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10/12/2014

The Price of Drugs

Lesley Stahl of CBS recently did a story for 60 Minutes on the high price of cancer drugs.  Physicians at Memorial Sloan Kettering and M.D. Anderson have been seeking to remedy the “financial toxicity” of cancer drugs, something which has been mentioned in this bioethics blog as well.

In Stahl’s story, Dr. Peter Bach of Sloan Kettering relates how a simple op-ed in the New York Times revealed the nature of the drug-pricing scheme:

“Because it was irrefutable evidence that the price was a fiction. All of those arguments that we’ve heard for decades, ‘We have to charge the price we charge. We have to recoup our money. We’re good for society. Trust us. We’ll set the right price.’ One op-ed in the New York Times from one hospital and they said, ‘Oh, okay, we’ll charge a different price.’ It was like we were in a Turkish bazaar. … They said, ‘This carpet is $500’ and you say, ‘I’ll give you $100.’ And the guy says, ‘Okay.’ They set it up to make it highly profitable for doctors to go for Zaltrap instead of Avastin. It was crazy!”

Much of the support for high drugs prices comes from physicians majoring in the drug business:

“Another reason drug prices are so expensive is that according to an independent study, the single biggest source of income for private practice oncologists is the commission they make from cancer drugs. They’re the ones who buy them wholesale from the pharmaceutical companies, and sell them retail to their patients. The mark-up for Medicare patients is guaranteed by law: the average in the case of Zaltrap was six percent.”

Dr. Leonard Saltz: What that does is create a very substantial incentive to use a more expensive drug, because if you’re getting six percent of $10, that’s nothing. If you’re getting six percent of $10,000 that starts to add up. So now you have a real conflict of interest.” (from the transcript)

Most startling is the case of the very successful treatment for chronic myeloid  leukemia (CML), the tyrosine kinase inhibitor imatinib (sold as Gleevec by Novartis).  Considering the drug has been on the market for over a decade, one might think that Gleevec would be an inexpensive cancer treatment in 2014, especially in a marketplace which includes several similar competitors.  Actually, the price has gone up significantly in recent years.

And Gleevec is a very helpful drug, a grand champion of effectiveness as far as cancer drugs go.  It is a shame that it’s price causes such a burden to those who are trying to recover from illness.

It seems that we do a lot of things that are toxic to ourselves and our society.  Maybe we ought to get back to the art of healing.

 

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