Why our drug costs are skyrocketing

Not to start off Sunday morning being all political, but I gotta say this really pisses me off.

No surprise that it isn’t just (former hedge fund manager) Martin Shkreli and Turing doing this stuff. Hey, it’s a business model. Shareholder value! Gotta enhance it–a sacred trust. And we play an important role: all that cash has to come from somewhere, amirite?

Nor is it just these “non-traditional” companies:

But while more conventional companies do not typically triple or quadruple prices overnight, they do often raise them year after year at a rate far faster than inflation. Big pharmaceutical companies like Pfizer and Merck raised list prices an average of 13 percent in 2014 and 8 percent so far this year, according to Deutsche Bank.

Dr. Irl B. Hirsch, a diabetes specialist at the University of Washington School of Medicine in Seattle, said insulin prices had risen so much in recent years that some patients were scrimping on groceries to pay for it. The price of a package of five Lantus injectable pens from Sanofi has gone from about $179 in 2010 to $372 last year, he said, and insurance will often cover only one package at a time.

Best health-care system in the world, so I’m told…

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I’m also alarmed by the rise in insulin prices that don’t seem justified by costs at all. The appearance of collusion by companies is also a huge alarm. David Mendosa and I both heard Irl Hirsch talk at ADA. David posted about this over at DiabetesDaily in a post “Why Does Insulin Cost So Much?” I also posted about this on my blog “ADA Ruminations - Does Insulin “Innovation” Actually Help Patients?

I think there are several factors which come into play here. First, the government seems unwilling to bring anti-trust cases against some of these companies. Second, we have no transparency, if we knew how much things actually cost there would be a total uprising against this immoral profit taking. And third, we actually opened the barn door by putting into law that Medicare Part D could not negotiate prices. Other countries control prices but NOOOOOO, our goverment let Pharma make it a law that Medicare had to just accept whatever Pharma wants to charge. And what Medicare pays so follow other payers.

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I saw that in today’s digital version of the Times, but I figured I should read it later as my bg is terrible due to raging DP and I didn’t want to stress out and have it go higher.

I’m also interested in why my generic drugs have skyrocketed in the past year or so.

It’s inelastic demand. If insulin cost $1,000 /box I’d still buy the same amount as if it cost $10. Luckily I could afford it, but realize many can’t. Contrast with pretty much every single other thing a consumer buys, where if the price rises they can buy less or none at all. This makes the basic economic principle of supply and demand not work in this case, and calls for some serious discussion about whether this may be one of the very few instances where regulatory price controls might not be unfortunately necessary— that promises to be a huge can of worms too though and the government would almost assuredly completely screw it up as well, so I’m not sure what the best option is.

I am no fan of regulation either. But the current system is already “regulated” — by the corporations.

The example given earlier that, by law, Medicare Part D can not negotiate prices is a jaw-droppingly obvious example of that, no? Negotiation is a hell of a long way from regulation, at least to my mind. I mean isn’t it a fundamental bit of Adam Smith style capitalism? The government has legally forbidden a basic component of a “free market” with the support of the usual proponents of free markets. How can this be??? :scream:

The truly amazing thing to me is how skillfully large corporations are able to herd the political forces in this country to continue “maximizing shareholder value”. (i.e. almost incomprehensibly large bonuses for the topmost executives). One of the key factors to accomplishing this seems to be shifting to what I think of as a Las Vegas model. The details of winning and losing are ignored. What they focus on is to make sure “the house” always comes out ahead in the end.

And it seems rather obvious to me that it always does. :disappointed:

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The people who embrace this most vehemently are, in my opinion, typically people who have never had to rely on that health system to save either their life or the life of a loved one.

When you are never forced to face reality you can very easily delude yourself that the world works in whatever way you want to think it does.

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Is this price issue only happening in the U.S.? Are other countries’ governments and insurance companies having to pay similarly higher prices? The idea of paying nearly $400 for a pack of pens is crazy to me. Even if I for some reason paid completely on my own, a pack of five Apidra pen cartridges would cost me just over $40, and that’s in Canadian dollars, so with today’s exchagne it’s more like $30 in the U.S. Lantus is more expensive (perhaps twice the cost), but that’s still under $100 in both countries (or should be!).

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[quote=“MarieB, post:3, topic:47793, full:true”]
I saw that in today’s digital version of the Times, but I figured I should read it later as my bg is terrible due to raging DP and I didn’t want to stress out and have it go higher.

I’m also interested in why my generic drugs have skyrocketed in the past year or so.[/quote]

I asked my insurance rep about this when I went to order a med and saw the price was 3x higher than I was used to paying. She told me that they promote the generics and are mindful of the toll of the price increases on their members. We looked up the cost of the the non generic versions of the meds on my list and those were incredible! So generic it is. She also said they are encouraging members to find ways to reduce the cost by doing things like Splitting Higher-Dose Pills, Comparing the cost between brand and generic, and even consider alternatives. She also said they do everything they can to negotiate costs, and try not to edit the formulary. We talked about how my own insulin is not on the formulary and how it is good that my doc knows how to write the RX to make sure that insulin is covered. Having a doc who knows the struggles is a big help.

