Gadfly | May 29th, 2019
Why Does A Once-Free Drug Now Cost $375,000 A Year? Easy In The U.S.!
It was only a matter of time. It had to happen. The American healthcare “system” that costs Americans twice as much as in any other developed country is now having another war over money—and it’s ironically appropriate it’s over human excrement. The money war is between drug companies and doctors and patients over a procedure called fecal microbiota transplants. It’s a revolutionary treatment that has sometimes been a home remedy. About 500,000 Americans get bacterial infections called Clostridioides difficule each year that kills about 30,000. Because of the money battle the Fecal Transplant Foundation has been created to protect patient interests. Catherine Duff (that’s her real name in case you think she adopted it from a body part!) defends possible patients for a transplant this way: “People have good reason to worry because for many patients, fecal transplants are a matter of life and death. The concern is that corporate greed will get in the way of patient access.”
The process involves transferring fecal matter from healthy people to the bowels of victims having the dangerous infection. The transplant restores the “good” community of gut microbes that may have been killed off by antibiotics or other factors. The fecal transplant has been around for about a decade. It has an 80% success rate and sometimes patients feel better within hours of receiving a transplant. Actually Ms. Duff was cured of the infection by a transplant conducted at home with an enema, saline, and her husband’s excrement. He blended his own stool and the mixture in their kitchen blender!
Drug companies and investors are salivating over all the money to be made if they can get the FDA to come up with some fancy regulations that will only approve fecal transplants controlled by Big Pharma. Scientists believe that other ailments and physical disorders may be treated with transplants of healthy materials and substances transplanted to patients. Obesity, autism, ulcerative colitis, Alzheimer’s, and possibly Parkinson’s come to mind. It will be interesting to see if drug companies can turn healthy excrement and other substances into big drug profits.
Medical Debt Is Still The Number One Cause Of Family Bankruptcies
As of this year Americans owe $750 billion to medical providers and to secondary bill collection agencies. Hundreds of millions of dollars worth of debt can be purchased for pennies on the dollar. As an example, two New York women paid $12,500 for $1.5 billion in overdue medical debt owed by 1,284 New York residents. Almost all of this debt is owed by people who earn less than double the federal poverty level. The poverty level for a family of four is slightly over $24,000. Americans will be harassed constantly by collectors of unpaid debt for partial payment.
Over 65% of personal bankruptcies are caused by medical bills families can’t pay. The total is increasing. Between 2013 and 2016 medical bills accounted for 58% of personal bankruptcies. About 530,000 American families have their finances wiped out each year because of high medical costs.
A study by the Consumer Bankruptcy Project (CBP) has concluded: “For middle-class Americans health insurance offers little protection. Most people have policies with so many loopholes, copayments, and deductibles that illness can put a family in the poorhouse. And even the best job-based health insurance often vanishes when a prolonged illness causes job loss-just when families need it most.” And currently about 34 million Americans have no health insurance at all. In 2018 Americans borrowed $88 billion to pay medical debt and one in four skipped care because of excessive cost. This means that each American owes $272 just in finance costs. The director of the CBP says: “Bankruptcy may provide a fresh start, but it comes at a high financial and emotional cost for those who file. Filing for bankruptcy can stop the financial bleeding that the healthcare system imposes, but curing that system’s ills is the only lasting solution.”
How Do The Drug Companies Make All This Money? Because Politicians Let Them
Five of the top eight most profitable large companies in America are drug companies. The three others are Facebook, McDonalds, and Apple. The five largest made nearly $60 billion in profits in 2018—and their CEOs collectively made over $113 million in compensation. The leader of the most profitable is Gilead Sciences at 49.7%. The four others: Abbvie--29.9%, Pfizer—26.9%, Eli Lilly—22%, and Bristol-Meyers Squibb—20.9%. The net profit margin of the manufacturer of generic drugs is 18.2%, of brand-name drugs 28.1%. Currently 44 states are suing the major drug companies for conspiring to establish higher prices for more than 100 generic drugs. It should be an interesting case. Here is one way Big Pharma makes a lot of money on older drugs.
The drug Firdapse has been around for years and is used to treat a rare neuromuscular disorder that affects about one in 100,000 people. It used to be provided free by a New Jersey drug company under the FDA’s “compassionate use” program for experimental drugs. But that is no more. Catalyst Pharmaceuticals received approval of the drug for general use from the FDA and will be able to market the drug for several years. A price was announced last December—only $375,000 a year! Senator Bernie Sanders challenged the price: “Catalyst’s decision to set the annual list price at $375,000 is not only a blatant fleecing of American taxpayers, but is also immoral exploitation of patients who need this medication.” GoodRX, a tracker and adviser on drug prices, has found that 20 outpatient drugs have a list price of over $25,000 for a one-month supply.
