The high cost of health maintenance

September 23, 2018

Like most people who have been lucky enough to have outlived their life expectancies at birth, I read the occasional article about the high cost of medications, visits to physicians’ offices, and various medical procedures. Unlike some people, I was fortunate to have qualified for Medicare coverage before I had any real need for such coverage, with the exception of cancer, which hit me a couple of years before the government program kicked in.


However, I did have insurance, for which I paid a pretty good chunk of money out of each paycheck. But, I can’t complain too much because most of the cost of treatment was covered, the process was successful, and I’ve been a cancer survivor for more than a decade. So, although I probably should have written an opinion piece about the high cost of health maintenance in our society, I haven’t, and I apologize for that.


The reality of the ridiculous expense of prescription medicines finally came home to me last week. By comparison to the experience of a great many people who need such medication, my story is truly inconsequential. But, it bears telling because it is illustrative of the greater burden with which people, especially the poor in our society, must deal on a regular basis.

A simple prescription


As some readers may have noticed, I did not have my regular column in last Saturday’s Tribune. The reason: I had cataract surgeries on both eyes, one at a time, about two weeks apart. The surgeries were deemed to be successful by the physician, but one eye ached and didn’t focus properly for a while. So, I couldn’t read well, and that included being able to see the words on my computer’s monitor. Hence, no column for the Sept. 15 edition of this newspaper.


About 10 days ago, I went to the surgeon for a post-op check up, and I complained about the trouble that I was having with one of my eyes. He examined me and prescribed eye drops which I was to use twice a day. I took his note to the pharmacy, but the brand that was indicated was not in stock. The pharmacist, however, assured me that the generic stuff she gave me was exactly the same as the prescribed medicine.


When I got home, I used a magnifying glass to read the active ingredient so that I could check with the surgeon to make sure that I would be using the proper medication. I learned that the generic equivalent to the prescription was sodium chloride solution. If you never took a class in chemistry, you’ll probably be surprised to learn that sodium chloride is common table salt.


A one-half ounce bottle of this miracle drug cost $18. Now, that expense is not going to cause me to have to break my piggy bank, but let’s look at how more serious price gouging can literally mean the difference between life and death.

The Turing example


In August, 2015, Martin Shkreli, the CEO of Turing Pharmaceuticals, boosted the price of Daraprim from $13.50 to $750.00. Daraprim is the preferred drug for the treatment of an infection to which people with HIV/AIDS and cancer are susceptible. According to Consumer Reports (CR), Shkreli immediately became the poster child of pharmaceutical greed. And, of course, the key question was: Why did Shkreli increase the price of the drug so dramatically. The answer: Because he could. There was no law against the outrageously inflated cost of the drug.


But, Turing is not an isolated case. When Valeant Pharmaceuticals bought the rights to Isuprel, a medication for heart disease, it raised the price from $180 per dose to $1,472. It also purchased Nitropress, used to control blood pressure, and jacked up the cost from $215 to $1,346. Then, it acquired Cuprimine (which treats Wilson’s disease, a rare genetic disorder), and boosted the price from $8.88 per capsule to $262.00 per capsule. CR reports that, in each case, “the drugs had no generic equivalents available, so Valeant was able to corner the market with a built-in base of consumers.”


Because of this revelation, CR undertook a national survey on the increased price of prescription drugs. The organization discovered that 30 percent of Americans (about 32 million people) had been hit with price increases for drugs that they took regularly that amounted to an average of $63, and some paid $500 or more. CR reported, “Our poll shows that when people were hit with higher drug costs, they were more likely to take unhealthy measures such as skipping doctor appointments, tests or procedures, or not filling their prescriptions or taking them as directed.”

Seeking solution


The AARP (American Association of Retired Persons) addresses the problem in its current bulletin. First, it advocates allowing Medicare to negotiate with pharmaceutical manufacturers. Because of its purchasing power, the government should be able to get better prices for beneficiaries. Second, the government should allow the importation of less-expensive drugs from Canada and members of the European Union, whose products are every bit as good as those made in the U.S.


Third, Americans, especially older residents, should have better access to lower-priced generic drugs. Legislation could be passed to prevent drug manufacturers from blocking the development of more affordable generic equivalents. Fourth, the legislature should enforce price transparency. Drug manufacturers should have to explain why their products cost so much and why the prices increase over time.


As AARP points out in its Bulletin, “The average retail price of a prescription drug taken to treat a chronic condition has reached $13,000 per year. That’s more than three times what it was when landmark drug legislation was passed (2006), and it’s about four-fifths of the average Social Security retirement benefit.”


Obviously, my trivial experience doesn’t come close to even scratching the surface of our national problem. But it did open my eyes to the plight of my fellow Americans who must take expensive prescription medication on a regular basis. I hope that it will do the same for our lawmakers.


• • •


Jim Glynn may be contacted at j_glynn@att.net.

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