While a morass of market forces seems to defy any practical solution to high drug prices, not to mention stakeholders with unreasonable profit margins, it is possible to start right out of the gate with an R&D solution. Scientific Collaboration among drug and therapy researchers is where it should begin, with the open-source collaboration that Open Therapeutics will soon offer. It will be a start toward helping keep Medicare afloat, and ensuring that seniors and the poor don’t have to decide between buying food and purchasing their prescriptions. Open Therapeutics’, new platform, Therapoid will debut in late spring, offering Global Therapeutic Solutions, through collaboration with capable and responsible scientists and research organizations across the globe. In the meantime, scores of other complicated political, marketing, and regulatory propositions have been put forth toward solving the continuing conundrum of high drug pricing:
Politicians on both sides of the aisle have tried to find solutions to mitigating drug prices through various channels, including Medicare’s direct negotiation of drug prices, but there’s a basic problem with any proposition for direct negotiation of drug prices: Medicare would have to be able to say “no” to drugs that might be expensive, but are still badly needed by people with chronic conditions. It would have to establish a list of covered drugs, known as a formulary, and be willing to leave drugs off.
The idea of negotiating with drug makers dates to the creation of the Medicare when Congress wrote a section into the law that banned the Department of Health and Human Services from getting involved in talks over prices. Individual, private drug plans that provide the coverage for Medicare can negotiate, though with some significant restrictions.
Melody Petersen, in her December 6, 2016 Los Angeles Times (LATimes.com) article, How Free Coupons for Patients Help Drug Makers Hike Prices by 1,000%, cites the prevalence of coupon use by drug manufacturers. Experts, though, are concerned that coupons, being used by dozens of companies, are adding to the nation’s medicine bill. That cost is passed along to most Americans through higher insurance premiums and taxes necessary to pay for government health programs.
One example that Petersen gives is Horizon Pharma’s charges of more than $2,000 for a month’s supply of a prescription pain reliever that combines two cheap drugs available separately over the counter. Another company, Novum, sells a small tube of a prescription skin rash cream combining two inexpensive decades-old medicines, for nearly $8,000.
The success of Horizon and Novum’s use of this strategy shows how America’s system of paying for prescription drugs enables executives to set astonishing prices on medicines that have been around for years. The coupons effectively prevent patients and doctors from learning the medicine’s true price tag.
One reader responded to the Los Angeles Times’ article, claiming that coupons issued by the drug manufacturer is the only way he can afford the high cost of a drug he takes for his condition. It appears to be a case of smoke and mirrors in which the discount helps one participant in the chain, in this case the patient, while other Americans pay for it through higher health insurance premiums.
Generic drugs could be part of the answer, though the time it takes to bring them to market is lengthy. According to Alfred Engelberg’s 2015 post in HealthAffairsBlog, (@fdncenter) Federal law prohibits the Food and Drug Administration (FDA) from approving a copy of a new drug for a period of seven to 12 years even if there are no patents. The FDA is also prohibited from approving a generic drug anytime a claim of patent infringement is alleged — a policy that has encouraged many patent claims just to delay competition. Drug patents also get extensions of up to five years and then an additional six-month extension for conducting studies of the new drug’s suitability for use in children. Collectively, all of these special monopolies prevent competition and keep prices high.
At least, if the cost of R&D is lowered right at the inception of the drug creation process, through research scientists’ collaboration, it will discredit some of the drug manufacturers’ rationale for the staggering cost of vital medications and therapies.