HCP Prewriting Assignment

Pharmaceutical companies go unchecked as they set astronomical, arbitrary prices on medicines for terminal illnesses. In 49 out of 50 states, the leading cause of bankruptcy in 2014 was found to be medical debt (Stech). (Massachusetts was the only state in which, medical debt came in second to loss of income.) The price of prescription drugs for diseases is a contributing factor to medical expenses and by extension, bankruptcy. Patients who suffer from diseases are the ones to face the rising costs of drug therapies. Once pharmaceutical firms have the rights to certain drugs, it has been seen in the past that they exponentially increase the prices by hundreds of percent before marketing them (Karthikeyan). Due to the lack of negotiation of drug prices, individually, those who market and sell the drugs make enormous profits while their consumers are scrambling to pay for them. 

Without a regulating or negotiating body for pharmaceuticals, in the United States, drug prices are left to the market competition, resulting in prices up to 16 times higher than their European or South American counterparts. The for-profit manufacturers argue that they must return the investment on high-risk research, which reflects the economic value of medicines (Hirschler). But sometimes, these corporations are found guilty of using markups on prices to cover their expenses on research for failed, unmarketable drugs. There are multiple loopholes where money can be made for these companies. For example, the FDA only retains the power to check the science behind a medication before profit; they cannot regulate costs or negotiate prices. The FDA can only determine whether one medication works better than its immediately previous counterpart. They don’t have the power to measure the quality improvement between one drug and the one immediately preceding it. There are new drug therapies that are radically more expensive than their predecessors, but only slightly more effective, perhaps providing the user with only a few more weeks to live than the significantly less expensive than its predecessor.

U.S. law is part of the problem. U.S. law actually protects companies from free-market competition and does not allow Medicare to negotiate prices. This is controlled by the Center for Medicare/Medcaid Services, and by nature, other insurance companies follow CMS’s example to oblige national healthcare laws and standards. Pharmaceutical firms use this to their advantage, as the sick citizens of the United States become their primary mode of profit. In other countries, there are caps put on the price of drugs and prices are negotiated “based on…the actual therapeutic benefit” (Llamas). And although, these multinational corporations still receive a healthy profit from other countries, their costs in the United States are up to 40 percent higher. This dilemma forces ill Americans, to either come up with the money or accept death as their immediate fate. This leaves many bankrupt and has families facing emotional and financial loss. Many European countries possess a Disclosure Code, requiring all health or pharmaceutical firms to record and report each of their gross profits and their spending on research, travel expenses, and collaborations.

The magnitude of this issue is being realized, as companies are now being investigated or called out to explain how they got to the listed market price. Presidential candidates are also calling attention to this tear in our health care system, as they discuss their plans for healthcare, should they be elected. Turing Pharmaceuticals, in September 2015, was caught in a controversy that they had increased the cost of Antiretroviral pills (AIDS drug) by more than 5000 percent overnight. After much public scrutiny and attention from presidential candidates, the CEO stated that they would mull over the decision to reduce prices, but failed to mention how (Harven). In December of last year, Pfizer, one of the largest multinational, pharmaceutical corporations around, set the price for a new breast cancer drug at $9850 per month. The badly documented journey of how Pfizer reached its price tag for this drug has US Congress rallying for its citizens. A Senate committee is actually having a hearing on drug prices that started in December 2015 and will restart when Congress reconvenes for the New Year (Rockoff).

American drug prices have more to do with the prices the market can bear, rather than rewarding innovation, research, and risk in the drug industry. Still, the workings of the American Society of Clinical Oncologists (ASCO) and many other organizations are attempting to make drug treatments more affordable cannot stand on its own. Pharmaceutical companies are protected by American laws, and not checked as far as how they arrive at their pricing. And yet, these corporations are able to advertise and appeal to patients directly while the cost of drugs individually is normally shielded to patients and physicians alike behind the code of copays and large insurance bills (L.N.). The further repercussions of increasing drug prices are as far as higher insurance costs, more “a la carte” treatment payments, and lesser holistic coverage. And in the event that companies and employers are required to pay high health insurance premiums for their employees, they are less inclined to raise salaries leading to a continuation of this morbid cycle (L.N).