In the movie Wall Street we are told by actor Michael Douglas (Gordon Gekko) that “greed is good, greed is right, greed works, greed clarifies, cuts through and captures the essence of the evolutionary spirit…” But the high cost of medicines also kills! When people can’t afford innovative immunotherapy for cancer, medications for hepatitis C or a drug to prevent rejection of a transplanted organ, the result can be death. That has not deterred the pharmaceutical industry from raising prices. The totals are in for 2021. According to STAT Pharmalot (April 21, 2022), spending on medications was up 12% to $407 billion!
How Times Have Changed!
I started writing about pharmaceuticals roughly 50 years ago. Our very first book, The People’s Pharmacy (St. Martin’s Press), noted:
“Americans spend about $11 billion on prescribed medications each year…”
That stat came from an article in Science (May 5, 1972) titled:
“The Overmedicated Society: Forces in the Marketplace for Medical Care”
50 years later to the day, I can say that we are more overmedicated now than ever. If you think $407 billion seems like a big number, just wait. The prediction from the IQVIA Institute for Human Data Science is that we will spend $450 billion by 2026.
Such numbers are mind boggling. Just consider COVID. According to IQVIA, we spent $29 billion on “COVID-19 vaccines and therapeutics” in 2021.
For comparison, it is estimated that Americans spent $13 billion on health and fitness technology, $45 billion on laptop computers and $73 billion on smartphones in 2021 (Statista, Aug. 17, 2021).
The High Cost Of Medicines Is Unlikely To Change!
The pharmaceutical industry is fighting tooth and nail to prevent Medicare from negotiating drug prices. Politicians have been talking for years about controlling the ever-rising costs of medicine. But talk is cheap!
Drug company bean counters have figured out that the pot of gold at the end of the rainbow is not found with antibiotics or blood pressure medications. The real money is for conditions such as cancer, neurological conditions and autoimmune diseases like rheumatoid arthritis, lupus, psoriasis and inflammatory bowel disease. Such drugs can easily run into six figures annually.
Fighting to Maintain the High Cost of Medicines:
An industry insider publication, Fierce Pharma offers this insight (Sept. 13, 2021):
“The latest round of pricing talks comes after years of discussion in D.C. Former President Donald Trump and his administration tried several strategies to lower prices during his term, but those efforts ran into various setbacks, and prices have continued rising along the way.
“While there seems to be momentum on the issue now, it’s not certain pricing reform will happen, the ODDO BHF analysts point out. Medicare pricing negotiations are a ‘flagship measure’ discussed during the recent presidential campaigns, but it’s ‘one of the most debated and contested [proposals] by both Republicans and some Democrats.’ The analysts think there’s a ‘very low’ chance the proposal will come to pass.”
The High Cost of Medicines in the US:
Lest you think this is a partisan issue, both Democrats and Republicans love pharmaceutical money.
The website OpenSecrets describes itself:
“Nonpartisan, independent and nonprofit, OpenSecrets is the nation’s premier research group tracking money in U.S. politics and its effect on elections and public policy.”
An article in OpenSecrets (Sept. 17, 2021) offers this insight:
“House Democrats who voted Wednesday against a key provision that would lower prescription drug prices in the $3.5 trillion reconciliation plan received large campaign contributions from pharmaceutical industry PACs and CEOs.
“Rep. Scott Peters (D-Calif.), who co-authored a letter in May with nine other moderate Democrats arguing reduced drug prices would hamper research and development of new medicines in the pharmaceutical industry, is leading the Democratic opposition to the drug pricing provision.
“The plan would allow Medicare programs to negotiate lower costs for prescription drugs instead of pharmaceutical companies setting their own prices with little competition. Peters voted against the provision during the bill’s markup in the House Energy and Commerce Committee on Wednesday and was joined by fellow Democratic Reps. Kurt Scharder (D-Ore.) and Kathleen Rice (D-N.Y.).”
I will be astonished if Congress agrees to allow Medicare to negotiate drug prices. Other countries negotiate the prices that they pay for prescription drugs. There is a reason why Americans pay the highest prices for medications anywhere in the world. The high cost of medicines is no accident. The pharmaceutical industry does not want that to change!
The High Cost of Medicines: Revlimid vs. Cancer:
A reader can’t afford Revlimid and has turned to India instead:
Q. Have you heard of any FDA concerns with Revlimid coming from pharmaceutical companies in India? The price in the US is outrageous, especially for a senior citizen.
A. We understand your dilemma. Revlimid (lenalidomide) is a critical medicine for the treatment of the blood cancer multiple myeloma. In the US, each pill can cost as much as $800. The normal cycle requires 21 days of treatment a month. That could lead to a bill of around $17,000. Even if you have insurance, the copay might be huge.
