When Saving Lives Brings on Medical Bankruptcy

By Chuck Norris

June 8, 2018 7 min read

Multiple Sclerosis (MS) is a debilitating, chronic condition that affects more than two million people worldwide. Its exact cause is unknown and its symptoms include paralysis, tremors, pain and fatigue. Its symptoms can be managed with treatment. Without it, they can become progressive, severe and incapacitating. As recently detailed in a Kaiser Health News report, after two drugs previously tried failed to control MS symptoms or to prevent repeated flare-ups, an Ohio patient found a third option that enabled her to walk comfortably, see clearly and return to work. The problem is, the drug is expensive, about $90,000 a year. There is no generic alternative. She was relieved that she had health insurance and a copay plan in place to cover much of the cost. The operative word was "had."

After three years on the medication, this year, she got a shock. Her health plan changed the way it handles these payments, and the money no longer counted toward her deductible. A deductible she now cannot afford to pay out-of-pocket. She is one of a growing number of consumers taking expensive medicine who make such a discovery.

Faced with such a situation, the AIDS Institute is among 60 HIV organizations that have sent letters to state attorneys general and insurance commissioners across the country asking them to investigate the copay assistance program changes in employer and marketplace plans. A reason for their concern — Daraprim, for example, which is used by AIDS and transplant patients, runs around $375 per pill when paid out-of-pocket.

According to the Journal of the American Medical Association, spending on prescription medications is already higher in the US, per capita, than in any other country in the world. This crisis in health care has been escalating for 30 years or more. A remedy is still not in sight. According to a Johns Hopkins University report, the price tag last year for prescription drugs in the United States was $425 billion, one out of every 10 health care dollars spent. It continues to soar. The average cost for a year's supply of medication for someone with a chronic illness has more than doubled since 2006. This increase is largely driven by brand-name drug prices that have been increasing in recent years at rates far beyond the consumer price index. There is often no generic alternatives to expensive brand-name drugs. As a result, people are being driven to make trade-offs between paying for their drugs or for food and mortgage. People saddled with catastrophic medical bills that are not covered within health care plans are literally being forced into medical bankruptcy. How are we allowing this to happen?

Everyone feels the repercussions of this - insurance companies, employers, employees, the government and taxpayers. Even those who are healthy and medication-free pay more when drug prices outpace inflation.

As noted in a recent commentary by Dr. Sudip Bose, a US Army Doctor, author and noted public speaker, drug companies point out that their costs to research, develop and bring a drug to market are astronomical; that they have to cover those costs and make a profit to continue to stay in business and develop even more innovative prescription medications that will help save more lives. This is true — to a degree.

What drug companies fail to mention is that, according to a 2017 AARP report, even after accounting for their research investments, these companies remain among the most profitable public businesses in America. An analysis from the research company Global Data also pointed out that 9 out of 10 big pharmaceutical companies spend much more on marketing than they do on research. According to the trade publication Ad Age, five of the ten fastest-growing ad spenders in 2015 were pharmaceutical companies. And for good reason — it sells product. In analyzing the profit margins of some drug manufacturers compared to other blue-chip companies — including Coca-Cola, GE, GM and Exxon — AARP research found that five out of the six top profiting companies were all pharmaceutical companies.

As reminded by Scott J. Knoer, the Chief Pharmacy Officer at the Cleveland Clinic in a commentary piece for TIME magazine, we have not always had drug ads. The Food and Drug Administration relaxed the rules in 1999 creating the deluge of ads we see today. What the Food and Drug Administration giveth, they can also take back.

While government regulators are at it, they might also want to put a halt on "pay-to-delay" payments. When a brand-name drug's patent is about to expire, allowing competing manufacturers to begin to consider making a lower costing generic alternative, it is common practice for brand-name manufacturers to pay these generic manufacturers to not produce a generic version.

Generally speaking, in America the focus of traditional medicine is - "a pill for every ill," says Dr. Bose. "What does that mean?" he adds. "It means we're often focused with prescription medication on treating symptoms and not on causes... Changing our food and exercise patterns is a long-term process that some people never accomplish. After all, it's not easy to change the habits of a lifetime when it comes to food consumption. But it should be a focus [and] at least one aspect of treatment when it comes to dealing with life-threatening illness."

While the President has vowed to take on high drug prices, introducing several bills aimed at cutting the cost of prescription pharmaceuticals, no clear path to reduced costs in the short term has yet to emerge. That is not good news for those sick and in need. For those who are healthy, heed the words of Dr. Bose: "...we also need to do our part in trying to make sure we don't set ourselves up to need some of those costly medications in the first place."

Write to Chuck Norris ([email protected]) with your questions about health and fitness. Follow Chuck Norris through his official social media sites, on Twitter @chucknorris and Facebook's "Official Chuck Norris Page." He blogs at http://chucknorrisnews.blogspot.com. To find out more about Chuck Norris and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.

Photo credit: at Pixabay

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