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Tanzania","publishDate":1513238506,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Two pills to wipe out hookworm could cost you 4 cents. Or $400.\u003c/p>\n\u003cp>It just depends where you live.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657832/table/pntd-0000402-t002/\">4 cents is in Tanzania\u003c/a>. That'll cover the two pills it takes to knock out the intestinal parasite. But in the United States, where hookworm has re-emerged, the price for two 200 mg tablets of albendazole can cost \u003ca href=\"https://www.goodrx.com/albendazole?drug-name=albendazole\">as much as $400\u003c/a>.\u003c/p>\n\u003cp>The pill will put an end to the problems hookworm can cause, such as anemia and protein deficiency as well as stunting growth in children.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When there's limited competition in the market, the company that holds the monopoly is able to price [the drug] however they want.'\u003ccite>Dr. Jonathan Alpern, HealthPartners Institute\u003c/cite>\u003c/aside>\n\u003cp>It's not just a problem with the anti-hookworm pill. Drugs for diseases of the developing world, in particular what are known as \"neglected tropical diseases\" like hookworm and \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2016/06/29/483721076/the-aleppo-evil-is-making-a-comeback\">leishmaniasis\u003c/a>, are enormously more expensive in the United States than in the developing world.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"There really is no good reason for this price,\" \u003ca href=\"https://www.healthpartners.com/hprf/investigators/ENTRY_194022\">Dr. Jonathan Alpern\u003c/a> says of the albendazole price tag. Alpern works for the HealthPartners Institute, the research division of a health care organization in Minnesota.\u003c/p>\n\u003cp>[contextly_sidebar id=\"WWHZxql76AEWQSa0dS4fXrjLNFG8AVIY\"]Impax Laboratories is the only pharmaceutical company that offers the drug in the U.S. Impax did not wish to comment on product pricing for this story but stated in an email to NPR: \"Given the very different regulatory regimes in the U.S. versus outside the U.S., pricing is a very awkward comparison.\"\u003c/p>\n\u003cp>Because the drug's patent expired decades ago, other companies can sell the generic version. But for medications that fight neglected tropical diseases, pharmaceutical companies have been slow to jump in and manufacture the medicine.\u003c/p>\n\u003cp>As for those that do: \"[Impax] fits into a category of companies that have taken drugs that have been around for many years, acquired the rights and jacked up the price [for the Western market],\" says Alpern.\u003c/p>\n\u003cp>Indeed, prices for generic drugs that treat neglected tropical diseases \u003ca href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005794\">are skyrocketing in the U.S.\u003c/a>\u003c/p>\n\u003cp>When a disease affects only a small number of patients in the U.S., \"there's less incentive for generic companies to enter the market,\" Alpern explains. That's because there's less potential for profit.\u003c/p>\n\u003cp>Hookworm, which was recently \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2017/09/12/550387650/the-u-s-thought-it-was-rid-of-hookworm-wrong\">discovered in a small community\u003c/a> in the U.S., is just one example of this trend.\u003c/p>\n\u003cp>[contextly_sidebar id=\"COtXc62j0KNxw4adAUKowpuaCpnf5tLX\"]Neurocysticercosis, a parasitic disease that causes seizures and epilepsy, is another example. The disease is rare in the U.S. with an estimated \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005108/\">1,000 to 5,000 new cases\u003c/a> every year. Either albendazole or praziquantel are used to treat the disease. Praziquantel is also pricey: \u003ca href=\"https://www.goodrx.com/biltricide?drug-name=biltricide\">about $525\u003c/a> for six 600 mg tablets.\u003c/p>\n\u003cp>Leishmaniasis, which affects 700,000 to a million people annually throughout the world, is more expensive to treat in the U.S., too. Though rare in the U.S. — only \u003ca href=\"http://phenomena.nationalgeographic.com/2015/10/19/leishmaniasis-tx/\">13 cases\u003c/a> were uncovered between 2000 and 2007 — the disease can cause disfiguring skin sores or swelling of the spleen or liver depending on the form of the disease that's contracted. Two 50 mg tablets of miltefosine for 28 days can treat the infection; the price of each pill wholesale is $685, according to Alpern's research.\u003c/p>\n\u003cp>\"When there's limited competition in the market, the company that holds the monopoly is able to price [the drug] however they want,\" Alpern says. \"In these cases, we often see companies taking advantage of their market position.\"\u003c/p>\n\u003cp>And some of these disease aren't all that rare. \u003ca href=\"https://www.bcm.edu/people/view/peter-hotez-m-d-ph-d/b1846a47-ffed-11e2-be68-080027880ca6\">Dr. Peter Hotez\u003c/a>, dean of the National School of Tropical Medicine at the Baylor College of Medicine, says certain neglected tropical diseases in the U.S. are surprisingly widespread, especially among those who may not be able to afford treatment.\u003c/p>\n\u003cp>For example, he estimates that \u003ca href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003012\">1.1 million Americans\u003c/a> are annually diagnosed with a parasitic infection called toxoplasmosis. The treatment is Daraprim; four 25 mg tablets currently cost between \u003ca href=\"https://www.goodrx.com/daraprim?drug-name=daraprim&form=tablet&dosage=25mg&quantity=4&days_supply=&label_override=Daraprim\">$3,000 and $3,400\u003c/a> on the U.S. market.\u003c/p>\n\u003cp>\"We have now identified nearly half-a-dozen neglected tropical diseases that are widespread in the U.S. among the poor, especially in the American South,\" says Hotez, who last year published \u003ca href=\"https://jhupbooks.press.jhu.edu/content/blue-marble-health\">\u003cem>Blue Marble Health\u003c/em>\u003c/a>, a book evaluating neglected diseases in America. \"In all, I estimate that 12 million Americans now live in extreme poverty with a neglected tropical disease.\"\u003c/p>\n\u003cp>Some of them are in Lowndes County, Ala., where a community of individuals was recently \u003ca href=\"http://www.ajtmh.org/content/journals/10.4269/ajtmh.17-0396\">discovered to have hookworm\u003c/a>. The average income in the county is just $18,036.\u003c/p>\n\u003cp>If patients don't have health insurance, they must pay the full price for prescriptions or skip treatment altogether.\u003c/p>\n\u003cp>[contextly_sidebar id=\"0rRNuKIWq50sVJE9FBqR0zIOBeqefU8E\"]\"Some of the people in Lowndes County are living off $600 or $700 a month,\" says Catherine Flowers, founder of \u003ca href=\"https://www.acrecdc.com/\">Alabama Center for Rural Enterprise\u003c/a>, a nonprofit that addresses poverty. \"People have told me they sometimes have to choose between buying medication and eating.\"\u003c/p>\n\u003cp>In cases where patients have Medicaid, taxpayers bear the burden.\u003c/p>\n\u003cp>In the years following albendazole's price hike in 2011, Medicaid spending on the drug went from under $100,000 in 2008 to more than \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1408376#t=article\">$7.5 million in 2013\u003c/a>. Medicaid spending on Daraprim, another tropical disease drug that just experienced a price hike, went from \u003ca href=\"https://www.washingtonpost.com/news/wonk/wp/2016/11/14/the-drugs-driving-up-medicare-spending/?utm_term=.1c130be6c3e1\">$2.2 million in 2014 to $15.7 million in 2015\u003c/a>.\u003c/p>\n\u003cp>Other times, U.S. patients bypass the system, Alpern says, by asking relatives in other countries to bring them the drug they need. In the United Kingdom, for example, 400 mg of albendazole costs just $2.\u003c/p>\n\u003cp>Why are prices so different in the U.S.?\u003c/p>\n\u003cp>\"In other countries, there are price control methods. The government steps in to ensure drug prices do not increase by a certain amount,\" Alpern says. \"There are no price control mechanisms in the U.S.\"\u003c/p>\n\u003cp>For patients with hookworm, there are few treatment alternatives in the U.S.\u003c/p>\n\u003cp>Mebendazole, which is less than half as effective than albendazole, according to hookworm expert Dr. David Diemert, is considered the second generic line of treatment for hookworm. Impax Laboratories also owns the rights to the drug. Between 2011 and 2016, mebendazole's price jumped more than 8,000 percent, \u003ca href=\"http://www.npr.org/sections/health-shots/2017/01/30/512400204/a-pinworm-medication-is-being-tested-as-a-potential-anti-cancer-drug\">from $4.50 to $369\u003c/a>.\u003c/p>\n\u003cp>Hotez agrees with Alpern's theory that pharmaceutical companies have a profit motive.\u003c/p>\n\u003cp>\"Presumably, small companies see a niche to make some quick cash,\" Hotez says. Meanwhile, in low-income countries, he says, \"many of these drugs are being donated for free [by pharmaceutical companies]. As an example, albendazole is \u003ca href=\"http://www.who.int/mediacentre/news/statements/2011/deworming_tabs_201109_09/en/\">donated by GlaxoSmithKline\u003c/a>.\"\u003c/p>\n\u003cp>According to its website, Impax is \"committed to making ENVERM [mebendazole] more affordable.\" The pharmaceutical company shared an \u003ca href=\"http://www.emverm.com/savings-program/\">online coupon\u003c/a> that can save patients up to $60 for a prescription that would cost more than $369.\u003c/p>\n\u003cp>Alpern hopes to see more companies start manufacturing the generic version of the drug. In his eyes, that's the ultimate solution.\u003c/p>\n\u003chr>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"http://nadiawhitehead.com\">\u003cem>Nadia Whitehead\u003c/em>\u003c/a>\u003cem> is a freelance journalist and a science writer at Texas Tech University Health Sciences Center El Paso. Her work has appeared in \u003c/em>Science\u003cem>, \u003c/em>The Washington Post\u003cem> and NPR. Find her on Twitter \u003c/em>\u003ca href=\"https://twitter.com/nadiamacias\">\u003cem>@NadiaMacias\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+A+Pill+That%27s+4+Cents+In+Tanzania+Costs+Up+To+%24400+In+The+U.S.&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"The medication fights hookworm. It's one of several drugs for \"neglected tropical diseases\" that are priced differently in the United States than they are in the developing world.","status":"publish","parent":0,"modified":1513209938,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":35,"wordCount":1200},"headData":{"title":"Why a Pill That's $400 in the U.S. Costs 4 Cents in Tanzania | KQED","description":"The medication fights hookworm. It's one of several drugs for "neglected tropical diseases" that are priced differently in the United States than they are in the developing world.