We cannot continue to discuss the cost of medicines and ignore the value these treatments offer the millions of patients whose lives depend on them and their value to our health care system.
Short-sighted focus on retail costs of a medication fails to paint a full picture of a drug’s impact on our health care system. For example, attention to a new treatment for hepatitis C routinely ignores the fact that it has a better than 90 percent effective rate in curing the disease. And, though there are costs associated with treatment, one must also recognize that it will prevent billions of dollars in future costs to our health system by avoiding expenses of previously less-effective treatments, treating cirrhosis or liver cancer, or expensive liver transplants and anti-rejection medications which would have been the alternatives for many hepatitis C patients.
Curing the disease saves money. Without the availability of new and forthcoming treatments for hepatitis C, the Milliman Institute predicted in 2009, that the total annual medical costs associated with the Hepatitis C population would have nearly tripled over 20 years, from $30 billion to $85 billion. Compare the cost of non-treatment with the fact that the cost of medicines overall has grown more slowly in recent years than other health care costs, and makes up just 10 percent to 12 percent of total health care spending.
Since 2000, the biopharmaceutical industry has invested more than $500 billion in researching and developing the next generation of medications. It’s important to remember that every drug enters the competitive market after a period of federally-regulated patent protection, and after those patents expire, lower-cost generics become available, helping achieve savings in the long-term while allowing the innovative company to recoup its investments and invest in the next medical breakthrough.
Just as medical innovation led to a cure for 90 percent of hepatitis C patients, innovation and the development of anti-retrovirals helped wrestle HIV/AIDS into a manageable disease. Baton Rouge has the fourth-highest case rates for AIDS in U.S. metropolitan areas, and for some, a lack of access to treatments presents a real threat to quality of life.
When the coverage that patients receive is consistently being squeezed through new and inventive bureaucratic obstacles to receive the medications their provider ordered, it is no surprise that they are frustrated. Requiring consumer to come up with 20 percent of their prescription drug costs out of pocket — compared to only 4 percent for hospital visits — is just another barrier to access. From high deductibles and limited formularies to a lack of transparency and high cost sharing, the burden of treating chronic diseases has been shifted to those fighting their illnesses. We will never contain health care costs without ensuring that life-saving treatments and cures are accessible to the patients who need them.
senior director of state government affairs, PhRMA