Specialty Drugs, Issues And Challenges

(What Is, 2012). Every year close to $800 billion dollars is spent on services that were non-essential. (PBS, 2012) That expenditure accounts for roughly 30% of the total healthcare spending that the United States is responsible for. (PBS, 2012) Professionals contribute to this number by participating in defensive medicine, which is recommending and performing tests and procedures that may not be necessary to protect them from lawsuits. (What Is, 2012) By giving in to the fear, these professionals are driving up the cost of healthcare. In 2015, drug spending increased by 9%, a slower but steady increase from the year before. (What Is, 2012) The United States has a substantial problem in the big pharma community. Unlike other countries, our prescription drugs have no price regulations through the government. Instead the drug makers oversee setting a price they view is correct. (Johnson, 2015) Thus, this leads to over priced products that most consumers who need them for everyday life won’t be able to obtain. Additionally, limited competition and small markets also drive up the cost of medication. Without additional generic brands to create a sense of rivalry, name brand drugs create a monopoly and raise prices with no opposition. (Johnson, 2015)

Imagine this: you are tragically diagnosed with a chronic life-threatening illness. Your only hope to survive is through medication to treat your disorder. The medicine is pricy but you can work out the costs each month. One day, you go to fill your prescriptions and realize the cost of a $13 pill has jumped to an astounding $750. You need this patented medication to survive and to afford it you end up losing your home, filing for bankruptcy, and sleeping in your car. This story sounds fictional but it is the reality for many Americans who can no longer afford their grossly overpriced medications.

"In the past two decades or so, health care has been commercialized as never before, and professionalism in medicine seems to be giving way to entrepreneurialism," commented Arnold S. Relman, professor of medicine and social medicine at Harvard Medical School (Wekesser 66). This statement may have a great deal of bearing on reality. The tangled knot of insurers, physicians, drug companies, and hospitals that we call our health system are not as unselfish and focused on the patients' needs as people would like to think. Pharmaceutical companies are particularly ruthless, many of them spending millions of dollars per year to convince doctors to prescribe their drugs and to convince consumers that their specific brand of drug is needed in

The cost of health care has been at the forefront of politics for years. It is one of the most talked about topics not just in political venues but also country wide. Every American has an opinion on how our economy can be fixed and they are passionate about health care reform. The price of insurance alone causes many Americans to not have coverage. For those that can afford coverage, the struggle to pay co pays is immensely crippling their bank accounts. Of these burdens on Americans today, the most frightening fact lies in the cost of prescription medications.

In 2014, the average cost for an individual rose to $5,615. For those that have an income over $200,000 have to pay a higher tax. This tax is called the Robin Hood redistribution and was set to begin in 2014 with the enactment of the Affordable Care Act. For the employers of companies, on average, they would have to pay around 30% for their employees to be covered with healthcare and insurance whereas in 2010, they only had to pay around 10%-20% of their healthcare and insurance. Currently, Americans have higher health insurance premiums, increased deductibles through their health plans, and the highest prescription drug costs our country has ever had. The costs in prescription drugs drastically rose between 2010 and 2014. Since 2010, the average cost for a patient to fill a prescription drug through commercial plans have risen by more than 25%. Drug companies put a higher cost on their drugs in 2014 as they saw the rise of those acquiring health insurance and healthcare. However, in states such as Kentucky and Arkansas, in 2014, people who skipped paying for their medication due to the cost being so high, dropped by 15% from roughly 43% to 28% due to Obamacare. Although, with Medicaid expanding, this puts more pressure on the middle-class population in the country as well as healthcare professionals as many physicians have to pay nearly half of what they earn to the

The cost of prescription drugs in America has risen to the level that most Americans could not afford them with out the help of an insurance plan. The greedy and capitalistic pharmaceutical companies rely on the United States to fund the future development of drugs with skyrocketing prices and enormous margins. Recently the issue has extended into the mainstream political arena, thanks in part to the new Medicare bill(2). With the push by congress for the importation of drugs from foreign sources, regardless of the potential long and short term consequences, the time to vocally support health care reform is upon the American public.

1 Kaiser Family Foundation Report on the Uninsured. Available at http://www.kff.org/uninsured/7451.cfm. 2 Danzon, P., et al. “The Impact of Price Regulation on the Launch Delay of New Drugs.” Health Economics, 2005; 14(3): 269-292. Available at http://hc.wharton.upenn.edu/danzon/html/Journal_Articles.htm. 3 The Boston Consulting Group. “Ensuring Cost Effective Access to Innovative Pharmaceuticals – Do Market Interventions Work?” April, 1999. Available at http://www.bcg.com/impact_expertise/publications/files/Ensuring_Cost_Effective_Access_Innovative_Pharmaceuticals_Apr1999.pdf 4 Thorpe, K. et al. “Differences in Disease Prevalence as a Source of the U.S.–European Health Care Spending Gap.” Health Affairs (Web Exclusive) Oct. 2, 2007. Available at www.healthaffairs.org.

