We are reminded often these days that skyrocketing prescription drug costs are forcing patients to ration or go without medications that help keep them alive.
Blistering price hikes for certain life-saving drugs, such as insulin and EpiPens, cancer-treating meds such as Rituxan, nerve-pain drugs like Lyrica and scores of others have garnered consumers’ attention, congressional hearings and lots of foot stomping by politicians.
But that’s about it.
President Trump promised to make lowering drug prices a top priority, but despite efforts by some lawmakers to address the issue, ultimately, accomplishing anything these days in the mire that is Washington seems unlikely. Meanwhile, the pharmaceutical cabal continues along, charging more and more with insurance companies simply pushing the increases along to patients. Pity those without insurance; it’s literally a choice of life or death in many cases.
And so we watch with interest as Dartmouth College senior and state Rep. Garrett Muscatel, D-Hanover, advocates a cap on at least one critical drug — insulin — through promised legislation for the next session. Muscatel says, in a story in the Valley News, that his proposal will limit the price for the drug to $100 out-of-pocket for a 30-day supply for those covered by state-regulated insurance plans. Depending on the manufacturer and the type of diabetes, insulin can cost more than $500 per vial, up from about $300 in 2013, so one can see the potential benefit of Muscatel’s legislation.
With more than 7 million Americans suffering from diabetes — and confronting the costs of their treatments — many end up heading to Mexico or Canada for less expensive supplies. But not everyone can even take that step.
There are many influences on the cost of insulin, but the forces are largely the same that affect all drug charges — the prices set by pharmaceutical companies, the markup pharmacies take when dispensing those medications and the rebates demanded by insurance companies in order to provide coverage. It’s a broken system, one rife with abuse and gouging.
According to some reports, consumers in this country pay four to 10 times more for certain medications than those in other industrialized countries, and it’s getting worse. “Big Pharma” justifies many of these price hikes by saying they need the profits to pour back into research and development for other drugs. But what about those formularies that have gone largely unchanged over the years, yet are still subject to jarring increases?
A bill in Congress would compel drug companies to negotiate pricing on 250 drugs that are without generics. Room in those rates would be left for R&D, but Health and Human Services would not agree on pricing that is more than 1.2 times the average price for the same drugs in Australia, Canada, Japan, Germany, France and the United Kingdom. The thinking is simple — why should the United States consumer pay more and subsidize lower costs elsewhere?
A recent column in the Washington Times provides a nice summation:
“Drug prices and insurance costs would fall dramatically here but likely rise somewhat abroad,” said Peter Morici, an economist and business professor at the University of Maryland. “Unlike with defense, the Democrats’ plan would force free riders among our allies to better pay their fair share.”
We have our doubts that commonsense legislation such as the one favored by Morici will prevail. The pharmaceutical lobby is deeply entrenched and influential in Washington. And because of that, states such as New Hampshire will most likely be left to piecemeal ways to mitigate drug costs. That less-than-ideal scenario would leave a patchwork of drug costs and regulation for patients and health providers to navigate, state by state.
Muscatel’s well-intentioned legislation will no doubt bring drug companies to darken the doors of the Statehouse in opposition. And, quite frankly, tackling this pressing issue one drug at a time is not the best medicine. But if it’s all we can get, and it saves lives, it might be the only prescription available.