It’s
beyond clear that the United States has the most exorbitant prescription drug
prices in the world. There’s no pretense; such costs are totally out of control.
The litany of ads for seriously expensive prescription drug solutions that
litter traditional television are clearly targeting elderly viewers, increasing
paranoia that “gee, that sounds like me and need to get some,” seem almost
inexcusable. The clamp on doctors’ effectively getting paid by pharmas to
prescribe their products shifted the marketing ads aimed at the patients
themselves. Do you really believe that lay people with no medical training are
the appropriate target for complex drug marketing?
Think
the opioid crisis just “happened”? That the massive marketing effort, starting
with oxytocin, was the result of justifiable demand in the marketplace, that
the ads targeting doctors and consumers of the easy pain-relief with limited
side effects had nothing to do with an addiction craze that has hit too many
American communities hard?
We
know that the 2010 Affordable Care Act (Obamacare or the ACA) made a huge and
now nasty concession to the pharmaceutical industry to generate their support
for the bill: the new healthcare exchanges would not contest the prices that
the pharmas charged or use their massive new bargaining power to reduce
prescription drug costs. And we know that the GOP-controlled administration,
plus red states hell-bent on containing ACA benefit programs, has done
everything to erode the coverage under the act and virtually nothing to reduce
the burdens of unaffordable prescription drugs. If anything, the approval of
“skinny” cheap, red state healthcare plans that have been allowed by the Trump
administration have eliminated “addiction services” from coverage… has made the
opioid epidemic that much worse.
The
only token Trump gesture directed at reducing drug costs has been “shame” to an
industry where shame has been purged a long time ago. Trump’s threat to issue
an executive order mandating that pharmaceutical companies post their real
costs on any advertising they issue generated a chorus of corporate guffaws and
statements of clear defiance. Muttering, “First Amendment, First Amendment,”
the CEOs of the biggest and baddest pharmas stated that they had no intention
of complying with such a directive. A few said that they might post pricing on
their Websites, but nothing more.
In
fact, the “business profits trump social benefits and individual rights” mantra
of the Trump regime seems to have emboldened some in the pharmaceutical
industry to fire back with a rather brazen retrenchment of “bilk the consumer”
business practices. They will happily spend massive sums marketing, but,
continuing their “fake news” campaign that they are just paying for their
egregious research and development costs, they continue to price their products
higher and higher. That the they cannot and do not charge those prices for the
same products in other nations suggests the magnitude of their mendacious cost
price-cost justification here in the U.S..
Nothing
brings this home more than the recent rather honest “we really do bilk the
consumer” statements from Pfizer’s CEO, Ian Read. Removing any pretense of
consumer-friendly pricing, Read declared that Pfizer would return to “business
as normal.” Writing for the November 2nd Los Angeles Times, David
Lazarus explains: “With those three words, the chief executive of
pharmaceutical giant Pfizer declared this week [late October] that his company,
and by extension the drug industry, is dropping any pretense of being open to
price cuts and will continue gouging sick people as much as they can.
“After
reporting a 45% increase in quarterly profit — 45%! — Pfizer’s CEO, Ian Read,
was asked about possible pushback from the Trump administration if he announced
price hikes in January after earlier saying the company would reconsider its
strategy of regular increases.
“‘I
expect our approach by the end of year will be what I would characterize as
business as normal,’ Read answered during a conference call with analysts… ‘We
price to the marketplace,’ he said. ‘We price competitively, and we will make
those decisions towards the end of the year and early in January.’
“In
other words, no more Mr. Nice Guy. Pfizer will once again reach as deeply as
possible into people’s pockets, regardless of what President Trump might want… Because
let’s face it: For all his talk of drug companies ‘getting away with murder,’
Trump has been all bark and no bite when it comes to sky-high drug prices. And
the industry knows it…
“Pharmaceutical
and biotechnology revenue soared to $775 billion from $534 billion from 2006 to
2015, according to the U.S. Government Accountability Office… The average
profit margin for the industry in 2015 was 17%. For the 25 biggest drug
companies, the average profit margin was 20%.
“And
now we have Pfizer, the happy people who bring us Viagra, posting a 45%
quarterly profit gain. For all of 2017, the company pocketed $21.3 billion,
with a big chunk of that coming in the form of a wet kiss from the Trump tax
cuts.
“In
July, Pfizer wanted everyone (and by ‘everyone,’ I mean Trump) to think it
could play well with others. It said it would put off its usual summertime
price increases as a goodwill gesture until Trump could implement his ‘blueprint’
on lowering U.S. drug costs.
“‘Pfizer
is rolling back price hikes, so American patients don’t pay more,’ Trump crowed
on Twitter. ‘We applaud Pfizer for this decision and hope other companies do
the same. Great news for the American people!’… Four months later, Trump’s
blueprint is largely wishful thinking and Pfizer, for one, is tired of being a
presidential punching bag…. ‘Look, our pricing — I don’t think our pricing
situation has changed,’ Chief Executive Read said this week. ‘Our pricing
philosophy is to price to the value of the product and price inside a
competitive marketplace.’
“That
notion of pricing ‘to the value of the product’ is key here. To a sick person,
a drug might have limitless value… I have Type 1 diabetes. Without insulin, I
will die. You could charge me whatever you like. If I have the money, I’ll pay
it. What choice do I have?...
“The
industry has spent more than $216 million on lobbying [in the U.S.] this year.
Its main trade group, Pharmaceutical Research and Manufacturers of America, or
PhRMA, has led the way with about $22 million in lobbying efforts, followed by
Pfizer with $9.4 million — the most of any single drug company.”
It
is fascinating to watch the legions of Republican lawmakers, who virtually all
voted repeatedly to repeal the ACA, who once argued that individuals should
make their own healthcare choices in a free marketplace without government
requirements… now speak about lowering drug prices and making sure that
preexisting conditions do not impact healthcare insurance costs. It seems the
tide has turned. The increasing shift to a gig economy combined with the rapid
rise and fall of once iconic and stable employers (Sears being the latest big
casualty) has made it abundantly clear that healthcare coverage can no longer
assumed to be available from employers anymore. The world has changed… and the
GOP is the least credible political faction to deal with fixing our healthcare
system.
I’m Peter Dekom, and it is time for
everyone in this country to face the reality that without significant
government regulation and control, healthcare would be relegated to a privilege
accorded only to those able to afford its escalating costs.
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