the protection of patents from the government for their products, preventing anyone else from selling the same drug at a lower price. The courts enforce these patents. They have tax breaks supporting new drug research.
What is the solution? I hope these hearings are the first step to reversing obscene drug prices.
Ironically, I spent my entire working life in pharmaceutical research, developing drugs that I may not be able to afford.
20
Pharmaceutical companies know they have us over a barrel. We need prescription drugs, temporarily or permanently for everything under the sun. Many of us have to take our physicians' word that we need an RX. We should be able to trust that the pharmaceutical companies will make our wellbeing, financial and otherwise, a priority; that won't happen on its own.
3
The USA is one of only 2 countries in the world that allows prescription drugs to be advertised on TV.
I live in Canada, in a border community, on north side of the St Lawrence River, with upstate New York on the south side - the contrast between the TV ads on network TV in the 2 countries is striking.
In Canada, the average life expectancy is 2 years longer than in the USA.
It's worth wondering: Is there a connection?
9
@Maurice GatienThe other country that has direct to consumer TV ads is New Zealand!! There are more sheep in NZ than people. There used to be hourly ads for Viagra and Cialis for ed-now the ads are for anti cancer and RA, etc. by monoclonal antibodies, etc. These are wonderful inventions. The profit margins are too enormous. The ed drugs are no longer so profitable since patent expiration and generic competition, so TV ads are for these expensive patented drugs. get it while you can is the capitalists motto. Let the poor eat cake if they cannot afford bread.Change the motto "e pluribus unum" to "it's all about money" and you understand America.
1
@ACL Interesting observation about New Zealand. Do know that, when watching US prescription-drug ads, necessary to filter what's being promised.
1
Congress had it in its power to alter this situation with changes to patent law, e g. a given medicine is only patent protected by its earliest expiring patent; minor modifications must be shown to be superior to the originals and given shorter duration patents, the techniques used for extended release, unless useful and innovative, in themselves cannot be used to extend patents, generic manufactures be given the clinical data and samples to develop extended release versions of their own. A overall profit cap on a patent would also preserve the incentive for development while limiting the price gouging.
2
These fellas will never come to heel before the Congress. Big Pharma and Friends (including the big generic makers now) give two orders of magnitude more contributions, plus other subrosa support, to our sitting and aspiring senators and reps. Nothing will ever overcome that dough. Note that Democrats feed in great numbers at the same trough as Republicans, when it comes to this money.
4
Several drug manufacturers spend more on marketing than they spend in research. So much for the 'high cost' of product development.
Drug pricing is an example of "market failure", where circumstances or unequal power overwhelm mystical free market controls.
If there were ever a prima facie case for government intervention. Legislation to reform patent law would be a good place to start.
9
@Charles Tiege
It's more of an example of political corruption, as well as a massive intelligence failure of the American voter in supporting 'free-market' Robber Baron Republicans who have zero interest in protecting society from winner-take-all vulture capitalist psychopaths.
Canadians, Europeans and the Japanese don't put up with this blood money extortion because they have functioning brains; Americans put up with hihgway robbery because they've been duped by Randian Republicans and the idiotic prosperity gospel.
26
Another question to ask: Over the last decade, how much money have you given to each and every member of the House and Senate, either directly or as your pro-rated share of monies laundered through PACs and similar entities? Then that data must be published and used to force future candidates to renounce such future donations as the legalized bribes they are to protect this industry.
17
Prescription costs in the U.S. are about 12 to 14% of the overall healthcare spending, which is close to the average for the developed countries (OECD members). Also, they are increasing at less than the average for the healthcare industry overall. If by heaping abuse on the industry (whose average profit margin is actually similar to many other industries and much lower than that of tech) we'll somehow be able to lower the country's drug spending by half, it will give maybe a 5% reduction in the country's healthcare bill - but will be quickly swallowed up by the inexorable growth in other expense - hospitals, doctor's pay and whatnot. At the same time we will permanently disable not only the innovation engine that is pharma and biotech industries, but will also destroy the leading position of our country in biomedical research in the world. Just be prepared to the time when you'll be anxiously awaiting the FDA approval of a new drug from WuXi Pharma or Beijing Genetics that had been introduced in China 15 years earlier... maybe your loved one's cancer can wait...
