Necessary pharmaceuticals are overpriced in the U.S., and this is in drastic need of change. This past Thursday, first steps toward this change were taken in the U.S. House of Representatives, where a bill was passed that will cap the monthly cost of insulin to $35 for those who are enrolled in public or state health insurance. Currently, the average cost of insulin per month ranges from around $480 to $1,340 depending on the brand and not including additional supplies, such as syringes and test strips.
This cap will benefit many in the U.S. who have diabetes and need insulin daily; clearly the difference between even $480 and $35 is quite significant, let alone the price reduction from over $1,000 to $35. Currently, with many rationing the amount of insulin they take, which is immensely dangerous, this change will give many more access to the medication they need.
However, it is important to note that if this passes in the Senate, it is still only a step forward. For one, $35 per month may still be difficult for some to afford — this adds up to about $420 per year, which, in addition to many other costs of living, is still not negligible.
In addition, insulin is just one of the many necessary medications pharmaceutical companies overprice. This bill does not address some of these systemic problems of the healthcare industry and, therefore, emphasizes the work that still needs to be done to improve the healthcare and pharmaceutical industries in this country. The necessity of this bill highlights the fact that the healthcare system is ineffective in treating and caring for the population and, thus, is in dire need of change.
When the patent for insulin was first sold in the 1920s, it was sold to the University of Toronto for only $1 in order to ensure that it was accessible and affordable for anyone with diabetes. However, due to pharmaceutical company greed as well as the greed of middlemen such as pharmacy benefit managers — people who negotiate prices with drugmakers on the behalf of insurance companies and large employers — the price of insulin has skyrocketed, endangering the lives of many in the U.S. who cannot afford these exorbitant prices. According to the Mayo Clinic, the most commonly used forms of insulin cost about 10 times more in the U.S. as compared to other developing nations.
Insulin is not the only medication that is largely unaffordable; other commonly used medications, such as epinephrine, are also extremely expensive. Epinephrine, usually in the form of an auto-injector EpiPen, is lifesaving as it is used to treat anaphylactic shock, a severe allergic reaction where multiple body systems, often including the respiratory system, are compromised. However, in 2016, the company Viatris Inc., formerly known as Mylan, raised the price of a two-pack of EpiPens from $100 to $600, making it largely unaffordable.
Other medications, especially ones used for rare diseases, can be much more expensive. Currently, the most expensive drug in the world is known as Zolgensma; it is used to treat spinal muscular atrophy in small children and costs about $2.1 million.
The healthcare system is extremely flawed in many ways, especially in terms of the costs of pharmaceuticals. A cap on the price of insulin is great and extremely necessary, but there is still a lot more that can and should be done in order to better combat some of the systemic reasons for why such pharmaceuticals are so expensive and to ensure that more pharmaceuticals are more accessible and affordable.
Dr. S. Vincent Rajkumar, a physician at the Mayo Clinic, listed several solutions for making pharmaceuticals more affordable. Aside from legislative methods to cap prices of pharmaceuticals, Dr. Rajkumar suggested having patent reforms to prevent monopolies in the healthcare industry, creating easier methods for generic drugs to enter the market, promoting the manufacturing of nonprofit generic drugs and creating laws to provide safer and more affordable access to certain medications, like insulin, when there are emergencies. Enacting all of these proposed solutions ensure that there is reform targeting the root of this problem while also making sure that people get access to the drugs they need.
In addition, it is worth taking note of how pharmaceuticals are made more affordable in other nations. Until the 1990s, pharmaceuticals in the U.S. were not much more expensive as compared to other countries. However, the U.S. did not have price controls put in place that countries like France, Germany, Sweden and the U.K. have; therefore, this allowed certain drug companies to make exorbitant profits with few to no legislative restrictions.
The Food and Drug Administration in the U.S. also allows for direct-to-consumer advertising, which is illegal in many other nations. In 1997, the FDA suggested that pharmaceutical companies may use these direct-to-consumer practices ethically, therefore also contributing to this increase that occurred in the 1990s. Direct-to-consumer advertising essentially is marketing that targets consumers, even in industries that may require middlemen, which is clearly true of the pharmaceutical industry. This may lead to many consumers believing that they need a certain drug, as it is marketed toward them, even if they do not actually need it. Many patients may also request these drugs regardless of the price.
The current system in place in the U.S. is not working; people should not have to pay thousands of dollars per month for necessary pharmaceuticals. Although this price cap for insulin will prove helpful — if it does indeed pass through the Senate — it is just one step forward in fixing the pharmaceutical industry. More permanent, substantial action must be taken in order to address the systemic problems with the pharmaceutical industry and to best benefit the population in the U.S.
This is one of those cases where I wish I could be surprised. But, I’d be more surprised if the US government did the right thing from the start regarding insulin prices. The fact that this is even a problem to begin with is ridiculous. We do need a massive overhaul of the system regarding insulin, but for now, small steps are all we can do. Well, even that’s progress, and it’s a good thing we have leaders who can make it. Still, this needs further evaluation — it’s not good if the president has to make an appeal for this during the SOTU. At the end, lower prices will lead to a healthier country.