3 Reasons Why Prescription Drugs Are So Expensive

 3 Reasons Why Prescription Drugs Are So Expensive

It is no secret that prescription drugs are outrageously expensive. After nineteen years of working with those transitioning into retirement and helping retirees shop Part D Drug Plans, I have come across some astronomic prices. To give you an idea, some of the prescriptions (without insurance, thank goodness) range from $40,000 per year all the way to $158,000 per year. And what’s more, the prescription that cost $158,000 was simply a small, white pill that my client took once a day. If you break that down to price per pill, the cost is $439 per pop. Talk about over-the-top!


The scary part is, I know this is a widespread issue. Its effects extend to burden millions of older and younger folks beyond my small office in Sidney, Ohio. I’m not naïve enough to believe that what I have witnessed is unique.


This raises the question: why? Are drug companies “getting away with murder” as Donald Trump proposed on his campaign trail? Is it a governmental failure to regulate a monstrous and out-of-control industry? Or are their prices ultimately justified? Well, I did a little digging, and it seems the general consensus centers around three main reasons:


Reason#1: The 20-Year Monopoly

If any of you have ever played the famous Parker Brother board game, you know that the game is over once one player has control of the board. It is the same with the drug industry, except their monopoly is not won through rolling doubles and buying properties, but by acquiring patents. Once a pharmaceutical company turns out a new drug, their patent grants them exclusive rights to the formula for 20 years. This prevents any generic drugs from being manufactured to provide competition. And no competition means unlimited control over price. Normally this excessive control wouldn’t be the case, but prescription drugs are not like new sneakers or television sets. Those who need them can’t live without them, and are, quite often, willing to pay anything to get them.


This wouldn’t be so bad if it were just for those first twenty years. After all, the pharmaceutical company does need some time to make profit back after dumping loads of resources into research and development to turn out the new drug. However, the companies often push their monopoly past the 20 years by changing their formula just enough to renew their patent. At that point, the monopoly can become a bit oppressive.


Reason #2: Can’t We Talk About This?

Many other countries negotiate heavily with drug companies to keep prices low. But the United States does not allow this. Medicare is not allowed to talk the price down, and others who might have a voice are silenced by the almighty dollar. Essentially, drug companies have full reign over what they charge for their prescriptions.


Imagine how much the United States could save if they allowed Medicare to have a say.  According to the Economist, Medicare is the drug companies’ “single biggest customer,” forking over $112 billion to purchase prescription medications for retirees. If they could use this buying power as leverage, AARP says that Medicare could save $16 billion annually. Then they could pass those savings over to you in the form of lower Part D premiums and fees.


Unfortunately, this is not the case as of now. Now, Medicare has to cover almost all drugs approved by the FDA, AARP says, “regardless of whether a cheaper, equally effective drug is available.”


Reason #3: Lack of Transparency in Drug Pricing

It is difficult to tell how much a drug is actually worth. Drug companies claim that research and development costs justify the high prices, but it is unclear as to how accurate this really is. Some sources, like Money Magazine dispute this explanation, citing that only 10-20% of revenue really goes to research and development.  Others, like AARP, point out that “9 out of 10 big pharmaceutical companies spend more on marketing than on research,” a statistic which shows a lot about where their priorities lie. And this all goes without saying that drug companies are rarely hurting for money anyhow. In recent years, it has proved to be a very lucrative industry.


Overall, it seems that drug companies have too much power in the United States economy. The question then turns to how can we lessen that power to make it fair for everyone involved without lessening the incentive for innovation. Because $439 for each measly pill is too much. I think everyone besides the drug companies can agree on that.


Until these issues are tackled, just do what is within your power. If you are approaching 65, get yourself on a Part D drug plan for your unique needs and situation.   Remember, at any given time there are 20+ drug plans to choose from, so don’t let company names drive you to the wrong plan.  Each person’s recommended drug plan is different based on their prescriptions.  Make sure and shop your drug plans!

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