Ridiculous drug prices in U.S.
Comments
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My dermatologist gave me a prescription for Efudex, a topical chemotherapy drug for skin cancer. When I called to get the price, I asked for the generic cost versus brand name cost. It's $296 for the generic and $350 for brand name. I purchased the same drug in Italy a few years back, without insurance, and paid $4.00. Luckily my insurance plan will cover all generics for $4.00, but the profit made by the pharmaceuticals here is outrageous. We really do need a change, soon.
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I have mixed feelings about this because I don't feel I know enough about it to have a definite opinion.
I have heard and read that the costs of researching and developing a new drug are enormous and span years and even decades. The pharmaceuticals spend millions and billions to develop one drug. So while I am sure they are in business to make money, I don't think they make as much as some believe.
Their costs are very high. They are not there to be a charitable organization; they need to make a drug -- like any other product -- "pay off." I am not saying they don't make too much profit because I don't really know. But it's perhaps not as simple as looking at what we pay for it (or the insurance company pays) and saying "those mercenaries, that's all profit!" because it's surely not.
The health care problem is a complex one.
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Carol--I used to think that it was true about the enormous costs of research to the private sector; however, last year there was a review of a book in the New York Times about the actual cost of drug research and the actual profits made by the drug companies.
The writer, Marcia Angell, is a Senior Lecturer in Social Medicine at Harvard Medical School. A physician, she is a former Editor in Chief of The New England Journal of Medicine. Her latest book is The Truth About the Drug Companies: How They Deceive Us and What to Do About It. (June 2006) Below is a link to the review of her book. It gives enough information to determine if in fact the drug companies are telling the truth about the cost of research and their actual profits.
http://www.nybooks.com/articles/17244
I am posting a few paragraphs below from the review, on the R&D factor and on profits. it's also important to remember that not all the drug research goes on in this country. About half or more happens in other countries, yet the cost of drugs in most European countries is about half or less. Obviously, the drug companies are making profits there, just not the same profits. The article also discusses this aspect of the drug business.
"First, research and development (R&D) is a relatively small part of the budgets of the big drug companies—dwarfed by their vast expenditures on marketing and administration, and smaller even than profits. In fact, year after year, for over two decades, this industry has been far and away the most profitable in the United States. (In 2003, for the first time, the industry lost its first-place position, coming in third, behind "mining, crude oil production," and "commercial banks.") The prices drug companies charge have little relationship to the costs of making the drugs and could be cut dramatically without coming anywhere close to threatening R&D.
Second, the pharmaceutical industry is not especially innovative. As hard as it is to believe, only a handful of truly important drugs have been brought to market in recent years, and they were mostly based on taxpayer-funded research at academic institutions, small biotechnology companies, or the National Institutes of Health (NIH). The great majority of "new" drugs are not new at all but merely variations of older drugs already on the market. These are called "me-too" drugs. The idea is to grab a share of an established, lucrative market by producing something very similar to a top-selling drug. For instance, we now have six statins (Mevacor, Lipitor, Zocor, Pravachol, Lescol, and the newest, Crestor) on the market to lower cholesterol, all variants of the first. As Dr. Sharon Levine, associate executive director of the Kaiser Permanente Medical Group, put it,
If I'm a manufacturer and I can change one molecule and get another twenty years of patent rights, and convince physicians to prescribe and consumers to demand the next form of Prilosec, or weekly Prozac instead of daily Prozac, just as my patent expires, then why would I be spending money on a lot less certain endeavor, which is looking for brand-new drugs?[4]
Third, the industry is hardly a model of American free enterprise. To be sure, it is free to decide which drugs to develop (me-too drugs instead of innovative ones, for instance), and it is free to price them as high as the traffic will bear, but it is utterly dependent on government-granted monopolies—in the form of patents and Food and Drug Administration (FDA)–approved exclusive marketing rights. If it is not particularly innovative in discovering new drugs, it is highly innovative—and aggressive—in dreaming up ways to extend its monopoly rights.
And there is nothing peculiarly American about this industry. It is the very essence of a global enterprise. Roughly half of the largest drug companies are based in Europe. (The exact count shifts because of mergers.) In 2002, the top ten were the American companies Pfizer, Merck, Johnson & Johnson, Bristol-Myers Squibb, and Wyeth (formerly American Home Products); the British companies GlaxoSmithKline and AstraZeneca; the Swiss companies Novartis and Roche; and the French company Aventis (which in 2004 merged with another French company, Sanafi Synthelabo, putting it in third place).[5] All are much alike in their operations. All price their drugs much higher here than in other markets.