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Why a Pill That's $400 in the U.S. Costs 4 Cents in Tanzania","datePublished":"2017-12-14T08:01:46.000Z","dateModified":"2017-12-14T00:05:38.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"437690 https://ww2.kqed.org/futureofyou/?p=437690","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/12/14/why-a-pill-thats-400-in-the-u-s-costs-4-cents-in-tanzania/","disqusTitle":"Why a Pill That's $400 in the U.S. Costs 4 Cents in Tanzania","nprImageCredit":"Kuni Takahashi","nprByline":"Nadia Whitehead\u003c/br>NPR Goats and Soda","nprImageAgency":"Bloomberg via Getty Images","nprStoryId":"567753423","nprApiLink":"http://api.npr.org/query?id=567753423&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/goatsandsoda/2017/12/11/567753423/why-a-pill-thats-4-cents-in-tanzania-costs-up-to-400-in-the-u-s?ft=nprml&f=567753423","nprRetrievedStory":"1","nprPubDate":"Tue, 12 Dec 2017 08:46:00 -0500","nprStoryDate":"Mon, 11 Dec 2017 11:06:00 -0500","nprLastModifiedDate":"Tue, 12 Dec 2017 14:33:15 -0500","path":"/futureofyou/437690/why-a-pill-thats-400-in-the-u-s-costs-4-cents-in-tanzania","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Two pills to wipe out hookworm could cost you 4 cents. Or $400.\u003c/p>\n\u003cp>It just depends where you live.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657832/table/pntd-0000402-t002/\">4 cents is in Tanzania\u003c/a>. That'll cover the two pills it takes to knock out the intestinal parasite. But in the United States, where hookworm has re-emerged, the price for two 200 mg tablets of albendazole can cost \u003ca href=\"https://www.goodrx.com/albendazole?drug-name=albendazole\">as much as $400\u003c/a>.\u003c/p>\n\u003cp>The pill will put an end to the problems hookworm can cause, such as anemia and protein deficiency as well as stunting growth in children.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When there's limited competition in the market, the company that holds the monopoly is able to price [the drug] however they want.'\u003ccite>Dr. Jonathan Alpern, HealthPartners Institute\u003c/cite>\u003c/aside>\n\u003cp>It's not just a problem with the anti-hookworm pill. Drugs for diseases of the developing world, in particular what are known as \"neglected tropical diseases\" like hookworm and \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2016/06/29/483721076/the-aleppo-evil-is-making-a-comeback\">leishmaniasis\u003c/a>, are enormously more expensive in the United States than in the developing world.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"There really is no good reason for this price,\" \u003ca href=\"https://www.healthpartners.com/hprf/investigators/ENTRY_194022\">Dr. Jonathan Alpern\u003c/a> says of the albendazole price tag. Alpern works for the HealthPartners Institute, the research division of a health care organization in Minnesota.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Impax Laboratories is the only pharmaceutical company that offers the drug in the U.S. Impax did not wish to comment on product pricing for this story but stated in an email to NPR: \"Given the very different regulatory regimes in the U.S. versus outside the U.S., pricing is a very awkward comparison.\"\u003c/p>\n\u003cp>Because the drug's patent expired decades ago, other companies can sell the generic version. But for medications that fight neglected tropical diseases, pharmaceutical companies have been slow to jump in and manufacture the medicine.\u003c/p>\n\u003cp>As for those that do: \"[Impax] fits into a category of companies that have taken drugs that have been around for many years, acquired the rights and jacked up the price [for the Western market],\" says Alpern.\u003c/p>\n\u003cp>Indeed, prices for generic drugs that treat neglected tropical diseases \u003ca href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005794\">are skyrocketing in the U.S.\u003c/a>\u003c/p>\n\u003cp>When a disease affects only a small number of patients in the U.S., \"there's less incentive for generic companies to enter the market,\" Alpern explains. That's because there's less potential for profit.\u003c/p>\n\u003cp>Hookworm, which was recently \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2017/09/12/550387650/the-u-s-thought-it-was-rid-of-hookworm-wrong\">discovered in a small community\u003c/a> in the U.S., is just one example of this trend.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Neurocysticercosis, a parasitic disease that causes seizures and epilepsy, is another example. The disease is rare in the U.S. with an estimated \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005108/\">1,000 to 5,000 new cases\u003c/a> every year. Either albendazole or praziquantel are used to treat the disease. Praziquantel is also pricey: \u003ca href=\"https://www.goodrx.com/biltricide?drug-name=biltricide\">about $525\u003c/a> for six 600 mg tablets.\u003c/p>\n\u003cp>Leishmaniasis, which affects 700,000 to a million people annually throughout the world, is more expensive to treat in the U.S., too. Though rare in the U.S. — only \u003ca href=\"http://phenomena.nationalgeographic.com/2015/10/19/leishmaniasis-tx/\">13 cases\u003c/a> were uncovered between 2000 and 2007 — the disease can cause disfiguring skin sores or swelling of the spleen or liver depending on the form of the disease that's contracted. Two 50 mg tablets of miltefosine for 28 days can treat the infection; the price of each pill wholesale is $685, according to Alpern's research.\u003c/p>\n\u003cp>\"When there's limited competition in the market, the company that holds the monopoly is able to price [the drug] however they want,\" Alpern says. \"In these cases, we often see companies taking advantage of their market position.\"\u003c/p>\n\u003cp>And some of these disease aren't all that rare. \u003ca href=\"https://www.bcm.edu/people/view/peter-hotez-m-d-ph-d/b1846a47-ffed-11e2-be68-080027880ca6\">Dr. Peter Hotez\u003c/a>, dean of the National School of Tropical Medicine at the Baylor College of Medicine, says certain neglected tropical diseases in the U.S. are surprisingly widespread, especially among those who may not be able to afford treatment.\u003c/p>\n\u003cp>For example, he estimates that \u003ca href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003012\">1.1 million Americans\u003c/a> are annually diagnosed with a parasitic infection called toxoplasmosis. The treatment is Daraprim; four 25 mg tablets currently cost between \u003ca href=\"https://www.goodrx.com/daraprim?drug-name=daraprim&form=tablet&dosage=25mg&quantity=4&days_supply=&label_override=Daraprim\">$3,000 and $3,400\u003c/a> on the U.S. market.\u003c/p>\n\u003cp>\"We have now identified nearly half-a-dozen neglected tropical diseases that are widespread in the U.S. among the poor, especially in the American South,\" says Hotez, who last year published \u003ca href=\"https://jhupbooks.press.jhu.edu/content/blue-marble-health\">\u003cem>Blue Marble Health\u003c/em>\u003c/a>, a book evaluating neglected diseases in America. \"In all, I estimate that 12 million Americans now live in extreme poverty with a neglected tropical disease.\"\u003c/p>\n\u003cp>Some of them are in Lowndes County, Ala., where a community of individuals was recently \u003ca href=\"http://www.ajtmh.org/content/journals/10.4269/ajtmh.17-0396\">discovered to have hookworm\u003c/a>. The average income in the county is just $18,036.\u003c/p>\n\u003cp>If patients don't have health insurance, they must pay the full price for prescriptions or skip treatment altogether.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"Some of the people in Lowndes County are living off $600 or $700 a month,\" says Catherine Flowers, founder of \u003ca href=\"https://www.acrecdc.com/\">Alabama Center for Rural Enterprise\u003c/a>, a nonprofit that addresses poverty. \"People have told me they sometimes have to choose between buying medication and eating.\"\u003c/p>\n\u003cp>In cases where patients have Medicaid, taxpayers bear the burden.\u003c/p>\n\u003cp>In the years following albendazole's price hike in 2011, Medicaid spending on the drug went from under $100,000 in 2008 to more than \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1408376#t=article\">$7.5 million in 2013\u003c/a>. Medicaid spending on Daraprim, another tropical disease drug that just experienced a price hike, went from \u003ca href=\"https://www.washingtonpost.com/news/wonk/wp/2016/11/14/the-drugs-driving-up-medicare-spending/?utm_term=.1c130be6c3e1\">$2.2 million in 2014 to $15.7 million in 2015\u003c/a>.\u003c/p>\n\u003cp>Other times, U.S. patients bypass the system, Alpern says, by asking relatives in other countries to bring them the drug they need. In the United Kingdom, for example, 400 mg of albendazole costs just $2.\u003c/p>\n\u003cp>Why are prices so different in the U.S.?\u003c/p>\n\u003cp>\"In other countries, there are price control methods. The government steps in to ensure drug prices do not increase by a certain amount,\" Alpern says. \"There are no price control mechanisms in the U.S.\"\u003c/p>\n\u003cp>For patients with hookworm, there are few treatment alternatives in the U.S.\u003c/p>\n\u003cp>Mebendazole, which is less than half as effective than albendazole, according to hookworm expert Dr. David Diemert, is considered the second generic line of treatment for hookworm. Impax Laboratories also owns the rights to the drug. Between 2011 and 2016, mebendazole's price jumped more than 8,000 percent, \u003ca href=\"http://www.npr.org/sections/health-shots/2017/01/30/512400204/a-pinworm-medication-is-being-tested-as-a-potential-anti-cancer-drug\">from $4.50 to $369\u003c/a>.\u003c/p>\n\u003cp>Hotez agrees with Alpern's theory that pharmaceutical companies have a profit motive.\u003c/p>\n\u003cp>\"Presumably, small companies see a niche to make some quick cash,\" Hotez says. Meanwhile, in low-income countries, he says, \"many of these drugs are being donated for free [by pharmaceutical companies]. As an example, albendazole is \u003ca href=\"http://www.who.int/mediacentre/news/statements/2011/deworming_tabs_201109_09/en/\">donated by GlaxoSmithKline\u003c/a>.\"\u003c/p>\n\u003cp>According to its website, Impax is \"committed to making ENVERM [mebendazole] more affordable.