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Name Brand Drug Costs Are Too High and Generics Are Growing Out of Reach

There is room for profit in the pharmaceutical industry. However, the amount of that profit should not cause suffering to patients, who are the pharmaceutical industry's consumer. As a country we must jointly stand together and insist on regulating the costs of these medications.
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Martin Shkreli is testifying before Congress today. The reason is because he raised the cost of Daraprim from $13.50 to $750 a tablet. The American people appear collectively outraged by this type of price gauging. Martin Shkreli, however, is only the tip of the iceberg.

Today is World Cancer Day and in the spirit of increasing awareness we need to talk about the cost of brand name drugs and generics in America.

"Your co-pay for this month is $2,986. Would you like to use your credit card?"

The customer service rep at Accredo Specialty Pharmacy asked the question as casually as if she were asking if I wanted fries with a burger. I'm guessing her nonchalant attitude is because I am not the only one on such an expensive medication. She probably states these insane prices and asks for credit card numbers hundreds of times a day. The costs probably feel less and less like real money the higher they become.

For most Americans, she might as well have said "your co-pay is a million dollars." Thousands of dollars are just as hard to come up with (and pay off) as millions of dollars, when a person does not have that kind of money available. Do you have a recurring $3,000 ready just for one co-pay, on one drug, for one month? I don't.

I am on a daily chemotherapy drug that is saving my life. I will take it every day for the remainder of my life, just as I have for the last nine years. It really is a miracle that this medication is working for me, but before you interject with, "Wow! You should be grateful to be alive!" I will tell you that I am very grateful, it is not an easy path, and that discussion is a different topic for another day.

When I first started taking Gleevec in 2007 the cost was around $3,000 a month -- since then the price has risen to over $9,000 a month. The reason for the cost increase is up for debate. Research and development for that particular drug was paid off years ago. Though research and development along with marketing and outreach seem to be the main reasons discussed when drug prices are increased. I have a growing cynical view, considering there are no real pricing parameters for pharmaceutical companies here in America.

Drug companies usually offer co-pay assistance programs for those who qualify. They even donate to some of the non-profits that assist patients. The theory is, companies will appear generous, and patients won't complain about the ridiculously unsustainable prices because they won't see them. Which, in turn, allows prices to continue to rise, masking a huge problem in our health care system.

After medical bankruptcy, I still was ineligible for co-pay assistance from the drug company who makes my chemotherapy. There are so many loopholes in our health care system, and I seem to fall into them, just as many patients do. I experienced years of stress and panic waiting each month to see if my chemo would be approved by the insurance company, and if I could afford the co-pay for that medically necessary prescription. Thankfully, at my wits end, I was finally referred to, and qualified for, a co-pay assistance program through an outside non-profit.

The thing about non-profits, and assistance programs in general, is that there are no guarantees they will be available for as long as patients need them. Recently I received letters from my co-pay assistance program alerting me to the fact that I may be ineligible next year, and the fund supporting my assistance is no longer solvent. The number of patients in need is growing and vastly outweighing the availability of funds non-profits have to give.

Which brings us to the topic of generics. Why are drug cost assistance programs even necessary? Why not just buy a cheaper drug? Many drugs are not yet available in generic form. Due to our patent laws, generics remain out of the American market for much longer than in other countries. Thus, the name brand drugs have a monopoly, making alternatives completely unavailable.

After Novartis' years of lawsuits over patents, my chemotherapy (Gleevec) will finally lose its monopoly this month and become available as a generic (Imatinib) through Sun Pharmaceuticals. Which should be a welcome financial relief for patients like me.

Here's the kicker: According to NPR, the price of Imatinib will be about 30 percent less than the price of Gleevec. Gleevec however, now costs over $9,000 a month. 30 percent less than $9,000 is still over $6,000 a month for the generic version of my chemotherapy. This makes the co-pays alone remain completely unaffordable for most patients.

Insurance companies, desperate for any type of discount from the brand name drug, will most likely insist patients switch to the generic form. Which does nothing for the patients who still need to come up with tremendous amounts of money in order to afford a drug they need to survive. If generic pricing is based on name brand pricing which is based on nothing concrete, we are setting our country up for an even wider divide between the haves and the have-nots.

Newton's third law states for every action there is an equal an opposite reaction. We see that theory play out in the costs of these drugs. The exorbitant amounts of money capitalistically collected on one end of the spectrum is missing on the opposite end because patients cannot afford to care for themselves. Where is the balance? What happened to an honest earning for an honest product? Was it lost when we began treating health care as an investment opportunity?

There is room for profit in the pharmaceutical industry. However, the amount of that profit should not cause suffering to patients, who are the pharmaceutical industry's consumer. As a country we must jointly stand together and insist on regulating the costs of these medications. If we do not, we will continue to see poverty unnecessarily grow due to the costs of treating illness.

Originally Posted on the Stupid Cancer Blog.