Since the United States is the major profit center, it is simply good public relations for drug companies to pass themselves off as American, whether they are or not. It is true, however, that some of the European companies are now locating their R&D operations in the United States. They claim the reason for this is that we don't regulate prices, as does much of the rest of the world. But more likely it is that they want to feed on the unparalleled research output of American universities and the NIH. In other words, it's not private enterprise that draws them here but the very opposite—our publicly sponsored research enterprise.
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To me it's wrong when the elderly are stopping their medicines or taking them in smaller doses so they can eat or pay the electric bill.
I think it's criminal that we keep Americans from crossing into Canada and getting their prescriptions filled for sometimes 1/4 the price they would pay in the US. And to say that there isn't enough quality control in other countries--that just boggles the mind. Especially when the drug might be manufactured in the US and then sent to Canada for distribution!
I'm sure there are all kinds of lobbyists for the drug manufacturers in Washington. If so, it's time to get them out of there!
Lots of the research monies that the drug companies get and use to come up with new drugs is provided by research grants, and also funded by colleges and universities w/research labs. There are chemists who work for years on a drug and get all the money from education grants or government research grants. Even some fundraising non-profits give monies for drug research.
It seems with all the monies raised, there should be a cure for some of the diseases in the world. Of course, a friend said to me, in jest, but I think there's some truth to it: Well, if the drug companies came up with a medication to end each disease, wouldn't they eventually go out of business? Something to think about.
And what are the 400 drugs that WalMart can sell to consumers for $4.00 a prescription? If they can do it, why can't these other providers do it--like Medco & Caremark? -
hi
medicine prices are a pinch in the pocket.
my friend is in her late 70's her eye drops are 350.oo she is even blind in one eye.
it would be nice if they could be cheaper.
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This is America, not Canada or Europe. It's called free enterprise. And the operative words about Marcia Angell are "Social Medicine". What is the price tag on that one?
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It's called free enterprise in Canada and Europe also, with humanity mixed in. The price tag is good treatment and reasonably priced drugs for everyone, not just those who can afford it.
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What were HD TV's selling for 5 years ago? Or desktop computers 10 or 20 years ago? Does Bill Gates make more than he should? Where would we be without cyberspace? Nothing is free, someone has to pay. Who's pocket would you pick? I could go on but this is not the place. Just felt the need to make my point.
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Since I pay federal taxes which are used to fund a good deal of the drug research from which the private drug companies make their enormous profits, it's my pocket that's being picked. In some cases we're talking about 500-1000% profit. I greatly admire Bill Gates who puts his money to good use helping those less fortunate than he. How nice if everyone who makes inordinate sums of money would do the same.
However, it was not Bill Gates who came up with the concept of cyberspace. I know this because I worked in Bell Laboratories in the 1980's where some of the first inklings of the internet began, perfected later in 1990 by Tim Berners-Lee, an English scientist. The internet started and has generally continued to be viewed by its earliest inventors and its earliest supporters as a non-profit enterprise. So perhaps you might want to eliminate cyberspace from your list of examples.
More important, every person alive on this planet will get sick some time in his or her life and will die. All of them will need some type of drug at some time to help them get better or to ease the pain of death. We all don't need high definition TV's (I don't have one and have no intention of buying one). We all need drugs at one point or another.
I would also mention that our government regulates the profits in many areas of business, including the amount of interest banks can charge on mortgages and on credit cards. There are many other examples where our government intervenes to pervent consumers from being ripped off by profiteers. Drug companies, because they have so many lobbyists in Washington, have managed so far to avoid such regulation. That's a shame and a disgrace, quite frankly. Medicare has been prevented (by regulations put in by the Bush administration) from demanding lower prices from drug companies. Private companies can and do demand lower prices.
But again, comparing the cost of life-saving drugs to the cost of high definition TV is not a valid comparison. Gangsters frequently make loans to desperate people at exorbitant interest rates. Generally, society looks down on such people as the lowest of the low. Why should we not view drug companies in the same light, worse perhaps, since for many people the drugs they can't afford to buy could save their lives or the lives of their children. No one is suggesting that drug companies should not make a profit; the drug company in Italy that sells the generic Efudex for $4.00 is making a profit or it would go out of business. That Duane Reade charges $296 for the same drug is a disgrace.
I could go on as well, but I believe the article I posted by Dr. Angell says it all.
