Healthcare Reform: A Case Study

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.

The rise in drug prices is causing the public to ask why this is so and why there isn’t anything being done, or what the reason could be for sky high prices. Some of the reasons include pharmaceutical companies setting their drug prices

Anyone who has purchased prescription medications has probably wondered why they cost so much, and rightfully so. Medication prices in the United States have been on a steady increase for decades, however, prices have been drastically increasing as of recent. Pharmaceutical companies have tried to justify these price increases due to the demand, the high cost of research, and the high costs of development and approval. Notwithstanding, the extent to which the prices have increased is not justifiable. Americans should be against these high medication prices and take action because pharmaceutical companies are taking advantage of our healthcare system in order to capitalize from the sick. In order shed some light on this issue, the magnitude, scope, and consequences of these prices must be examined.

In a speech based in Kentucky in March, Donald Trump called drug prices “outrageous” and has intended plans to fix these issues during his presidential years. These high priced drugs are affecting the Americans, and especially our health-care system. “Not only are drug manufacturers launching products with high prices, they are routinely raising the prices of existing drugs — even decades-old drugs — by double-digit rates.” (High-Cost Drugs - AHIP) Unlike other countries, America has nobody telling these medicine-supplying companies how cheap, or how expensive their products may be. Increasingly, due to no price barrier, insurers are raising deductible prices to pass the prices along. After mainstream drug patents expire,

Anyone who has purchased prescription medications has probably wondered why they cost so much, and rightfully so. Medication prices in the United States have been on a steady increase for decades, however, prices have been drastically increasing as of recent. Pharmaceutical companies have tried to justify these price increases due to the demand, the high cost of research, and the high costs of development and approval. Notwithstanding, the extent to which the prices have increased is not justifiable. Americans should be against these high medication prices and take action because pharmaceutical companies are taking advantage of our health care system in order to capitalize from the sick. In order shed some light on this issue, we must examine the magnitude, scope, and consequences of these rises in price.

After gaining heat in the news, Martin Shkreli announced that he would be lowering the price of his medication. Valeant, another drug company has also been under fire lately for the pricing of their medicine. Democrats in the House of Representatives have demanded that Valeant release their info about how they price their drugs. This demand could spread to other pharmaceutical cooperation's; forcing all companies to reveal their pricing strategies. (Ramsey) A few months ago, New York became one of 7 states with bills requiring pharmaceutical companies to reveal their prices. The other states are California, Oregon, Massachusetts, North Carolina, and Pennsylvania. However none of the bills have succeeded. If the bills were passed, all pharmaceutical cooperation's would be forced to submit quarterly reports on the changes to their pricing. (Owens). The war to fight against corrupt businesses has only just begun. Over time, the government and private pharmaceutical corporations will better cooperate and work together to have logical pricing in medicine based on funding and production

There is also the issue of many people forgoing certain needs in order to not have to reduce their prescription use. Rather than forcing themselves to space out their medication more than they are supposed to be as prescribed, these people start cost cutting in other areas of their lives. Many will forgo basic needs, such as food, in order to get to a point of affordability of their medication. This cost-cutting generally can occur before the gap, just as drug reduction does, and typically continues through the gap until catastrophic coverage is reached, or until they reach the next year and reset the entire process (Madden and Graves, 2009; Nekhlyudov and Madden, 2011; Zivin and Madden, 2009).

This is a serious long-term concern, and needs to be addressed. Some methods to ensure medications are lowered and kept at prices Americans can afford, is to create policies to demand transparency from pharmaceutical companies, allow generic drugs to be created, and remove the ban on Medicare permitting them from negotiating prices on medications.

The EpiPen is only one out of numerous lifesaving medications that pharmaceutical companies have increased the price to an amount that the average consumer cannot afford. As both a concerned constituent and a health care provider, I would never want people to have a lack of access to medications that could potentially save or improve their quality of life for any reason. It is now imperative that the government on all levels demand transparency in the cost to create and manufacture medications and also enforce drug price controls. Senator McEachin, this is why I want you to co-sponsor and support Senator Emmett Hanger’s prescription drug price transparency bill (SB487). This bill will require drug manufacturers to give information on the cost of research and development, manufacturing, marketing, price changes, and profits for each prescription drug sold in the Commonwealth of Virginia for a wholesale cost of $10,000 for a single treatment course (SB487: Prescription drug price, n.d.; Silverman, 2016).