The journalist Nadia Kounang further explains the differences between what the U.S pays on drugs and other similar developed countries, in the article Why pharmaceuticals are cheaper abroad. Kounang displays how much American need to pay for Gleevec (cancer medication) which is $6,214 (per month/per customer) whereas in Canada patients only have to pay $1,141 and in the U.K $2,697 (Kounang 1). These prices are the result of different organizations setting different price ranges with drug companies (U.S.A), and these enables American insurance companies to take advantage of it (Kounang 1). While in other countries there are not as many organizations, so this helps to set a deal of a price that benefit both the drug company and consumers (Kounang). Strictly speaking, by having these different medical insurance companies it has made it difficult for patients to afford their medication because there is no singular organization that can set drug price ranges with pharmaceuticals, while in other countries they don’t a variety of different medical insurances which enables the country to provide treatments that its citizens can afford. Thereby, if the government does not fully cooperates with other medical insurances, lowering the cost of medication will be difficult without affecting research and development. And as a result people who can not afford them will still struggle to obtain their required prescriptions.

Between 2001 and 2011, the average patient’s out-of-pocket (OOP) cost for brand-name prescriptions rose by more than 80% (Tungol, et al., 2012, p. 691). The increasing OOP costs have contributed to a decrease

Health care costs are extraordinarily high and keep getting higher. Individuals in the US that do not have access to medical services are running as high as 43.4 million and This number has grown by over a million in each of the last three years. (AFSCME, n.d.). The rise of prescription drug

The Affordable Care Act is an once-in-a time change to the U.S. social insurance system. It guarantees access to medicinal administrations for all Americans, rolling out new driving forces to improvement clinical practice with a specific end goal to develop better coordination and quality, gives specialists more information to enhance, clinicians and patients more information to make them more regard perceptive buyers, and changes the portion system to remunerate the regard. The Act and the medicinal services information development programs in the American Recovery and Reinvestment Act empty various limits to pass on choice care, for instance, trivial administrative multifaceted nature, inaccessible clinical data, and lacking access to fundamental care and joined human services providers (Kocher, 2010).

In an article in the Mayo Clinic Proceedings, the doctors laid out their long list of proposed reforms, which includes allowing Medicare to negotiate with drug companies for lower costs. The group also wants patients to be allowed to get medication from Canada, which some Medicare negotiate prices with pharmaceutical companies and letting patients import less expensive medicines from other countries like Canada. The experts’ article notes the same cancer drugs in Canada cost about half of what they do here in the U.S.

According to the article from David Lemberg (2012), “$2.5 trillion pie is big pharma” but my friend’s daughter had to shell out $450.00 for 1 month supply of Lyrica because she has the Affordable cost insurance. The less you spend for premium, the more out of pocket expense you will incur; the seniors of Florida are being milked out of their retirement. No wonder I saw it on the new where pharmacist are saying that the waiting lines are longer, and they cannot train pharmacy technician fast enough. Unfortunately, because of greed, fraud and disparities in health care, it will be a waging battle to curtail this ridiculous wasteful spending. Bookkeepers are now crook keepers, or should we call it is the American

The cost of health care in the United States continues to rise. National healthcare expenditures totaled over $2.9 trillion in 2013, equating to $9,255 per capita (Centers for Disease Control and Prevention [CDC], 2015). This is a consequence of both private and government healthcare financing mechanisms including: high unit prices, market power, specialized medicine, medical malpractice, private health insurance costs, ill populations, not utilizing best practices, and a medical model versus population health focus (Kutter, 2008; Rice & Unruh, 2016; Sultz & Young, 2014).

For the past few years, there has been consistent media coverage detailing the trends of escalating prescription drug cost. Furthermore, articles question the pharmaceutical industry’s motives for such a significant increase in the cost of medications. There are accusations that industry price increases are a result of tactics to increase profits. In particular, the media’s coverage focused on major drug companies where price increases were obviously egregious. For example, Valeant Pharmaceuticals, Turing Pharmaceutical and Mylan Pharmaceutical were called before Congress in the past year, to answer questions pertaining their significant price increases for life saving medications. These three companies are considered to be outliers in the