There is an excellent article in the most recent issue of Mayo Clinic Proceedings by 118 Cancer Doctors entitled, “In Support of a Patient-Driven Initiative and Petition to Lower the High Price of Cancer Drugs.”
The article describes the current state of HIGH cost cancer drugs as follows:
- 33% of people will have some type of cancer at some point in their lives.
- In 2014, ALL of the new cancer drugs approved by the FDA cost >$120,000 per year.
- Patient out-of-pocket costs for these new cancer medications can be up to $30,000 per year.
Then, the article goes on to List the Recommendations these 118 cancer doctors would propose to Lower Cancer Drug Costs
- Initiate at process post-FDA approval for the review of the value a new drug brings and propose fair pricing.
- Allow Medicare to negotiate prices (my editorial: Not letting Medicare negotiate prices for drugs is like not letting the Department of Defense negotiate prices for military contracts, one would consider that a little weird.)
- Allow the Patient-Centered Outcomes Research Institute (PCORI)—which was created as part of Health Reform to research comparative effectiveness of medications, tests and treatments—to include Drug Costs as part of their evaluation process. PCORI is currently banned from evaluating drug costs.
- Allow the importation of drugs from other countries like Canada to spur competition.
- Prevent the delay of access to generic medications by drug companies. Currently drug companies ‘pay to delay’ the release of generic medications.
- Reform the patent renewal process to prevent unnecessary extension of patents that give drug companies a monopoly on selling their medications at a high price.
- Encourage physician professional societies to incorporate drug costs when creating guidelines for cancer care.
There have already been settlements related to the high cost of medications—not just cancer medication—between payers of healthcare and pharmaceutical companies. See the New York Times article from July 23, 2015 by Andrew Pollack entitled, “Drug Prices Soar, Prompting Calls for Justification.” It is an excellent article if you are interest in learning more.
What does this mean for healthcare consumers and employee benefits professionals:
- Cancer and non-cancer drug costs have surged and that has drawn even greater attention to the pharmaceutical industry. They seem to have even more of an X on their back now.
- As the famous Supreme Court Justice Brandeis said, “Sunlight is the best disinfectant.” Continued price-transparency around drug costs will likely lead to their eventual reduction. Therefore, speak up as an individual to your employer and to your government representative. Speak up as an employer to your Pharmacy Benefits Manager and Insurance Carrier.
Lastly I will leave you with a quote from 1888 from James Bryce, which is thought to be where Justice Brandeis got the idea for his quote. It’s a little long, but it’s not every day you read a great quote from 1888:
“Public opinion is a sort of atmosphere, fresh, keen, and full of sunlight, like that of the American cities, and this sunlight kills many of those noxious germs which are hatched where politicians congregate. That which, varying a once famous phrase, we may call the genius of universal publicity, has some disagreeable results, but the wholesome ones are far greater and more numerous. Selfishness, injustice, cruelty, tricks, and jobs of all sorts shun the light; to expose them is to defeat them. No serious evils, no rankling sore in the body politic, can remain long concealed, and when disclosed, it is half destroyed.”
Whew! That was a doozy, but well worth the read.
To learn how Compass shines the light on healthcare costs and quality for over 2,000 employers and over 2 million members, visit compassphs.com