angel-535505_640The opaque nature of medication costs is among the great vexations of physicians and patients.  Despite the internets ability to find out the most arcane information, the simple price of a medication at your local pharmacy is impossible to determine using internet search.   You literally have to call the pharmacy directly and ask about drug prices….you cannot find out any other way.

Beyond this frustration is the recent price escalation of an old medication into the stratospheric price range, when Turing Pharmaceuticals was just blasted for buying at 60 year old medication that treats a rare infection called Toxoplasmosis, and raising the price by 4000% overnight.  After the backlash, the drug manufacturer backed off, sold the rights to this old medication back to it’s previous producer, and the price has been raised, but by a much smaller margin so that it can be profitably produced and available for those in need.

This type of price gouging is to be contrasted with other expensive medications whose price is exorbitant, but more understandable given the risks and rewards entailed in developing breakthrough medications.    SOVALDI from Gilead Pharmaceuticals is one such medication.  A breakthrough cure for Hepatitis C,  a disease that has incredible morbidity and mortality associated with it, as well as huge costs in it’s treatment, SOVALDI is pricey, at $1000  per pill.   But, taken 1 pill daily for 6 months, it has a 90+% cure rate for  a formerly difficult-to-treat condition, and it will provide overall savings by reducing overall healthcare costs.

Is BIG PHARMA the devil or our savior?   Well….from my perspective, it is a bit of a mix. Historically, it has been BIG PHARMA that brought to market amazing life-saving treatments:  Lily brought us Insulin (without them….thousands of children would have died from untreated diabetes in the 20’s and 30’s), Lederle Labs took a major risk backing the SALK POLIO VACCINE bringing to market a life altering immunization, Merck developed methods for large-scale penicillin production around the time of World War II that saved thousands and would have been unobtainable without their risk-taking.    But, there are currently other instances of marketing hype, or price-gouging that these same pharmaceutical companies participate in that taint their reputation and make them worthy of scorn.

BIG PHARMA is no better or worse than the american system itself.  Filled with amazing inventiveness and value production, it also makes money on non-risky and ‘me too’ products that the world just doesn’t need, but with effective advertising and marketing they can makes the money flow.

If you want an exciting and accurate account about what it takes to make a breakthrough in pharmaceuticals, read “The Billion Dollar Molecule”…by Barry Werth.