\" The pharmaceutical company shared an \u003ca href=\"http://www.emverm.com/savings-program/\">online coupon\u003c/a> that can save patients up to $60 for a prescription that would cost more than $369.\u003c/p>\n\u003cp>Alpern hopes to see more companies start manufacturing the generic version of the drug. In his eyes, that's the ultimate solution.\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://nadiawhitehead.com\">\u003cem>Nadia Whitehead\u003c/em>\u003c/a>\u003cem> is a freelance journalist and a science writer at Texas Tech University Health Sciences Center El Paso. Her work has appeared in \u003c/em>Science\u003cem>, \u003c/em>The Washington Post\u003cem> and NPR. Find her on Twitter \u003c/em>\u003ca href=\"https://twitter.com/nadiamacias\">\u003cem>@NadiaMacias\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+A+Pill+That%27s+4+Cents+In+Tanzania+Costs+Up+To+%24400+In+The+U.S.&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/437690/why-a-pill-thats-400-in-the-u-s-costs-4-cents-in-tanzania","authors":["byline_futureofyou_437690"],"categories":["futureofyou_1"],"tags":["futureofyou_948","futureofyou_232"],"featImg":"futureofyou_437691","label":"futureofyou"},"futureofyou_435763":{"type":"posts","id":"futureofyou_435763","meta":{"index":"posts_1591205157","site":"futureofyou","id":"435763","score":null,"sort":[1507051849000]},"guestAuthors":[],"slug":"most-americans-want-drug-prices-controlled-why-wont-congress-act","title":"Most Americans Want Drug Prices Controlled. Why Won't Congress Act?","publishDate":1507051849,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Of all the promises President Donald Trump made for the early part of his term, controlling stinging drug prices might have seemed the easiest to achieve.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is a very aggressive lobby that is finding any and all means to thwart any reform to a system that has produced very lucrative profits.'\u003ccite>Ameet Sarpatwari, Harvard Medical School\u003c/cite>\u003c/aside>\n\u003cp>An angry public overwhelmingly wants change in an easily vilified industry. Big pharma’s recent publicity nightmare included thousand-percent price increases and a \u003ca href=\"https://www.vanityfair.com/news/2017/08/martin-shkreli-verdict\" target=\"_blank\" rel=\"noopener\">smirking CEO who said\u003c/a>, “I liken myself to the robber barons.” Even powerful members of Congress from both parties have said that drug prices are too high.\u003c/p>\n\u003cp>But any momentum to address prescription drug costs — a problem that \u003ca href=\"http://www.kff.org/slideshow/public-opinion-on-prescription-drugs-and-their-prices/\" target=\"_blank\" rel=\"noopener\">a large number of Americans\u003c/a> now believe government should solve — has been lost amid rancorous debates over replacing Obamacare and stalled by roadblocks erected via lobbying and industry cash.\u003c/p>\n\u003cp>“There is a very aggressive lobby that is finding any and all means to thwart any reform to a system that has produced very lucrative profits,” said Ameet Sarpatwari, an epidemiologist and lawyer at Harvard Medical School who follows drug legislation. “Everything that’s coming out is being hit and hit hard — even stuff that’s commonsensical.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"RiRCaAhGLSSzIv8VTS6OBlnq3jBDwE0j\"]Those in Congress concerned with health policy have spent much of the year advancing proposals to overhaul the Affordable Care Act, none of which would affect pharmaceutical pricing. The latest Republican proposal, by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, is no different.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Meanwhile, more than two dozen bills aimed at curbing drug costs have been introduced in this or the previous Congress, according to the Drug Pricing Lab, a Memorial Sloan Kettering Cancer Center program \u003ca href=\"https://drugpricinglab.org/tools/dpl-policy-tracker/\" target=\"_blank\" rel=\"noopener\">that has catalogued ideas for reducing prices.\u003c/a> Many have bipartisan support.\u003c/p>\n\u003cp>Proposals include importation from other developed countries, where regulations keep prices down; allowing government to negotiate the price of Medicare-covered drugs; speeding approval of cheaper generics; requiring notification before raising drug prices; and restricting consumer drug ads.\u003c/p>\n\u003cp>Other ideas that haven’t made it to legislation include banning patents for pills that simply copy or repackage existing medicines; and adjusting prices according to a drug’s effectiveness.\u003c/p>\n\u003cp>“There’s clearly no single solution out there that will solve this rapidly rising spending,” said Dr. Peter Bach, who leads the lab. But, he added, “there’s not a lot of fundamental disagreement about the direction this needs to move.”\u003c/p>\n\u003cp>Trump drew new attention to the issue last month by tweeting that Merck’s chief executive, Kenneth Frazier, “will have more time to LOWER RIPOFF DRUG PRICES!” after Frazier quit the president’s manufacturing council to protest his remarks about white supremacists in Charlottesville, Va.\u003c/p>\n\u003cp>Those comments matched Trump’s \u003ca href=\"http://www.politico.com/story/2017/01/trump-press-conference-drug-industry-233475\" target=\"_blank\" rel=\"noopener\">characterization earlier this year of drug companies\u003c/a>as “getting away with murder.” That same January day, a dozen Republican senators, including Ted Cruz of Texas, John McCain of Arizona and Mike Lee of Utah, voted for the old liberal idea of letting Americans buy less-expensive drugs from Canada.\u003c/p>\n\u003cp>[contextly_sidebar id=\"urt72cNaNX4YKl7iNuU8fZ3qlRARZvTT\"]The measure was attached to a budget resolution and \u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2017/jan/18/other-98/viral-image-about-democratic-senators-and-big-phar/\" target=\"_blank\" rel=\"noopener\">wouldn’t, by itself,\u003c/a> have allowed importation. It failed 52 to 46 after 13 Democrats voted against it, with some citing safety concerns about foreign-sourced medicine — an idea promoted by American drugmakers.\u003c/p>\n\u003cp>Even so, the vote prompted speculation that a pharma price deal might be within reach.\u003c/p>\n\u003cp>Sen. Lee is one of the Republicans who favor importation as a way to increase competition. “When we’re talking about garden-variety, generic drugs that can be easily imported from another country that has regulatory procedures that make them safe?” he said in an interview. “I don’t see why not.”\u003c/p>\n\u003cp>In response to the new threats, the Pharmaceutical Research and Manufacturers of America, already one of Washington’s biggest-spending trade groups, \u003ca href=\"http://www.politico.com/story/2016/10/phrma-lobby-pricing-battle-230277\" target=\"_blank\" rel=\"noopener\">increased member dues by half\u003c/a> last year to prepare for battle.\u003c/p>\n\u003cp>The pharmaceutical and health products industries \u003ca href=\"https://www.opensecrets.org/lobby/indus.php?id=H&year=2017\" target=\"_blank\" rel=\"noopener\">spent $145 million\u003c/a> on lobbying for the first half of 2017, according to data from the Center for Responsive Politics.\u003c/p>\n\u003cp>Drug manufacturers gave $4.5 million to congressional campaigns in that period, including six-figure donations to House Speaker Paul Ryan; Rep. Greg Walden, head of the House Energy and Commerce Committee; and Sen. Orrin Hatch, head of the Senate Finance Committee, according to a Kaiser Health News analysis.\u003c/p>\n\u003cp>PhRMA’s “Go Boldly” campaign, showing heroic researchers seeking cures, has spent $28 million so far this year on six ads shown on about 4,600 national TV channels, according to iSpot.tv, an ad tracker.\u003c/p>\n\u003cp>The industry hired former FBI director Louis Freeh \u003ca href=\"https://storage.googleapis.com/m1738/20170605_Report%20on%20Counterfeit%20Drugs.pdf\" target=\"_blank\" rel=\"noopener\">to study\u003c/a> the impact of importation. He concluded that it would “leave the safety of the U.S. prescription drug supply vulnerable to criminals seeking to harm patients.” Import proponents argue the Food and Drug Administration could easily ensure safety by licensing and inspecting Canadian suppliers.\u003c/p>\n\u003cp>Drugmakers say that high prices reflect heavy investment in innovation and drug development. They reject the notion that the industry wields too much influence in Washington.\u003c/p>\n\u003cp>“These are important issues with significant ramifications,” Holly Campbell, a PhRMA spokeswoman, said. “So we will continue to be engaged with the administration to advance solutions that improve the marketplace and make it more responsive to the needs of patients.”\u003c/p>\n\u003cp>The top 10 publicly traded U.S. drug companies made $67.8 billion last year, after taxes, regulatory filings show.\u003c/p>\n\u003cp>Efforts to restrain prices have made little progress in the executive branch, either.\u003c/p>\n\u003cp>The White House has long been expected to issue an executive order on drug costs. But \u003ca href=\"https://www.nytimes.com/2017/06/20/health/draft-order-on-drug-prices-proposes-easing-regulations.html?_r=0\" target=\"_blank\" rel=\"noopener\">leaked documents\u003c/a> show that deliberations have focused on things the industry wants, such as \u003ca href=\"https://khn.org/news/exclusive-white-house-task-force-echoes-pharma-proposals/\" target=\"_blank\" rel=\"noopener\">extending overseas patents\u003c/a> and changing a drug-discount program for hospitals, and not so much on lowering prices.\u003c/p>\n\u003cp>Gerard Anderson, a health policy professor at Johns Hopkins University, said Trump’s draft order “did not talk at all about branded drugs or about specialty drugs,” including for rheumatoid arthritis and cancer, that have seen especially steep price increases. “If that represents the administration’s thinking, then my guess is there is not much effort.”\u003c/p>\n\u003cp>Trump’s ongoing feud with congressional Republicans, especially Senate Majority Leader Mitch McConnell, means “you’re not going to get any strong direction or leadership out of the White House” on drug prices, said Vishnu Lekraj, who follows pharma stocks for Morningstar, an investment research firm.