Drug companies and those who want to regulate them can offer widely divergent accounts of what it costs to bring a miracle drug to market. Can’t someone not on either side crunch the numbers?
There has also been insightful reporting lately questioning whether drug companies have been losing their taste for R&D investments in favor of buying drugs that others have developed and are almost ready to bring to market. Indeed, Gilead got Sovaldi by acquiring another drug company.
I’d like to read more about the investment history of Sovaldi and, indeed, whether it makes a difference if the big companies purchase their breakthroughs rather than grow their own.
Then, of course, there are the issues that go beyond Sovaldi, the ones the California Healthcare Foundation’s website was referring to when it called Sovaldi “a canary in the coal mine of drug policy.”
“Sovaldi and other high-priced drugs such as Lucentis, an eye medication made by Genentech that can cost as much as $2,000 per dose, are,” the website explained, “part of an expected wave of breakthroughs in new, expensive pharmaceutical treatments for a variety of diseases and chronic conditions.”
How will we pay for all of these breakthroughs? Will we continue to be alone among developed countries with no price controls on prescription drugs?
What about our at best haphazard policies about who gets priority when it comes to this kind of expensive treatment? The cost for the Sovaldi treatment in Britain is $57,000, and it is given to patients on a priority basis according to how threatening their hepatitis C is.
In the United States, there is no coherent policy. Various officials and regulators (most of them working in state agencies) have jurisdiction over insurance coverage for different patient populations. Sovaldi has now focused new attention on how these officials grapple with whether and how to limit who gets these budget-busting drugs. So far, it seems on its way to becoming an infuriatingly inconsistent patchwork, depending on which state patients live in, or even who insures them.
Does our system for doling out hearts and kidneys for implants offer any analogous solutions?
Will Sovaldi force state and federal officials to have the courage to make tough choices? Or will they be fearful of the political fallout? Remember how politicians cowered when accused of trying to set up “death panels” as part of Obamacare, when, in fact, all that they proposed was that Medicare pay doctors for the time they spent counseling patients on hospice and end of life care?
That, in fact, is the ultimate issue raise by Sovaldi. One that goes well beyond doing more by way of pricing regulation to control the predictable behavior of those making a fortune selling it.
Reporters need to start pinning down politicians and regulators who should be establishing systems for making these kinds of tough choices fairly, openly and consistently and ask them how many more Sovaldis it is going to take before they start.
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