8
In one thing the US is indeed world-leading: totally useless TV ads.
And there are many alternatives before you turn to Chinese products. Fact is, if other countries manage to have higher life expectancy at higher quality of life levels, then all that world-leading does nothing for Americans.
IMHO the absolute underlying issue is obesity. There is no 'drug' against it. But it creates a host of conditions that simply require Americans to depend on drugs at younger and younger age, setting the table for drug-dependence for the rest of one's life. Fix that, and you take a lot of wind out of BigPharma's sails.
@cobbler do you work for a pharmaceutical company? Nothing you said can justify making a drug like insulin unaffordable for people with diabetes. The men who developed the drug gave the patent away for free because they knew the drug would save millions of people’s lives. Why is it necessary to make a life saving drug that has existed for almost a century unaffordable for the people who need it? All I see is evil people profiting of of the sick and dying.
I work for one of these gigantic drugmakers.
1. The percentage of funds that companies invest in research is an inflated number because they include all of the medical departments that help to further support drug sales. So-called advisory boards, to make sure that medical education lecturers know the company data, would be captured under this bucket.
2. Big Pharma lies to the world and itself when it keeps saying that "patients come first." This is all empty talk. All of the day-to-day effort is to maximize sales.
3. Big pharma continues to do as much as possible to draw attention away from significant side effects. When researchers ask questions that might lead to understanding side effects better, companies don't want to sort it out. They'd rather have everyone try a treatment rather than figure out the smaller group who will get the real benefit.
4. Big pharma is scared to be innovative. Research is most likely to occur on sure bets like extending the use of an existing drug, rather than going in a new direction.
5. Big pharma cannot handle internal dissent. Whistleblower lawsuits continue to occur because wrong doing still happens. Companies continue to overstate the effectiveness of a treatment and to minimize the risk of the side effects. Speaking up about this in a big pharma company leads to retaliation.
6. Major academic centers and their experts are in collusion with drugmakers. For some, it is simply the money. For others, it is naiveté.
162
Otvazhnyy - It's gotten much harder to find objective clinical safety information, for the very reasons you cite. Last year, The Cochrane Group - set up to review and evaluate clinical evidence not tainted by commercial views - fired one of its founders, Dr. Peter Gotzsche, by a close vote. Dr. Gotzsche was a critic of the safety profile of one of the vaccines - specifically HPV. Even the so-called "good guys" are under attack.
6
@Otvazhnyy
Drugs are released onto the public before a real safety trial. Faster to market, faster to profit. We are guinea pigs. Big Pharma budgets a line item specifically for new drug law suits. They find it's cheaper that way, for them.
The always touted R & D costs as the prime driver of new development costs they give as their main reason for high drug prices is dwarfed by the discretionary marketing costs in the top ten Big Pharma income statements.
5
@Otvazhnyy
Thanks for the insider view. You work for just 1 company so I'm not sure it's fair to assume they're all in the same boat. But certainly their actions overall indicate there's commonality- it's very common to buy other companies instead of trying to create drugs themselves and they all have massive marketing budgets.
1
Why am I forced to watch repetitive adverts for prescription drugs if I turn on the television if I’m neither a doctor or a pharmacist and have no qualifications to choose one drug over another for the treatments of my ailments? This practice needs to be legislated out of existence. I travel to Europe and Asia every month and I’ve never seen a drug ad on any of their TVs. And yet apparently drug prices in those places are much less. What’s the connection? I would be very happy to both not be forced to watch pill advertisements and have lower costs on any prescriptions my doctor writes for me. That would be a win win.
