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“Follow the money.” A still common phrase initially imbedded into the national lexicon back in the wacky decade of the 1970s, the years of Machiavellian politicians, the end of the Vietnam War, and Watergate.
“That’s a nice history lesson, Dr. Rosick, but what does that have to do with medical issues?” some of you might be thinking. “I thought this was a column about medicine!” Actually, I see this as a column about health, and while medicine certainly fits under that umbrella, so do things like politics and money and unbridled greed, the latter of which is currently driving up the price of a simple medical device — the Epipen — to $600, an increase of over 500 percent.
“So what?” some people might say. “If it’s that expensive, that means the pharmaceutical company must have spent billions to develop the drug and need to recoup their investment.” Now, while I have no trouble with someone or some corporate entity making a decent profit off hard work, the company that owns the rights to the Epipen, Mylan, spent NO money on development of the drug — they simply bought the rights to the device back in 2007. Ever since, they have controlled a near monopoly on an injectable form of epinephrine.
Epinephrine is a life-saving drug that cost pennies on the dollar used by patients who suffer from deadly anaphylactic reactions brought about by everything from bee stings to certain foods.
Now Mylan has decided to fatten its coffers by jacking the price into the stratosphere. This unconscionable increase in prices just happened to coincide with the FDA-mandated recall of Auvi-Q, the main competitor of the Epipen.
Always remember: ”Follow the money.”
As a physician working in a primary care clinic, I’m asked by many patients on a weekly basis why prescription drug prices are so high, or why insurance prices are skyrocketing even though we were told that the Affordable Care Act would be the means to bring affordable (hence the name) medical insurance to everyone in this country.
To fully answer both those questions would take hours, but here’s one reason prescription drug prices for the Epipen and other meds are out of control. (Why Obamacare isn’t living up to its promises is fodder for another column.) Prescription drug prices in the United States are higher then in any other westernized country in the world because, unlike all those other countries, the U.S. doesn’t have price controls; pharmaceutical companies are free to charge any price they want, even for medications like Epipens that cost next-to-nothing to make. This is in contrast to Canada, which has a national drug review board that examines by comparative research what drugs work the best for the conditions/ diseases the pharmaceutical companies tout them for and also determines how effective they potentially are compared to similar drugs already available. The Canadian government is then able to set limits on what pharmaceutical companies can charge for medications.
“So Dr. Rosick, if you’re implying that prices for drugs in Canada are significantly less expensive, I can just go over there and get my medications, right?” it's a valid question, and unfortunately, the answer is no, at least according to our own federal government. You see, the U.S. Food and Drug Administration has, for all practical purposes, declared it illegal to buy any medication from any foreign country. So while you can go across the border and buy clothes, food, alcohol — just about anything your heart desires — from our northern neighbor, you can’t buy medications. Lower priced medications. Even medications that may save your life.
“Follow the Money,” or in the case of Mylan and the Epipen, follow the money and the politicians. Call me cynical, but I find it darkly amusing that the CEO of Mylan is the daughter of a United States senator, Joe Manchin, D-W.Va., who, amazingly, has declined to comment on the Epipen fiasco.
Unless we the people voice our frustration through emails and phone calls to our representatives and senators, unless we become truly involved in the political process and work for real change and not just vote in — decade after decade — the same two political parties at every election, positive and lasting changes in both our medical system and our society at large will, unfortunately, never happen. And because of this, people will die for the want of a simple, inexpensive medication made crazily expensive by amoral people just following their love of money.
(Dr. Edward Rosick, who is an osteopath and head of the Healthy Campus Initiative at Michigan State University, is the author of " Optimal Prevention.")