The War on Drug Prices

Cost of Drugs_cartoon
Most Americans ask the question, is the price I pay for prescription medications FAIR? In other words, what is the true cost of developing, making and selling a medicine, AND how much profit seems reasonable? This is what we tackled last week during our Community Conversation with experts from the U of Washington’s International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

KEY FACTS THAT INFORMED OUR DISCUSSION
Tufts estimates that it costs $2.6 billion to develop an FDA approved drug, a number that increases 9% per year.  People in the US pay more for drugs than people in other countries for a few reasons: 1) we use more medications because we have better access to new ones, 2) we have a higher burden of chronic disease like diabetes and obesity, and 3)  in the US, the government protects drug manufacturing monopolies and limits price negotiations while other countries have more price regulation.

Another reason people in the US (and in Canada and Europe) pay more for medications is simply because, on the whole, we can afford to. Picture a world map, and picture all the people who live on Earth.  At 326 million, the US population is 4.4% of the world’s 7.5 billion people, but the US accounts for 50% of all medication sales in the world. Mind blown.

We are looking for VALUE in our medications.  We want medications that are novel and offer leaps of improved quality of life.  We are willing to pay more for medications that achieve this high bar, but there is a point for every person where price will exceed our ability to purchase a medication.

Finally, we learned about the trade-off between innovation and access.  Monopoly protection funds innovation. In turn, industry creates more new drugs in the long run that cost more money in the short run and poorer access. “But if new medicines aren’t invented, then no one can access them in the long term.” (ISPOR)  How can the market incentivize innovation if not through the almighty dollar?

DISCUSSION THEMES
Many in the room were for the first time faced with the reality that the US foots HALF the bill of medications in the world.  I don’t think anyone, besides the facilitators, was prepared for this data.  As the discussion dug deeper, we realized that our drug costs fund innovation of new medications and devices.  Despite the relationship between US drug prices and world drug innovation, many participants still did not think it FAIR that people in the US pay more than those in other countries.

Some held high the banner of altruism and seemed happy having the US play this role.  Others felt perhaps that even within the US that medication prices should be on a sliding scale based on what a household could afford.  Some shared personal stories about themselves or people they know who have had to choose between paying for their medications and paying other bills.

Yet others remained firm that prices could drop while maintaining innovation if pharmaceutical companies could lower their profits to reasonable margins.  Some attendees implied that companies could reduce their expenses by accelerating the clinical research process, a point that was strongly opposed by a former industry employee.  Pharmaceutical companies have no interest in accelerating clinical research in this manner because it would cause less confidence in drug safety.

As we were wrapping up our Conversation, we faced the question of whether or not the way we finance medications is sustainable.  Our vocal attendees had faith in the free market to correct anything that was broken.  Others remarked that the balance of medications on and off patent would also help with price competition once medications go off patent.

Our ISPOR facilitators emphasized that drug pricing is a complex ecosystem.  They recommended that consumers, scientists, policy-makers and health care providers and administrators continue to learn and share their perspectives, in venues such as Community Conversations, as much as possible in order to find a stable and sustainable relationship between medication access and innovation.

To read some excellent resources on the topic, visit the Community Conversation archive and scroll until you find the “war on drug prices” topic.

~JenWroblewski

Half of US adults 40 to 75 eligible for statins

A report in today’s Seattle Times suggests that cholesterol lowering statins will be in most of your futures.  Based on research from Duke University (which surveyed 4,000 people) it is now estimated that half of US adults between the ages of 40 to 75, and nearly all men over the age of 70 meet recently changed criteria for the use of statins. 

The guidelines for the use of statins were devised by the American Heart Association and the American College of Cardiology.  The Duke study estimates that half a million strokes and heart attacks over a ten year period could be prevented if the new guidelines were followed. 

There is some criticism of the new guidelines which favor the use of statins over other lifestyle changes (such as not smoking or working to reduce stress).