19
I watch too much TV. No matter the time of day, nor channel and show, I witness at least 5-6 advertisements for pharmaceuticals, and since cable networks are very careful to synchronize ad breaks so that if you switch channels during commercials you still only can ever land on a commercial, I notice that as likely as not I run into additional commercials for pharmaceuticals, a high percentage of the times I flip. They never advertise low margin or generics, only the highest margin, lowest competition medications, the recent ones with new patents or artificially extended patents.
The expenditures for advertising are incredibly huge. Because they are willing to pay huge margins for advertising, the networks favor them with their advertising time and slots.
Every time the very same medications are priced far,far below what consumers and services are charged in other countries.
Drs and researchers have long since gone the way of directorship at the pharmaceuticals, long ago replaced by MBA and financial operators whose only goal is to use any means necessary and possible to extract every dollar of wealth back for themselves and their investor hedge fund. Even today'd research doctors are after as many billions as they can amass by patenting their work and plugging it all into the American Dream machine.
Who pays for all of that in the end? The American consumer...because, you know, "Never give a Sucker an even break."
19
The pharmaceutical industry has a very large conflict of interest. Me-too drugs are quite profitable but add little to real patient care.
Just imagine what a cure for diabetes type I would do. Then imagine what it would do to the drug company's bottom line. Cure the people, and you have no profit.
The goal is to keep people alive and sick. That way their profits are secure. From their viewpoint, what could be better?
64
@Mac
You write:
The goal is to keep people alive and sick.
So true.
The perfect target drug is one that a patient must take everyday for the rest of their life, has a brand new patent that will expire, hopefully, never ( with some slight of hand legal maneuvers), have a minimum of side effects ( just enough to not kill the suckers), be funded by tax monies for the basic research, keep the patient alive but never actually cure their condition.....
Well, you get my drift.
We do not have a healthcare system. We have a disease care system. All physicians ( I am one) study disease in med school. Few physicians have any idea of true health. Their education teaches that health is the absence of disease which is ridiculous.
It is like saying, Mrs. Smith is in pain because she doesn't have enough pain relievers in her body.
The system is rotten to the core.
And the public is being held hostage to big money ( politicos, insurance companies, big pharma, hoodwinked doctors, lawyers+).
Think for yourself, people, if you want to survive this mess. Take care of yourselves and keep healthy. The wolves are guarding the chicken coop.
2
So the rumors of industry-suppressed cures for any of the cancers may well be true.
1
@simon sez physicians also don't know enough about the F in FDA. Medical Schools don't require a course in food in nutrition and frequently if the course is offered, it's only an elective. The diseases that people get today can often be better managed and treated by adding diet modification to meds.
1
Do many Americans even know that the EU countries DON’T ALLOW on TV the high -cost, direct to consumer pharma commercials that swamp Americans 24/7? Our drug ads have increased in recent years.
What are the ripple effects on our health care politics? It’s past time for US media to publicize this. Only New Zealand for some reason also allows TV drug ads.
And many countries don’t allow the paid election campaign ads on media that inundate Americans. Wikipedia says this is to ‘prevent special interests from dominating the political discourse’. That's some different political culture.
In the US our discourse is so dominated by special interests, it seems normal, and even more so since the Court's 2010 Citizens United that ok'd unimited money in campaign donations.
Other capitalist democracies like profit too, but it isn’t so idealized over all other values. Instead, drugs are seen as a matter between doctor/patient, not marketed like any consumer product. Here some would call that “un-American.”
I don’t see NYT columnists discussing this---is it taboo?
And abroad, do big insurance and pharma lobby and donate to their politician’s campaigns---as a legal norm?
A vicious cycle of big money and politics keeps our HC the world's most profitable. American media can write outraged editorials, but it avoids discussing reforming campaign finance as the 1st step. Taboo?
52
@Meredith
Yes, yes and yes, Meredith, but big money does far more than just corrupt the drug industry. I don't know one industry that is not more or less corrupted.
America is all about money!
A 2015 study of every drug on the market between 2005 and 2015 found a “startling departure from the classic conceptualization of intellectual property protection for pharmaceuticals.”
