Pharmaceutical companies, such as Mylan, greatly increasing the price of existing drugs for vulnerable patients needs close scrutiny.
IT’S back-to-school time, and for me that means time for my boys to get their EpiPen prescriptions renewed. Two of my sons have food allergies. They are not life-threatening, and Benadryl works to relieve their symptoms, but their physician also prescribes an epinephrine auto-injector (the most common is Mylan’s EpiPen two-pack). And since it is prescribed,by the first day of school, I must fill the prescriptions and deliver them to their respective school offices.
While I appreciate having this medication at the ready, I can’t help but be bothered by the fact that Mylan recently increased the price of this drug by 500 percent to $600. And according to the manufacturer’s label, the medication will expire in 12 months and have to be replaced.
This week amid public outcry, and what’s likely a move to ensure that they don’t lose any ground to their competitors and to shore up their stock, Mylan announced on Monday it will soon release its own generic at $300 per pack.
Granted, I have good insurance, and the cost impact to me — while annoying — is minimal. However, other patients who need this lifesaving treatment are no doubt feeling the impact of the dramatic price increase of the two pack, even though it has been on the market for years.
This is only one example of a string of gigantic cost increases coming from the pharmaceutical industry, and there’s an evolving pattern: make an indispensable drug and then hike the price.
It appears Mylan is taking advantage of its customers who need to come in for their yearly refills. This is on the heels of several makers of the drug naloxone increasing the price of the drug by as much as 17-fold, not long after attention was drawn to that fact that naloxone can save the lives of people in the midst of a drug overdose. Public-health officials around the county highlighted naloxone as a crucial weapon in our arsenal to fight a growing epidemic of opioid-related deaths.
And of course there’s the impact on the new drugs that, the majority of the time, cure hepatitis C. Miraculous, however, the treatment costs close to $100,000 per patient. Recently, the courts ruled the state of Washington must cover this drug for Medicaid enrollees and inmates with the disease, as well as for public employees. The cost for Medicaid and corrections alone is expected to be more than $100 million during the 2015-2017 budget cycle.
These examples of monopolized market-manipulation price gouging to the vulnerable is akin to stores selling a bottle of water for $10 in a flood-stricken area.
The skyrocketing cost of drugs impacts more than a patient’s out-of-pocket costs; it gets blended into other costs as well, such as overall insurance premiums, increased use of utilization-management tools, such as prior authorizations, and will possibly increase taxes to offset the costs.
We can’t ignore the fact that other health-care priorities will suffer. To offset high drug costs, insurance companies may step up their use of prior authorization — requiring physicians to justify their use of such drugs — in order to control costs in other areas, delaying needed care for patients. The state’s reimbursement of health-care providers for services may continue to diminish, impacting access to care — particularly in underserved areas.
I’m not arguing the merits of lifesaving treatments, but am raising attention to the fact that the alarming trend in the pharmaceutical industry to strategically jack up its drug prices will have severe consequences to the health-care-delivery system that is so desperately trying to rein in rising costs.
Washington state has taken a step to dig into these costs further by creating the Patient Out-of-Pocket Costs Task Force. The task force is charged with evaluating factors that contribute to out-of-pocket costs for patients and considering the health and economic impacts of those costs, both to patients and to the state. The task force must either provide recommendations or a summary of the discussions to the appropriate committees of the Legislature by Dec. 1.
It will then be up to our Legislature to consider solutions — and solutions we need. If rising pharmaceutical costs are allowed to go unchecked, all of our efforts to reduce waste and inefficiencies in health care would be for naught, as we will still have unaffordable care in Washington state and the U.S.