Editorials, Opinion

Here’s how to lower prescription costs

In rejecting the pared down Build Back Better Act, Sen. Joe Manchin made clear that the only provision he still supports is codifying Medicare’s ability to negotiate prescription drug costs.

Such a law would undoubtedly help hundreds, if not thousands, of West Virginians to contain the ever increasing cost of necessary medication. But there’s no reason to stop at only helping Medicare/Medicaid beneficiaries.

The joke is that America is the only country where patients tell doctors what to prescribe them. And this is mostly true — only the U.S. and New Zealand allow pharmaceutical companies to advertise prescription drugs directly to the public.

To be clear, other countries do allow drug companies to advertise over the counter (OTC) medications. These would be your brand name anti-inflammatories or allergy drugs like Tylenol or Claritin. What they limit are ads for prescription drugs like immunotherapies and specialized and mental health medications.

 Congress has the ability to limit the way drug companies market their products, bringing our policies in line with other developed countries, which could then lead to lower prices for consumers.

Spending on drug advertising has increased over the years, but it can take a while for the exact numbers to roll in.  According to one 2019 study published in the Journal of the American Medical Association, overall spending on marketing had reached almost $30 billion in 2016.

Companies spent around $9.6 billion on direct to consumer (DTC) marketing — such as the commercials that dominate cable, glossy ads in magazines and pop-ups online — in 2016, with about $6 billion of that on advertising prescription drugs. To put that in context with what we mentioned earlier, that means pharmaceuticals spent less than $4 billion marketing OTC drugs to the entire world and $6 billion marketing prescription drugs just to America and New Zealand.

If that number is infuriating, wait until you hear how much drug companies spend schmoozing doctors. According to that same study, companies spent $20.3 billion on marketing to physicians in 2016. Multiple studies have shown that marketing directly to physicians works: One 2017 study followed hospitals that had allowed “detailing” (face-to-face meetings between pharmaceutical reps and doctors, which tend to include free samples) then discontinued the practice and found, after policy changes, the market share of detailed drugs decreased and the share of non-detailed drugs increased. Detailing makes up the   largest share of direct-to-physician marketing, but “educational” (read: wine and dine) meetings with featured physician speakers cost $2 billion in 2012, according to Pew Charitable Trusts.

It’s only gotten worse. According to “A How-To Guide to Marketing to Physicians and Consumers,” nine of the 10 largest pharmaceutical companies spend more on sales and marketing than on research and development. But, the article noted, “pharma marketers waste over $1 billion trying to get a hold of doctors.”

According to the Health Tracker System, in 2019, “the U.S. spent $1,126 per capita on prescribed medicines, while comparable countries spent $552 on average.” U.S. health insurers pay more than any other comparable country, and U.S. patients pay more out-of-pocket, too. Many brand name prescription drugs also cost more in America than in other developed countries.

It’s hard to imagine the extra billions drug companies spend on marketing to U.S. patients and physicians don’t impact our prescription drug costs. Even if nothing else changed, if Congress brought American regulations in line with other countries’ DTC marketing rules,  roughly $6 billion  could be passed on to consumers as savings or invested back into research and development.

There’s no need to spend millions marketing a specialty drug to the entire country when only a handful of people need it. But U.S. regulations allow drug companies to do just that, then pass the cost — and then some — on to all of us.