Instead of inventing new medicines, the study found that 74% percent of new patents during the decade went to drugs that already existed. It found that 80% of the nearly 100 best-selling drugs extended their exclusivity protections at least once, and 50% extended their patents more than once—with the effect of prolonging the time before generics could reach the market as drug prices exploded.
One of the most expensive cancer drugs on the market is Revlimid, priced at over $125,000 per year of treatment, Celgene sought 105 patents on Revlimid, many of which have been granted, extending its monopoly until the 2036. That gives the Revlimid patent portfolio a lifespan of 40 years, which allows Celgene to block generic competitors from entering the market.
A recent analysis found that several of Celgene’s patents are mere add-ons—not fundamentally new to deserve a patent. But because of the patent fence around Revlimid, payers are likely to spend $45 billion in excess costs on that drug alone as compared to what they would be paying if generic competitors were to enter when the first patent expires in 2019.
American PhRMA has devolved into a Robber Baron rentier class of corporate psychopaths that resembles a criminal syndicate that deserves prosecution under RICO laws.
https://cnb.cx/2KhXu8w
334
@Socrates
Hey, you didn't attack Republicans. Are you OK? /s/
Looking to RICO? What about Vermont Democrats who shelter a Socialist senator with a $600,000 summer house .. while Vermont refuses to approve single payer?
1
@Socrates Sounds to me like: 'Your money or your life'!!
5
Bang Ding Ow...yes, we should definitely prosecute Americans for home ownership.
The home is 1,800 square feet, less than the average square footage of an American home built in 2010-that was 2,392 square feet. (Though the size of American homes have been growing at a rapid rate.)
The senator's wife, Jane Sanders, said they sold her family's lake home in Maine, which enabled them to purchase their new abode.
"The entire family is very excited about it," Jane Sanders said.
https://www.npr.org/2016/08/12/489787309/the-internet-can-turn-quickly-even-on-bernie-sanders
Counseling is available.
13
A vial of insulin at a cost of $1,500? On what planet?
I'm a diabetic and pay $80.00 online for a vial of common short-acting insulin. One vial lasts almost one month.
If arguing for high drug prices, please get the facts straight.
3
@Peter
You don't use the long-acting insulin, do you ?
"Between 1987 and 2014, the wholesale price of a 20-ml vial of Humulin U500—a concentrated form of long-acting insulin that more and more people with diabetes are using to control blood sugar—rose from $170 to $1,200, according to Truven Health Analytics. By January of 2017, the list price was $1,400."
https://www.ontrackdiabetes.com/type-1-diabetes/insulin-prices-still-high
Maybe you should get your facts straight.
19
My insulin cost $2,000 a month. My share after co-pays is $800. You must have a very nice insurance plan.
@Peter
Look at the cost of longlasting pens(Lantus). The article is correct.
it's not 'just' drug prices, it's everything. i remember when gasoline was 25 cents a gallon. so was a loaf of bread.
2
@linh
Your comment is disturbingly misleading, myopic and infantile; drug prices have gone up significantly more than the rate of general inflation; thank you for the false equivalence.
A recent (September 2018 study from AARP, the senior citizen advocacy group, found that in 2017, retail prices for 267 widely used brand-name prescription drugs increased by an average of 8.4% – compared to a general inflation rate of 2.1% over the same period. The report shows that the annual average retail cost of a brand-name prescription drug was nearly $6,800 in 2017. But had pharmaceutical price increases been limited to the country’s general inflation rate between 2006 and 2017, that cost would have been more than $4,600 lower.
https://www.investopedia.com/articles/personal-finance/040516/senior-health-drug-prices-double.asp
95
It is time for the Government to take over and produce the drugs that other big Pharma businesses won't produce, except at a very inflated price. Then, go on to advancing drugs from the research that has already been paid for...university grants from the US Science Foundation, etc.
