Dexamethasone, a steroid that appears promising for COVID-19 patients, has a long and storied history in medicine. We talk with experts about its many uses, and explore how it might save lives in this pandemic. Writer, Reporter, Editor, Narrator: Sara Reardon Animator: Donald Pearsall
Drug Pricing Theme Issue: Is Pharma Earning Too Much?, R&D Costs Required to Bring a New Drug to Market, Probiotic Safety, and more
One in 4 people in the US has difficulty paying the cost of their prescription medications. This stark fact was recently reported in a 2019 Kaiser Family Foundation public opinion poll among a nationally representative random sample of 1205 adults.1 Persons who reported having the greatest difficulty affording their prescription drugs were those who most needed them, including those who took 4 or more prescription drugs, spent $100 or more per month on their drugs, and reported being in fair or poor health.
From a Becker’s Hospital Review (BHR) online release article:
10 drugs and medical devices approved by the FDA since Dec. 6:
- Enhertu is Japanese drugmaker Daiichi Sankyo’s drug designed to treat HER2-positive breast cancer.
- Padcev is Astellas Pharma’s drug designed to target specific cancer cells to treat urothelial cancers.
- Control-IQ Technology controller is Tandem Diabetes Care’s insulin device, designed to help diabetes patients tailor their treatments to their individual needs.
- Vascepa is Amarin Pharmaceuticals’ drug, a fish oil-derived pill designed to treat cardiovascular events.
- EXALT Model D is Boston Scientific’s device, the first fully disposable duodenoscope, designed to reduce the risk of infections in patients treated with the device.
- Vyondys 53 is Sarepta Therapeutics’ drug designed to treat Duchenne muscular dystrophy, which the FDA had previously rejected.
- GSP Neonatal Creatine Kinase-MM kit is PerkinElmer’s device, used to detect Duchenne Muscular Dystrophy in newborns.
- Unidose liquid system is AptarGroup’s device that uses a nasal spray to treat seizures. It is the first and only nasal treatment for patients with epilepsy.
- Avsola is Amgen’s drug, a biosimilar of Johnson & Johnson’s Remicade. It is designed to treat rheumatoid arthritis, Crohn’s disease, plaque psoriasis, psoriatic arthritis and ankylosing spondylitis.
- cobas vivoDx is Roche Molecular Systems’ device, designed to diagnose MRSA hours faster than traditional tests.
From a USA Today online article:
In people with Type 1 diabetes, the pancreas can’t make insulin. Those with the condition require several doses of insulin a day and spent $5,705 per person on it in 2016, an increase of $2,841, or 99%, per person since 2012, according to the nonprofit Health Care Cost Institute.
(Podcast interview “This Weekend With Gordon Deal”, 12-14-19)
Costs continue to rise, so much so that almost half of people with diabetes have temporarily skipped taking their insulin, according to a 2018 survey by UpWell Health, a Salt Lake City company that provides home delivery of medications and supplies for chronic conditions.
“Insulin prices doubled in a four-year period,” said Cathy Paessun, the director of the Central Ohio Diabetes Association. “They continue to go up, and the infuriating thing is that there is no change in the process for creating the product.”
From a British Medical Journal (BMJ) online article:
…primary care providers (general practice, paediatrics, and internal medicine) performed the best, giving a considerably lower percentage of antibiotic prescriptions without a documented indication (12%) than other specialists such as gynaecologists and urologists, who commonly prescribed antibiotics (24%), as well as those in all other specialties (29%).
As many as two in five antibiotic prescriptions (43%) provided in outpatient settings in the US could be inappropriate, a study published by The BMJ has found.1
Researchers from Oregon, USA, looked at prescriptions in ambulatory settings such as primary care and found that a quarter (25%) were deemed to be inappropriate, while a further 18% did not have an indication.
To read more: https://www.bmj.com/content/367/bmj.l6961
From a New England Journal of Medicine article:
Medicare negotiation of prescription-drug prices would bring U.S. government policies in line with those of other high-income countries, and the idea is popular with both the public and policy analysts. But it would represent a sea change for pharmaceutical firms, which will maintain that any threat to their pricing power will slow innovation.
Negotiating prices of 10 too-little drugs and 10 too-late drugs to levels currently paid in the United Kingdom would produce about $26.8 billion in savings in 2019 alone, most of which ($25.9 billion) would come from savings on drugs in the latter category. Over time, the drugs included could change. For instance, in 2020 this category might include Revlimid (lenalidomide), which generated $6.5 billion in 2018 U.S. sales; its price in the United Kingdom is 32% of that in the United States.
Americans all along the political spectrum favor allowing Medicare to negotiate the prices it pays for prescription drugs.1 In September, House Speaker Nancy Pelosi (D-CA) introduced what is now called the Elijah E. Cummings Lower Drug Costs Now Act of 2019 (H.R. 3), and the bill would have Medicare do just that.
Although there are draft pieces of legislation and regulation that take aim at the rising cost of drugs, H.R. 3 is the legislative tip of the spear for price negotiation. If it became law, Medicare would target drugs that claim the largest share of the health care budget and that face limited competition from generics or biosimilars. I propose an alternative set of drugs for price negotiation: those that have too little evidence to support full approval or are too late in their life cycle to justify continued high prices.