As Obamacare continues to implode, issues with our healthcare system continue to expand. We are fortunate in the United States to have access to the best technologies in the world. We also spend more of our GDP on healthcare than any other industrialized nation in the world. Although the ACA does address insurance costs (by passing on high prices to the young and healthy) as well as access (by providing access to care for all Americans even with pre existing conditions) it does NOT address the escalating cost of drugs and medical devices. I believe that the lack of regulation of the pharmaceutical industry and the prices that they are allowed to set on newly developed drugs is yet another (in the very long list) of major flaws in the legislation.
This week in the New York Times, I was troubled by a story touting the release and FDA approval of a new drug for the treatment of a particular type of aggressive blood cancer known as mantle cell lymphoma. Mantle cell carcinoma has a very poor prognosis and is very difficult to treat. This new drug has been shown to help treat the disease but offers no cure. Most patient who start therapy with the drug see 1.5 years of good results but then no longer respond. For cancer patients time is everything–however the issue with this particular drug is the shiny new price tag–$120K annually. According to analysts the drug could be worth nearly 6 billion in annual sales for Johnson & Johnson and their drug-making partners Pharmacyclics Inc. The drug is expected to also be approved to treat a common cancer in elderly people known as CLL or chronic lymphocytic leukemia which will expand its indications to an even more common and larger group of patients.
Doctors who specialize in the treatment of cancers are concerned about the astronomical prices. Certainly, they are excited to have another treatment option (especially a new one that comes in pill form) but they are surprised at the cost of therapy. The new therapy has been shown to be superior to current therapy in clinical trials–however the new drug does not offer a cure. The company supplying the product argues that the cost of the new therapy “is in line with other new drugs for cancer”. It seems to me that for pharmaceutical makers the cost is based on what the market will bear–given no limits for cost, they are free to charge whatever they like. It is disturbing that those that make potentially life changing (and potentially life extending) therapies profit from the hopelessness and desperation of those suffering with a terminal illness such as rare and advanced cancers. To me, it is reminiscent of the carpetbaggers after the Civil War.
Why is it that physician payments are dictated by bureaucrats–Medicare, Medicaid, CMS and the insurance companies? Why is it that hospital reimbursement is dictated by the same? In the same breath, politicians and others allow pharmaceutical makers to dictate their own terms as to the cost of their product. Are there hands reaching into deep pockets?
At some point as providers of healthcare we must step in and advocate for our patients and loudly exclaim… “ENOUGH”.
As evidenced by a recent change in the law in the state of Maine, medical consumers are beginning to take matters into their own hands. In landmark legislation, Maine recently legalized the import of prescription drugs from pharmacies outside the US. As I discussed on Fox Business recently with Melissa Francis, there are inherent risks with obtaining prescription drugs from pharmacies outside of the FDA’s jurisdiction–there may be impurities and the quantities of the active compound may vary. However, I believe that competition from outside the US is the only thing that will ultimately bring drug prices in the US back within sight. Big pharma will argue that the cost of research and development requires a high price tag–however, I do not believe that the US consumer must foot the entire bill.
We MUST continue to innovate and produce novel, more effective therapies. It is essential that we support our pharmaceutical industry colleagues in the research and development of new technologies through participating in clinical trials and examination of outcomes data. However, we must stop short of providing big pharma with a blank check to charge whatever they like for newly developed drugs. I am opposed to big government and more regulation in general–but something must be done to control drug cost. Maybe the answer lies in the beauty of the great state of Maine. Maybe if we allow a little competition from the outside, prices may fall and ultimately more patients will have access to potentially life saving drug therapy and hope will not cost a life’s savings anymore.