9
Here's a thought: Just as tobacco advertising was banned on TV, so should ads for pharmaceuticals, as they once were. Any casual TV watcher must have noticed that drug ads are now the dominant commercials - they, and their interminable list of dire side effects are inescapable. Where it used to be, a few short years ago you'd see these ads just on the nightly news, probably because of their older demographics, now they're ubiquitous. Obscure channels that show reruns of "Gomer Pyle", and who used to hawk nothing more expensive than a $29.95 garden hose, are now running ads for medications that cost $100,000 a year. Strangely, many of these drugs treat conditions possessed by only a minute percentage of the population; advertising them relentlessly is not going to increase that number. The only conclusion is, that these companies have money to burn, which they can use more effectively by actually plowing it into research, rather than whining about how expensive that is.
54
"Now they must demand answers from pharmaceutical companies."
Sorry, that is just not bloody likely. Especially with Citizens United. The pharmas have enough to give $20 million to each and every legislator and administration administrator, and turn around and do it again next year. It's called re-investment. There's a reason pharmas are the highest return industry according to the financials, far above every other industry (except maybe the social media monsters), and have been for a long time.
20
Getting control of pharma and insurance companies should have been the very first step of healthcare reforms during the Obama era.
15
@Karen
Woulda shoulda coulda. Yesterday is gone. Let it go. Instead, let's focus on making positive consumer-focused improvements in our inhumane health care system TODAY.
To start with, no prescription drug can be sold in the U.S. for more than 15% of what it is sold for in any other industrialized country, such as Canada, the UK or France.
7
@loveman0
That is a great idea!
When was that law passed?
I take one prescription drug that costs $316 for 30 tablets.
When does the 15% rule go into effect?
2
@loveman0
Beggin your pardon but.. I take one drug that if purchased here would be $520.00 for 90 days supply. I buy it out of Canada for $74.00 delivered. Fairly greater that 15%! If I couldn't get it from Canada (its actually made in the UK) I would just do without. I pay 720.00 a month for insurance that has a $6500.00 deductible. Somehow I don't think I'm all that unusual amongst people who don't have a "company plan".
3
Citing the moves against tobacco 25 to 30 years ago, makes it sound easy.
It was not then and it will not be now.
I spent over half year sponsoring the Non-Smokers Rights Act in Canada 31 years ago. The hearings started with the testimony by all the big tobacco firms that cigarettes did not cause illness (to the best of their knowledge). Then, big tobacco cited "commercial free speech" to defend themselves.
After months of hearings, it was the landmark study on second hand tobacco smoke damaging the smoker's family members and those in the service industry that served smokers that changed the momentum to create smoke free common transit carriers and offices.
Bringing big pharma to heel will take at least as great an effort and will require a cadre of motivated Members of Congress who are willing to devote much of this session of Congress to no other issue.
That's a "big ask".
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Healthcare in general has problems which we need to solve, but let's be careful conflating big pharma with big tobacco. The world would be a better place without tobacco, but it would be a far worse place without pharmaceuticals. I'm not convinced that state AG litigation is the right way to fix this. I mean, look at where the tobacco settlement money went . . .
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@Pete
Yeah, maybe tobacco is a bad comparison. Big pharma most closely parallels the cosmetic industry, which combines inexpensive ingredients, and with fancy packaging, extravagant promises, and and a limitless advertising budget sells them at a ridiculous profit to a gullible market - and like most pharmaceutics, they are meant to be used for the rest of your life.
The drug companies have traditionally justified their high prices by citing research and development costs. Now, though, they seem to believe they should be entitled to charge what they determine the cost of averted health care costs, such as hospitalizations or even the value of extended health and life. That's what their exorbitant prices represent. Imagine if Jonas Salk believed that. He didn't. Congress has to return to promoting and protecting the public health of all Americans and ensuring costs are affordable certainly for basic drugs like insulin.
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@Michael Burgess.....Agree. Jonas Salk polio vaccine came out in the 50s and 60s for wide public use. At that time big money, pro corporate values didn't dominate politics and govt as much as now.