Competition within the marketplace is not being controlled effectively by the FTC. Insurance companies against medical care facilities are killing consumers pocketbook. Brand name pharmaceutical companies against a generic drug pharmaceutical cause inflation in prices as the two drug companies compete with each other. Real life examples are overwhelming to hear. In concluding efforts of this argument here are some strong real life examples supporting the thesis. “ Since 2007, Lyrica has helped treat the pain of those who suffer from fibromyalgia. In 2014, the drug was Pfizer’s top-selling drug and brought in $5.17 billion in sales, and in 2015, the drug was the pharmaceutical giant’s second-best selling drug bringing in $4.8 billion. The price of the drug increased by about 51 percent over the three years, which produced $208 million sales attributed solely to the price hike.” (The Facts About Rising Prescription Drug Cost, 2016, p.2) The previous real life examples like narcan, epipen, and 0.9% normal saline are all very similar examples of sales skyrocketing and prices continuously on the rise. A perfect example of the FTC and FDA not doing their job is the next example. “Sovaldi, a drug to treat Hepatitis C virus, costs $1,000 per day for the 12-week course of treatment amounting to $84,000. Additionally, a drug like Sovaldi is often prescribed in concert with other drugs, significantly raising the total treatment cost. An 18-month investigation by United States Senate Committee on Finance into Gilead Sciences’ Hepatitis C drugs Sovaldi and Harvoni found that “the company pursued a marketing strategy and final wholesale price of Sovaldi…that it believed would maximize revenue…Fostering broad, affordable access was not a key consideration in the process of setting the wholesale

Turing pharmaceuticals in particular, raised the price of Daraprim from $13.50 to $750 per tablet. The narrow market demand for Daraprim, and Turing’s complete control of the distribution of Daraprim allowed Turing to act like a monopoly. Additionally, the approval process of the FDA provide less incentive for other pharmaceutical companies to produce generic forms of the drug. The FDA can speed up the approval process, and aid other pharmaceutical companies compete. Moreover, the government can allow Medicare to negotiate price of drugs with pharmaceutical companies, as a result lowering the price of the drugs and guaranteeing the safety of

For the 469 drugs on the market since the end of 2004, prices increased by 25.6% from 2005 to 2009, while the general growth rate was 13.3%. Consumers taking drugs to treat chronic diseases found that their average yearly cost increased from $2,160 to $3,168. Not many people know the transition of prices in the medical field. ”Last year pharmaceutical costs grew 13.6 percent – faster than any other part of the healthcare industry – and pharmaceutical company profits were nearly 20 percent in 2012, double the average profit margin for the S&P

Our government needs to bargain for better prices from drug companies, “ Not only would negotiation substantially reduce prices, seniors and people with disabilities can pay for their drugs” (bernie). In many countries the government sets a price limit on medication costs so that drug companies can’t raise prices too high; so, people can pay for their prescriptions (CNN). The negotiation for better drug prices could save medicare between $230 billion and $541 billion over the next decade (bernie). We need to arrange for better prices from drug companies and, while we are doing that, people should be able to get their medicine from outside the country.

The bill reauthorizes the programs regarding the exclusivity of specific medications and drugs that contain single enantiomers, the orphan grants program and critical path public-private conglomerates (Messer, 2017). Additionally, the drug supply chain is strengthened and protected by the bill whereby it requires the Secretary to emphasize the aspects of new medications that seek licensure or approval for a rare condition or disease as an already approved medication to highlight that the new drug is clinically superior to an already approved or licensed drug. Specifically, this provision directs on the labeling of drugs by adding pediatric information and expressing the need for the administrator of health and human services to commit in taking legislative actions to cut the prices for prescription drugs (Tingle, 2017). Finally, the Secretary of health and human services is expected to convene a public meeting to highlight on varying aspects of clinical trials including the inclusion and exclusion criteria. Under this title, certain medications from outside the United States ordered during a shortage, can only be imported if labeled correctly and authorized by the manufacturer (Congress.Gov, 2017). Considerably, a penalty has been stipulated for

The Affordable Care Act attempted to lower the financial burden of prescription drugs for patients. The Act provided a $250 yearly rebate to those people in the coverage gap to help pay for their medication, in addition to a 50% discount on brand-name prescription drugs for seniors within the coverage gap (Protection 2010). However, given the current government’s plans to eliminate the Act, this annual rebate seems to be a solution of the past. A viable change that can be made is revising Medicare Part D, the part concerned with prescription drug coverage, so that the Department of Health and Human Services is able to negotiate drug prices. In addition, the practice of “pay-for-delay”, in which large pharmaceutical companies pay off companies threatening to release generic versions of the drug, needs to be eliminated. Senator Patrick Leahy of Vermont is currently trying to pass a bill (S.3056 - CREATES Act of 2016) that would eliminate the “pay-for-delay” practice (Leahy 2016).