Prescription Drugs: The Rising Price of Health

AlexCA mother trying to refill her child’s asthma inhaler now finds the errand prohibitively expensive. Drug prices continue to increase, providing little breathing room for those who use medication regularly. Some take matters into their own hands and use less than the prescribed amount in order to cut costs; others look for options in the generic drug market. Whatever the case, drug prices are becoming problematically high in the U.S.

Bringing in $85 billion of net profits in 2012 alone, the top pharmaceutical companies, such as Pfizer and AstraZeneca, significantly influence the nation’s economy. By the end of 2014, IMS Health, a leader in healthcare information and services, expected global pharmaceutical sales to supercede $1 trillion. As the profits increase and the prices of day-to-day pharmaceuticals become too high for the everyday consumer, questions arise: how are these profits utilized? Are these prices necessary or exploitative?

Much of the profit is devoted to lobbying and advertising for the drugs. Roughly $100 million is spent per year on lobbying expenses and campaign funds to ensure that drug companies’ interests are protected. In Steve Kroft’s report for 60 Minutes, he discusses the Medicare prescription drug bill passed in 2003 that “prohibited Medicare and the federal government from using its vast purchasing power to negotiate lower prices directly from the drug companies.” The lobbyist heavyweights loomed in the background and pulled strings to level the playing field as they wished. Voting polls were open for three hours as opposed to the usual 15 minutes to gain enough representatives’ votes in support of it. As a result, once a pharmaceutical company places a patent on a drug, it’s able to set the price as it sees fit. The elimination of competition does away with price regulations that would arise from a free market economy. Lower regulation leads to higher prices for the consumer.

Medications in the United States are priced much higher than those in other countries. For example, someone can purchase two bottles of Rhinocort in the United States for $250. Fly to Romania, and those same $250 dollars buy 51 bottles of the same drug. A natural inflation of drug prices is expected due to the increasing cost of modern technology used in drug production, but the large price gap between medications in different countries has no relationship to inflation. European countries have a system in which governments can bargain for lower prices, relieving the public from paying full research costs. In America, the research costs fall upon the consumer. This inflames prices.

Consumers naturally look for a way to avoid paying so much for medication and tend to purchase generic brands of medicine, most of which are completely safe. However, recent generic drugs have, in fact, encountered safety issues. For example, extended release pills may remain partially patented because the drug and the pill capsule have separate patents. Generic brands therefore have to create their own pill capsule, which may not be as reliable. In one case involving a generic form of Toprol XL, an extended release capsule failed to work and caused chest pains. In Katie Thomas’s article “Generic Versions of Toprol XL, a Heart Drug, Are Recalled,” Dr. Harry Lever expressed his concern about generics: even though the US Food and Drug Administration (FDA) deemed these generics a safe alternative, consumers assume they are exactly the same as the big name brands when they don’t always turn out to be so.

 

Other generics affect issues in the body such as blood clots and high blood pressure, which are very sensitive to dosage of certain medications. A company must only prove that a generic is bioidentical to the brand name. This claim is more deceiving than it may sound. Being “bioidentical” means that a drug follows the safety guidelines and delivers 80-125 percent of the same active ingredient, which can cause inaccuracies in dosage. A consumer who switches to a generic pill could possibly take too high or too low of a dose, putting them at unforeseen risk.

In addition to chemical inadequacies, the location of the manufacturing sites can cause problems. India’s drug market is expanding fast and has little regulation. In recent years, the FDA has found “serious contamination, such as presence of flies” in drugs coming from India. Since these discoveries, the FDA has shut down multiple plants of the company, Ranbaxy, which produced the medication. Increased regulation may solve some problems. However, the checks on foreign drug facilities are fewer than domestic ones. This puts the consumer at risk since the FDA still continues to claim that there is nothing dangerous about generics. The FDA fails to acknowledge that contaminated drugs from international markets may not be identified, as even the Drug Controller General of India admitted that many facilities would have to be shut down if the FDA began enforcing American standards.

Though the risk involved with generics is small, the consumer must also consider that name brand drugs are much more regulated. Is assured safety worth the price of these medications? That’s up to the individual to decide, but for the future, it’s important for consumers to voice their opinions and push for change.

 



Alex Carico can be reached at john.carico@wustl.edu


'Prescription Drugs: The Rising Price of Health' has 1 comment

  1. November 19, 2014 @ 6:30 am Nicholson

    Alex, your dad sent this to me! I am so impressed, but I am not surprised.

    Reply


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