I wish there were something we could all do to stop skyrocketing costs. And more and more drugs are coming to the market, seems every quarter we get one or two new diabetical products. I might be an old minded person but I just need the same old one I’ve known for years. I am sad that my condition(s) are fodder for industry and I can’t negotiate my costs for their products. It is not like we take these things for fun and games…we would die without them!

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Can you tell us more about this? This strategy might help a lot of people!

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my endo writes my insulin prescriptions out so that they reflect that they are used for my insulin pump specifically. medicare will pick up some of the cost, but certainly not all of it.
what astounds me about the medicare system is that i live off of my monthly SS check. medicare must obviously know just much they are sending me, as well they must know how much my RX costs are; it makes no sense to me that this system would recognize that i cannot pay for all of my prescriptions with what $$ they send me. and whats worse is that the $$ they are sending me is actually from my own money earned from when i was working.

one other thing that baffles me is that medicare pays for my pump and my pump supplies (and believe me, i know i am fortunate for that) . how do they expect me to actually use my pump if i have no insulin to fill it with?

i feel this system has failed me and too many others and that it is shameful and w/out excuse.

Millions of dollars in campaign contributions and unlimited politician funding with “dark money” makes herding today’s politicians a relatively easy task. Since we now view corporations as people, we have slid into a system of, by, and for the corporations. Some describe this system as oligarchy, some, fascism. In any case, we no longer enjoy the system of a constitutionally-limited representative-republic form of democracy. But we do have plenty of bread and circus to keep us distracted.

Sorry for the negative tone but my usual optimism is fading. :worried:

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Yes, but I feel it goes much beyond that. The populace has also been herded. Partly it’s getting enough people to believe that our current health care is “the best” and if it changes they will lose out. And partly it’s encouraging people to adopt the attitude that they are powerless and it can never be changed.

Every time someone says, “I never vote. What’s the point? It’s all rigged anyway”, somewhere, someplace, a corporation grins unabashedly.

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Even with the poor attitude I displayed above, I still vote. I always have. I have not given up that this insane trajectory we’re on can be reversed. Unfortunately, voters are a minority.

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As I understand it, one of the reasons we pay so much here is because they DO face having to negotiate prices everywhere else. Those yachts and mansions aren’t gonna pay for themselves folks–somebody’s gotta kick in for 'em.

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My right wing friends understand that health care is important to me. They know we diabetics aren’t an island unto ourselves, that we require medicine. If we have faith we won’t need medicine and then we too can become radicalized. But it’s too late for us if we are already dependant on medicine. My right wing friends accept me for who I am. Of course I can’t support the right wing it would mean certain death for us who are not grounded in the faith as evidenced by our cursed illness. My right wing friends accept me for who I am. A person who cannot live independently, making for myself all that I need. I forget where I heard this illustration. The person who invented the polio vaccine had an okay paying job. So he did not try to make money from the vaccine. The money he earned was what he made and it was enough. When he was asked about it he said something like ,“Would one charge for sunshine?” This Jewish person was crucified by Rome but said to rich people, “Give away all your wealth to the poor.” And “It is not possible for rich people to be part of or enter into heaven.” And also that we should all be like the traveler, a Samaritan, who saw an injured stranger and paid for the care of the injured person, no questions asked and whatever the cost, an open tab.

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I live in the Philippines. The price of insulin has gone up here too, at least for the modern insulins that I use. I haven’t checked if the prices for the old insulins are still not increased. I am now paying about US$20/cartridge of aphidra, compared to about $14 when I first started using it.

Prices here are driven to some extent by what people can afford, as few if any people have medical insurance that covers the costs of meds here. Many people can’t afford the costs of diabetic medications here, and there is little to no education about ways to eat that will reduce how much insulin / meds are needed, in this sugar laden country.

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Yes, it’s happening worldwide. My charity, T1International, recently collected anecdotal prices of insulin and people pay anywhere from $3 to $60 per vial. We are building an advocacy force for this issue and other similar issues to ensure that everyone with type 1 has affordable insulin and supplies. Check out www.insulin4all.tumblr.com where you can support our WDD campaign about this. As irrational_JOhn put it, many people - even people with diabetes - don’t think about this issue until they struggle themselves. Let’s get the word out and do something about it! :slight_smile:

Hi JustLookin. Sorry to hear that the prices have gone up for you so much. :frowning: We have a worldwide map tool. I would love to add Philippines to the map! http://t1international.com/resources/t1worldwide/ Would you like to help? We also need all the support we can get with our #insulin4all campaign www.insulin4all.tumblr.com. Thank you!

*In Austria, a vial of Apidra, Humalog or Novolog is 35 Euros. that is 10 times less than what it costs our insurance or Medicare part B. We need to have the law changed that forbids negotiating for drug prices. The Pharmacy /Drug companies spend more on TV advertising than on R & D. that’s the opposite of what they tell us. They wrote the Affordable Care Act, so what good could come of that for consumers/patients.

Hi Elizabeth. What do I need to do? I can find out the locally available insulins and their costs. I know there are some hospital based subsidized insulin program. But I wouldn’t qualify as I am a foreigner. I can ask my friends about this / what is available.

Costs of strips also varies very widely. I get one that costs about $15 for a box of 25 strips. But often they have promos where you can buy 3 and get 4. However, $15 is more than minimum wage here.