Health Affairs’ blog had an interesting discussion of the problems of our drug patent system and it’s costly consequences.
One critical incentive for ongoing drug discovery and development is the temporary monopoly pricing that manufacturers can command for novel drugs. Yet this incentive, embedded in current patent and regulatory policy, does not guarantee that manufacturers will deliver novel products with clinically meaningful benefits. Indeed there are many diseases—including Alzheimer’s disease and Amyotrophic lateral sclerosis (ALS)—that pose significant patient, family, and societal burden but have not benefited from meaningful treatment advances.
Meanwhile, the American public appears increasingly wary of the unintended consequences of these market-based incentives. Since the early 2000s, regulatory actions have focused increasing public attention on shortfalls in the efficacy and safety of already marketed drugs — including the withdrawal of celebrated “blockbusters.” Recently, patient and insurer attention has focused on the list prices of novel specialty drugs, including those to treat cancer, that commonly exceed $50,000 per treatment course — these drug prices have also grown faster than all other medical spending.
Medicynical Note: In the U.S. the medium and average family incomes are about $50-60,000/year. So we are talking drugs that cost multiples of the annual incomes of families. A few of these drugs have miraculous effects but most offer slight improvement in patint’s outcomes.
Other countries try to control these expenditures by providing strong guidelines on expensive medications use; negotiating prices with the manufacturers and suggesting equally or more effective alternatives. Their costs are significantly less than ours. The Affordable Care Act has started this process but whether or not it’s political overseers (under the influence of drug companies contributions) will allow a rational implementation remains to be seen.