Drug Prices Contribute to Failure of Treatment
There’s no escaping the significant increase in drug prices and the apparent disproportionately high prices we pay in the United States when compared to other countries. And then there are the huge price hikes for old drugs like Daraprim by Martin Shkreli and the EpiPen debacle spearheaded by Heather Bresch from Mylan. We know these prices impact patients and their compliance with prescribed treatment and likely disproportionately affecting people with lower incomes. These issues do need to be addressed but there are some simple opportunities that might help move us towards more affordable drugs.
We know from some studies of sewer effluent that this contains good evidence for assessing community use of illicit drug use. This study in Nature showed higher usage of Cocaine at the weekends and there are moves by researchers and others to test wastewater as part of “the war on drugs” strategy. In fact, there is enough concern over the effects of drugs being flushed down the drain that there are several programs attempting to stop this practice through education
Which leads me to an incremental approach to reducing the cost and waste in our pharmaceutical supply system. Reducing the prescribed quantities to be in line with actual usage which in particular for ointments and creams would make a lot of sense. For chronic conditions long-term therapies this will not work – in fact, the complete opposite, it will add cost and frustration. If a patient is taking a regular antihypertensive medication providing an extended supply of the medication to save the frustration or challenges of refilling the medication is an essential part of reducing the friction for the patient
Share the Savings
This is also not an opportunity to squeeze more profits out at the expense of the poor beleaguered patient. In other words, don’t do what Charmin did and cheat the customer. They were caught shrinking the toilet roll (they tried a similar move in 2013) by everyone who had bought a toilet roll holder sized for the original roll. No one would have been upset had they seen a commensurate drop in price but much as they did in 2013 this was about extracting out more profits without the appearance of raising prices
Reducing the size of the tubes to more closely align with actual usage has been used in other countries effectively. Fewer resources can be the mother of invention. You don’t need a tube of cream that is 5g when you are only going to use a fraction of this.
Do you have any better suggestions? What small change have you seen that makes a difference to improve drug prices and make them more accessible and affordable? Do you think smaller packaging will make a difference? What one thing could we do that would have a big impact in this area?
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