Ethics of Rising Drug Costs
Rising insulin prices have recently gained national
attention – insulin is needed by patients to survive, yet its prices have
rapidly risen beyond unaffordable for many. These high prices comprise
patients’ well-being, and have resulted in deaths when patients try to stretch
their insulin supply.
While
insulin may be in the spotlight for now, it is far from being the only drug to
have seen drastic price increases. The dilemma
of prescription prices has become an ethical issue that needs to be addressed
on a national scale. Many drug companies
claim these high prices are necessary due to the costs of research and
development. Nirmal Mulye, CEO of Nostrum Laboratories increased the price of nitrofurantoin
to over $2,000 bottle, Nitrofurantoin, however, has been on the market for decades
and Mulye doesn’t contribute the rise in price to R&D expenses. Mulye
claims he was able to increase the price because Nostrum is one of two
companies that sells a liquid form of the drug. He raised the price because he
could, and patients have no choice but to pay. When asked about the change in
price, Mulye stated ‘“I think it’s a moral requirement to make money when you
can… to sell the product for the highest price”’ (Hiltzik, 2018, “Drug Executive:
It’s a ‘moral requirement’ to charge patients the highest price”, LA Times). I
think it’s safe to say most people (especially patients) would disagree with
Mulye’s statement, and his idea of a “moral requirement”. Some companies have
already taken stances in direct opposition to rising costs.
Many
insurance companies have recently capped insulin prices, and manufacturers like
Sanofi and Eli Lilly initiated new savings programs with significantly improved
prices (Sanofi’s deal is 10 boxes of pens for $100 each month). Other
companies, like Walmart have also made deals with companies to have their own
generic insulins at lower price. It’s refreshing
to see manufacturer’s and insurance companies holding themselves more
accountable for patient care, but it’s something that should have happened
decades ago. Denying patients access to a drug that they die without is highly
unethical in any situation, let alone to increase profit margin. Sanofi, Eli Lilly,
and other manufacturers have begun to hold themselves accountable for patient
well-being, triggering reform in the industry, but another manufacturer has
been leading this ethics battle for decades.
In 1980s,
Ivermectin manufacturer Merck realized that the drug could be used to treat onchocerciasis,
also known as river blindness. The parasitic disease was endemic in Western
Africa. Upon realizing that they possessed the treatment, Merck created the
Mectizian Donation Program in partnership with the WHO, pledging to donate as
much Ivermectin as needed for as long as was needed to countries in need. The
program was expanded to include treatment of lymphatic filariasis (elephantiasis),
another parasitic infection treated by Ivermectin. GSK partnered with Merck to
donate albendazole for the treatment of elephantiasis. To date, Merck has
donated over 2 billion treatments through the program. Several participating
countries have been able to eliminate river blindness, with others well on their
way to achieving the same goal.
As ethics
in pharmacy draws more attention, hopefully more manufactures, insurers, and
pharmacies will take steps to ensure the welfare of their patients around the globe.
Programs like Merck’s MDP have saved countless lives, and those companies have
been successful, despite the cost of the drugs they have donated. R&D for
new drugs will always be a costly expense in pharmacy, but Merck and others
have proved that high drug costs aren’t necessary for company survival, and may
be a sign of our own greed.
References
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