States are looking for ways to curb the usage and cost of expensive medicines

States are looking for ways to curb the usage and cost of expensive medicines

There are a number of conditions that are treatable with expensive specialty drugs. According to the NY Times article, these drugs could cost as much as 100,000 per month, as discussed in the article below. Because of the outrageous costs of some of these medicines, it is pushing up the cost of insurance for all of us, as the drug companies are giving vouchers to decrease the out of pocket cost for the recipient, making it more affordable for the recipient since the voucher absorbs some or all of the out of pocket cost. This brings the question of what the drug really should cost, since market forces are all but eliminated. What would happen to this person if this drug was unavailable, as it was prior to its introduction? Would they otherwise not survive? Is there a better way of handling the problem through a different type of research that is not geared toward developing a drug, but instead toward finding a way to resolve the problem permanently for a one time cost.

A different thought process may actually cure the problem however, drug companies are in the business of finding drugs that need to be taken dependently, because this is their business model. They are not in the business of curing anything. Through the subscription model, the drug company can make a fortune. Drug companies are becoming aware that patients are being asked to pitch in a greater amount per prescription, however, in a drug that costs 10,000 per month, most families cannot afford the cost and it is clear that neither can our society.

The reality here is that without insurance covering the outrageous cost, this person would never afford or take such a medication. Perhaps the cost would be much lower if insurance did not exist, since the drug company would likely have to make it affordable or never manufacture the product. Whether or not this is true is for discussion later on, however, the fact is that drugs like these are unaffordable and their long term use is unsustainable. Check out the NY Times article below that explores this idea.

States Seek Curb on Patient Bills for Costly Drugs

By Published: April 12, 2012

The hemophiliadrug that saves 7-year-old William Addison from uncontrolled bleeding costs $100,000 a year. His family’s insurance pays virtually all of it.

But his mother, Victoria Kuhn, says she is terrified that the insurance company may start requiring patients to pay as much as a third of the cost of the drug. “I don’t know where we’d find $30,000,” said Ms. Kuhn, who lives in Falmouth, Me.

Spurred by patients and patient advocates like Ms. Kuhn, lawmakers in at least 20 states, from Maine to Hawaii, have introduced bills that would limit out-of-pocket payments by consumers for expensive drugs used to treat diseases like cancer, rheumatoid arthritis, multiple sclerosis and inherited disorders.

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