Perspectives: Why Does This HIV Drug Cost $75 In Africa and $39,000 In America?
Read recent commentaries about drug-cost issues.
The New York Times:
H.I.V. Drugs Cost $75 In Africa, $39,000 In The U.S. Does It Matter?
A new gold-standard triple therapy for H.I.V. has just made its debut in Africa. It costs $75 a year. In the United States, many people with H.I.V. take an almost identical therapy. It costs $39,000 a year. The United States is infamous for its high cost of health care — and H.I.V. medicines are a big part of that. Plenty of drugs carry outrageous prices: EpiPens, insulin, cancer treatments, even some antibiotics. But no class of medicines is more scandalously expensive than for H.I.V. These medicines are by far the largest item in Medicaid’s drug budget, the third largest for the insurance exchanges and the fifth largest for commercial insurers. (Tina Rosenberg, 9/18)
The Detroit News:
The Delusion Of Foreign Drug Importation
The Trump administration has just announced the formation of a working group at the Food and Drug Administration to study legalizing the importation of foreign-made drugs. Although the study is limited to a narrow set of circumstances in which imports might be allowed, it sets us on a path we shouldn't step on. The goal is to lower costs and prevent price-gouging by drug makers who find themselves with monopoly power over a particular treatment -- say, an out-of-patent medication for a rare disease with only a single generic manufacturer in the market. But proponents of imports are only starting with the narrow case. Their real goal is to allow foreign imports on a massive scale. (Peter Pitts, 9/17)
The Wall Street Journal:
Drug Rebates Aren’t ‘Kickbacks’
The Trump administration is close to issuing a new rule that could effectively ban rebate payments from drug manufacturers to pharmaceutical benefit managers, or PBMs. The plan is misguided. A full ban would backfire and increase costs to consumers. The regulation, now under review at the Office of Management and Budget, could remove the safe-harbor protection for rebate payments under an anti-kickback law. But rebates are price discounts, not kickbacks. They reduce prices based on sales volume: Drug companies charge less when more of their drugs are sold to patients. (Josepth Antos and James C. Capretta, 9/16)
The New York Times:
Transparency Hasn’t Stopped Drug Companies From Corrupting Medical Research
On Thursday, Dr. José Baselga resigned from his position as chief medical officer at Memorial Sloan Kettering Cancer Center. Earlier this month, ProPublica and The New York Times revealed that he’d received millions of dollars from drug and device companies whose fortunes he stood to affect. He also sat on the board of at least six companies, where his fiduciary responsibility to them might conflict with his obligations to the cancer center. Most of his outside income was not disclosed to the journals in which he published, in violation of their requirements. Although his case is extreme, these kinds of conflicts of interest are virtually universal in the upper levels of academic medicine. (Marcia Angell, 9/14)
Huge Price Hikes By Drug Companies Are Immoral
Several pharmaceutical companies have been jacking up the prices of their drugs in unethical ways. Most recently, Nirmal Mulye, founder and president of Nostrum Pharmaceuticals, defended his decision to more than quadruple the price of nitrofurantoin, used to treat bladder infections, from about $500 to more than $2,300 a bottle. He said it was his "moral requirement to sell the product at the highest price." (Robert Klitzman, 9/18)
Cigna Express Scripts Deal: Hard Part Lies Ahead
Cigna Corp. has successfully dodged two giant obstacles in its attempt to purchase pharmacy-benefit manager Express Scripts Holding Co. First, it got past Carl Icahn, who tried to convince investors to vote no on the deal in August, only to drop the effort days later after giving it further thought. And on Monday afternoon, it won clearance from the Department of Justice to go ahead with the transaction. But the hardest part lies ahead. This is a period of massive uncertainty for the PBM business, and Cigna is paying $54 billion for the pleasure of having to navigate it. (Max Nisen, 9/17)
Innovation And Lower Drug Prices Are What's Needed To End Tuberculosis
The United Nations “high-level meeting” on tuberculosis will take place in less than a month and the political declaration that emerges from it will, for better or worse, shape the global response to the world’s deadliest infectious disease for years, perhaps decades, to come. There is a very real risk that the declaration could undermine, rather than improve, access to medicines for the more than 10 million people who fall ill with tuberculosis every year. To prevent this from happening, we must distinguish disagreements that are honest from those that are dishonest. (John Stephens, Brabha Mahesh and Brian Citro, 9/13)
New England Journal of Medicine:
Limiting State Flexibility In Drug Pricing
To reduce the burden of high-cost, low-value drugs, Massachusetts has proposed establishing a closed formulary, in which certain drugs can be excluded from coverage, for its Medicaid program. In late June, however, CMS denied the state’s request without explanation. (Nicholas Bagley and Rachel E. Sachs, 9/13)
New England Journal of Medicine:
Will Courts Allow States To Regulate Drug Prices?
In 2017, Maryland enacted a statute that prohibits manufacturers from “price gouging” on any “essential off-patent or generic drug.” But in April 2018, a panel of the federal Fourth Circuit Court of Appeals overturned that statute. (Christopher Robertson, 9/13)