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Anne, thank you for the information about the Marcia Angell's book. I often wonder where the prices come from on anything in the pharmacy. I'm thankful that the prices do eventually come down, but even with the 10 years the generics are kept at bay, it seems like they could recoup their money. So glad the computer companies aren't covered by similar laws. We'd still be waiting a whole lot longer for lower prices.
I think what disturbs me the most about the state of our pharmaceuticals is beyond the cost of research, but the topics of the research itself. For example, I recently came across the description of a book written by a doctor about iodine. He espouses a theory linking breast cancer with deficient levels of iodine. I haven't read the book, but it certainly put some wishful thinking into my head that, hey, could it be possible to prevent cancer just by making sure my iodine levels are up to par? Why am I 3+ years post diagnosis and just now hearing of this for the first time? In our current climate, I doubt a scientific study would even get off the ground for such a topic, mainly because iodine is readily available and cheap.
I have to wonder, how hard is anyone looking for a cure or a form of prevention? I have papers from my insurance company stating that EACH one of my chemo treatments cost $13,000. No one received that amount, but that's mainly because I can't even begin to pay the $46,000 that was leftover as MY part of the bill for my treatments. Just think of all the money raised in pink October, Komen walks, and many many other nonprofit fund raising projects. I don't know the stats, but I have the impression that boatloads of money are raised for research. Yet the people who are sick are still expected to pay for the reserach every trip to the pharmacy. They're already making boatloads of money from chemo. If someone discovered a cure that was inexpensive, I wonder if it would ever see the light of day.
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There is a new movie out on DVD called "SICKO". It is a portrayal of the medical system in the US and also includes the stories of some of the 911 rescue workers and their inability to get followup medical treatment there. A must see.
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My husband has been taking meds for an ulcer for a number of years. During that time, we have had 2 different insurers through 2 different employers, a brief period with no insurance, and a brief period with Medicaid. The charge for the same drug at the same pharmacy under each of those situations has been different. (I'm not talking about our portion of the cost, but the "total cost" listed on the receipt). Insurance #1, a 30-day supply was $138. No insurance=$178. Medicaid=$94 and Insurance #2 $200+. We're talking changing from insurance #1 to no insurance, medicaid, then insurance #2 in the span of 6 months.
I think the cost to the consumer/insurer is way too high for many drugs. I'm really confused, though, how the same pharmacy comes up with such a range of prices for the same drug depending on the consumer's method of payment. Something's wrong there.
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And another idiosyncracy of insurance: I was prescribed Coreg. Without insurance: $133. With insurance, I pay $29/month. I asked my doctor to switch me to the generic which is $18 for 3 months.
BUT, the generic is available via Walmart, Target, and many other mass-market pharmacies here now for $4/month WITHOUT insurance. Yes, I know they charge under their cost. But it's funny that I can pay $18 for the convenience of having it mailed tome, or $12 for the cost of going to the pharmacy 3 times (once each month).Definitely check on whether generics are available. The only difference for me is that I take pills twice/day instead of the non-generic long-acting pill once a day.
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Quote:
2 Mar 2008 09:41 PMThis is America, not Canada or Europe. It's called free enterprise. And the operative words about Marcia Angell are "Social Medicine". What is the price tag on that one?
I, and most people who understand it, call it "Single Payer Health Care". And the price? Major savings from the current system that is run by the insurance companies and the profits go into their pockets - major profits, major losses to their subscribers, the subscriber's health care providers and, yes, even the drug companies.
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Yes, there are good and bad to be said about Social Medicine. I have relatives in Finland and they pay 50% taxes to be covered "from cradle to grave." I probably should say from 10 months before birth to grave. They are very happy with this system and they get good care. I have a friend in Norway. Same situation. When her little girl was old enough for nursery school they just enrolled her. No fuss & no fees. After school care--in the winter would you believe skiing instruction and other winter sports. All kinds of sports in the summer. They have 4-6 weeks of vacation per year. Not barely 2 weeks per year, or for some there is no vacation or sick leave here in the US. Work parttime--chances are no sick leave or vacation, no holiday pay.
The bad. Most middle class in Finland do not own a car. If they do, they often share one care with several related family members. When company comes from out of country they will ask to borrow a friend's car to give a tour or go to a museum. Otherwise they bicycle or walk or take public transportation. You want to own your own car in Finland? The last I heard, which was 10 years ago it cost $1500.00 to register your car, then there's the cost of insurance, upkeep & gas, which is much more than the $3.44 I saw at the pump today.
In Finland they build housing communities around places of work. All your shops are there, your workplace, the parks and leisure activities. You can get around and purchase what you need without hopping in a car and driving 30+ miles to the mall.
