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October 19, 2004
Epidemic of Good Sense Spreading, Scientists Say
Posted by Derek
Thanks to the Red Sox and the Cardinals, I'm pressed for blogging time today. But I wanted to point out an article by Malcolm Gladwell that was just posted at the New Yorker site. Entitled "Don't Blame Big Pharma", it's a look at Marcia Angell's book - with which he's not impressed - and at the drug pricing issue in general. It contains indisputably sensible stuff like the following, regarding the prices of prescription versus generic drugs:
"It is not accurate to say, then, that the United States has higher prescription-drug prices than other countries. It is accurate to say only that the United States has a different pricing system from that of other countries. Americans pay more for drugs when they first come out and less as the drugs get older, while the rest of the world pays less in the beginning and more later. Whose pricing system is cheaper? It depends. . ."
I think Gladwell's key point is this one, and it's well worth thinking about:
"The core problem in bringing drug spending under control, in other words, is persuading the users and buyers and prescribers of drugs to behave rationally, and the reason we’re in the mess we’re in is that, so far, we simply haven’t done a very good job of that."
Of course, that would mean that a good part of my industry's profits might well be made through the suboptimal decisions of its customers - not that we we'd be alone in that category, for sure. But it's not a group I feel comfortable being a member of, and I'd rather we found a way out of it. More thoughts on this to come.
Comments (4)
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1. Paul on October 19, 2004 10:12 AM writes...
The above is not necessarily true though.
Everybody wants the best for themselves, and wants someone else to pay. Why take Zantac when your insurance plan pays for Nexium? Who cares if it only works a little better at 20 times the cost? Why should an MD prescribe Zantac instead of Nexium when some lawyer will trash him for not using a newer, marginally more effective medication?
Vioxx (R.I.P.)/Celebrex/Bextra are no more efficacious than Motrin, and only safer in those who do not take aspirin, or prone to GI bleeding.
Why, then, are millions of people taking these medications? Same reasons - insurance pays the difference so the patient doesnt care, and doctors live in fear that one of their patients will sue for a GI bleed that may or may not be caused by medication.
Permalink to Comment2. Derek Lowe on October 19, 2004 11:40 AM writes...
Free, you're going to have to convince me that your comment isn't an ad for your associated web site. Explain what, exactly, you mean by "linking arms" and "not buying expensive meds". Make it good, make it interesting, and no ads, please.
Permalink to Comment3. Clay on October 19, 2004 2:08 PM writes...
I never read Angell's book, but I read her essay in the New York REview of Books. Gladwell's response, to my mind, puts her argument--warped by the heat of her self-righteous indignation--into the garbage can. Several months ago, who could have expected such a rational voice in such a prominent publication?
Permalink to Comment4. jeet on October 19, 2004 4:32 PM writes...
fear of lawsuits is a problem, however most of the docs I talk to tell me that they just give the patient what they want (in terms of brand) so that they can move on.
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