Cutting prescription drug prices has become one of the most popular campaign promises of our time. And why not? Who wouldn’t want to pay less for these pills that cost hundreds if not thousands of dollars?
But let’s be clear which prices we’re talking about. If our critics are harping on the costs of breakthrough cancer therapy, then they’re just nuts. Immuno-oncology drugs are rewriting the prognoses of dreaded diseases such as malignant melanoma and lymphoma almost monthly.
CAR-T treatments are re-engineering T-cells to make each patient his or her own tumor-fighting machine. Checkpoint inhibitors are now being used in combinations reminiscent of our war against HIV. In the short term, the costs of these drugs and more to come will remain high, but the day we can beat most cancers will grow ever closer.
If they’re complaining about drugs such as Sovaldi, with its “infamous” $1,000 a pill price tag, critics should recall that after pushback, insurers had no problem covering it. It’s a no-brainer. Compared with the costs of long-term care of these patients, drug treatments that cure hepatitis C or help patients with cystic fibrosis are a bargain.
Finally, if our critics are fearfully anticipating the costs of whatever solution we eventually find for Alzheimer’s and other dementias, then too bad. Pharma researchers have spent billions of dollars in the search for breakthroughs with precious little to show for it. Yet research goes on.
But without the prospect that successful treatment will have commensurate financial rewards, venture capital will evaporate overnight. And insurers won’t cringe at these prices either. The cost to Medicare of treating Alzheimer’s is already in the trillions. Effective treatments will be a win regardless of the sticker price.
Even our critics acknowledge the increased prices of prescription drugs are due to the fact they’re better.
Writing in The New York Times, Austin Frakt noted, “The push for precision medicine — drugs made for smaller populations, including matching to specific genetic characteristics — may make drugs more effective, therefore harder to live without. That’s a recipe for higher prices.”
What’s most exasperating are the suggestions now being proposed. An especially silly idea floated by the administration is forcing advertisers to include their prices in their ads. Will patients note the price and say, “Forget it! At that price, who needs to live longer, anyway?”
The fact is, when a drug is a medical necessity, manufacturers do whatever is possible to ensure all eligible patients receive their treatments, regardless of financial status.
In any case, “manufacturer’s price” is illusory. We all know how it goes. Company A develops and prices a new drug. Wholesaler B demands a discount and marks the drug up. Pharmacy chain C fiddles with the price again. Now payer D gets into the act. The final cost often has little relation to the “manufacturer’s price.” So why put it in the ad?
Only in a very few, well-publicized cases have pharma manufacturers resorted to price increases that could be fairly called gouging. But they’re a drop in the bucket compared to the myriad of breakthroughs that allow us to live longer, healthier lives.
Let’s not allow artificial measures designed to drive down drug prices to jeopardize our ability to maintain this incredible record of progress.