So, guess we weigh the good with the bad. Here we can probably go to any doctor we want if we have the cadillac plan. We have access to specialists if we need them, can get a surgery without waiting 6 months or longer, and low cost drugs if we have insurance. The bad is that if you don't have insurance in this country, you could lose your house and everything because you can't pay for medical care for a serious illness.
Some may call it free enterprise. I call it being held captive, no matter how I look at it the drug companies get all the perks and the little people get none. it's not free enterprise, it's highway robbery!
grace -
Okay, I admit I haven't read all the posts. Hmmm..Walmart sounds good. I take one generic drug, Effexor, that costs $135 for 90 days, and Metoprolol Succinate Er Tabs (Toprol XL) that costs $91. I had a big surprise. My drug plan doesn't kick in until I read a $2200 deductible. So, my order totaled $476.66 for 90 days. Of course there were other generics there also and one non-generic, Lipitor. AND that's NOT including Arimidex. I called to aske the price on Arimidex and it is somewhere around $745 for 90 days. So, may I say, I have hardly ANY insurance until I reach my deductible. I hate this new insurance!!! So, if you add $745 to the $476 it would = $1221.66 out of MY pocket!
Our new insurance is going to force us to set up an HSA when we get our income tax return..and yes it's been filed!
We have marvelous insurance before.
Janet, even though one has insurance can one still buy their drugs from Walmart or Target?
Shirley
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Shirley--we need to put our brains together to figure out a way for you to get your drugs for less money. That's a huge amount for you to spend out of pocket. I've checked Canadian drug prices against those here and found vast differences in price. Perhaps you can order your drugs from Canada. I was told when I checked with some pharmacies in Canada, that the drugs are not usually stopped coming through the mail but if they were, they'd either refund my money or send me another package.
You can also find very big differences between drugs offered here by different companies. I found the generic of Efudex (in U.S.) for $92.00, versus the price Duane Reade offered of $296.00.
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In 2006 when we were signing up for our insurance at work for 2007, they were encouraging us to purchase what medicines we could at Walmart (no Target close) for the $4.00. You just have to tell them not to file it on your insurance. I am getting my hubby's 800mg tylenol at walmart for $4.00 a month verses $40.00 for 3 months.
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But not everything is $4-able via Walmart. My insurance decided to "reclassify" one of my asthma medicines last summer and no longer cover it (it's not that I NEED it or anything, right?!?). They also went up on my premium and prescription drug rider (I'm self-employed), so I am now paying more money for less coverage - and I have to out-of-pocket my $150 asthma med every month. It is not available for $4 anywhere as far as I know.
Something is very wrong with this picture...
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I just finished reading The Truth about Drug Companies. Thanks for the reading suggestion anne. It's no secret that the pharmaceuticals are a powerful lobby group in Washington, but I didn't realize the depth and breadth of their infiltration into doctors offices, journals, research labs and medical schools.
I still don't know how they come up with their prices, and apparently nobody does. The author refers to a 'black box' which the industry calls marketing and administration, which is $35 billion dollars annually. Nobody but the companies themselves knows how that money gets spent, and that's a mighty hefty markup for something unknown. And it's more than what they budget for research and development, which is seems to be more of an exercise in how to get their drug to market than genuine research. I never realized that all they have to do is show their drug is better than a placebo. They are not required to compare their product against existing drugs already on the market for treating the same condition. And heaven help anyone with an unusual disease. The drug companies won't even bother to find something that might help them. I knew they were greedy, but I didn't know it was this bad.
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I have not read the "Truth About Drug Companies" because I don't need to get any angrier than I already am.
What people need to realize is that the pharmaceutical, insurance, oil and other big businesses run this government - not the other way around. There is no way that the drug companies are going to give up their huge profits made on the backs of the un- or underinsured in this country. And the insurance companies aren't going to loosen their grip on us either.
I am paying $700 per month for private insurance.....my yearly contract is up in May, can't wait to see the raise I'll get now that I have BC. Anyway, I checked to see if Arimidex is covered and it is NOT. So I will have to pay the entire amount, plus all my copays, plus my deductibles, out of pockets AND premiums. I am self employed and my husband is on social security/medicare.
It is difficult to beleive that in 2008, the richest country in the world still cannot figure out a way to make sure that every American has access to health care but if we face facts that greed is the bottom line in this country then I guess it's not so hard to figure out.
