Those with prescription drug coverage feel the effects less, but they also face drug co-payments that have increased significantly, particularly for newer drugs for which generic alternatives don’t exist.
Drug development is increasingly expensive. Despite technological advances, the number of new drugs per billion dollars spent on research and development has been cut in half every decade since 1950. But in some cases, consumers and even physicians have protested what they see as pharmaceutical companies crossing the line from profiting into profiteering.
Doctors Protest Prices for Drugs That Treat Chronic Myeloid Leukemia
Doctors specializing in a type of cancer called chronic myeloid leukemia (CML) published a commentary in Blood, the Journal of the American Society of Hematology stating that the prices of drugs used to treat CML are so high as to border on immoral. An extremely effective drug made by Novartis called Gleevec entered the market in 2001 and cost about $30,000 per year in the US then. Since that time, the price has tripled, despite competition from newer drugs, which cost even more than Gleevec.
Despite drug company programs for those who can’t afford the drugs, the commentary notes that in developing nations, cancer specialists actually proposed bone marrow transplants — a risky, grueling one-time treatment — because it costs less than continuous treatment with drugs like Gleevec. The American patent on Gleevec expires in 2015, which should provide some price relief. Novartis, however, is encouraging physicians to switch patients to Tasigna, a newer drug still under patent.
Neglected Diseases in Developing Nations
Last March, Bill Gates spoke to the Royal Academy of Engineers in London concerning diseases in developing nations, saying, “Our priorities are tilted by marketplace imperatives. The malaria vaccine, in humanist terms, is the biggest need, but it gets virtually no funding. If you are working on male baldness or the other things you get an order of magnitude more researching funding because of the voice in the marketplace.”
In other words, pharmaceutical research focuses on lucrative rather than most-needed products. This is disastrous for the global poor, because their diseases aren’t profitable enough to attract R&D interest. These “Neglected Diseases,” like Chagas disease, malaria, Dengue fever, river blindness, and tuberculosis, don’t prompt research despite massive suffering in developing nations. Where drugs exist, they are often too expensive to be practical, or require sustained treatment over long periods to be effective.
New Models for Drug Development
Basic pharmaceutical R&D has traditionally taken place within silos, where there is little communication across labs, let alone across companies. This lack of information sharing means labs may be hamstrung by problems other researchers have already solved. Private and governmental agencies around the world are proposing new R&D paradigms that could avoid some of these problems. One suggestion is the use of cash prizes — rather than patents — for cures for neglected diseases. Once the cure is proven and the prize awarded, the cure would exist as open-access intellectual property, allowing manufacturers worldwide to compete to manufacture the drug cost effectively.
Some members of the World Health Organization have proposed an open platform for researchers in different locations in the world to pool data and coordinate work. Funding grants would require that the research exist on a public “observatory” that’s cloud-hosted and openly accessible. Private researchers have already tried similar approaches. For example, an open source malaria project in Australia attracted the attention of a post-doctoral student in Scotland, who tracked the project’s open lab books online. The post-doc student was able to synthesize a compound that the researchers in Australia were having difficulty with. The two laboratories interacted mostly through Twitter.
Will Public (and Physician) Outcry Help?
In at least one case, physician outcry over the cost of cancer drugs has made a difference. In the fall of 2012, physicians at New York’s Memorial Sloan-Kettering Cancer Center refused to use a new drug for colon cancer called Zaltrap. Zaltrap had not been shown to be more effective than an existing drug for colon cancer, yet it cost twice as much. The Sloan-Kettering physicians went public in a New York Times op-ed article, and the manufacturer of Zaltrap, Sanofi, later dropped the price by half.
Zaltrap, however, was an unusual case, because an alternative, equally-effective drug already existed, and the cost of Zaltrap was particularly steep at over $11,000 per month. While physicians may feel more empowered by the actions of the doctors at Sloan-Kettering and those who wrote the commentary on CML drugs, physician outcry is not likely to be a big factor in reducing drug prices for the typical American. However, these actions could plant the seeds for dialogue among physicians, patients, and pharmaceutical companies about just how profitable drugs need to be to sustain continuing research and development.
On a side note, while we at eDrugstore.com can’t reduce the prices that drug manufacturers are charging for medications, we can offer a simple, secure (and sometimes more affordable) way to order those drugs.
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