The news that Medicare will begin negotiating pricing with drug companies is good news for those on Medicare, and for the financial stability of the program overall.
Unfortunately, for those not covered by Medicare it will likely lead to additional exorbitant price increases for drugs. In health care, this is known as “cost shifting.” In simple terms, it is the process in which one group pays more for their care because another group is paying less.
I have written several times on these pages about the runaway cost of prescription drugs, and it continues to amaze me how collectively helpless we are to do anything about it.
In 2015, shortly before I mentioned the drugs Humira and Enbrel in a Press Herald column, they were priced (according to the pricing site goodrx.com) at $2,800 a month. These are competing drugs (used to treat a variety of inflammatory diseases), made by different drug companies, and yet their pricing was within a few dollars. Since then, these drugs have figuratively walked hand in hand, in raising their prices: $3,500, $4,200, $5,500, to where they are today: Humira at $6,653 and Enbrel at $6,775, a price difference of $122 between them.
The simple question on those increases is: Why? Is it cost of ingredients? Manufacturing? Labor? No, I am sure the reason is “because they can,” and the drug companies will continue to do so until they are stopped.
A few years ago, the government tried to force drug companies to show pricing in their ads. The manufacturers took it to court, claiming it was a violation of their First Amendment right to free speech (or, more specifically, their right to not speak). And they won; there is seldom pricing in their ads.
I can tell you, though, as a general rule of thumb, if you see people singing and dancing in an advertisement, then it is an expensive drug. Skyrizi – a treatment for plaque psoriasis, psoriatic arthritis and Crohn’s disease – at a cost of $19,700 per dose, is a prime example of that. At six doses in year one, that’s $118,200. Fortunately, “only” four doses per year are needed thereafter. Since the drug companies won’t put their pricing out there I wish this fact could somehow go viral, which is something I’m too old to initiate.
One of the main problems is that those who could be most influential in bringing about change aren’t doing anything to achieve that change, and I suspect they are conflicted.
Politicians vaguely say, “We need to lower the cost of prescription drugs,” but I have never heard one of them use or say names like Humira, Enbrel, Skyrizi or any other expensive drug. Not once. Drug manufacturers give “generously” to politicians in both parties, and I’m sure that is one reason that the subject of prescription drugs is one of the few topics in which there is no political divide.
Similarly, I have yet to hear the national news media speak out on the topic. Watch the nightly news shows, any of them. Their major advertisements are for drugs (see names above). Similar to politicians, I have never heard a network news anchor speak any of their names. Not once. Sadly, in both instances, it seems to be a case of “don’t bite the hand that feeds you.”
While watching the Skyrizi ads on television, I can’t help but notice the beautiful blue sky highlighting all the fun going on below. Given the name, it’s understandable. But when I watch the ads, it brings to mind the expression: “The sky’s the limit,” which means there is no limit. Based on the way things are going, I can’t disagree.
Send questions/comments to the editors.