\u003c/p>\n\u003cp>Trump isn’t the only one in his administration criticizing drug companies. Scott Gottlieb, the FDA commissioner, has accused the industry of \u003ca href=\"https://blogs.fda.gov/fdavoice/index.php/2017/06/fda-working-to-lift-barriers-to-generic-drug-competition/\" target=\"_blank\" rel=\"noopener\">“gaming” the system\u003c/a> to delay the appearance of cheap generics after patents expire. He has pledged to speed applications for generics when there is little competition as part of a \u003ca href=\"https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm564725.htm\" target=\"_blank\" rel=\"noopener\">“drug competition action plan”\u003c/a>while opposing stronger measures like allowing importation.\u003c/p>\n\u003cp>But promoting generics is “reasonably small potatoes” compared with the money that could be saved by putting direct pressure on brand-drug prices, Anderson said. Gottlieb has served on the boards of \u003ca href=\"https://www.opensecrets.org/news/2017/04/fda-nominee-gottlieb/\" target=\"_blank\" rel=\"noopener\">several pharmaceutical companies\u003c/a> and reaped large consulting and speaking fees from the industry.\u003c/p>\n\u003cp>Yet even small potatoes might be a long shot — despite widespread agreement that change is needed.\u003c/p>\n\u003cp>“It is sort of remarkable to see just how far the system can bend before meaningful reform is taken,” said Sarpatwari of Harvard. “If there ever was a time to strike while it’s hot, it’s now.”\u003c/p>\n\u003cp>\u003cem>Elizabeth Lucas and Sydney Lupkin contributed to this report.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>KHN’s coverage of prescription drug development, costs and pricing is supported in part by the \u003ca href=\"http://www.arnoldfoundation.org/\" target=\"_blank\" rel=\"noopener\">Laura and John Arnold Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Any momentum to address prescription drug costs has been lost amid rancorous debates over replacing Obamacare and stalled by roadblocks erected via lobbying and industry cash.","status":"publish","parent":0,"modified":1507051849,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":1355},"headData":{"title":"Most Americans Want Drug Prices Controlled. Why Won't Congress Act? | KQED","description":"Any momentum to address prescription drug costs has been lost amid rancorous debates over replacing Obamacare and stalled by roadblocks erected via lobbying and industry cash.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Most Americans Want Drug Prices Controlled. Why Won't Congress Act?","datePublished":"2017-10-03T17:30:49.000Z","dateModified":"2017-10-03T17:30:49.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"435763 https://ww2.kqed.org/futureofyou/?p=435763","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/10/03/most-americans-want-drug-prices-controlled-why-wont-congress-act/","disqusTitle":"Most Americans Want Drug Prices Controlled. Why Won't Congress Act?","nprByline":"Jay Hancock\u003c/br>Kaiser Health News","path":"/futureofyou/435763/most-americans-want-drug-prices-controlled-why-wont-congress-act","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Of all the promises President Donald Trump made for the early part of his term, controlling stinging drug prices might have seemed the easiest to achieve.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is a very aggressive lobby that is finding any and all means to thwart any reform to a system that has produced very lucrative profits.'\u003ccite>Ameet Sarpatwari, Harvard Medical School\u003c/cite>\u003c/aside>\n\u003cp>An angry public overwhelmingly wants change in an easily vilified industry. Big pharma’s recent publicity nightmare included thousand-percent price increases and a \u003ca href=\"https://www.vanityfair.com/news/2017/08/martin-shkreli-verdict\" target=\"_blank\" rel=\"noopener\">smirking CEO who said\u003c/a>, “I liken myself to the robber barons.” Even powerful members of Congress from both parties have said that drug prices are too high.\u003c/p>\n\u003cp>But any momentum to address prescription drug costs — a problem that \u003ca href=\"http://www.kff.org/slideshow/public-opinion-on-prescription-drugs-and-their-prices/\" target=\"_blank\" rel=\"noopener\">a large number of Americans\u003c/a> now believe government should solve — has been lost amid rancorous debates over replacing Obamacare and stalled by roadblocks erected via lobbying and industry cash.\u003c/p>\n\u003cp>“There is a very aggressive lobby that is finding any and all means to thwart any reform to a system that has produced very lucrative profits,” said Ameet Sarpatwari, an epidemiologist and lawyer at Harvard Medical School who follows drug legislation. “Everything that’s coming out is being hit and hit hard — even stuff that’s commonsensical.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Those in Congress concerned with health policy have spent much of the year advancing proposals to overhaul the Affordable Care Act, none of which would affect pharmaceutical pricing. The latest Republican proposal, by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, is no different.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Meanwhile, more than two dozen bills aimed at curbing drug costs have been introduced in this or the previous Congress, according to the Drug Pricing Lab, a Memorial Sloan Kettering Cancer Center program \u003ca href=\"https://drugpricinglab.org/tools/dpl-policy-tracker/\" target=\"_blank\" rel=\"noopener\">that has catalogued ideas for reducing prices.\u003c/a> Many have bipartisan support.\u003c/p>\n\u003cp>Proposals include importation from other developed countries, where regulations keep prices down; allowing government to negotiate the price of Medicare-covered drugs; speeding approval of cheaper generics; requiring notification before raising drug prices; and restricting consumer drug ads.\u003c/p>\n\u003cp>Other ideas that haven’t made it to legislation include banning patents for pills that simply copy or repackage existing medicines; and adjusting prices according to a drug’s effectiveness.\u003c/p>\n\u003cp>“There’s clearly no single solution out there that will solve this rapidly rising spending,” said Dr. Peter Bach, who leads the lab. But, he added, “there’s not a lot of fundamental disagreement about the direction this needs to move.”\u003c/p>\n\u003cp>Trump drew new attention to the issue last month by tweeting that Merck’s chief executive, Kenneth Frazier, “will have more time to LOWER RIPOFF DRUG PRICES!” after Frazier quit the president’s manufacturing council to protest his remarks about white supremacists in Charlottesville, Va.\u003c/p>\n\u003cp>Those comments matched Trump’s \u003ca href=\"http://www.politico.com/story/2017/01/trump-press-conference-drug-industry-233475\" target=\"_blank\" rel=\"noopener\">characterization earlier this year of drug companies\u003c/a>as “getting away with murder.” That same January day, a dozen Republican senators, including Ted Cruz of Texas, John McCain of Arizona and Mike Lee of Utah, voted for the old liberal idea of letting Americans buy less-expensive drugs from Canada.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The measure was attached to a budget resolution and \u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2017/jan/18/other-98/viral-image-about-democratic-senators-and-big-phar/\" target=\"_blank\" rel=\"noopener\">wouldn’t, by itself,\u003c/a> have allowed importation. It failed 52 to 46 after 13 Democrats voted against it, with some citing safety concerns about foreign-sourced medicine — an idea promoted by American drugmakers.\u003c/p>\n\u003cp>Even so, the vote prompted speculation that a pharma price deal might be within reach.\u003c/p>\n\u003cp>Sen. Lee is one of the Republicans who favor importation as a way to increase competition. “When we’re talking about garden-variety, generic drugs that can be easily imported from another country that has regulatory procedures that make them safe?” he said in an interview. “I don’t see why not.”\u003c/p>\n\u003cp>In response to the new threats, the Pharmaceutical Research and Manufacturers of America, already one of Washington’s biggest-spending trade groups, \u003ca href=\"http://www.politico.com/story/2016/10/phrma-lobby-pricing-battle-230277\" target=\"_blank\" rel=\"noopener\">increased member dues by half\u003c/a> last year to prepare for battle.\u003c/p>\n\u003cp>The pharmaceutical and health products industries \u003ca href=\"https://www.opensecrets.org/lobby/indus.php?id=H&year=2017\" target=\"_blank\" rel=\"noopener\">spent $145 million\u003c/a> on lobbying for the first half of 2017, according to data from the Center for Responsive Politics.\u003c/p>\n\u003cp>Drug manufacturers gave $4.5 million to congressional campaigns in that period, including six-figure donations to House Speaker Paul Ryan; Rep. Greg Walden, head of the House Energy and Commerce Committee; and Sen. Orrin Hatch, head of the Senate Finance Committee, according to a Kaiser Health News analysis.\u003c/p>\n\u003cp>PhRMA’s “Go Boldly” campaign, showing heroic researchers seeking cures, has spent $28 million so far this year on six ads shown on about 4,600 national TV channels, according to iSpot.tv, an ad tracker.\u003c/p>\n\u003cp>The industry hired former FBI director Louis Freeh \u003ca href=\"https://storage.googleapis.com/m1738/20170605_Report%20on%20Counterfeit%20Drugs.pdf\" target=\"_blank\" rel=\"noopener\">to study\u003c/a> the impact of importation. He concluded that it would “leave the safety of the U.S. prescription drug supply vulnerable to criminals seeking to harm patients.” Import proponents argue the Food and Drug Administration could easily ensure safety by licensing and inspecting Canadian suppliers.\u003c/p>\n\u003cp>Drugmakers say that high prices reflect heavy investment in innovation and drug development. They reject the notion that the industry wields too much influence in Washington.\u003c/p>\n\u003cp>“These are important issues with significant ramifications,” Holly Campbell, a PhRMA spokeswoman, said. “So we will continue to be engaged with the administration to advance solutions that improve the marketplace and make it more responsive to the needs of patients.”\u003c/p>\n\u003cp>The top 10 publicly traded U.S. drug companies made $67.8 billion last year, after taxes, regulatory filings show.\u003c/p>\n\u003cp>Efforts to restrain prices have made little progress in the executive branch, either.\u003c/p>\n\u003cp>The White House has long been expected to issue an executive order on drug costs. But \u003ca href=\"https://www.nytimes.com/2017/06/20/health/draft-order-on-drug-prices-proposes-easing-regulations.html?