A penny saved: How we could rein in drug costs
A recent major study compared four diabetic medicines for their effectiveness at reducing blood sugar and vascular events when each was added to a standard first-line medicine. One of the four drugs has been around for decades and costs about $15 a month and the other three − including one form of insulin − were new and cost hundreds of dollars.
Although low blood sugar did occur slightly more often with the older of the four drugs, it was still rare and they all had similar effects in their diabetes control and major vascular outcomes. This is significant considering the main premise for the development of the new meds is their supposed lower incidence of hypoglycemia.
Diabetes and its early form called “metabolic syndrome” are now affecting a third of the country’s adult population, so the study has big implications.
The high cost of insulins − really analogues of insulin − is a national crisis and is becoming a subject of political campaigns. Three forms of insulin are available over the counter for about $25 for a typical month supply. Many diabetic patients are unaware of this, as are many physicians who treat diabetes, or they believe these newer drugs are far superior or safer, leading to more prescriptions for the expensive analogues.
Three percent of patients who take any prescription medication are responsible for about one-third of drug costs in America − now averaging about $1,000 a year for every man, woman, and child in the country. They are mostly for boutique medications to treat cancer or autoimmune conditions. Many effective alternatives are available for much less money.
U.S. drug costs are the highest in the world and 40% higher than in the second-most expensive country. This is because pharmaceutical companies have lobbied for this right from both parties in Congress. The price of these drugs is generally not reflective of the cost of development, and advertising directly to the public often misrepresents medical guidelines.
I have long been a proponent of playing hardball with drug companies using one of the strategies they routinely use for profiteering from the limited healthcare dollar. Have a federal lab tweak a popular insulin analogue molecule just enough to legally call it a new medication then fast track it to the market and place it on formularies for a fraction of the cost. Federal and state governments would not just see huge cost savings, but acquire a highly profitable revenue source.
The bigger problem is that the opportunity cost of this money could help supply health insurance to many of the 30 million Americans without it. Diabetes and metabolic syndrome are very inexpensive to manage in early stages, but instead we choose to pay the massive costs of treating the end-stage diseases they are responsible for when undiagnosed or undertreated.
This sort of misappropriation of the limited healthcare dollar is seen across the board with hospitals, insurance companies, and medical device manufacturers and should be the basis for discussion about future healthcare reform.
William Culbert is an Oak Ridge resident and retired physician.
This article originally appeared on Oakridger: Guest column: How we could rein in drug costs
