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How Prescription Drugs Got Hijacked and What You Can Do About It

How Prescription Drugs Got Hijacked and What You Can Do About It
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BY STEVE NUBIE

Many prescription drug prices in the U.S. are soaring and the reason is driven by greed, corruption and ineffective government legislation.

The current outrage over the rising price of pharmaceuticals was inflamed when Martin Shkreli, the CEO of Turning Pharmaceuticals raised the price of a prescription medicine designed to treat cancer and HIV 5,000%. A pill called Daraprim that used to cost $13.50 was hiked to $750 for one dose.  This is a medicine designed to be taken for weeks on a daily basis at home.  For most people the price was out of reach.

Recently, the pharmaceutical company “Mylan” raised the price of Epipens from $100 for a twin-pack to $650. Epipens are portable syringes designed to inject epinephrine or adrenaline for someone suffering from a severe allergic reaction.  These reactions can be caused by everything from bee stings to food and other factors, but when they occur treatment needs to be administered immediately.

To make matters worse, Epipens have a shelf life of one-year. Many people with severe allergies need to have an Epipen with them at all times not only on their person, but in the car at work and at home.  Too often the $650 cost escalates to $1,300 and more because they require additional doses.

It would help if insurance and Medicare would cover the total cost, but there’s a problem. According to a study released by The Journal of the American Medical Association co-pays and deductibles have risen with many insurance plans in the past year and both insurance and Medicare pay less as a result, but some of the greatest impacts are less obvious or publicized.

  • Research and Development is often pointed to by big pharma to justify rising costs. According to the JAMA only 10 to 20% of profit is reinvested in R&D from an industry that has the highest profit margins in the U.S.
  • Generics are always doing battle to bring less expensive medicines to market. In fact, many pharmaceutical companies will make a non-pharmaceutical change to their products to reapply for a new patent and prevent the development of generics.  A common practice is to re-coat a pill and use that as a pretense for a new patent.  The U.S. patent system is actually designed to grant a 20-year patent to certain drugs and the pharmaceutical companies then “game” the patent system with these modest, non-pharmaceutical changes as the patents approach expiration to prevent generic development.  This has a significant affect on the reduced cost of generics which can offer a savings in a range from 30% to 55% less than a branded pharmaceutical.
  • One of the key findings from a study done by the Harvard Medical Schools is the existence of what was described as “government-protected monopoly rights” for drug manufacturers. These monopoly rights range from patent abuses to questionable payment practices directed to pharmacy managers.
  • Unlike the rest of the world, U.S. pharmaceutical companies are allowed to set their own prices according to the JAMA. The contrast to this practice is seen in countries with nationalized health care like Canada, the U.K. many Scandinavian countries and others.  In those counties the government either negotiate the drug prices or refuse to cover the costs.  This does not occur in the United States.In fact, the Republican majority congress of 2003 barred a Medicare drug benefit from negotiating prices. This affected more than 40 million Americans covered by Medicare. There was also evidence presented by the JAMA that pointed to third party pharmacy benefit managers like CVS Health and Express Scripts who shifted market share to branded medicines in return for payments from drug companies. This correlated the Harvard Medical School findings related to “government-protected monopoly rights”.
  • The FDA has not helped with the approval of generic options. Backlogs for approval run up to three or four years for a generic manufacturer to get approval for products not protected by patents.

One of the conclusions that emerged from the report is that no single, piece of legislation with solve all of the factors affecting prescription drug prices. Until some action is taken and some changes implemented relative to laws, legislation, and business practices the options are few for many people.

  • Option 1. Ask your medical care provider to specifically stipulate a generic alternative to the drug they are prescribing if it’s available. Some doctors accept commissions for prescribing branded medicines even when an approved generic drug is available.
  • Option 2.  Ask your pharmacist if there is a generic alternative.  Pharmacies will sometimes default to a branded drug due to the higher profit margin and some of the questionable payments and commissions that pharmacies receive for the sale of many branded medicines.
  • Option 3.  Many folks have explored Canada as an option for lower pharmaceutical prices.  They’ve done this both online and driving across the border.  Both actions have some risk.  Some online pharmacies have been found to sell counterfeit drugs, and customs in the U.S. at the Canadian border impose tariffs on the transport of pharmaceuticals that exceed a prescription that is usually limited to a 30 to 90-day supply.  In addition, Canadian pharmacies will often limit a filled prescription to this same 30-90 day amount.
  • Option 4.  Ask your doctor if there is an economical alternative to a high-priced branded or generic medicine that provides the same benefits. There are alternatives for an asthma medicine called Albuterol that provides the same relief, and there is a generic Epipen called Adrenaclick that offers an emergency injection of epinephrine according to Consumer Reports.
  • Option 5. Consider the stated policies of public officials and either contact them to express your feelings about the current lack of government regulation, or vote for someone who has made this issue one of their priorities.
  • Option 6.  Pharmacies and drug makers offer discounts on many prescription drugs depending on financial need, public pressure due to unfair pricing practices, institutional needs such as schools, or as promotional incentives.  Mylan is trying to counteract the negative press with various discounts and offers.  It’s worth contacting any drug manufacturer to assess their programs and incentives if you can’t find an alternative.

The tragedy is that as we age our need for pharmaceutical solutions increase. If none of the options we’ve covered or other solutions work for you the only alternative is to carefully consider the positions of your elected officials and vote accordingly.

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Steve Nubie
Steve Nubie has been writing professionally for 38 years. He is a published author with 10 books to his credit, has written for CBS Entertainment for the Twilight Zone series, and has written hundreds of articles for magazines and the Internet. He has served as Chief Creative officer in the marketing and advertising industry, was an Executive career-coach, is a chef and has traveled extensively living in Asia for two years, and London for two years.