WHY ARE MEDICAL DRUGS SO EXPENSIVE?
It has often been said that the rising cost of healthcare is due to drugs, especially cardiac drugs, and oncology drugs. Well, yes and no. Drugs on the average forms about 10-20% of a countrys' healthcare budget. In a developed country where they demand the latest and keep all 80 yaer olds alive, then maybe about 20%. In a developing country where the main issues are infectious diseases, maybe about 10% or less. In a developing country where the main health issues are non-communicable, chronic diseases and cancers, then somewhere in between, maybe about 15%. Please note that admin cost for healthcare is about 30% ( in comparison ). Sometimes, I do not understand why many are attacking the pharmas and NOT the insurance companies, third party payers and also the hospital and public hospital admins?
I had looked into this issue, for the overall issue of raising HC cost? Should we follow the first world way?
It is obvious from the onset, when first world made Healthcare ( HC ) a business, following the free market, laissez faire model, everything is for profit and the sky is the limit depending on market forces. No regulations, as propounded by the Hayek / Friedman / Chicago boys. There should be no regulations. The good thing is, there will be innovations and improvements. The bad thing is cost and rising cost.
Now, do you want to have a state regulated way, where the state has a social responsibility and control the prices of goods and services in the healthcare industry? Then you can expect less innovations and improvements.
Now, on the issue of generics. It is true that much of the cost of branded drugs is to repay R&D and also A&P budget – to send you doctors to conferences ( read holiday ) on business class at 7 star hotels and drink wine, and in some cases even shopping? Where is this money coming from? R&D can be very costly with the stringent regulations nowadays. For every drug that make it to market use, about 80-90 fail ( I am told ). So now, big pharmas buy over small pharmas whose drugs are in advance stages, and that looks promising. That is costly.
When drugs are manufactured, the standard of the drugs, depend very much
on GMP ( Good manufacturing practices ), and post market surveillance
in case a side effect got missed like Rosiglitazone. GMP and post market
surveillance standards vary very widely amongst countries. It is their
countrys’ standard. Some country just got no standard, so drugs come out
as good as flour powder packaged in blister packs. Of course generic
drug companies are unlikely to do R&D for new drugs and obviously no
post market surveillance.
So, you take your choice – free market with innovation and raising cost, or regulated markets with lesser cost, but minimal innovations and improvement. Branded products with good GMP and postmarket surveillance, or just hit and run manufacture?
What is best for your patient and your country? You decide.
One thing that you all can do is- travel economy unless long flights, pay your own hotel and registrations unless you are invited faculty, and no eating and shopping on drug pharmas / device companies please. That would be a step in the right direction.
I rest my case.
I had looked into this issue, for the overall issue of raising HC cost? Should we follow the first world way?
It is obvious from the onset, when first world made Healthcare ( HC ) a business, following the free market, laissez faire model, everything is for profit and the sky is the limit depending on market forces. No regulations, as propounded by the Hayek / Friedman / Chicago boys. There should be no regulations. The good thing is, there will be innovations and improvements. The bad thing is cost and rising cost.
Now, do you want to have a state regulated way, where the state has a social responsibility and control the prices of goods and services in the healthcare industry? Then you can expect less innovations and improvements.
Now, on the issue of generics. It is true that much of the cost of branded drugs is to repay R&D and also A&P budget – to send you doctors to conferences ( read holiday ) on business class at 7 star hotels and drink wine, and in some cases even shopping? Where is this money coming from? R&D can be very costly with the stringent regulations nowadays. For every drug that make it to market use, about 80-90 fail ( I am told ). So now, big pharmas buy over small pharmas whose drugs are in advance stages, and that looks promising. That is costly.
So, you take your choice – free market with innovation and raising cost, or regulated markets with lesser cost, but minimal innovations and improvement. Branded products with good GMP and postmarket surveillance, or just hit and run manufacture?
What is best for your patient and your country? You decide.
One thing that you all can do is- travel economy unless long flights, pay your own hotel and registrations unless you are invited faculty, and no eating and shopping on drug pharmas / device companies please. That would be a step in the right direction.
I rest my case.
1 comment:
Ah, Doc, you may rest your case but humans being humans will want all the creature benefits, especially if they are offered free!
Who cares if the patient will eventually have to foot the bill!
I understand that there is in existence health management companies whose sole purpose in life is to control medical expenses of private companies and are adding another layer of cost to the cost of healthcare.
They should never be implemented at all.
They will also deprive employees of needed health care just to save the private companies money.
Also, this country, like many third world countries have lax regulations regarding the quality of drugs sold here.
And if the country is lax, the drug companies will be equally lax!!!
What they sell here may never be allowed in, say, the US!!!!
Insurance companies are also another factor that jacks up the costs of health care.
Some doctors may take it that since it is a private insurance company that is going to foot the bill, then the sky's the limit!!!
What they don't seem to realise that eventually the insurance companies will increase the premiums to be paid by their customers!!!!
All in all, these are the factors that will have a significant bearing on the costs of healthcare in this country and proper policies must be worked out to minimise them to benefit the patients.
Thank you.
Regards,
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