8
We know the answer to those questions. I attend a wide range of pharma conferences x MD, investors, etc. In the US, profits are now a major driver of health care decisions. Health providers try to maximize profits. If other entities allow it, they will. Justifications are easy: value added in years or quality of life (it justifies any price); costs (includes marketing, billions in compensation, etc.). Everybody who can, tries to increase income. Hospital managers are paid millions; device providers huge amounts (see apnea treatments). The government can reduce drug costs over $100B/year AND improve desirable health outcomes for patients. Demand that drugs (for FDA AND coverage by payors) provide substantial benefits (medical necessity); patients receive adequate evidence for competent informed consent (including detailed data on benefits of alternatives, long term risks, costs); clinical trials compare drug v. best known treatment with optimal nutrition and lifestyle; providers liable for misleading data (like cigarettes). We can start now!
Ex. Billions are spent on drugs to treat Crohn’s Disease. Based on my research, Exclusive Enteral Nutrition (an elemental diet that provides bowel rest and healing) followed by restrictive diets such as Special Carbohydrate Diet (vegetables, fruits, lean protein) achieves greater remission rates, mucosal healing, and fewer relapses than any other treatment I found in professional journals or conferences describing forthcoming treatments.
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After losing a close family member to the hidden (by the company, for the sake of profits) side effects of a prescription drug, I spent many years trying for stronger prescription drug safety laws and regulations, as well as trying to get prescription drug advertising banned (only two countries permit it - the U.S. and New Zealand). Watching every bill fail, often at the eleventh hour, I realized I was up against such a giant foe that it wasn't going to happen. Along with price regulation, there's more that needs to be done to corral this industry.
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The members of the Senate Finance Committee should also be asking these executives to explain the differences in pharmaceutical prices in the US vs other nations. Why do Americans pay so much more for the same drug compared to other nations? Does the lack of drug price ceilings in the US result in Americans subsidizing the lower prices of pharmaceuticals in the rest of the world?
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With heart disease and diabetes, how much good can a person do for him or herself through lifestyle changes? Apparently eating right and doing the right kind and amount of exercise are keys to improving heart conditions and diabetes over the medium term. I say this with caution, not being a doctor. But increasingly, we hear that diet and lifestyle are paths to good health in very many cases. So it is not only the drug industry but the food industry that should be the focus of Congressional inquiry and research. I think the public is ready for a sea change, and the companies will, I hope, realize this and see the writing on the wall. But the different parts of the establishment have been quite unready to face change in recent years, so without public opinion, these extremely important health issues will not be addressed.The United States is a democracy only to the extent that the people make their voices heard. But test yourself: remember what you thought about vegan diets ten years ago, and what you are thinking right now. Big change, right? That's wonderful!
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@pedroshaio Insulin-dependent Type 1 diabetes has nothing to do with lifestyle. Type 1 diabetics need insulin or they will die, simple as that. Being a vegan will not help.
Government policy on health issues should be made with complete information from experts, not amateur opinions. Heart disease, cancer, and diabetes are serious illnesses that kill people. Their health is more important than "lifestyle" or Big Pharma profits.
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@ML Among those who are diagnosed with diabetes, 91.2 percent have type 2 diabetes and 5.6 percent have type 1 diabetes. (University of Iowa study). And there is consensus about lifestyle and diet being very important for type 2 diabetes.
High drug prices are supported by laws. And those laws need to be changed.
A hospital may only charge a percentage above its costs. If aproceedure costs 80 dollars, and a hospital may only mark up the total 25%, the final cost to the patient or insurance company is then 100 dollars.
If an insurance company,, again, by law, must function profitably with a 25% gross profit margin,, that 100 dollar bill then is 125.00.
The ONLY way,, the one and only way a hospital, or an insurance company may make more money,, is to spend more money. Sounds backwards,, but there is truth in it. Double the original cost to 160 dollars,, and now the hospital can charge 200 dollars,,, and the insurance company can then charge 250 dollars.
The hospital made 20 dollars in the first case, and the insurance company, 25 dollars. In the second case the hospital made 40 dollars and the insurance company 50 dollars. Same employees. Same overhead. double the return.
There is therefore a disincentive to lowering drug prices. Pharmacies make more money from the higher prices, hospitals make more money, insurance makes morre money.
