Drug Prices - Epipen in the news


#183 (In Topic #136)
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Some problems are obvious.     

I don't make decisions or come to conclusions based on one or even a few news articles but I do take notice of issues like the one we've seen over the last year or so concerning companies that purchase exclusive drugs just so they can corner or nearly corner the market and drive the price up.  It is unfortunate that there are individuals and investors whose behavior is so bad it demands the government steps in and creates regulations that punish those corporate behaviors.  But pricing people out of the market on a drug like Epipen resulting in denying people access to healthcare with no offsetting benefit to the healthcare system is one of those situations.

The first direction I look when seeking a solution is how do we make sure there is competition.  Many of the articles you can read today address this in a way so that you can see there is a fine line that needs to be tread between rewarding the developers of a drug through patent protections and also letting those patents expire to allow competition.  Another avenue that gets discussed is the one that I think will provide the most benefit looks at how we "regulate" the industry.  Even though we have a Food and Drug Administration in reality most of the reasons drugs get taken off the market is due to lawsuits.  Policing the effectiveness of our drugs through lawsuits is not efficient the way we do it now.  In order to make it more efficient we have to change that system.  Currently, it is very random which cases are taken to court, the lawyers benefit more than the patients or perhaps one patient benefits when many others don't.


I read articles like these and see there is an issue that needs investigation and correction:

I would like to see a regulatory system where the "judges" have a background in medicine and the results of the "lawsuits" (complaints) go to benefiting the patients; both former patients and future patients.  If a company has to pay fines those fines need to go to those hurt by the product.  Lawyers/regulators have to be paid but they can be paid  a salary as part of a government or advocacy agency which would allow most of the "award" to go to paying for the medical treatment of those hurt or to make the drug safer for future patients.   

As with almost every issue the solution to keep companies from gouging patients will need to address a number of things that make the issue complicated.  Obviously, rewarding top executives by raising salaries from $2 million a year to $18 million a year while raising the price of a critical drug from $55 a dose to $350 a dose needs to be addressed.  Reading other articles, you can see that other companies stopped selling competing drugs because of lawsuits.  Look at links found in this article for more background:  
The EpiPen, a Case Study in Health Care System Dysfunction  Any solution would have to address why so many healthcare companies are forced to take their products off the market.  But when you address that question you want to make sure that the solution we go with makes sure our drugs are as safe and effective as possible.  

What I find ironic after reading these articles is that Epinephrine, which is the drug that the Epipen uses, is pretty inexpensive.  What Epipens do is allow people to take that drug fast in an emergency.  Other methods of delivering the medicine are confusing for some people and the wrong dose has been given.  This led to lawsuits which force the alternative methods off the market.  Because there is no competition and maybe because the makers of Epipen have to assume that eventually they will have to fight a lawsuit, the price of the Epipen goes up a lot.  This results in some people buying Epinephrine and then using an adhoc way to "refill" the Epipen or something similar.   These adhoc ways have to be more dangerous that the other methods from the other companies.  

The solution to keep drug prices lower must be able to address the greed that convinces people that they need a $16 million dollar a year raise more than a six year old needs to breath.  Reading the articles it looks like the effectiveness of the marketing campaign would have earned the CEO a decent raise even without the price hike.  That marketing campaign was very effective in increasing sales.  They did not have to take advantage of the fact their competition stopped selling products and jack up the price, they did if for greed and greed alone.

Even with that said, the solution needs to ensure that competition isn't driven from the market place because our system relies on lawsuits to tell us if a product is safe.   To solve this, I believe we need to get away from our lawsuit dependent system that rewards lawyers and maybe one person out of a thousand.  Instead, I would like to see a system where the majority of the money a company has to pay when a product is defective goes to help support all the people injured by the product.  And if that product can be made safe then that money should be used to make it safe and bring it back on the market whether it is through the original company, or if the product was defective because the company was purposely negligent, then through another more responsible company.  

Continue reading my thoughts on The Healthcare System
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