This is just a side note but did anyone notice that the recent discovery that a meat processing plant that was using "downed" cows was made by an undercover camera that the Humane Society placed there? An organization that is funded by donations? NOT discovered by the FDA which is a tax funded organization supposedly devoted to the welfare of the American people. Anyone wonder why our government couldn't figure this out? Gee, think there was any money passed under the table?
Off my soapbox.
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It's been over 2 years since I received the bill for the portion of chemo my insurance didn't cover. The first round of paperwork added up to something like $113K for 8 rounds of chemo. Then my measly insurance 'negotiated discounts' and paid what my policy provides. What was leftover for ME to pay was $47,000. Talk about shock and awe! Who needs terrorists with medical bills like this?? Geez louise. I just couldn't fathom how chemo could be so expensive.
I never did pay that bill. They eventually stopped sending invoices and stopped making phone calls. I suppose I should do my credit report to see what shows up. I did that in '06 and was surprised that hardly anything medical showed up. Anyway, I'm not so angry anymore over what they wanted to me to pay, but it still perterbs me no end that they just seem to snatch prices out of the air. It's still not abundantly clear to me how the pricing is determined, aside from my perception that they just seem to charge as much as they think they can get and the depths of their greed is without limit. I remember a thread a long time ago about neulasta. Based on 'explanations of benefits' paperwork, members reported a range in price from $2,000 to $7,000 for one shot of neulasta. Mine rang to the tune of $6,000 a pop.
I don't know what the answers are, but things sure seem rotten to the core on many levels. I've been contemplating a return to vegetarian diet simply because I deplore the conditions the animals are subjected to. Knowing that chicken and dairy farms are plagued with deplorable conditions also leads to the notion that I should give up dairy and eggs too. These are measures too drastic to take overnight. I love milk. I love butter. I love to bake cookies and cakes. With pharmaceuticals, politics, and media these days, it's becoming more and more difficult to determine who has credible information. Both my mother and grandmother had bc and survived for decades afterwards with nothing but surgery for treatment. After a very long learning curve on this disease, I'm wondering how much benefit I really received from chemo, radiation, and tamoxifen. I feel more like a cash cow than a survivor sometimes.
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Check out www.canadapharmacy.com I order half of my mom's medicine from here and they are a certified drug company. They are recommended by AARP. Most of her medicines are half the price they are here. Some are generics, but that is because their patient laws aren't governed by our goverment! My brother-in-law is a pharmacist and he swears by these prescriptions. Check it out.
Clubmember5
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According to the Canadian website they have generic Arimidex. I believe it was $351 for 90 days. My onc said we'll be getting generic here next year. Right now for Arimidex for 90 days (brand name) for me is $743. I have to reach a $2200 deducitible before my prescription plan kicks in. That's my new insurance.
My previous insurance was so good that I never paid one penny for chemo or Neulasta or Procrit that I had twice (or whatever shot they gave me to up my red blood). All of the meds I ordered were so cheap. Even Xeloda that I brought home from Duke pharmcy..I brought home $4000 worth of Xeloda for $5.00. I would have had to pay $15 except that we had reached a point where we paid only $5.00 for EVERY drug, not just generic. But that's long gone since AT&T bought out the Bell system. We're going to go to the poor house before it's all over!
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Althea - and when they do "head to head" studies they compare drugs that aren't really comparable because they do completely different things for the same disease!
guggerdy - amen
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shirley, I sure hate to hear how much you're spending on arimidex. My onc told me to take tamoxifen, which was a relief at the time. I don't have anything to help me pay for prescriptions. So I hear your pain. And I will be interested to hear your progress reports on this. The whole issue of generics is another topic of the book about drug companies.
The patent holders will file not just one but several patents on a drug that goes to market. When the timeline runs out, which *should* be a green light for the generics to be developed, the patent holders will actually sue the generics companies for violating one of the more obscure patents, which are sometimes as insignificant as the color and shape of the pill.
It sounds like navigating a mine field. And once a lawsuit is filed, the patent holder automatically gets another 18 months to sell their drugs at top dollar without competition.
Y'know, whatever happened to the racketeering laws? I hardly even know what a racketeering law prohibits, but it sure seems like the drug companies are like a gigantic mafia. It sure seems like a whole lot of people deserve to be in jail because of how this industry works.
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Just because my onc said it would come out in generic form next years doesn't mean it really will. However, the Canadian pharmacy provided above offer the generic. Still not cheap. I would hate to spend a bunch of money that didn't go toward my deductible.
I just recently ordered about $450 worth of meds. Darned insurance!
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