Are you angry about the ever-escalating cost of medicine? Here are some examples you may not be aware of. Humira (adalimumab) is highly advertised on TV. It is used to treat Crohn’s disease, ulcerative colitis, rheumatoid arthritis and psoriasis. A month’s worth runs about $6,000. Zytiga (abiraterone) is a valuable drug for metatastatic prostate cancer. A month’s supply is around $12,000. Revlimid (lenalidomide) extends life for multiple myeloma patients. The cost: $15,000 to $20,000 a month. A 30-day supply of Cinryze for hereditary angioedema could exceed $50,000. Drug price gouging is out of control but there are no laws against it. Why not?
Must She Work Forever to Pay for Hubby’s Humira?
Q. I am so confused. My husband takes Humira for his arthritis. He is 68 and on my health insurance. I am 67 and still working. He is retired.
I am looking at retirement, but it doesn’t look like Medicare covers Humira.
What do people do? It’s so incredibly expensive! Do I have to keep working just to pay for his drugs?
A. Welcome to the Alice-in-Wonderland world of prescription drug insurance. According to GoodRx, a month’s supply of self-injectable Humira could cost over $9,000 without insurance. Even with a coupon, the cost could be over $6,000.
Before you retire, you and your husband will need to sign up with Medicare, including a Part D plan that pays for your prescription drugs. There are many different providers offering Part D plans and each covers a different list of drugs on its formulary. Comparison shopping is essential to make sure that the plan you select covers the medicines you take.
There should be a program that will cover “biologics” such as Humira. There are several options including Actemra, Cimzia, Enbrel, Orencia, Remicade or Simponi. Your husband’s doctor will need to determine if any of these would be a suitable substitute in the event that he cannot find a plan that covers Humira.
What Is Price Gouging?
September is still hurricane season. When people are frantic to buy gasoline so they can evacuate before a hurricane hits, gas station owners may raise the price by a dime per gallon. If the only gas station with fuel boosts its price by two or three dollars per gallon, people become outraged. Many states have laws against such price gouging during emergencies.
The Attorney General of NC reported more than 600 complaints during Hurricane Florence several years ago. Not surprisingly, people grumbled about the cost of gas, food and water. But when someone desperate to have a tree removed was charged $12,000, the attorney general moved it to the top of his to-do list.
Why We Hate Price Gouging:
Americans hate price gouging. It challenges our sense of fairness when the price of something we desperately need is raised well beyond a reasonable cost.
If removing a large oak tree normally costs $1,500, is it fair to charge $12,000 after a storm? Some people justify price gouging on the grounds that greed is good. Their slogan, “let the market determine the price.”
But Americans hate gougers who prey off desperate people who cannot afford outrageous prices. That’s why many states have laws that prevent unscrupulous individuals from charging excessive prices during emergencies.
Drug Price Gouging is Outrageous!
Unfortunately, there are no laws that prevent drug companies from spiking their prices to maximize profits. Martin Shkreli became notorious when he raised the price of an old drug called pyrimethamine (Daraprim) by more than 5,000 percent. This medication is crucial to treat a parasitic infection called toxoplasmosis in immunocompromised patients.
Another outrage occurred when Nostrum Pharmaceuticals raised the price of an antibiotic called nitrofurantoin by 400 percent. That took the price from about $475 per bottle to over $2,300.
Nitrofurantoin: Drug Price Gouging?
Nitrofurantoin has been used to treat bladder infections since 1953. It was originally sold under the brand name Macrodantin. In 1976 a bottle of 100 pills cost $15.85. It is not strictly comparable, though, since Nostrum’s generic nitrofurantoin is sold as a liquid. A full course of treatment might require one to two bottles.
The substantial increase in price wasn’t what created a firestorm of controversy, however. After all, a competitor, Casper Pharma, makes a brand name nitrofurantoin product called Furadantin. Earlier this year Casper raised its price to $2,800 a bottle. As far as we can tell there was no outcry.
What got the CEO of Nostrum into hot water was his justification for the 400 percent increase.
Nirmal Mulye got a lot of attention when he claimed that he had a:
“moral requirement to sell the product at the highest price.”
Mr. Mulye went on to say:
“The point here is the only other choice is the brand at the higher price. It is still a saving regardless of whether it is a big one or not.”
The FDA Weighs in on Drug Price Gouging:
Mr. Mulye has a completely different understanding of morality than we do. FDA Commissioner Scott Gottlieb also objected to Mr. Mulye’s claim.
He responded in a tweet:
“There’s no moral imperative to price gouge and take advantage of patients. FDA will continue to promote competition so speculators and those with no regard to public health consequences can’t take advantage of patients who need medicine.”
We fear that the FDA has very little clout when it comes to drug price gouging. There are no laws that restrict drug companies from charging whatever they want. The pharmaceutical industry will fight any restrictions on pricing as you will discover in this article.
If a real cure was discovered for cancer or Alzheimer’s disease the company could charge a million dollars a shot even if it would bankrupt the country. Do not count on legislators to push back.
What About Generic Drugs?
Most people assume that generic drugs are inexpensive. That was the original idea, after all. Manufacturers of such products do not have to do expensive clinical research to prove their medications work.
Although generic drugs are usually less expensive than their brand name counterparts, some companies have found opportunities to increase prices dramatically. There have even been charges of price fixing by some generic drug companies.
Is There Any Hope for the Future?
Most countries negotiate prescription drug prices. The pharmaceutical industry doesn’t like this, but if companies want to sell their products in Europe, they have to justify the price.
No such negotiation takes place in the U.S. We agree with Commissioner Gottlieb that price gouging is unconscionable when it comes to people’s health. Perhaps someday our government will reconsider its position about negotiating drug prices. In the meantime, you will find our “10 TIPS FOR SAVING MONEY ON MEDICINE” at this link.
What Do You Think?
You may wish to listen to our interview with Lisa Gill of Consumer Reports. It is Show 1308: Saving Money on Prescription Drugs.
What is your opinion on drug price gouging? Do you think the industry should be allowed to charge whatever the market will bear? Have you ever encountered a medicine you could not afford? Share your thoughts below in the comment section.