_r=0\" target=\"_blank\" rel=\"noopener\">leaked documents\u003c/a> show that deliberations have focused on things the industry wants, such as \u003ca href=\"https://khn.org/news/exclusive-white-house-task-force-echoes-pharma-proposals/\" target=\"_blank\" rel=\"noopener\">extending overseas patents\u003c/a> and changing a drug-discount program for hospitals, and not so much on lowering prices.\u003c/p>\n\u003cp>Gerard Anderson, a health policy professor at Johns Hopkins University, said Trump’s draft order “did not talk at all about branded drugs or about specialty drugs,” including for rheumatoid arthritis and cancer, that have seen especially steep price increases. “If that represents the administration’s thinking, then my guess is there is not much effort.”\u003c/p>\n\u003cp>Trump’s ongoing feud with congressional Republicans, especially Senate Majority Leader Mitch McConnell, means “you’re not going to get any strong direction or leadership out of the White House” on drug prices, said Vishnu Lekraj, who follows pharma stocks for Morningstar, an investment research firm.\u003c/p>\n\u003cp>Trump isn’t the only one in his administration criticizing drug companies. Scott Gottlieb, the FDA commissioner, has accused the industry of \u003ca href=\"https://blogs.fda.gov/fdavoice/index.php/2017/06/fda-working-to-lift-barriers-to-generic-drug-competition/\" target=\"_blank\" rel=\"noopener\">“gaming” the system\u003c/a> to delay the appearance of cheap generics after patents expire. He has pledged to speed applications for generics when there is little competition as part of a \u003ca href=\"https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm564725.htm\" target=\"_blank\" rel=\"noopener\">“drug competition action plan”\u003c/a>while opposing stronger measures like allowing importation.\u003c/p>\n\u003cp>But promoting generics is “reasonably small potatoes” compared with the money that could be saved by putting direct pressure on brand-drug prices, Anderson said. Gottlieb has served on the boards of \u003ca href=\"https://www.opensecrets.org/news/2017/04/fda-nominee-gottlieb/\" target=\"_blank\" rel=\"noopener\">several pharmaceutical companies\u003c/a> and reaped large consulting and speaking fees from the industry.\u003c/p>\n\u003cp>Yet even small potatoes might be a long shot — despite widespread agreement that change is needed.\u003c/p>\n\u003cp>“It is sort of remarkable to see just how far the system can bend before meaningful reform is taken,” said Sarpatwari of Harvard. “If there ever was a time to strike while it’s hot, it’s now.”\u003c/p>\n\u003cp>\u003cem>Elizabeth Lucas and Sydney Lupkin contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>KHN’s coverage of prescription drug development, costs and pricing is supported in part by the \u003ca href=\"http://www.arnoldfoundation.org/\" target=\"_blank\" rel=\"noopener\">Laura and John Arnold Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/435763/most-americans-want-drug-prices-controlled-why-wont-congress-act","authors":["byline_futureofyou_435763"],"categories":["futureofyou_1"],"tags":["futureofyou_302","futureofyou_948","futureofyou_137","futureofyou_442"],"featImg":"futureofyou_435772","label":"futureofyou"},"futureofyou_434619":{"type":"posts","id":"futureofyou_434619","meta":{"index":"posts_1591205157","site":"futureofyou","id":"434619","score":null,"sort":[1501780309000]},"guestAuthors":[],"slug":"drug-puts-a-750000-price-tag-on-life","title":"Drug Puts A $750,000 'Price Tag On Life'","publishDate":1501780309,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Jana Gundy and Amanda Chaffin, who live within two hours of each other in Oklahoma, each have a child with the same devastating disease.\u003c/p>\n\u003cp>The genetic condition, spinal muscular atrophy, robs its sufferers of muscle strength, affecting their ability to sit, stand or even breathe.\u003c/p>\n\u003cp>So both moms were ecstatic when the Food and Drug Administration approved the first treatment for the condition two days before Christmas in 2016. It seemed the gift they had been waiting for — a chance to slow the heartbreaking decline of their young sons.\u003c/p>\n\u003cp>But that common hope has taken them down different paths: In April, Gundy's child, who is on private insurance, began getting the drug \u003ca href=\"https://www.spinraza.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Spinraza\u003c/a>, which costs $750,000 for the initial year of treatment. Chaffin's child, a Medicaid enrollee, did not, as his state regulators debated whether to offer it to children like him who use ventilators to breathe.\u003c/p>\n\u003cp>Across the country, similar stories are playing out as private insurers and already-squeezed state Medicaid programs wrestle with what, if any, limits to place on patients' access to break-the-bank drugs — weighing the needs of the ill against budget realities.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At the same time, policymakers and physicians increasingly demand to understand why drug manufacturers affix price tags that have risen to once unimaginable highs.\u003c/p>\n\u003cp>\"It looks like a drug that works for a tragic condition that afflicts children and cripples and kills them. That's the good news,\" \u003ca href=\"http://www.drugepi.org/faculty-staff-trainees/faculty/jerry-avorn/\">Dr. Jerry Avorn\u003c/a>, a professor of medicine at Harvard Medical School, says of Spinraza. But \"how in the world did the price of $750,000 a year get chosen?\"\u003c/p>\n\u003cp>Biogen, the maker of Spinraza, defends its price.\u003c/p>\n\u003cp>\"We compared industry norms for other drugs in rare disease. We looked at the efficacy and safety profile of the drug itself,\" says Dr. Wildon Farwell, an epidemiologist and senior medical director of clinical development at \u003ca href=\"https://www.biogen.com/en_us/search.html\">Biogen\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">The logic of comparing a new drug to extremely high-priced drugs already on the market only fuels an inflationary cycle.\u003c/aside>\n\u003cp>But that logic — comparing a new drug to extremely high-priced drugs already on the market — has only fueled an inflationary cycle, Avorn says, adding: \"In my view, that's akin to a kid who gets caught bullying another kid and beating him up after school, and says, 'Well, all the other kids were beating him up so it's OK.' If it's wrong, it's wrong.\"\u003c/p>\n\u003cp>The stress is unbearable for families trying to obtain treatment for sick children, who are caught in the arcane world of coverage decisions and businesses' price calculations.\u003c/p>\n\u003cp>\"The longer we wait, the more ... [his ability to move] will be gone and there's a chance of not getting it back,\" says Chaffin of Kayden, her 4-year-old son, who was diagnosed with SMA as an infant.\u003c/p>\n\u003cp>In late May, Oklahoma's Medicaid program approved rules barring coverage of Spinraza for patients dependent on ventilators.\u003c/p>\n\u003cp>[contextly_sidebar id=\"LaqAJKwQYtEl0uRFlhItRGRGbVPXKuR3\"]At that same time, Gundy watched hopefully as her 12-year-old son, Kyle, who also uses a ventilator, received the first three of the six doses he will get this year, following approval by his private health insurer. Says Gundy, \"We've seen some minor muscle movement return.\"\u003c/p>\n\u003cp>Spinraza isn't a cure for SMA, which affects 10,000 people in the U.S., but clinical tests show it holds promise for some. Scientific discoveries by researchers at the University of Massachusetts Medical School in the early 2000 — partly funded by grants from the National Institutes of Health and donations from patient-advocacy groups — helped pave the way for Spinraza.\u003c/p>\n\u003cp>The drug was granted \"orphan\" status, which provides tax credits for research and helped speed the review process. It won approval in five years after the start of clinical trials, based on results of a few small studies.\u003c/p>\n\u003cp>The FDA cited interim results from one of those studies in giving its OK; 40 percent of the patients given the drug in that study showed improvement, compared with none in the control group. Final results came later, showing 51 percent of treated children demonstrated improvement.\u003c/p>\n\u003cp>Spinraza was tested only on children, most under age 2, though it was \u003ca href=\"https://www.fda.gov/Drugs/InformationOnDrugs/ucm536955.htm\">approved\u003c/a> for pediatric and adult use.\u003c/p>\n\u003cp>All that means Biogen's research and development costs likely were not unusually high, although the company would not release figures. Five days after getting the FDA's approval to sell the drug in the U.S., Biogen announced the price: $125,000 a dose, or $750,000 for the first year. Fewer doses in following years drop the total annual cost to $375,000. The drug must be taken for life.\u003c/p>\n\u003cp>The FDA does not know or consider pricing when it grants approval.\u003c/p>\n\u003cp>If just half of U.S. patients get treatment for one year, the tab would be more than $3.7 billion. Spinraza brought in $203 million in the second quarter of this year, more than four times its revenue in the first quarter.\u003c/p>\n\u003cp>When Biogen unveiled the price tag, one Wall Street analyst at the investment bank Leerink predicted \"a storm of criticism\" and that insurers would parse \"which patients receive access.\"\u003c/p>\n\u003cp>Families that include a child with SMA are a close community, and Chaffin keeps in touch with other SMA families via Facebook, where the have-nots can watch what happens with the kids who received the drug.\u003c/p>\n\u003cp>\"There are similar kids his age that live in different states and are [on a ventilator] and they are seeing movement come back and strength coming back,\" says Chaffin. Because SMA often affects the muscles around the mouth, \"Kayden lost his smile in 2014, but he has a little smirk left. These parents are seeing their smiles coming back.\"\u003c/p>\n\u003cp>Good news came to Chaffin in late July. After receiving the required two denials from her state's Medicaid program, Kayden was accepted into Biogen's patient assistance program. The program helps patients' families navigate their insurance, covers the cost of the drug if they are denied and, in some cases, helps with other costs, too. But it isn't available to everyone. Some government programs — Medicare and Medicaid, for example — restrict efforts to eliminate copayments for drugs.\u003c/p>\n\u003cp>Kayden will get his first injection in mid-August — eight months after the drug was approved.