Ken Gordon

Executive Director

Community Conversation – 23andMe – What Can Your Genes Tell You

Last evening (Tuesday March 18, 2014) the Northwest Association for Biomedical Research (NWABR) hosted a Community Conversation that explored the issues around Direct-To-Consumer Genetic Testing.

These Community Conversations are a partnership between NWABR and the Institute for Translational Health Sciences at the University of Washington.  The purpose of these Community Conversations is to enable members of the public to become engaged with emerging issues in the bioscience realm.  Our hope is that an engaged public will be better placed to think through complex scientific and ethical issues, make informed contributions, build relations with experts in the field – and most importantly – provide those same experts with feedback from a community perspective on these issues.

At the Community Conversation hosted yesterday evening around 35 people gathered to discuss direct-to-consumer genetic testing services.  The company 23andMe has been providing this service to customers and approximately 650,000 people have both had their DNA tested and agreed to share their records to help build a DNA database that will, hopefully, in the future improve the accuracy of the findings that 23andMe can report to their customers.

The FDA has asked 23andMe to stop marketing the health benefits of this testing service and to no longer provide direct findings to customers about any health implications arising from the genetic tests that they perform.  The FDA is concerned that a consumer may misinterpret the results that they receive from 23andMe and subsequently make poorly informed health care decisions.

Yesterday’s Community Conversation was held at Kakao Chocolate + Coffee in Westlake.  The Conversation was facilitated by Sarah Nelson and Lorelei Walker, who are MPH and PhD candidates in Public Health Genetics at the University of Washington.  Following the presentations from Ms. Nelson and Ms. Walker the participants had a wide ranging discussion that touched on: privacy, trust, potential commercializing of DNA, the need for access to this information. the need for help in interpreting the information, resistance from some members of the medical community, the current lack of diversity in the 23andMe database, support for and frustration with the FDA and much more.

As we the staff at NWABR watched the conversation progress we were amazed that such a great group had come out on a Tuesday evening, given up their own time, and dived so eagerly into this complex area.  We were again reminded of just how rich discussions can be when these two sometimes diverse worlds come together.

Regards

Ken Gordon

Executive Director

Northwest Association for Biomedical Research

Registration Opens for NWABR’s Camp BIOmed, a new summer camp for high school students

Students entering 9th-12th grade can now sign-up for three of the four exciting summer camp sessions organized by Northwest Association for Biomedical Research (NWABR).  Each of the four camp tracks for Camp BIOmed are a week long and will be repeated for seven weeks, starting July 7 through August 23.

Students and parents can register and find additional information about the programs at www.nwabr.org/campbiomed.

The four summer camp programs focus on various topics relating to biomedical research and its ethical conduct, which include:

Bioethics thru Gaming
Protein Foldit! Be a Citizen Scientist
Hive Bio (Do it Yourself) Lab with Neuroscience
Lab Intensive Experience

Throughout the summer camps, students will take part in hands-on experiments at local biomedical businesses and research facilities, track their own findings as part of these experiments in lab journals, and tour local Seattle biomedical organizations. Each week of the summer camp will conclude with a culminating expo where campers will share all group and individual projects and contributions.

Early bird registration is open now for members for $450-$525 depending on track.  Non-members can begin registering on January 29 by signing up as a member ($25, plus the camp fee).  The price for camp for all will increase after March 31 by $90 for all tracks.  Financial assistance for partial camperships are available for students to attend the program.  The financial assistance application is available in the camp registration at http://www.nwabr.org/campbiomed

To register for Camp BIOmed check out www.nwabr.org/campbiomed

For more information, contact camp@nwabr.org

About NWABR

NWABRs mission is to promote the understanding of biomedical research and its ethical conduct. NWABR is dedicated to strengthening public trust in biomedical research, through education and dialogue. Through our diverse membership of academic organizations, biotech industry, non-profit research institutes, health care, and voluntary health organizations, along with extensive education programs, we foster a shared commitment to the ethical conduct of research and ensure the vitality of the life sciences community.