This IS what is happening. There is no competition. Additional profits are regulated by public comment and public law,,, but the public law,, is encouraging and annual 10% increase each and every year.
This is the nut to crack. Good luck.
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First, I’m sure the pharma CEOs will blame profits in the distribution system even though those middle men take only small share of the drug costs. It will be their primary smokescreen.
As to how prices are set, we already know that. They are set based on how desperate the patients are to have them. Some recent drug cure regimes are priced based on how much it would cost to care for a patient with the disease for a lifetime, not based on costs of development plus a nice profit.
Imagine if one were to have priced the polio vaccine according to that reasoning: A lifetime of invalid care on an iron lung. Just think how nonsensical that kind of argument is, but that is how it’s done.
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@Jazz Paw And this is why the argument that starts with the tobacco industry is a non-starter. Drugs may cause problems and be far less effective than the industry may want us to believe, but the Federal Government itself, through the FDA, assures that the risks are outweighed by the benefits when used as designed. Tobacco, it is for recreation, addictive, and deadly. All three open the door to a regulatory intervention.
What is the value of a Hepatitis C cure? To the state, it is many thousands of dollars a life of illness or transplant. To those living with Hep C, it is the assurance that they won't die of liver disease or liver cancer. When it comes to my own life, there is little I might not pay to get what I need to live another day.
Our country is a capitalist one. And this government abhors controls over industry, 'socialism' they will call it. And without government limits OR negotiating power, the market will present an unending demand for a limited resource, and pricing will continue to create huge profit, and an unending burden on all who are in need.
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It is nice that the government is getting involved, but they don't buy drugs for the vast majority of insured people, thus they have little leverage. If we had a single-payer system, drug companies would have to go to a single buyer that covered everyone is the nation. Then we could leverage that volume just like they do at Home Depot or Amazon. Easy solution.
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The questions raised by this editorial need to be directed at all of the players our 'health care system,' including insurance companies, 'big pharma' and hospital corporations. We, the people, who spend so much money on health care, should demand transparency and honesty from all of those players. We want to know how much of our money goes into actual health care, and how much ends up in the pockets of millionaire CEOs and share holders. We should have no doubt that we can achieve reasonable universal coverage while spending less than we do now. And, to the members of Congress: are you representing us, or the corporations?
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@eandbee
"And, to the members of Congress: are you representing us, or the corporations?"
Friend, we all know the answer to that one.
This is bogus.
Congress can find out the answers to all the questions posed here if they:
Speak with auditors
Speak with the analysts who cover the companies
Look for whistleblowers
etc.
Given that the Federal government (us) pays for the basic research, the pharmaceutical companies have hoodwinking us for far too long.
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@Rex Daley
....and "we" have let us be hoodwinked.
The difference in prices for the exact same drug in the exact same dosage with only the labeling translated into Spanish costs 1/3 of what it costs in the US here in Panama. The translation actually should make the drug slightly more expensive in Panama. The senate needs to investigate why these prices vary so much from country to country. Panama is a particularly good example because it has a very highly developed private healthcare system and its currency is the US dollar.
Second, Congress must change the Medicare statutes to require Medicare to use its vast purchasing power to negotiate better prices from pharmaceutical manufacturers.
Third, research and development is oftentimes a red herring. Penicillin was discovered by accident from a moldy piece of bread in a lab refrigerator. Many drugs invented to do one thing have been failures only to find second lives doing something else. Accidental discovery and unintended second uses have very low r and d costs. As you pointed out insulin has been around for almost 100 years. Not too much r and d costs involved in the increased prices for insulin! The Senate should demand detailed information from each company about r and d costs related to each product it sells and how much of its selling price is attributable to r and d. The companies will fight them strongly, but Congress must find the strength it has used against the cigarette industry in the past.
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I worked for a pharmaceutical company and witnessed how our lobbyists influenced politicians to the company's benefit. This company is no longer in existence but was indeed a very lavish, frivolous run corporation.
Physicians and staff expected to be catered to if a rep wanted time to sell a product.
