Drug pricing: A new prescription
By Sylvia Pagán Westphal
SEPTEMBER 14, 2014
WHAT WOULD happen if a company invented a drug that, taken once, cured a major disease like diabetes or Alzheimer’s, which affect millions of Americans? The answer: Our health care system could not afford it, even if the drug were priced extremely reasonably by today’s standards (say, $20,000).
That’s the sad realization from the ongoing controversy over who pays for Sovaldi, a hepatitis C drug launched this year by Gilead Sciences and priced at $1,000 per pill, or $84,000 for a 12-week course. The drug has been a budget-buster for health plans, with critics arguing that treating 3.5 million hepatitis C patients with it is unsustainable.
What’s more, Sovaldi is being labeled the canary in the coal mine of excessively priced drugs, with John Rother, CEO of the National Coalition on Health Care, warning of an upcoming “tsunami of expensive medicines that could literally bankrupt the health care system.”
We definitely need a national dialogue about drug prices, but Sovaldi is not the right poster child for that campaign. The vast majority of the very expensive drugs in our medical arsenal are taken for life and cost thousands of dollars per month. Sovaldi is a one-time charge in the lifetime of a patient, and in almost every patient, it’s a cure
A full course of Sovaldi (12 weeks) costs about the same as the full course of the previous therapy (24 to 48 weeks), a fact that seldom gets mentioned. But the previous therapy didn’t work very well, so doctors were not prescribing it much. When Sovaldi came out, insurers were overwhelmed by the demand.
So what the Sovaldi story has crystallized is that our health care system is not well designed to handle cures that are needed for millions of people. Payers are thinking year-to-year, faced with the debacle of paying $84,000 today to cure patients who might leave them tomorrow. The misalignment of interests could not be clearer.
With an unprecedented number of game changers in the industry’s pipelines, we must address the dizzyingly complex issue of prescription-drug prices. Like other aspects of the health care system, this one defies a simple solution. But there are some reforms that should be on the agenda now, including:
Continued here http://www.bostonglobe.com/opinion/...rescription/IaZrB2asExUqWY5yZnqciN/story.html
By Sylvia Pagán Westphal
SEPTEMBER 14, 2014
WHAT WOULD happen if a company invented a drug that, taken once, cured a major disease like diabetes or Alzheimer’s, which affect millions of Americans? The answer: Our health care system could not afford it, even if the drug were priced extremely reasonably by today’s standards (say, $20,000).
That’s the sad realization from the ongoing controversy over who pays for Sovaldi, a hepatitis C drug launched this year by Gilead Sciences and priced at $1,000 per pill, or $84,000 for a 12-week course. The drug has been a budget-buster for health plans, with critics arguing that treating 3.5 million hepatitis C patients with it is unsustainable.
What’s more, Sovaldi is being labeled the canary in the coal mine of excessively priced drugs, with John Rother, CEO of the National Coalition on Health Care, warning of an upcoming “tsunami of expensive medicines that could literally bankrupt the health care system.”
We definitely need a national dialogue about drug prices, but Sovaldi is not the right poster child for that campaign. The vast majority of the very expensive drugs in our medical arsenal are taken for life and cost thousands of dollars per month. Sovaldi is a one-time charge in the lifetime of a patient, and in almost every patient, it’s a cure
A full course of Sovaldi (12 weeks) costs about the same as the full course of the previous therapy (24 to 48 weeks), a fact that seldom gets mentioned. But the previous therapy didn’t work very well, so doctors were not prescribing it much. When Sovaldi came out, insurers were overwhelmed by the demand.
So what the Sovaldi story has crystallized is that our health care system is not well designed to handle cures that are needed for millions of people. Payers are thinking year-to-year, faced with the debacle of paying $84,000 today to cure patients who might leave them tomorrow. The misalignment of interests could not be clearer.
With an unprecedented number of game changers in the industry’s pipelines, we must address the dizzyingly complex issue of prescription-drug prices. Like other aspects of the health care system, this one defies a simple solution. But there are some reforms that should be on the agenda now, including:
Continued here http://www.bostonglobe.com/opinion/...rescription/IaZrB2asExUqWY5yZnqciN/story.html