\u003c/p>\n\u003cp>Now this low-income family faces one more hurdle: finding the estimated $2,000 per injection to cover doctor and hospital costs for the six shots Kayden will need in the coming year.\u003c/p>\n\u003cp>In addition to the financial questions, there are other unanswered concerns among families and medical professionals. Will Spinraza work in older children or adults? No children involved in the study were on ventilators at the start of the trial. Is it safe for children on ventilators? Also, because SMA's rate of decline varies, how can doctors, families or insurers measure if the drug is stalling the disease's progression? And, finally, how long will its effect last?\u003c/p>\n\u003cp>For some fast-track drugs like Spinraza, FDA approvals don't offer this kind of guidance.\u003c/p>\n\u003cp>\u003ca href=\"http://www.seattlechildrens.org/medical-staff/susan-d-apkon/\">Dr. Susan Apkon\u003c/a>, who treats dozens of children with SMA as a physiatrist at Seattle Children's Hospital — and who urged Washington state's Medicaid pharmacy board to cover the drug — says there is no easy answer.\u003c/p>\n\u003cp>\"If a drug works, we want to give it to the child or adult, whatever the drug is,\" says Apkon, who does not receive money directly from Biogen but is a co-investigator in one of the company's ongoing studies.\u003c/p>\n\u003cp>Still, \"there is one pot of money, and we need to figure out how it gets distributed,\" she says. \"The system is broken.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">With any costly new drug, it all comes down to “tough choices.”\u003ccite>Jack Hoadley, health policy analyst at Georgetown University’s Health Policy Institute.\u003c/cite>\u003c/aside>\n\u003cp>With any costly new drug, it all comes down to \"tough choices,\" says \u003ca href=\"http://explore.georgetown.edu/people/jfh7/\">Jack Hoadley\u003c/a>, a health policy analyst at Georgetown University's Health Policy Institute.\u003c/p>\n\u003cp>\"Treating one of these patients may mean not treating 1,000 patients with some other, less expensive problem — or saying they have to raise more tax dollars,\" he says. \"Private insurers have the same trade-off. Do we pay for this if it will ultimately raise our premiums?\"\u003c/p>\n\u003cp>Coverage eligibility varies by insurer and, in Medicaid, by state.\u003c/p>\n\u003cp>Most insurers and Medicaid programs require that patients show some kind of proof of progress — or at least maintenance of function — in order to continue therapy beyond initial doses.\u003c/p>\n\u003cp>While agreeing that the drug offers some hope to patients, Donna Sullivan, chief pharmacy officer for \u003ca href=\"https://www.hca.wa.gov/\">Washington State Health Care Authority\u003c/a>, which oversees Medicaid, says the price tag rankles her.\u003c/p>\n\u003cp>During a recent meeting with Biogen officials, Sullivan was blunt: \"I told them the price was unethical.\"\u003c/p>\n\u003cp>In her state, there are about 150 children with SMA. After reviewing the data on Spinraza, Washington Medicaid approved broad coverage rules, including allowing patients on ventilators to get the drug.\u003c/p>\n\u003cp>But large new spending puts additional pressure on state budgets. When combined with economic downturns, that can lead lawmakers to trim medical provider payments or optional Medicaid services, which include adult dental care, podiatry, chiropractic treatment and other services.\u003c/p>\n\u003cp>Crystal Ramos, of Pasco, Wash., whose 3-year-old twins have SMA, is thankful that Medicaid covers the drug. After four doses, she says she is already seeing some improvement in her boys.\u003c/p>\n\u003cp>The boys are on her insurance through her job as a teacher, but Medicaid picks up what her private insurance does not, which totals about $2,500 per injection.\u003c/p>\n\u003cp>She calls Spinraza's price \"beyond crazy.\"\u003c/p>\n\u003cp>\"They're putting a price tag on life, which sucks,\" she says. \"In the end, we have to pay it if we want our kids to live, and they know it.\"\u003c/p>\n\u003chr>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem> is a nonprofit health newsroom, an editorially independent part of the Kaiser Family Foundation. You can follow KHN senior correspondent Julie Appleby on Twitter \u003c/em>\u003ca href=\"http://twitter.com/Julie_Appleby\">\u003cem>\u003cstrong>@Julie_Appleby\u003c/strong>\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Drug+Puts+A+%24750%2C000+%27Price+Tag+On+Life%27&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"The high cost of Spinraza, a new and promising treatment for spinal muscular atrophy, highlights how the cost-benefit analysis insurers use to make drug coverage decisions plays out in human terms.","status":"publish","parent":0,"modified":1501780309,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":47,"wordCount":1694},"headData":{"title":"Drug Puts A $750,000 'Price Tag On Life' | KQED","description":"The high cost of Spinraza, a new and promising treatment for spinal muscular atrophy, highlights how the cost-benefit analysis insurers use to make drug coverage decisions plays out in human terms.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Drug Puts A $750,000 'Price Tag On Life'","datePublished":"2017-08-03T17:11:49.000Z","dateModified":"2017-08-03T17:11:49.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"434619 https://ww2.kqed.org/futureofyou/?p=434619","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/08/03/drug-puts-a-750000-price-tag-on-life/","disqusTitle":"Drug Puts A $750,000 'Price Tag On Life'","nprByline":"Julie Appleby\u003c/br>Kaiser Health News","nprImageAgency":"Nick Oxford for Kaiser Health News","nprStoryId":"540100976","nprApiLink":"http://api.npr.org/query?id=540100976&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/2017/08/01/540100976/drug-puts-a-750-000-price-tag-on-life?ft=nprml&f=540100976","nprRetrievedStory":"1","nprPubDate":"Wed, 02 Aug 2017 14:15:00 -0400","nprStoryDate":"Tue, 01 Aug 2017 13:05:00 -0400","nprLastModifiedDate":"Wed, 02 Aug 2017 14:42:31 -0400","path":"/futureofyou/434619/drug-puts-a-750000-price-tag-on-life","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Jana Gundy and Amanda Chaffin, who live within two hours of each other in Oklahoma, each have a child with the same devastating disease.\u003c/p>\n\u003cp>The genetic condition, spinal muscular atrophy, robs its sufferers of muscle strength, affecting their ability to sit, stand or even breathe.\u003c/p>\n\u003cp>So both moms were ecstatic when the Food and Drug Administration approved the first treatment for the condition two days before Christmas in 2016. It seemed the gift they had been waiting for — a chance to slow the heartbreaking decline of their young sons.\u003c/p>\n\u003cp>But that common hope has taken them down different paths: In April, Gundy's child, who is on private insurance, began getting the drug \u003ca href=\"https://www.spinraza.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Spinraza\u003c/a>, which costs $750,000 for the initial year of treatment. Chaffin's child, a Medicaid enrollee, did not, as his state regulators debated whether to offer it to children like him who use ventilators to breathe.\u003c/p>\n\u003cp>Across the country, similar stories are playing out as private insurers and already-squeezed state Medicaid programs wrestle with what, if any, limits to place on patients' access to break-the-bank drugs — weighing the needs of the ill against budget realities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At the same time, policymakers and physicians increasingly demand to understand why drug manufacturers affix price tags that have risen to once unimaginable highs.\u003c/p>\n\u003cp>\"It looks like a drug that works for a tragic condition that afflicts children and cripples and kills them. That's the good news,\" \u003ca href=\"http://www.drugepi.org/faculty-staff-trainees/faculty/jerry-avorn/\">Dr. Jerry Avorn\u003c/a>, a professor of medicine at Harvard Medical School, says of Spinraza. But \"how in the world did the price of $750,000 a year get chosen?\"\u003c/p>\n\u003cp>Biogen, the maker of Spinraza, defends its price.\u003c/p>\n\u003cp>\"We compared industry norms for other drugs in rare disease. We looked at the efficacy and safety profile of the drug itself,\" says Dr. Wildon Farwell, an epidemiologist and senior medical director of clinical development at \u003ca href=\"https://www.biogen.com/en_us/search.html\">Biogen\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">The logic of comparing a new drug to extremely high-priced drugs already on the market only fuels an inflationary cycle.\u003c/aside>\n\u003cp>But that logic — comparing a new drug to extremely high-priced drugs already on the market — has only fueled an inflationary cycle, Avorn says, adding: \"In my view, that's akin to a kid who gets caught bullying another kid and beating him up after school, and says, 'Well, all the other kids were beating him up so it's OK.' If it's wrong, it's wrong.\"\u003c/p>\n\u003cp>The stress is unbearable for families trying to obtain treatment for sick children, who are caught in the arcane world of coverage decisions and businesses' price calculations.\u003c/p>\n\u003cp>\"The longer we wait, the more ... [his ability to move] will be gone and there's a chance of not getting it back,\" says Chaffin of Kayden, her 4-year-old son, who was diagnosed with SMA as an infant.\u003c/p>\n\u003cp>In late May, Oklahoma's Medicaid program approved rules barring coverage of Spinraza for patients dependent on ventilators.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>At that same time, Gundy watched hopefully as her 12-year-old son, Kyle, who also uses a ventilator, received the first three of the six doses he will get this year, following approval by his private health insurer. Says Gundy, \"We've seen some minor muscle movement return.\"\u003c/p>\n\u003cp>Spinraza isn't a cure for SMA, which affects 10,000 people in the U.S., but clinical tests show it holds promise for some. Scientific discoveries by researchers at the University of Massachusetts Medical School in the early 2000 — partly funded by grants from the National Institutes of Health and donations from patient-advocacy groups — helped pave the way for Spinraza.\u003c/p>\n\u003cp>The drug was granted \"orphan\" status, which provides tax credits for research and helped speed the review process. It won approval in five years after the start of clinical trials, based on results of a few small studies.