Pharmacies Without Borders -The True Cost of American Pharmaceuticals

Inaccessible Medications

The United States has long been considered a leader in the fields of medical innovation, research, and drug development. But when it comes to delivering these innovative medications to the people who need them, the U.S. is far behind the curve.

The reason? The exorbitantly high cost of pharmaceuticals.

While the world leader in medical progress continues to discover new breakthroughs in the field of pharmaceutical science, life-saving medications have become inaccessible to patients due to high drug prices. The costs of drugs in the U.S. has risen to such a degree, in fact, that patients are being forced to travel across borders in order to obtain fairly-priced medications. But what are the long term effects of this kind of system? What are the repercussions for patients, U.S. pharmacies, and the healthcare system as a whole?

The Expatriates of Big Pharma

In the midst of political debates and soaring drug prices, the people who stand to lose the most are the patients who rely on these medications. When necessary drugs like insulin become unaffordable, patients are forced to take extreme measures. Many are traveling across the border to Canada, or going south to Tijuana, where they can purchase medications at a fraction of the cost of U.S. drugs.

Canadian pharmacies are concerned about the potential consequences from the the influx of American buyers.

The term medication tourism has come to be applied to this type of travel, with some insurance providers even offering travel plans for those who need to purchase their prescriptions out of the country. Of course, this has raised some important questions about the effects of outsourcing medical treatment this way. Will insurance companies decline as employment rates and pooled medical coverage decreases? Will the economy of the U.S. suffer from this outflux of buyers?

The U.S. isn't the only country that finds this trend worrisome. As caravans of U.S. citizens have began traveling to Canada for affordable insulin, Canadian pharmacies have expressed concerns over their own insulin supplies. If Americans continue to deplete the supply of Canadian drugs, it could lead to shortages that would force Canadian pharmacies to raise their prices.

Research and Development vs. Profit

So what are the causes of the high costs of drugs in the first place? The main reason, according to big-name companies like Pfizer and Merck, is to support research and development. In essence, these companies claim that in order for research to continue - and for better, more effective drugs to be created - consumers need to pay top dollar for the drugs that already exist.

This sounds like a plausible answer; after all, the drugs we have today only exist with the backing of billions of dollars' worth of research. However, a deeper look into the cost spent on R&D vs. the cost of the medications themselves shows a wide disparity. A large chunk of the money spent on drugs funnels directly into profit.

The fact is that there is no regulation in the U.S. for drug prices. Unlike most developed nations, which cap prices on pharmaceuticals to keep them within a reasonable amount, American drug companies are allowed to charge as much as they like. What may seem like an abuse of free enterprise is really a simple model of capitalism. If a drug works and is in high demand, then the sky's the limit when it comes to how much you can charge.  

The Sovaldi Dilemma

A prime example of drug companies overcharging simply because they can, is in the case of the drug Sovaldi. The drug was approved in 2013 for the treatment of Hepatitis C, and came as a breakthrough in the treatment of the disease. Boasting a high success rate, Sovaldi cured patients while sparing them the terrible side effects of earlier drugs. For patients facing liver disease and cirrhosis, Sovaldi is a miracle pill - that is, if you can afford the price tag of $84,000 for the twelve-week treatment.

Because of its enormous cost, Sovaldi is only approved for the sickest patients; in some cases, patients must be entering stage 4 liver disease before Medicaid will approve treatment. Even then, the cost is so extreme that insurance companies are extremely limited on the amount of cases they'll green light.

Tallying the Human Cost

While even patients with good insurance may be unable to afford the most expensive treatments - such as Sovaldi - patients who are uninsured find themselves unable to get access even to common and generic drugs. Many patients have resorted to rationing their treatment in an attempt to save money, with up to 25% of diabetic patients now rationing their insulin usage. While the short term consequence of this is bad enough - patients suffering or even dying simply because they can't afford medications - there are long-term effects as well. Patients who can't afford the simple treatments and cures that are available will inevitably develop worsening health problems down the road, adding to the financial load of U.S. healthcare.

So what's the solution? Is there a solution in sight, even as America's drug crisis steadily increases?

As bleak as the situation seems, there are ways it can be improved. One way is to increase the approval and promotion of generic drugs. Generics often work as well as name brands, and they introduce healthy competition into the pharmaceutical marketplace. Giving patients the option of an affordable generic would help level the playing field and encourage big companies to lower their own prices.

Generics often work as well as name brands, and they introduce healthy competition into the pharmaceutical marketplace.

Promoting generic brands would mean having policies in place that help eliminate patent loopholes. While patents are a necessary aspect of the pharmaceutical business, companies have become skilled at finding loopholes that extend these patents far beyond their expiration dates, removing the opportunity for generic brands to enter the market.

Another idea is lobbying for government control of life-saving drugs, such as Sovaldi and breakthrough cancer treatments. Pushing for government-ordained price caps on these drugs would help control the highly inflated prices we have today.

While the state of the drug industry has become problematic, it isn't without hope. By backing the changes we want to see in the drug industry, we can help move towards what everyone should see as a crucial goal - getting affordable medications into the hands of the people who need them most.