My Response To Robert Brischetto On High Drug Prices

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It was certainly sad to read of the death of Robert Brischetto’s friend from hepatitis C virus, or HCV (“For too many, life-saving drugs out of reach,” Oct. 26). His friend could not afford the expensive drug (Sovaldi) to treat this disease.

We probably should not, however, base drug policy on a single case. Mr. Brischetto did mention that “Astronomical drug costs are becoming all too common” and “hiking drug prices has become standard practice among most pharmaceutical companies.”

But he gave no numbers on how many companies are raising prices or how much prices are going up in general.

A recent report from Express Scripts, a company that provides integrated pharmacy benefit management services, sheds light on this issue. Their Prescription Price Index shows that, "since 2008, the average price of brand drugs has almost doubled, while the average price of generic drugs has been cut roughly in half."

The generic side is important because according to Zachary Brennan of the Regulatory Affairs Professionals Society, “86% of all US prescriptions are filled as generics.” So that means that actually most of the drugs people have bought since 2008 have gone down in price.

One drug that has been in the news recently is Daraprim, whose price jumped from $13.50 a pill to $750 (done by Turing pharmaceuticals). It costs the equivalent of five cents in India.

It is so cheap in India because it much easier and less costly there to put a generic drug on the market. According to George Mason University economist Alex Tabarrok, “this issue is almost entirely about the difficulty of obtaining generic drug approval in the United States.”

Mr. Brischetto mentioned there was an effort to help pay for plane fare to send his friend to India where Sovaldi is just $10 per pill. Perhaps if we were making it easier for generics to get on the market in the U.S., it would have been available here at a lower price.

In the case of Daraprim (which is used to treat toxopasmosis, an infection), a company called Imprimis Pharmaceuticals, Inc. is now offering a compounded formulation that works as an alternative. It can be ordered from the company’s website. You get 100 capsules for $99.

This is what we need, more competition in the market. We need to speed the approval of generics.

Right now, there are about 3,000 generics waiting FDA approval. It could take three years to clear this back log. 

The FDA is trying to speed things along. Getting that to happen has bi-partisan support. Both Hillary Clinton and  Republican Senator David Vitter back these efforts.

Economist Alex Tabarrok says that “if a drug is approved in Europe it ought to be approved here.” We should also allow importation of any generic approved for sale in Europe.

Faster approval can save lives. Nobel Prize winning doctor George Hitchings estimated that the five year delay in getting the anti-biotic Septra to the market led to 80,000 deaths.

It took about ten years longer to get beta blockers on the market in the U.S. than in Europe. The lack of these drugs, used to treat heart attack victims and people with high blood pressure, led to 250,000 deaths.

What the prescription drug market needs is more competition and easier entry to the market. Let’s hold off on price controls for now.