Let’s Play the Expensive Drug/Procedure Game

We make it impossible for Americans legally to order their prescription drugs from other countries, even when it is the same drug made by exactly the same company. Hard to justify “quality-control” reasons for this wasteful, uncompetitive and malignant restriction when it is exactly the same product.

So let’s play the game with a little help from the April 17th Huffington Post, citing: “The latest data from the International Federation of Health Plans, an industry group representing health insurers from 28 countries including the United States, once again illustrates that American patients pay the highest prices in the world for a variety of prescription drugs and common procedures like childbirth and hospital stays.” We’re not even going to look at the cheapest alternatives (which would really shock you) to each of the following ailments/procedures… I am simply going to give you the numbers for the second most expensive price in the world (by country).

Acid Reflux. Common Treatment, Nexium. Standard Prescription Cost Range in the United States ($196 to $395): average $215. Standard Prescription in New Zealand: $60.

Multiple Sclerosis. Common Treatment, Copaxone. Standard Prescription Cost Range in the United States ($3,875 to $4,018): average $3,903. Standard Prescription in Switzerland: $1,357.

Common Treatment, Gilenya. Standard Prescription Cost Range in the United States: ($4,169 to $12,792): average $5,473. Standard Prescription in Canada: $2,541.

Leukemia. Common Treatment for Some Form, Gleevec. Standard Prescription in the United States ($5,482 to $11,007): average $6,214. Standard Prescription in Switzerland: $3,633.

Hospital Stay (Daily Rate). Cost Range in the United States ($1447 to $12726): average $4293, New Zealand average: $2,491.

By-Pass Surgery. Cost Range in the United States ($47,982 to $151,886): average $75,345, Australia, $42,130.

Hospital Delivery (Physician and Hospital). Cost Range in the United States ($7,308 to $17,354): average $10,002, Switzerland, $8,307.

When you are desperate, facing a life and death moment, costs can literally kill you. “Prescription drugs are particularly expensive in the U.S. relative to elsewhere in large part because most other countries set prices for medicines through their universal health care programs, which the U.S. doesn't have. This can hit hardest for people, even those with health insurance, when they need the latest medicines to treat serious diseases.

“Look at the price differences in the U.S. for these big-ticket prescription drugs, which are about twice as expensive in America as in the next-highest country and much more so than in the lowest-cost nations… And despite the persistent claims by nearly anyone holding or seeking public office in the U.S. that America has the best health care system in the world, there's scant evidence that we're getting higher-quality medical treatment or enjoying healthier lives than our counterparts abroad. What's more, the U.S. still leaves tens of millions of its own citizens without health coverage, and will continue to do so even a decade into the implementation of Obamacare.” Huffington Post.

We rank 80th on a global scale measuring a mix of quality of healthcare with relative access to the system. There are 33 countries with better infant mortality rates than we have. There are 34 nations with longer average life expectancies than do we. When Obamacare passed, any semblance of creating competitive low cost components – from a government low cost insurance alternative (like Medicare) to allowing access to cheaper prescriptions from overseas – were crushed by powerful industry lobbyists whose jingling cash-hints of campaign contributions made the difference.

Think all this won’t impact your actual treatments? Bottom line, if a treatment is likely to work (and you desperately need it) but it’s too expensive, your health and life just might not be worth saving even if you have coverage. Folks are seriously thinking about how to apply cost-savings to expensive treatments. “Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care.

“The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how health care dollars are spent… ‘We understand that we doctors should be and are stewards of the larger society as well as of the patient in our examination room,’ said Dr. Lowell E. Schnipper, the chairman of a task force on value in cancer care at the American Society of Clinical Oncology.

“In practical terms, new guidelines being developed by the medical groups could result in doctors choosing one drug over another for cost reasons or even deciding that a particular treatment — at the end of life, for example — is too expensive. In the extreme, some critics have said that making treatment decisions based on cost is a form of rationing.” New York Times, April 17th. Death panel, anyone? For example, there is a new highly effective treatment for Hepatitis C, but costs an average of $84,000 to administer. Want to pay for that under Medicaid, Medicare or expect easy coverage under a pile of lower-end insurance policies? See a battle looming?

And every year, medical costs rise faster than the average worker’s pay rises. Every year for well-over a decade, the buying power for average Americans has fallen. The medical cost lines are going to cross the affordability line at this pace, sooner rather than later. We’re close to that even now. Most of us won’t even be able to afford the deeply discounted, often government subsidized cost of Obamacare. Then what? Why do we begin to solve problems when it’s too late to do it intelligently and effectively? Because incumbents with money want it that way.

I’m Peter Dekom, and we are way too blasé about life and death issues that really impact our daily lives… like financial regulations to prevent collapse or really addressing environmental quality and healthcare… but that’s okay, it only hurts our children and grandchildren, so who cares?