The FDA has not been able to inspect most foreign manufacturing plants since early in the pandemic. As a result, it’s hard to verify the quality of many medications made abroad. Your physician will need to monitor your progress carefully to make sure the medicine is working as anticipated.
One other option may be to seek financial help. Several patient assistance programs provide significant discounts for under-insured or low-income individuals on Revlimid. Each has its own eligibility requirements, but your oncologist might have someone on staff who could help you sort through them.
What Happens When Insulin Prices Skyrocket?
A study in JAMA Internal Medicine (Dec. 3, 2018) discusses the impact of the high cost of insulin on patient health. Dr. Elisabeth Rosenthal comments in her article titled “When High Prices Mean Needless Death.”
The high cost of medicines can affect patient access. Over the last ten years, the price of insulin has tripled in the US. This is a life-saving medication for people with type 1 diabetes.
A small survey of almost 200 patients who need insulin found that a quarter of them had reduced their doses in order to save money. People reported using less insulin than prescribed, stretching out the insulin or not filling an insulin prescription because of cost.
Not surprisingly, those who reported skimping were less likely to be controlling their blood sugar adequately. As a result, they may experience negative health consequences.
Elisabeth Rosenthal, MD, Calls BS!
Dr. Rosenthal starts her invited commentary in JAMA Internal Medicine with this statement:
“I have spent the last 5 years of my life as a journalist writing about the irrational costs and prices across the US health care system. But if there is 1 fact that should cause national embarrassment it is the high price tag we affix to living with type 1 diabetes.”
Dr. Rosenthal points out that the cost of insulin in other countries is substantially lower than in the US. People in the U.S. who couldn’t afford their insulin have died.
“That is because people with type 1 diabetes are both beneficiaries and pawns in the business ventures of drug makers, device manufacturers, and insurers, and sometimes these companies seem willing to sacrifice a pawn or 2 for profits. Today people with type 1 diabetes are again at an increased risk of becoming ill and even dying prematurely because of the price.”
We invite you to read Dr. Rosenthal’s commentary at this link.
Dr. Rosenthal: A Voice of Reason!
We had the honor of interviewing Dr. Elisabeth Rosenthal on our syndicated public radio show in March, 2017. The title of the program was Show 1114: How Health Care Became Big Business. Here is a link to that interview.
You can listen to the FREE streaming audio by clicking on the green arrow above Dr. Rosenthal’s photo. Or, you can download the FREE podcast of the show by going to the bottom of the page and clicking on the Download the mp3 link. When that page comes up, you can purchase a CD or choose the MP3 version for free by clicking on the arrow on the right just above the add to cart box. Listen on your phone or other electronic device.
Reports from Readers:
Visitors to this website have shared their own experiences with insulin.
Crystal is a nurse:
“I am also seeing atrocious prices on insulin. I use Lantus. My MC Part D provider doesn’t cover it. If I order from them, it’s $1600 for 90 days and lands me in the donut hole with the second filling. Good Rx is about $900 & doesn’t count toward the donut hole. But if I ask for a script for a 10 ml vial to draw up my own dosage with an insulin syringe, the cost is about $190 for 90 days and doesn’t count either.
“Those fancy pens are VERY expensive. In fact, any injectible in a fancy delivery device will cost a lot more. For insulin, hospitals don’t buy the pens. They use multi-dose vials because it is so much cheaper.”
Ken also needs insulin and is really mad:
“I can see paying more for some new miracle drug but the two drugs I need are Ranexa, which has been out since 1985, and insulin which has been available since 1922. A one-month supply for me would be over $1000.
“All big pharma does is make a little change that doesn’t really do anything different and applies for a new patent, tying up the medication for decades. I think by now they have recouped their research and development costs. Greedy SOBs. While I’m at it what is the four letter word that will get you fired in the drug industry….’CURE.’ They don’t want to cure any diseases because that would hurt their profits. They want a country full of sick people that will never get well.”
Cathy and her husband will have to put off retirement:
“My husband needs several different kinds of insulin daily. With the cost, we don’t see how he can retire and afford his medications.”
Ellie is worried about her son:
“My son has Type 1 diabetes and the cost of his insulin pens is at least $400 a month. We have to pay that as we have a high-deductible plan. I worry that he won’t be able to pay this when he’s out on his own. I have emailed my legislator and didn’t even get a reply back.”
What Do You Think About the High Cost of Medicines?
Share your thoughts about the high cost of medicines. Can you afford your insulin? How about other medications? You may want to read our new article about CAR-T and the treatment of B cell lymphoma. You may have a hard time believing the cost of this immunotherapy for cancer.
If you would like to read about practical strategies for cost savings, consider our eGuide to Saving Money on Medicine. It offers insights about buying brand name pharmaceuticals from Canada and can be found under the Health eGuide tab.