The federal Medicare program and private health insurers waste nearly $3 billion every year buying cancer medicines that are thrown out because many drug makers distribute the drugs only in vials that hold too much for most patients, a group of cancer researchers has found.We could, of course, use the power of the government to prevent this, but that would be un-American, wouldn't it?
The expensive drugs are usually injected by nurses working in doctors’ offices and hospitals who carefully measure the amount needed for a particular patient and then, because of safety concerns, discard the rest.
If drug makers distributed vials containing smaller quantities, nurses could pick the right volume for a patient and minimize waste. Instead, many drug makers exclusively sell one-size-fits-all vials, ensuring that many smaller patients pay thousands of dollars for medicine they are never given, according to researchers at Memorial Sloan Kettering Cancer Center, who published a study on Tuesday in BMJ, formerly known as the British Medical Journal....
“Drug companies are quietly making billions forcing little old ladies to buy enough medicine to treat football players, and regulators have completely missed it,” said Dr. Peter B. Bach, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering and a co-author of the study. “If we’re ever going to start saving money in health care, this is an obvious place to cut.”
... In one example, the study said that in the United States Takeda Pharmaceuticals sells Velcade, a drug for the treatment of multiple myeloma and lymphoma, only in 3.5-milligram vials that sell for $1,034 and hold enough medicine to treat a person who is 6 feet 6 inches tall and who weighs 250 pounds. If a patient is smaller, then a quantity of the precious powder is thrown away.
Some of these medicines are distributed in smaller vial sizes in Europe, where governments play a more active role than the United States does in drug pricing and distribution....Do you loathe Martin Shkreli? This is Shkreli Lite. It's not a flamboyantly evil SOB jacking up the basic price of a drug -- it's faceless suits using a sleazy trick to squeeze more money out of a drug without appearing to raise the price. Sick and dying patients still get screwed.
Christopher Kelly, a spokesman for the Food and Drug Administration, said the agency objected to companies’ proposed vial sizes only if it believed that an excessively large volume of medicine “could lead to medication errors or safety issues due to inappropriate multiple dosing.”
... Congress has not given the drug agency the authority to consider cost in its decisions.
We don't have the national will to stop this sort of thing. Even if we were to elect Bernie Sanders, we'd need a Congress (and probably a Supreme Court) very different from the current ones in order to curtail abuses like this. We're not ready for the all-out war we'd need to fight. And so they're going to keep doing this sort of thing to us.
On the plus side, petroleum jelly is still pretty cheap, which eases the pain of the screwing...
ReplyDeleteEasy, boy.
ReplyDeleteSometimes a larger volume merely suggests the price isn't related to production cost but simply gouging on price..They could well charge as much for half the volume.
ReplyDeleteUnknown's point was on my mind too, reading this. Are these medicines really so physically precious? Like gold or a handmade Swiss watch? I'd like to see proof of that. Going after the extra product seems like a cheap way to pretend to be "doing something" about drug prices. After going to all the trouble of regulating dosages the most any patient can expect is to save a few pennies while still being savagely price-gauged on a perfectly measured product.
ReplyDelete"We're not ready for the all-out war we'd need to fight. And so they're going to keep doing this sort of thing to us."
ReplyDeleteOh, well. I guess that settles it, nevermind.
Democrats are going to continue to not pound this issue as life-and-death for Americans, and it will continue to be the kind of thing that only gets talked about on hole-in-the-wall liberal blogs. Because gosh, it'd just be so hard to do something about it, there's so many titanic forces allied against us, why don't we just shelve the issue until the Democrats paymasters give us permission to tinker around the edges?
If you don't put a spotlight on the issue, if you never talk about it, if you never introduce it into public discourse, it will remain a political impossibility. I understand that Dems couldn't pass any form of single payer even if we elected Sanders, but to just throw up our hands and say "We don't have the national will to stop it (because our Dem pols don't want to)" is dead-ender thinking. Complacency is not "pragmatism".
I didn't say our Democratic pols don't want to -- I said we don't want to. There's no concerted effort to elect true progressives to Congress. There isn't even a glimmer of an effort. There isn't a significant grassroots effort to fight these abuses outside the electoral process, either. There's just "Let Bill and Hillary wave a magic wand and fix health care" followed by "Let Barack Obama wave a magic wand and fix health care"followed by "Let Bernie Sanders wave a magic wand and fix health care."
ReplyDeleteWhat Steve M said.
ReplyDeleteAlso, what unknown said: the marginal cost of most of these drugs is practically zero - once you know how to make and use it. The monopoly over the knowledge of making and using the drugs is what sets the drugs, so mindless ranting and raving about the Evil Big Pharma gets us exactly nowhere. Core issues, people, core issues.
sets the prices on the drugs
ReplyDeleteI don't know that production costs are driving prices for drugs like Velcade, but particularly in cancer where more drugs are things like monoclonal antibodies, you could sometimes see meaningful cost savings from selling smaller doses. I think there are also other issues with assuming patients are 6'6" and 250lbs males.
ReplyDeleteI don't know that production costs are driving prices for drugs like Velcade, but particularly in cancer where more drugs are things like monoclonal antibodies, you could sometimes see meaningful cost savings from selling smaller doses. I think there are also other issues with assuming patients are 6'6" and 250lbs males.
ReplyDeleteInstead of cursing the dark why not light a candle? We have been lobbying congress to change countless things for God knows how long, and how far has it gotten us? Wouldn't it be easier to simply find out which companies are engaging in this, publicize the information, and boycott their products? There are plenty of generic alternatives to most drugs. The only way to fight corruption is to shine a light exposing it. If we scrutinize them enough, they will either be forced to change their ways or simply go out of business
ReplyDelete