One of the biggest health issues facing Americans is the high cost of prescriptions. It’s something the country could fix, but hasn’t. As a consequence, millions of Americans are pressured into breaking the law to get the medicines they need at prices they can afford.
An Idaho woman told her story recently. A medicine she uses to relieve the symptoms of menopause, Vagifem, has priced itself out of her reach. A year’s supply here costs about $1,000, but in Canada, it sells for less than $100.
“The price went up. And we’d lost a lot on the stock market, and we’re living on fixed incomes,” Lee Higman told the New York Times. What real choice did she have?
That didn’t matter to the Food and Drug Administration. It impounded the 90 tablets she ordered from Canada which is, in fact and unreasonably, illegal. That means that millions of Americans are similarly breaking the law in order to get crucial prescriptions that they cannot otherwise afford.
On its website, the FDA notes that “in most circumstances it is illegal to import drugs into the U.S. for personal use” because the agency cannot guarantee they are safe and effective. It also prohibits “reimportation” of drugs made in the United States because it cannot guarantee the medications were not tampered with or stored improperly.
That all may be true, but the FDA could figure out a way to guarantee the quality if it wanted to. And there is more to it. The policy is also meant to protect the U.S. pharmaceutical industry, which seeks to make up in the United States what it loses elsewhere. The industry says it needs high prices here in order to cover the costs of researching and developing new drugs and, indeed, there is something to that.
Critics say the industry is gouging the public. The organization Health Care for America Now!, a consortium of interest groups, reported industry profits of $83.9 billion in 2012 and $711 billion over the past decade.
It should be obvious that the industry needs to be compensated for its work and equally obvious that that work is costly. No one who believes in capitalism begrudges the industry a profit.
But it is no less obvious that profits of $83.9 billion leave plenty of room to help ensure that Americans can buy the drugs they need at more reasonable prices. When policies of the American government force millions of otherwise honest Americans to break the law in order to protect their health, something is radically wrong.
There are answers. One is to end the ban on importing drugs. There is no good reason not to do this and allow Americans to safeguard their health.
Another is for Congress to allow the government to seek group discounts for the prescriptions provided through Medicare and Medicaid. That is simply good business, yet Congress, under pressure from the pharmaceutical industry, prohibited that perfectly logical and common approach when it approved the Medicare prescription drug benefit sought by then-President George W. Bush.
Yet another is for the government to shorten the time that the developer of a new drug has exclusive rights to it before allowing manufacturers of generics to offer a lower-cost version.
This is an exciting time in medicine, in no small part because of the new drugs that are available. Conditions that once required hospitalization and even surgery can now be handled less invasively. That’s progress, and more is on the horizon.
But that progress is of vastly diminished benefit if too few people can afford the drugs in the first place. That’s a killer, and it needs to change.