Drug Prices in the United States
By Rick Redalen, M.D.
Pharmaceuticals are again making the news. Martin Shkreli, CEO of Turing Pharmaceuticals is once more in the news. That is the gentleman who increased the price of the lifesaving drug Daraprim by 5000% or from $13.50 per pill to $750.00 per pill. To improve his image he has cut the price by 50% to hospitals. Following his appearance in front of the House Oversight and Government Reform Hearing he allegedly tweeted it was hard to accept that these imbeciles represent the people of our government.
I think when you look at something like this more closely after you are past the disdain and hatred most people using Daraprim have for this man, you can see how this can happen.
After all he is not doing anything outside the law. He is trying his best to make a living. Making hundreds of millions of dollars off some of our most vulnerable citizens must be OK with Congress being they are ultimately the ones who allow this to happen.
Perhaps our government leaders feel if they throw enough heat at Mr. Shkreli we will all forget they are the ones responsible for the laws that allow Mr. Shkreli to do this. In 2003, Congress and President Bush enacted the “Medicare Prescription Drug, Improvement and Modernization Act,” which established a prescription drug program for Medicare. That legislation expressly prohibited Medicare from negotiating drug prices with pharmaceutical companies. Wouldn’t you love to have something everybody needs and you can charge whatever you want? Why don’t they just charge us what they will sell their compassion and morality for?
According to a report by House Democrats the United States is exclusive among industrialized countries because it is the only country that fails to protect its citizens from discriminatory drug pricing. Canada, France, Italy, Germany, Japan and the United Kingdom all negotiate on behalf of their citizens to obtain lower prices for brand name drugs. As a result, purchasers in these countries pay significantly less for prescription drugs than uninsured senior citizens in the United States.
Drug companies counter this by saying they need the additional money to pay for R & D or research and development. However the American National Institutes of Health (NIH) pays hundreds of millions for drug companies to do research and development. Our big Pharma companies never tell us this do they? You draw your own conclusions. There will be more to follow.
How did Something as Personal as Medicine become so Impersonal?
By Rick Redalen, M.D.
I first started practicing medicine in 1969 as a family practitioner. I by chance became one of those rare people whose mentor was the chief of pathology, urology and general surgery for most of his life in Bethesda Hospital in St. Paul, Minnesota. Dr. Arthur Lundholm was at my side and taught me tirelessly in all of those specialties for five years. I guess you could call it the greatest multispecialty residency available. He also taught me how important it was to know your patient.
In the early years of my practice it would be a rare time when most of my partners could not say “Hi” to a person in the waiting room, call them by their first name and ask about other members in the family. This was also true of most other family practitioners I knew. This is immensely helpful in caring for patients. You know their history and what medications they are on. It is much harder to care for a stranger.
Have you ever wondered when you go to a clinic why you may end up with a different physician each time you go? Often the large multispecialty clinic does not really care who you see. One reason for this is that a physician who sees his same patient population all the time and befriends them, is also more likely to take that group of patients with him if he leaves practice in that clinic.
When HMO’s, PPO’s and large corporations inched their way into the practice of medicine seeing patients became a numbers game for them. The more patients a physician working for them sees, the more money they will make. Suddenly doctors had quotas. This means a family coming in to see you who lost their child yesterday is given about the same amount of time as someone who has poison ivy.
I think all of you realize this manner of rules and regulations by corporate America does not fit the picture of the kindly old family practitioner. Can this be changed? Maybe with time, but I doubt it. There is simply too much money to be made in medicine. The United States spends more on health care per capita than any other industrialized country in the world. We also are also one of the highest in the world on what percentage of our GDP goes to healthcare.