Drug costs high but still better than alternatives

drugcostsPOST SUMMARY: (via Boston Globe) Fewer than 4 percent of patients use specialty drugs, but they account for 25 percent of total drug spending.  “The impact of the specialty tier benefit design falls disproportionately on patients who are living with diseases and conditions that are serious and life-threatening,” said Marialanna Lee, Northeast Region state government affairs director for the Leukemia & Lymphoma Society. Often the specialty drug is the only one available for these conditions, she said. “It’s going to cost more in the long run,” predicts Patricia Ferland Weltin, executive director and founder of the Rare Disease United Foundation. If denied drugs that keep them well, she says, “They’re going to end up in the E.R, they’re going to end up sick, costing more money than if they took the drug. . . .

Today’s New York Post has a different take on drug prices as written by Peter Pitts..

Expensive new drugs, often get fingered as the culprit to rising US healthcare costs. The truth is closer to the reverse. Consider Sovaldi, which has a 90 percent cure rate for Hepatitis C, a disease affecting over 3 million Americans. A three-month treatment cycle of the new drug costs upward of $84,000. On the market for just a few months, Sovaldi has already clocked in a record-shattering $2.3 billion in sales.  One pre-Sovaldi “best practice” treatment for Hepatitis C, the drug Pegasys. This requires one injection a week for 48 weeks — and very few patients see the treatment through to completion, so much of that treatment, both physician time and drug cost, is wasted. Nor is it that much cheaper: At about $7,000/month, the full course of treatment is over $70,000 — barely less than the cost of the three months needed for Sovaldi to work a cure.  The price of not using Sovaldi is very high. One in three patients with the Hepatitis C virus eventually develops liver cirrhosis, and managing these patients is costly. A “routine” liver transplant (where the liver is from a cadaver) costs close to $300,000; a “living donor” transplant is even more expensive.

It’s remarkable that some large insurers have the chutzpah to complain that curing 3 million Americans of hepatitis C will bankrupt health-care systems. Data recently published by the PwC Health Research Institute suggests the reverse. The study shows that the use of Sovaldi will actually drive down overall spending within a decade. According to the authors, “The challenge may lie in targeting the patient most in need of the more expensive course of therapy.”

imagesOKlet’s be honest here.  The real culprit in high health care, drugs is due, in large part, to our unhealthy lifestyles.  We can now surf the Internet as couch potatoes while watching TV and it’s much easier to order unhealthy take-out food than cook health meals which take time.  If drug company CEO’s are called before Congress they should clearly and openly share the costs of developing new drugs and the fact that only 11% of health care dollars go into Rx drugs.

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Right now pharma has a giant target on its back, but even if they talk “facts” the American public distrusts the messenger.  It’s time for all of us to admit that individuals bear a large part of the responsibility for health care costs.

 

One thought on “Drug costs high but still better than alternatives

  1. Terry Nugent

    Granted, lifestyles play a role in disease, and all stakeholders should and to some extent do try to influence behavior.

    However, it seems to me that the pricing issue needs to be addressed in several other ways. First, pharma needs to have a strong value story well and unabashedly told. Second, patient advocacy groups need to be leveraged to persuade credible public figures to stand up for the industry. What if Michelle Obama or someone of that stature spoke out in favor of the industry to pressure payers to provide access? Granted, this seems unlikely since pharma is generally a piñata for politicians, but if the value story is valid, which in the case of Sovaldi it is, it would be hypocritical to deny it.

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