Drug prices are often front and center when it comes to discussions about health care, and for good reason. As both a state senator and a pharmacist, I deal with these issues every day on both a government and business level.
We find ourselves in a tough spot as a nation. On one hand, we lead the world in the research and development that creates most of the world’s new “miracle drugs”. It costs billions to develop and deliver a new drug to market. We don’t want to take actions that will degrade our global leadership in innovation.
On the other hand, patients and care providers cannot be blamed for sometimes feeling that drug prices are out of control.
We are all aware of the dramatic advances that have been made in treating diseases like cancer, diabetes, HIV, rheumatoid arthritis and other chronic conditions. Most of us have great faith that genetic research will one day produce new cures for such diseases.
Just recently I heard a news item on the radio about a potential new cancer vaccine that is “causing excitement” among researchers. I hope it is true. If those researchers are successful, they and their investors will be richly rewarded, as they should be. The socialists among us believe we can simply eliminate private investment and profit from that equation and still produce that same cancer vaccine. That is demonstrably untrue.
In response to growing concerns over drug pricing, various proposals have been floated in Congress and by the administration. In my opinion, some proposals are on the proverbial “right track,” while others are heading in the wrong direction.
For example, extreme progressives like Bernie Sanders advocate importing drugs from Canada to fix high drug costs. They say, “Drugs are cheaper up north, so let’s just import them!” It sounds great, but it is a typical socialist solution that completely ignores the real problem while creating a host of new problems.
First, the Canadians simply don’t have the level of supply required. Second, our own Food and Drug Administration would have to authorize it, which they will not. (This is based on my own conversations both with the FDA and CHS, the Canadian Health Service.) Third, like many other nations, Canada embraces government price controls.
Finally, anyone who truly understands how drugs are sold and distributed in the U.S. knows that there are very solid technical reasons that such importation is not viable. There are also serious concerns about drug safety, since the CHS cannot guarantee origin and purity on foreign-sourced drugs.
The Trump administration is considering yet another “wrong track” proposal to tie reimbursement rates for Medicare Part B — for drugs administered to patients in a clinic or hospital setting — to an average of prices charged in other countries. But many of the nationalized systems in which everyone gets “free” health care, viewed by some as utopia, are threatened by accelerating costs and deteriorating quality; many don’t get access to the latest drugs until long after introduction. Just importing foreign drug pricing is no more workable than importing the actual drugs.
However, one proposal from the administration deserves our full support, which is serious reform to a badly abused drug rebate system. Rebates were originally supposed to directly benefit patients, but instead have become a major profit center for “middlemen” like pharmacy benefit managers, or PBMs, and health plans. The administration’s plan to reroute manufacturer rebates back into patients’ pockets is a positive step that will directly help consumers deal with drug costs.
Historically the FDA’s mandate has been to prioritize safety and purity above all. The FDA does that extremely well, but fulfilling that mission naturally results in higher costs and limited availability. Meanwhile, other countries have determined that universal access is most important, which eventually results in price controls, shortages and rationing.
That is the pharmaceutical tightrope we must walk moving forward. We must square our legitimate need for consumer cost savings today against the need for adequate investment in the new cures of tomorrow. Beware those who tell you that there are easy answers — chances are they are trying to sell us something we would soon regret buying.