During the 2016 campaign, then presidential candidate Donald Trump thundered against the “rip off” prices of prescription drugs. Why not? Demonizing an unpopular industry always makes a good sound bite.
However, during his first year in office, President Trump did little about drug prices except occasionally bash pharma or its leaders.
Finally, we’re getting particulars. Trump’s proposals appear to be a hodgepodge, ranging from old Democrat ideas such as allowing Medicare to negotiate directly with manufacturers to requiring drug ads to disclose prescription prices.
Another idea is to move high-priced drugs from Medicare Part B to Part D, making many truly unaffordable.
It’s hard to say if these are Trump’s ideas or just the unedited products of a White House brainstorming session.
So if we’re just brainstorming, why not open the table to other ideas? Here’s one. Let’s keep encouraging the FDA to simplify drug approval and reduce the backbreaking costs of developing new agents.
If administration officials think patients will be stunned by seeing drug prices in ads, how do they think pharma CEOs deal with the enormous costs of developing these drugs? The typical price tag for bringing a new drug to market is about $2 billion, Matthew Herper wrote in a Forbes article last year.
It’s become expensive to develop drugs — especially those for specific mutations and tiny patient populations.
But instead of recognizing and helping the industry adapt, the government is making innovation more costly.
Consider the 2017 tax overhaul, which sliced in half a manufacturer’s tax credits associated with developing an orphan drug. The rationale was pharma manufacturers were gaming the system by seeking orphan drug indications and then marketing products for more common diseases.
Apparently, it’s wrong to make drugs that are useful to too many people. It seems they don’t understand that often, the first step toward developing a drug that benefits a majority is finding one that helps an underserved minority.
Yet it’s not just the government that opposes streamlining drug development.
The New York Times recently marshaled its editorial board to sound a warning suggesting accelerating drug development into the 21st century could send the industry back to the days of patent medicine.
They argued the FDA should require stricter standards for approval. Go back to the standard of two large, well-controlled trials. Forget objective responses or biomarkers as study endpoints.
And that wasn’t all. The Times also suggested federal officials use “cost benefit analysis to set a drug’s list price.”
Great. Our critics want to tell us how to test the drugs, how to market them, and even how much to charge.
What they don’t tell us is how to discover them.
I’d like to ask our critics if they have any ideas for stopping Alzheimer’s. The companies that have tried to halt this scourge have invested — and lost — billions of dollars, with very little to show for it.
But someday the inevitable will happen, and the wall will begin to crack, like it did with HIV and hepatitis C.
Once again, I supposed we’ll hear wails about the high cost of this new generation of drugs.
Wouldn’t it be nice if we didn’t have to go through the same damn nonsense one breakthrough after another?
Sander Flaum is a principal at Flaum Navigators.