\u003c/p>\n\u003cp>The FDA cited interim results from one of those studies in giving its OK; 40 percent of the patients given the drug in that study showed improvement, compared with none in the control group. Final results came later, showing 51 percent of treated children demonstrated improvement.\u003c/p>\n\u003cp>Spinraza was tested only on children, most under age 2, though it was \u003ca href=\"https://www.fda.gov/Drugs/InformationOnDrugs/ucm536955.htm\">approved\u003c/a> for pediatric and adult use.\u003c/p>\n\u003cp>All that means Biogen's research and development costs likely were not unusually high, although the company would not release figures. Five days after getting the FDA's approval to sell the drug in the U.S., Biogen announced the price: $125,000 a dose, or $750,000 for the first year. Fewer doses in following years drop the total annual cost to $375,000. The drug must be taken for life.\u003c/p>\n\u003cp>The FDA does not know or consider pricing when it grants approval.\u003c/p>\n\u003cp>If just half of U.S. patients get treatment for one year, the tab would be more than $3.7 billion. Spinraza brought in $203 million in the second quarter of this year, more than four times its revenue in the first quarter.\u003c/p>\n\u003cp>When Biogen unveiled the price tag, one Wall Street analyst at the investment bank Leerink predicted \"a storm of criticism\" and that insurers would parse \"which patients receive access.\"\u003c/p>\n\u003cp>Families that include a child with SMA are a close community, and Chaffin keeps in touch with other SMA families via Facebook, where the have-nots can watch what happens with the kids who received the drug.\u003c/p>\n\u003cp>\"There are similar kids his age that live in different states and are [on a ventilator] and they are seeing movement come back and strength coming back,\" says Chaffin. Because SMA often affects the muscles around the mouth, \"Kayden lost his smile in 2014, but he has a little smirk left. These parents are seeing their smiles coming back.\"\u003c/p>\n\u003cp>Good news came to Chaffin in late July. After receiving the required two denials from her state's Medicaid program, Kayden was accepted into Biogen's patient assistance program. The program helps patients' families navigate their insurance, covers the cost of the drug if they are denied and, in some cases, helps with other costs, too. But it isn't available to everyone. Some government programs — Medicare and Medicaid, for example — restrict efforts to eliminate copayments for drugs.\u003c/p>\n\u003cp>Kayden will get his first injection in mid-August — eight months after the drug was approved.\u003c/p>\n\u003cp>Now this low-income family faces one more hurdle: finding the estimated $2,000 per injection to cover doctor and hospital costs for the six shots Kayden will need in the coming year.\u003c/p>\n\u003cp>In addition to the financial questions, there are other unanswered concerns among families and medical professionals. Will Spinraza work in older children or adults? No children involved in the study were on ventilators at the start of the trial. Is it safe for children on ventilators? Also, because SMA's rate of decline varies, how can doctors, families or insurers measure if the drug is stalling the disease's progression? And, finally, how long will its effect last?\u003c/p>\n\u003cp>For some fast-track drugs like Spinraza, FDA approvals don't offer this kind of guidance.\u003c/p>\n\u003cp>\u003ca href=\"http://www.seattlechildrens.org/medical-staff/susan-d-apkon/\">Dr. Susan Apkon\u003c/a>, who treats dozens of children with SMA as a physiatrist at Seattle Children's Hospital — and who urged Washington state's Medicaid pharmacy board to cover the drug — says there is no easy answer.\u003c/p>\n\u003cp>\"If a drug works, we want to give it to the child or adult, whatever the drug is,\" says Apkon, who does not receive money directly from Biogen but is a co-investigator in one of the company's ongoing studies.\u003c/p>\n\u003cp>Still, \"there is one pot of money, and we need to figure out how it gets distributed,\" she says. \"The system is broken.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">With any costly new drug, it all comes down to “tough choices.”\u003ccite>Jack Hoadley, health policy analyst at Georgetown University’s Health Policy Institute.\u003c/cite>\u003c/aside>\n\u003cp>With any costly new drug, it all comes down to \"tough choices,\" says \u003ca href=\"http://explore.georgetown.edu/people/jfh7/\">Jack Hoadley\u003c/a>, a health policy analyst at Georgetown University's Health Policy Institute.\u003c/p>\n\u003cp>\"Treating one of these patients may mean not treating 1,000 patients with some other, less expensive problem — or saying they have to raise more tax dollars,\" he says. \"Private insurers have the same trade-off. Do we pay for this if it will ultimately raise our premiums?\"\u003c/p>\n\u003cp>Coverage eligibility varies by insurer and, in Medicaid, by state.\u003c/p>\n\u003cp>Most insurers and Medicaid programs require that patients show some kind of proof of progress — or at least maintenance of function — in order to continue therapy beyond initial doses.\u003c/p>\n\u003cp>While agreeing that the drug offers some hope to patients, Donna Sullivan, chief pharmacy officer for \u003ca href=\"https://www.hca.wa.gov/\">Washington State Health Care Authority\u003c/a>, which oversees Medicaid, says the price tag rankles her.\u003c/p>\n\u003cp>During a recent meeting with Biogen officials, Sullivan was blunt: \"I told them the price was unethical.\"\u003c/p>\n\u003cp>In her state, there are about 150 children with SMA. After reviewing the data on Spinraza, Washington Medicaid approved broad coverage rules, including allowing patients on ventilators to get the drug.\u003c/p>\n\u003cp>But large new spending puts additional pressure on state budgets. When combined with economic downturns, that can lead lawmakers to trim medical provider payments or optional Medicaid services, which include adult dental care, podiatry, chiropractic treatment and other services.\u003c/p>\n\u003cp>Crystal Ramos, of Pasco, Wash., whose 3-year-old twins have SMA, is thankful that Medicaid covers the drug. After four doses, she says she is already seeing some improvement in her boys.\u003c/p>\n\u003cp>The boys are on her insurance through her job as a teacher, but Medicaid picks up what her private insurance does not, which totals about $2,500 per injection.\u003c/p>\n\u003cp>She calls Spinraza's price \"beyond crazy.\"\u003c/p>\n\u003cp>\"They're putting a price tag on life, which sucks,\" she says. \"In the end, we have to pay it if we want our kids to live, and they know it.\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem> is a nonprofit health newsroom, an editorially independent part of the Kaiser Family Foundation. You can follow KHN senior correspondent Julie Appleby on Twitter \u003c/em>\u003ca href=\"http://twitter.com/Julie_Appleby\">\u003cem>\u003cstrong>@Julie_Appleby\u003c/strong>\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Drug+Puts+A+%24750%2C000+%27Price+Tag+On+Life%27&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/434619/drug-puts-a-750000-price-tag-on-life","authors":["byline_futureofyou_434619"],"categories":["futureofyou_1062","futureofyou_1"],"tags":["futureofyou_948","futureofyou_1275","futureofyou_1332"],"featImg":"futureofyou_434620","label":"futureofyou"},"futureofyou_175840":{"type":"posts","id":"futureofyou_175840","meta":{"index":"posts_1591205157","site":"futureofyou","id":"175840","score":null,"sort":[1465233066000]},"guestAuthors":[],"slug":"consumers-finding-lowest-prescription-drug-prices-via-apps","title":"Consumers Finding Lowest Prescription Drug Prices via Apps","publishDate":1465233066,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Most people don't shop for lower prescription drug prices. They should, especially now that there are easier ways to do so.\u003c/p>\n\u003cp>More than a dozen websites and apps are vying to help U.S. consumers find the lowest prices for prescription drugs by comparing prices and searching for deals, similar to the way Expedia looks for cheap airfare or Bankrate.com looks for low mortgage rates.\u003c/p>\n\u003caside class=\"pullquote alignright\">Recent studies show that more than one in five prescriptions in the U.S. go unfilled, in part due to financial hardship, yet only 17 percent of consumers are willing to check multiple pharmacies for lower drug prices.\u003c/aside>\n\u003cp>\"Patients want to see a pharmacy that says 'every-day low prices,' but most pharmacies can't achieve that because the way prices are configured is pure mayhem\" said Professor Darius Lakdawalla, a health economist at the University of Southern California. \"That's why consumers need to know: 'Where can I get my beta blocker for the best price?'\"\u003c/p>\n\u003cp>Recent studies show that more than one in five prescriptions in the U.S. go unfilled, in part due to financial hardship. Yet only 17 percent of U.S. consumers are willing to check multiple pharmacies for lower drug prices, according to a survey by Consumer Reports.\u003c/p>\n\u003cp>Q: What do these services do?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Websites and apps like GoodRx and WeRx are doing two basic things: searching local pharmacy prices and then applying various discounts and coupons available to customers. The search results will show, for example, that a 30-day supply of a common cholesterol drug is $11 at Wal-Mart and $13 at a Kroger pharmacy. In both cases the price is linked to a coupon which the app downloads so the customer can give it to the pharmacist.\u003c/p>\n\u003cp>The services are exploiting the complex, nearly-constant negotiations between pharmacies, drugmakers and pharmacy benefit managers that result in wide price disparities for commonly-used medications to find the best deals available that day.\u003c/p>\n\u003cp>\"We're trying to give you a baseline of information so that you can make the right decision,\" says Doug Hirsch, founder and CEO of GoodRx, the largest and oldest of the services.\u003c/p>\n\u003cp>GoodRx, founded in 2011, offers 25 million users access to discounts from pharmacies, drugmakers and pharmacy benefit managers. Newer services include BlinkHealth, which says it negotiates lower drug prices by pooling its users with customers of pharmacy benefit managers. Each of the companies claims to have the lowest prices available, so consumers may want to shop around.\u003c/p>\n\u003cp>Q: Who stands to benefit most from these services?