It’s All About the Money

Preventing Premature Births, How Much Should It Cost?

It cost $30 a month when local pharmacies made it as a gel – and it worked, for the last 8 years. It’s a treatment that helps women carry high-risk pregnancies to term. Now that K-V Pharmaceuticals has gotten it approved as an injectable drug by the FDA and patented it, they want to charge $1,500 per dose, or $6,000 per month. They say that’s ok because a typical 20 week course of Makena, the drug in question, would cost $30,000, while a premature baby would cost on average about $51,000 in the first year, and since after outcries they dropped their price to about $15,000 per 20-week course, that’s a big savings, assuming it works. They also claim government rebates and financial assistance to the needy will help those who can’t afford it get treatment (for something that was already available at a very reasonable price).

They’ve warned pharmacies they would face FDA enforcement if they continued to compound the drug – after pressure from professional medical societies and Senator Sherrod Brown of Ohio, the FDA stated it would not attempt to prosecute pharmacies unless there were safety concerns.

Naturally, the company invested money in the product in order to gain FDA approval – nearly a quarter of a billion dollars, according to an email statement to NPR. But according to Senator Brown, they could make billions of dollars in a single year off of their drug if they would price it similarly to the original generic drug, more than enough to pay for their investment and profit from the drug. And George Saade, president of the Society for Maternal Fetal Medicine, says that there is no measurable medical difference in the medications, only possible logistical benefits in having a product made by a company available everywhere, instead of compounded locally.

In Cutting Budgets, Who Feels the Cuts First?

The mentally ill are both men and women, and according to some statistics, women make up as many as 80% of the workers in health care. So when I heard a story about the cuts in states’ budgets that cause state psychiatric hospitals to be closed, which causes the mentally ill who go to hospitals to be kept in the ER for sometimes days waiting on a bed in a psychiatric hospital – it is troubling.

I once considered going to an ER and voluntarily committing myself for the 72 hour cooldown period. I was conscious enough to know which hospital had a psychiatric ward and to know I would rather spend some time in a less clinical facility. I received a reduced rate at the facility I chose, because they received state funding. Maybe those things would be different now. I would have left if I had had to pay for it all out of pocket – I didn’t have it. And if I had been turned away, sent to the emergency room, I don’t know how that would have affected my eventual recovery, into a stable life today. Years later I count that weekend as a turning point for me.

One ER doctor in the report I heard asked, if this was pneumonia, would we be okay with making them wait 30, 40, 60 hours to get a bed? To get adequate treatment? If we say we treat mental illness with parity, how do we explain this?

Comments

  1. I.A. Scott says

    A 200x markup once the patent is approved sounds like a good argument to abandon pharmaceutical patents altogether. I can’t speak for the US medical system but I imagine that means pharmaceuticals are draining absolutely stinking amounts of money out of the NHS.

  2. says

    I.A. Scott,

    I understand most drugs developed here are sold much more cheaply in foreign countries than they charge us here. That’s one of their arguments for why they need to gouge Americans in order to make drug development profitable enough to attract brilliant people.

    My problem with that argument? I want some confirmation there IS anyone worth their salary in medicine these days. And when we get boned with drugs that do more harm than good, there’s no refund even though obviously someone did something that was at best stupid and at worst criminal.

    I just recently saw a clip from Not the 9 O’Clock News (old 80s British comedy sketch show) in which a member of Parliament said he wasn’t going to tax cigarettes and beer and other totally unnecessary stuff – he was instead going to tax wheelchairs, and walking sticks for the blind and so on. Then, deadpan, he says we should note that in doing so, he has chosen to hit at those members of society who cannot fight back.

    Yep. Business as usual with politics.

  3. firebird says

    I was impressed the regulating agency told them no. But in general the while thing is ridiculous.

    I heard about a program in one if the New England states where a board of experts say down and figured out what all kinds of medical stuff cost – for an MRI, say, one use with of depreciation of the machine, the technician’s time, the portion of utilities and space in the facility, the expert to read the MRI, etc. Then that was what an MRI cost (with a reasonable profit if applicable) for everyone, no matter if they were self pay or a big insurance company or a small one. It sounded great, but a) a lot of work, and bureaucracy, and b) likely to break down over time into unhelpfulness over time like everything else we have tried.

  4. Sally says

    Jennifer Kesler,

    US pharmaceutical companies have for many years now been using so-called ‘Free Trade Agreements’ in — so far unsuccessful — attempts to pressure the Australian government to cripple our Pharmaceutical Benefits Scheme so that they can gouge us too.

    Of course that doesn’t mean that US prices will go *down* — just that the companies’ profits will go even higher.

    Ain’t capitalism wonderful?

  5. says

    It’s complete bullshit to mark up the prices so high on these necessary drugs. But can I just say that it makes me proud as an Ohioan that Sherrod Brown is the one fighting back against this? I’m very glad that I voted for that man.

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