February 14, 2016
Whose fault is it? The cost of medications has finally reached unacceptable levels. Every day patients come in requesting changes in their medications as they can’t afford to buy them. No matter that they need their medications or that their medications are lifesaving pills, they simply can’t afford them. Whose fault is it?
The other night, I was watching the Democratic debate and Hillary proudly announced that her “Hillary Care/Obama Care” was tackling the pharmaceutical industry. Are the companies that make your medications at fault? I used to think so but I no longer believe it.
I just got back from Mexico and was both shocked and pleased to find that Voltaren Gel, a non steroidal anti-inflammatory gel I use for my aching joints, was on sale for $9 a tube. The cheapest I have ever seen it in the US is $50 a tube and most insurance companies require a mountain of paperwork before they will even consider paying for it.
Novartis makes Voltaren Gel; and, other than the Spanish words on the box, the Mexican and American products are almost identical. So, if the pharmaceutical companies are the villains driving up the cost of our medications, why isn’t Novartis charging $50 a tube in Mexico? Remember, I said that the Mexican and American versions were almost identical? Could the difference in the accompanying paper inserts account for the higher cost of the American product? I think so. Let me explain.
The American product comes with reams of enclosures: paper from the manufacturer, the doctor and paper from the pharmacy that fills it. There are detailed instructions and even more detailed warnings. The Mexican product does not. Apparently, Mexicans can figure out how to apply the gel and that it is not a suppository or eye drop and Americans can’t get it right.
In reality, all the documentary inserts are instructions that are designed by attorneys to protect the pharmaceutical company, doctor and pharmacy against lawsuits. These papers are scrutinized and approved by the FDA and then are reviewed by trial attorneys seeking to win the lottery by suing all parties involved in the care of a patient. There is a cost to the legal system in this country and I think these legal costs are what are driving the cost of your vital medications through the ceiling. The result is that, while all the rulemakers are “covering their backsides” with legal mumbo jumbo, the price of this protection has made your medications unaffordable despite their critical role in keeping you healthy.
Have you seen the law firm’s commercial on TV where the actor says that the manufacturer of Plavix has settled a suit for $650,000 and you or your loved one may be owed money? Who do you think pays that $650,000? You do! You pay for every outrageous suit filed in a US court.
You pay when you buy a chair, a car, food, pharmaceuticals, etc. Manufacturers and owners of businesses pay liability insurance and the cost of that insurance becomes overhead and the cost of overhead is passed to the consumer. Let me get back to the cost of your medication.
Why aren’t the candidates for the presidency talking about tort reform (according to Wikipedia, “Tort reform refers to proposed changes in the civil justice system that aim to reduce the ability of victims to bring tort litigation or to reduce damages they can receive”)? Could it be because they are attorneys? Perhaps the contributions that the trial attorneys’ lobbies make to the candidates’ Superpacks really do influence their judgment? Whatever the cause, something has to change.
Unfortunately, what is changing is my patients’ health. They are going without their medicine or seeking cheaper, less effective alternatives.