Curb­ing the high cost of drugs

Los Angeles Times - - OPINION -

Re “Why drugs cost so much,” Ed­i­to­rial, April 26

As your ed­i­to­rial notes, there are “le­git­i­mate con­cerns” with AB 463, a bill in­tended to boost trans­parency on drug pric­ing that was re­cently in­tro­duced in Cal­i­for­nia. The leg­is­la­tion’s re­quire­ments would re­sult in an in­ac­cu­rate and mis­lead­ing por­trayal of the cost of de­vel­op­ing new treat­ments while fail­ing to pro­vide pa­tients with any ad­di­tional in­for­ma­tion about their out-of-pocket costs for medicines.

AB 463 only fo­cuses on the medicines that make it to mar­ket, while com­pletely ig­nor­ing the 90% that fail dur­ing testing, a costly yet vi­tal part of dis­cov­er­ing new treat­ments. Ad­di­tion­ally, the leg­is­la­tion does not take into ac­count the tremen­dous value th­ese medicines pro­vide to pa­tients, Cal­i­for­nia’s health­care sys­tem and the state’s econ­omy.

Real trans­parency leg­is­la­tion would in­stead fo­cus on giv­ing pa­tients greater in­for­ma­tion about the costs in­sur­ers im­pose to see a doc­tor or to get a pre­scrip­tion — in­for­ma­tion that is se­verely lack­ing in the cur­rent in­sur­ance mar­ket­place.

John J. Castel­lani

Wash­ing­ton The writer is pres­i­dent and chief ex­ec­u­tive of Phar­ma­ceu­ti­cal Re­search and Man­u­fac­tur­ers of Amer­ica.

The an­swer to the ques­tion of why drugs cost so much is ob­vi­ous: There is no free mar­ket for new drugs be­cause there is no com­pe­ti­tion.

A mo­nop­oly on a drug lasts un­til a com­peti­tor slightly mod­i­fies the mol­e­cule, patents it and sells it un­der a new name. For the few ini­tial years, the orig­i­nal drug man­u­fac­turer can charge as much as it wants. Why should the price not be as high as a com­pany can get it?

The vic­tims are the sick peo­ple who can­not af­ford high prices, the in­sur­ance com­pa­nies and the gov­ern­ment health­care or­ga­ni­za­tions (which means the rest of us).

Some­how, drug prices need to be con­trolled. Drug man­u­fac­tur­ing could be con­sid­ered as a “util­ity” since this mar­ket is not com­pet­i­tive. Since one can­not choose one’s gas, wa­ter or elec­tric­ity com­pany, those prices are reg­u­lated.

Phar­ma­co­log­i­cal re­search could also be rec­og­nized as a field of public in­ter­est, per­haps as an added mission of the Na­tional In­sti­tutes of Health, a fed­eral agency that has been ex­traor­di­nar­ily suc­cess­ful in all other as­pects of med­i­cal re­search.

AB 463, which aims at col­lect­ing in­for­ma­tion, is a wel­come first step at ad­dress­ing this prob­lem.

John Sch­lag, MD

Bev­erly Hills The writer is a dis­tin­guished pro­fes­sor emer­i­tus at UCLA’s School of Medicine.

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