More on drug prices

Jon Holmlund wrote yesterday about pricing for new “orphan” drugs. Today I’ll look at a few articles that came across my virtual desk in the last week that deal with the pricing of existing drugs.

First, last Thursday, John Castellani, the head of the the drug industry’s trade group Pharmaceutical Research and Manufacturers of America (PhRMA), expressed concern that under the Affordable Care Act’s silver and bronze plans, which require patients to pay more medication costs, patients’ “out-of-pocket expenses are potentially so high that we have to be concerned about whether or not people will be able to afford to continue to get their medicines.”

Then, last Friday, from, an article about the steep rise in the wholesale prices of many drugs. In 2013, there was $19.3 billion in revenue declines for pharmaceutical companies due to patent expirations; this was offset by $20 billion of sales growth from increases in prices for existing branded prescription drugs.

(The juxtaposition of these two articles made it feel like PhRMA is saying, “Hey, we’ve raised our prices so much that we’re worried about people’s ability to pay for them! Someone better do something!”)

This past Wednesday came the news that the FDA is planning to study what would happen to prescribing practices if prescription drug ads contained price information. An interesting question. I can say that as a physician who has been blessed with good health and therefore has not had to purchase many medicines myself, I have an embarrassing lack of knowledge about the cost of many medications that I prescribe. Would it make a difference if I knew? Should it make a difference? Or should efficacy and safety of therapy be the only consideration?

(Clearly, the price — when I am aware of it — makes a huge difference, especially considering that a large percentage of the population I serve is underinsured or uninsured. The question of whether or not it should is more thorny; but if drug prices continue their dizzying spiral upwards, it is one even those with the best insurance will have to consider.)


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