It’s not the only example of fleecing American sheep. For decades drug prices have continued to rise faster than the rate of inflation. Brand-name drug prices have tripled in the last decade, leaping from an annual cost of $1868 in 2006 to $6798 in 2017 according to AARP. The elderly average about 4.5 medications each so their costs per year could reach over $30,000. The U.S. is the only developed country that does not negotiate drug prices by government action. All countries that have a national universal health program have drug review boards that negotiate drug prices with manufacturers.
Humira, advertised nightly during supper, is the top-selling drug in the world. It sold for $3,431 per month in the U.S. in 2015 but for $982 in France. Humira treats autoimmune diseases such as psoriasis, Crohn’s disease, and severe arthritis. Advair, an asthma medication, cost $310 a month in the U.S. but only $38 in Germany. Prescription drugs in Canada cost an average 33% less than in the U.S. The drug mafia is playing all Americans for suckers—and Congress lets them get away with it! Former drug company CEO Martin Shkreli is in federal prison for committing fraud—but it’s for hedge fund tricks, not the sale of drugs. However, he has gained national infamy for raising the price of Daraprim, a 60-year-old drug that is used to fight parasitic infections, to $750 a pill that had been $10 a pill --before he bought the company that had the original patent. And he is not the worst of the drug thugs and thieves.
The Big Question For Pharma: Does It Really Cost $2.6 Billion To Develop A Drug?
Drug companies claim their pricing structure covers the high cost of developing drugs and need an average14-year monopoly to make a profit. Why should Pfizer make a net profit of about 27% when amazing Amazon makes 3.2%? AARP says: “The reality is that virtually all new drug have roots in government-funded research at the National Institutes of Health. Every one of the 210 new drugs approved by the FDA between 2010 and 2016 began life in NIH-funded labs.” Yes, the private companies ran the clinical trials that were used to approve the use of the drug, but the initial research was done with taxpayer funds. Because generic drugs developed to follow a brand-name drug often sell for 90% less than the brand-name drugs, patent owners will do almost anything to keep generics off the market. Brand-name drug companies kept 142 generics off the market for a period of time between 2005 and 2013, costing the government (Medicare and Medicaid), insurance companies, and patients many billions of dollars.
The Ultimate Quest For Gold By Big Pharma
Because of our unhealthy diets we have 100 million people with diabetes or prediabetes. Over 30 million are on insulin, the 100-year-old drug that controls the disease. Those with prediabetes will mostly likely need the drug soon. Over 400 million people in the world are on the drug. The difference in the price of insulin around the world emphasizes the greed of Big Pharma. In Mexico a three-month supply will cost you $600. In this country it will cost you $3,700. A box of insulin pens in the U.S. will run about $700. The same box in other countries: Germany $73, Israel $57, Greece $51, Rome $61, Taiwan $40.
Many border people buy their insulin in Canada. Recently six diabetes patients from Minnesota drove to an Ontario pharmacy just three blocks from the border and bought $12,400 worth of insulin (U.S.) for $1,265. Another Minnesotan bought $5,250 of insulin (U.S.) for $410 in Canada. It will last him for about four months.
Over one million Californians cross the Mexican border annually for health care and to buy drugs. As an example, Humira is a rather expensive arthritis drug, costing about $4,500 a month. In Mexico it will cost you about $1,650.
The sad tale of the obscene insulin prices in the U.S. is perhaps only exceeded by the greed of the Sackler family in the production and sale of opiate drugs, particularly Oxycontin. Eight members of the family have made a total of $13.4 billion off the drug market—and their product has been estimated to have killed about 200,000 through overdoses. Overdoses now kill more than 72,000 in the U.S. each year, and 49,000 are caused by opiates. We are in the middle of a tremendous opioid epidemic is primarily caused by the Sacklers. One of the biggest lawsuits in U.S. history has been filed against the Sacklers by a group of 500 cities, counties, and eight Native American tribes from every corner of the country-and 26 states.
The group accuses the family of hiding the dangers of Oxycontin for tremendous profit, a drug more potent than heroin or morphine. They are accused of deceiving doctors and patients about the addictive qualities of the opiate. Perhaps this lawsuit, which will most likely take years to settle, will finally give the drug industry a cleansing, flushing enema.
P.S. Big Pharma: Why are you charging $1,780 for a month’s supply of Truvada (a treatment for HIV), when an Australian patient pays $8? The entire drug and insurance industries need a big enema!
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