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Sun, Dec

The Prescription for Winning the Affordable Prescription Drug Battle: Be on the Side of the Consumer

LOS ANGELES

ALPERN AT LARGE--Amidst all the craziness of the world, there's still one big issue in our lives that stands out: the cost of health and survival.

 And it's no secret that prescription costs--and not just the expensive, billion-dollar-blockbuster types we've seen coming out over the past few years--are killing us. Literally, they are killing us.

When it's a choice between food, rent, and generic, decades-old prescriptions that are now pennies to make, it's a truly life and death issue that MUST not be ignored. 

Contrary to popular belief, our health insurers are NOT always the bad guys. Sometimes a given health plan IS obnoxious and cruelly self-serving, but it's not just that simple. 

So when Blue Cross/Blue Shield pledges $55 million to make a new subsidiary of Civica (a nonprofit drug maker founded in 2018 by a group of hospitals) that will focus on outpatient generic medications, that's big news that's long overdue.

Don't subscribe to the New York Times and can't access the last link? Try this one from The Hill.

It's big news, and it's from the same folks who brought you over the counter Allegra, Claritin, and Zyrtec--the health plans want to both save costs to the consumer and to themselves when over the counter medications are sold as prescription only (which jacks up the cost to all parties involved). 

In other words, those evil health plans sometimes are evil, but it's neither fair nor accurate to presume they're always evil. Sometimes we must remember that those who run these plans are humans, and that saving costs also means providing better access. 

Governor Newsom is also trying to increase generic competition with a California-branded, state-supported company. 

I'm not a fan of the governor, overall, and I think that union issues will eclipse cost-effective, consumer-focused results in our current public sector climate. 

Yet it's hard to argue with the governor's sentiments--including the concept that drug manufacturers need more scrutiny in anti-competition, RICO act enforcement laws that are supposed to protect American taxpayers/consumers.

Yet if generic drug makers are either not up to the job, and/or are even collaborating to keep prices of decades-old, cheap-but-vital medications so far overpriced as to be unaffordable, SOMEONE needs to step in.

And health plans who want to both help their consumers and save their own cost overruns are perhaps a very motivated source to do that.

Particularly when about 78%, as the above link from Reuters reports, of the $335 billion in annual U.S. drug spending goes to generic versions of branded drugs that have lost patent protection.

Both Democrats and Republicans are fighting each other, but the one thing they appear to have in common is their proclamation that there isn't enough competition to lower drug prices. 

And when market competition decreases, generic drug prices increase, as the American College of Physicians reports, based on an article from the Annals of Internal Medicine.

So, it's to be understood that the socialistic approach of price controls might drive us to slam the drug makers...but if they're solely profit-driven, suddenly they'll be a few "manufacturing slowdowns or problems" that make the prices go up more. If a drug maker will be obnoxious and callous, that won't end.

But good ol' capitalism might be an even better idea--jack up the number of generic makers, and the prices MUST go down (presuming these multiple makers aren't in cahoots, which might be the case at times). 

Something has to change. Something has to give.

Because when you're paying $200+ a month for a medication decades older than you are, something is just plain wrong.

And you don't need to be a doctor, health plan CEO, or drug maker executive to figure that out.

(CityWatch Columnist, Kenneth S. Alpern, M.D, is a dermatologist who has served in clinics in Los Angeles, Orange, and Riverside Counties, and is a proud husband and father to two cherished children and a wonderful wife. He was (termed out) also a Westside Village Zone Director and Board member of the Mar Vista Community Council (MVCC), previously co-chaired its Outreach Committee, and currently is Co-Chair of its MVCC Transportation/Infrastructure Committee and Vice-Chair of its Planning Committee. He was co-chair of the CD11 Transportation Advisory Committee and chaired the nonprofit Transit Coalition and can be reached at [email protected]. He also co-chairs the grassroots Friends of the Green Line at www.fogl.us. The views expressed in this article are solely those of Dr. Alpern.)

-cw