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Drugs, Big Pharma, conflicts of interest, and why U.S. patients pay too much for medication

February 26, 2016

Tags: drug costs, drug prices, step therapy, pharmaceutical industry lobbying

by Pat McNees ( Updated 3-1-17, 10-6-16, 9-26-16)
Highlights from below:
• "Republican candidates blame skyrocketing drug costs on over-regulation and a few drug companies' 'pure profiteering,' but don't say that Medicare should negotiate drug prices or that the government should limit drug maker’s profits, steps that might dramatically shake up the marketplace....they’re not even making modest suggestions to stem rising costs, focusing instead on hammering a few headline-making companies that they portray as bad actors. "
• "High cancer drug prices are harming patients because either you come up with the money, or you die."
• Polls show high drug costs as "voters' No. 1 health concern," but the candidates are "caught in the box of Republican free market orthodoxy — and also, of long-standing relationships with the pharmaceutical industry, a lobbying powerhouse on the Hill."
• It doesn't matter if a cheaper (often generic) version may be available if doctors don't pay attention to costs and consumers believe the more expensive drug is probably more effective. Moreover, doctors who do pay attention to costs have an incentive to prescribe the more expensive version of a drug, not the generic version.
• Step therapy ('fail-first" drug policies allow health insurance to practice medicine. Designed to keep insurance costs down, step therapy ("fail first" protocols insist that a patient start with a traditional lower-cost drug and advance to a newer, more expensive drug only if the first drug fails to produce the desired results. For new drugs that are clearly more effective, this means doctors and patients have to jump through hoops to get patient to the more effective drug, in order to get insurance coverage."
• 'It’s sort of embedded in the health care system that the price is never the price, unless you’re a cash-paying customer,' Mr. Fein said. 'And in that case, we soak the poor.'”'
• A Pro Publica investigation shows that many doctors are being paid by the same drug companies whose medicines they prescribe. (more…)