The “most important factor” that drives prescription drug prices higher in the United States than anywhere else in the world is the existence of government-protected “monopoly” rights for drug manufacturers, researchers at Harvard Medical School report today.
The researchers reviewed thousands of studies published from January 2005 through July 2016 in an attempt to simplify and explain what has caused America’s drug price crisis and how to solve it. They found that the problem has deep and complicated roots and published their findings in JAMA, the journal of the American Medical Association. The study was funded by the Laura and John Arnold Foundation with additional support provided by the Engelberg Foundation.
“I continue to be impressed at what a complex and nuanced problem it is and how there are no easy solutions either,” said lead study author Dr. Aaron Kesselheim, a professor who runs the Program on Regulation, Therapeutics and Law at Harvard Medical School and Brigham and Women’s Hospital. “As I was writing, the enormity of the problem continued to shine through.”
Five key findings in the JAMA review:
Government intervention helped fuel the steep rise in prescription drug costs by granting monopolies to drug manufacturers and by mandating coverage in government-funded healthcare programs, authors of a review concluded.
In the U.S., per-capita spending on prescription drugs reached $858 in 2013, more than double the average for 19 other industrialized nations. Prescription spending accounted for 17% of the total cost of personal healthcare services.
The cost and complexity of drug development have contributed to the higher prices. However, the federal government essentially blocked the two most effective means of controlling prescription costs by delaying access to generics and placing constraints on government agencies’ ability to negotiate prices with drug manufacturers, Aaron S. Kesselheim, MD, JD, of Brigham and Women’s Hospital and Harvard Medical School, and co-authors wrote in the Aug. 23/30 issue of the Journal of the American Medical Association.
A strain of E. coli resistant to two last-resort antibiotics has for the first time been reported in the United States.
The strain was found in the urine of a man treated at a New Jersey hospital two years ago. It was tested in 2016 as part of a larger analysis of bacteria from the hospital.
For hard-to-treat bacteria infections, the antibiotics colistin and carbapenem are considered the big guns — a last line of defense when nothing else is working. In recent months mcr-1, a gene which confers resistance to colistin, has been found in E. coli from over 30 countries, including bacteria isolated from pigs and people in China and a patient in New York City.
Similarly the gene blaNDM-5 renders the antibiotic carbapenem useless against its bacterial carrier. In 2012, the Centers for Disease Control and Prevention found carbapenem-resistant bacteria in about 4 percent of US hospitals.
Researchers and health officials have feared the joining of these two genes in a single bacterial strain, as it could set the stage for the rise of superbugs that can’t be treated with our current arsenal of drugs. The combination has been detected before in other countries, including Germany, Venezuela, and China, but until now, it has never been seen within the United States.
Prime Therapeutics deal would integrate pharmacy, Blue plan.
Eagan-based Prime Therapeutics has formed a strategic alliance with drugstore giant Walgreens that would combine the companies’ specialty and mail-order pharmacy businesses.
In addition, health plan subscribers with pharmacy benefits managed by Prime Therapeutics would have preferred access to Walgreens pharmacies as part of the agreement announced Monday.
Financial terms were not disclosed, but Prime officials believe it could spur growth that pushes the firm beyond its position as the country’s fourth-largest pharmaceutical benefits manager (PBM).
Prime Therapeutics is owned by 14 Blue Cross and Blue Shield insurance companies, so the agreement with Walgreens brings together two of the country’s strongest brands in health care, said Jim DuCharme, the chief executive of Prime Therapeutics, in an interview.
“Nobody in the industry has integrated and connected the health plan — the Blue plan — with the retail pharmacy network, with the PBM, for unification of data, technology and overall drug cost reduction,” DuCharme said. “So, that’s probably the most unique feature of this strategic alliance.”
Health insurers hire PBMs to manage the pharmacy benefit portion of health plans. That means everything from negotiating prices with drug companies to structuring formularies that stipulate patient co-payments for different medications.
PBMs assemble a network of retail pharmacies where health plan subscribers can get their prescriptions at the lowest cost. The companies also directly fill prescriptions for patients through mail-order pharmacies as well as specialty pharmacies focused on high-cost and complex medications.