Regarding answering questions: I hope our politicians will be above board and admit their own influence from large corporations. This seems to be our America.
Hypocrisy seems to be the word of the day.
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@OpieTaylor, My closest friend's wife is a practitioner at a local clinic. The Pharmaceutical companies cater into their break room a lavish hot and cold breakfast buffet *every single work day* of the year.
Do you think that this kind of largess goes unnoticed by the physicians and practitioners in the clinic? How is this even legal? I'll bet it is, though.
1
Elected officials have made a lot of noise about the cost of prescription drugs. Now they must demand answers from pharmaceutical companies.
It's not going to be Cory Booker!
21
Indeed it is time ... well past the time to rein in big pharma. But how realistic is it to expect politicians to bite the hand that feeds them. Lobbyists for the industry in Washington outnumber the people they're lobbying two to one. The industry is spending in excess of $150 million a year to dissuade congress from passing any legislation that would impact it adversely...while donating millions directly into their re-election campaigns. Is that a formula for sound congressional oversight of an industry that has such profound, ominous implications for public health? I think not.
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@thegreatfulauk.....that's the issue. Legal mega donations/lobbying is such a norm in our politics, that our media hardly discusses it. Profound ominous implications for our democracy.
Our famous 1st amendment protects our famous 'free press' media from explicit censorship, but media is subject to other pressures that narrow its coverage.
Because of big money norms in politics affecting HC and drug prices, the media doesn't fulfill it's function to inform voters.
If the media put this issue on the news every day, maybe we wouldn't be lagging dozens of other capitalist nations who have had lower cost HC for all for generations.
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@thegreatfulauk
The best return on investment is to invest in legislation, hands down.
6
@thegreatfulauk
I watched the Pharma lobbying play out - in 2007 -when PDUFA (prescription drug user fee act) was up for re-authorization. Henry Waxman, and a few others who cared, inserted stronger prescription drug safety wording into the bill. At the eleventh hour - poof - all those words disappeared, and the "altered" bill passed with flying colors, thanks to BigPharma. The losers were us, the American pubic.
2
A government-granted and enforced monopoly (a patent) requires a government-enforced cap on profits, via statutory regulation of prices.
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@Joe Ryan Not in the US where the constitution enables Congress to create uniform laws on patents and provides for no limitation on that authority. It just won't happen.
2
This editorial is accurate. Drug cost are far too high in this country, and both big and small pharma need to answer for this. Extortionate drug costs are one of the major contributors to the enormous costs of medical care in the US, on a per capita basis, some of the highest in the world
But there is one thing the editorial doesn't mention, and should: how this country's out-of-control tort system is contributing to the cost of medical drugs. A jury recently issued a verdict of almost half a billion dollars against Johnson and Johnson, claiming that talc-based baby powder caused ovarian cancer. And this was for a single lawsuit; there are many more to follow. The "science" that talc (or asbestos contamination of talc) causes ovarian cancer strongly appears to be junk science. But the patient died, and the jury was sympathetic.
The money has to come from somewhere, and such lawsuits are a major contributor to the costs of drugs in the US.
We shouldn't abandon tort law, and the concept to legal liability for negligence. But the system in the US is out of control, and serves many to make some lawyers fabulously wealthy. We desperately need legal reform, or there may not be any pharmaceuticals in the US, regardless of price.
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@Alex Talc isn't a drug, it's a preparation of natural substance. How can you conflate drug prices with tort claims on a non drug?t
We need legal reform, we need a total revamp of the patent and generic gaming process. And drugs that benefit from public research funding of any kind must be provided at reduced pricing; pharmaceuticals shouldn't gauge they public when their primary research was generated by public funding.
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@Alex
I learned that drug companies budget a line item for payouts to settle up with innocent victims and their families who suffer disabilities and death from the side effects of prescription drugs, so your comment about the need for tort reform rings hollow with me. If the drug companies were honest in revealing the results of clinical trials, instead of claiming them as "proprietary information", patients wouldn't have so much injury and death in the first place.
17