\u003c/p>\n\u003cp>Patients who are taking several generic drugs and have no insurance or high co-pays. Most of the largest savings to be had are for generic drugs, where competition between multiple manufacturers and pharmacies leads to a wide range of prices.\u003c/p>\n\u003cp>Discounts on newer, branded drugs are harder to find, since they are typically produced by one company that doesn't have to cut prices to compete. Still, services like GoodRx can link to drugmaker coupons that bring down the price of even high-end drugs like Humira, an injectable treatment for psoriasis. These coupons irk insurers because they entice patients to opt for the branded drug by making the out-of-pocket cost to the patient comparable to that of a generic — but they don't reduce the higher cost the insurer has to pay for the medication. Still, it helps patients reduce the amount of money leaving their wallets.\u003c/p>\n\u003cp>Some of the priciest drugs won't appear on pharmacy apps at all. Specialty cancer drugs like Avastin, for example, must be administered at a doctor's office and aren't available at the pharmacy.\u003c/p>\n\u003cp>Q: How do these discounts work with my health insurance?\u003c/p>\n\u003cp>They don't. The prices quoted by apps need to be paid by the consumer and can't be used to lower your co-pay. However, the services' cash prices are often less than patients' co-pays, especially for those in high-deductible health plans. For example, it may be cheaper to fill a $4 prescription for a generic drug at Wal-Mart or Target than to use your insurance and pay a $12 co-pay. In these cases, pharmacy apps simply direct customer traffic to long-standing offers at big-box stores. In other cases, the services provide a streamlined way of obtaining coupons and discounts that consumers would otherwise have to juggle on their own.\u003c/p>\n\u003cp>Q: So where do these discounts come from?\u003c/p>\n\u003cp>In some ways, pharmacy apps are just updating a decades-old business. Many of the offers found on GoodRx and similar services come from discount programs offered by prescription benefit managers like MedImpact and OptumRx. Those companies are best known for negotiating lower drug prices on behalf of large employers and insurers, but they also have separate businesses offering discount pharmacy cards to consumers who pay cash. The cards have been distributed through the mail, newspapers and magazines for more than 20 years. Pharmacies like the programs because they ensure a steady stream of cash-paying customers. And the card programs pocket a small percent of each transaction, a sort-of finder's fee. This is also one of the ways that the new services make money.\u003c/p>\n\u003cp>GoodRx pulls together discounts offered by six pharmacy benefit companies. Consumers who don't want to use the website or the app can send away for a GoodRx pharmacy discount card.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The vast majority of Americans just don't know there are all these tools available and there's so much room to save if only they know how to take advantage of them,\" says GoodRx's Hirsch.\u003c/p>\n\n","blocks":[],"excerpt":"Websites and apps search local pharmacy prices and then apply various discounts and coupons available to customers. ","status":"publish","parent":0,"modified":1475121141,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":946},"headData":{"title":"Consumers Finding Lowest Prescription Drug Prices via Apps | KQED","description":"Websites and apps search local pharmacy prices and then apply various discounts and coupons available to customers. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Consumers Finding Lowest Prescription Drug Prices via Apps","datePublished":"2016-06-06T17:11:06.000Z","dateModified":"2016-09-29T03:52:21.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"175840 http://ww2.kqed.org/futureofyou/?p=175840","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/06/06/consumers-finding-lowest-prescription-drug-prices-via-apps/","disqusTitle":"Consumers Finding Lowest Prescription Drug Prices via Apps","nprByline":"Matthew Perrone\u003cbr />Associated Press","path":"/futureofyou/175840/consumers-finding-lowest-prescription-drug-prices-via-apps","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most people don't shop for lower prescription drug prices. They should, especially now that there are easier ways to do so.\u003c/p>\n\u003cp>More than a dozen websites and apps are vying to help U.S. consumers find the lowest prices for prescription drugs by comparing prices and searching for deals, similar to the way Expedia looks for cheap airfare or Bankrate.com looks for low mortgage rates.\u003c/p>\n\u003caside class=\"pullquote alignright\">Recent studies show that more than one in five prescriptions in the U.S. go unfilled, in part due to financial hardship, yet only 17 percent of consumers are willing to check multiple pharmacies for lower drug prices.\u003c/aside>\n\u003cp>\"Patients want to see a pharmacy that says 'every-day low prices,' but most pharmacies can't achieve that because the way prices are configured is pure mayhem\" said Professor Darius Lakdawalla, a health economist at the University of Southern California. \"That's why consumers need to know: 'Where can I get my beta blocker for the best price?'\"\u003c/p>\n\u003cp>Recent studies show that more than one in five prescriptions in the U.S. go unfilled, in part due to financial hardship. Yet only 17 percent of U.S. consumers are willing to check multiple pharmacies for lower drug prices, according to a survey by Consumer Reports.\u003c/p>\n\u003cp>Q: What do these services do?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Websites and apps like GoodRx and WeRx are doing two basic things: searching local pharmacy prices and then applying various discounts and coupons available to customers. The search results will show, for example, that a 30-day supply of a common cholesterol drug is $11 at Wal-Mart and $13 at a Kroger pharmacy. In both cases the price is linked to a coupon which the app downloads so the customer can give it to the pharmacist.\u003c/p>\n\u003cp>The services are exploiting the complex, nearly-constant negotiations between pharmacies, drugmakers and pharmacy benefit managers that result in wide price disparities for commonly-used medications to find the best deals available that day.\u003c/p>\n\u003cp>\"We're trying to give you a baseline of information so that you can make the right decision,\" says Doug Hirsch, founder and CEO of GoodRx, the largest and oldest of the services.\u003c/p>\n\u003cp>GoodRx, founded in 2011, offers 25 million users access to discounts from pharmacies, drugmakers and pharmacy benefit managers. Newer services include BlinkHealth, which says it negotiates lower drug prices by pooling its users with customers of pharmacy benefit managers. Each of the companies claims to have the lowest prices available, so consumers may want to shop around.\u003c/p>\n\u003cp>Q: Who stands to benefit most from these services?\u003c/p>\n\u003cp>Patients who are taking several generic drugs and have no insurance or high co-pays. Most of the largest savings to be had are for generic drugs, where competition between multiple manufacturers and pharmacies leads to a wide range of prices.\u003c/p>\n\u003cp>Discounts on newer, branded drugs are harder to find, since they are typically produced by one company that doesn't have to cut prices to compete. Still, services like GoodRx can link to drugmaker coupons that bring down the price of even high-end drugs like Humira, an injectable treatment for psoriasis. These coupons irk insurers because they entice patients to opt for the branded drug by making the out-of-pocket cost to the patient comparable to that of a generic — but they don't reduce the higher cost the insurer has to pay for the medication. Still, it helps patients reduce the amount of money leaving their wallets.\u003c/p>\n\u003cp>Some of the priciest drugs won't appear on pharmacy apps at all. Specialty cancer drugs like Avastin, for example, must be administered at a doctor's office and aren't available at the pharmacy.\u003c/p>\n\u003cp>Q: How do these discounts work with my health insurance?\u003c/p>\n\u003cp>They don't. The prices quoted by apps need to be paid by the consumer and can't be used to lower your co-pay. However, the services' cash prices are often less than patients' co-pays, especially for those in high-deductible health plans. For example, it may be cheaper to fill a $4 prescription for a generic drug at Wal-Mart or Target than to use your insurance and pay a $12 co-pay. In these cases, pharmacy apps simply direct customer traffic to long-standing offers at big-box stores. In other cases, the services provide a streamlined way of obtaining coupons and discounts that consumers would otherwise have to juggle on their own.\u003c/p>\n\u003cp>Q: So where do these discounts come from?\u003c/p>\n\u003cp>In some ways, pharmacy apps are just updating a decades-old business. Many of the offers found on GoodRx and similar services come from discount programs offered by prescription benefit managers like MedImpact and OptumRx. Those companies are best known for negotiating lower drug prices on behalf of large employers and insurers, but they also have separate businesses offering discount pharmacy cards to consumers who pay cash. The cards have been distributed through the mail, newspapers and magazines for more than 20 years. Pharmacies like the programs because they ensure a steady stream of cash-paying customers. And the card programs pocket a small percent of each transaction, a sort-of finder's fee. This is also one of the ways that the new services make money.\u003c/p>\n\u003cp>GoodRx pulls together discounts offered by six pharmacy benefit companies. Consumers who don't want to use the website or the app can send away for a GoodRx pharmacy discount card.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The vast majority of Americans just don't know there are all these tools available and there's so much room to save if only they know how to take advantage of them,\" says GoodRx's Hirsch.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/175840/consumers-finding-lowest-prescription-drug-prices-via-apps","authors":["byline_futureofyou_175840"],"categories":["futureofyou_1060"],"tags":["futureofyou_948","futureofyou_947"],"featImg":"futureofyou_100908","label":"futureofyou"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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