Sunday, October 4, 2015

The ridiculous pricing of pharmaceuticals in the U.S.

I just wrote this letter to my two senators and my representative, and I hope you'll do the same:

Dear ________,
I practice Emergency Medicine at Hennepin County Medical Center. We have been very adversely affected by the sudden increase in prices of many necessary and previously affordable generic drugs.
One example is nitroprusside (brand name Nitropress), which is essential for lowering critically elevated blood pressure. The drug has become unaffordable because Valeant Pharmaceuticals bought the drug and suddenly raised the prices exorbitantly. This company has done the same for many drugs, and other companies have done the same for many others.
The only reason this is possible is that the U.S. does not regulate drug prices as all other countries do. Valeant, it turns out, has not only raised all prices, some by as much as 2000%, as in the case of Cuprimine, a treatment for Wilson's disease for which they now charge $36,000 per month (!), but they have also changed their corporate headquarters and outsourced all their employees.
After acquiring 3 companies, they fired 750 of 790 employees at Medicis Pharm (one acquisition), 3000 of 4100 at Bausch and Lomb, and 420 of 977 at Salix. See references at bottom.
So we in the U.S. have to pay exorbitant prices for drugs while all the work to produce them is outsourced to other countries, AND they changed their headquarters to Canada so that rather than paying 35% in taxes, they now pay 3.3%.
And our patients all suffer, as do our hospitals which have to pay prices that they cannot afford.
All for a company that does not engage in any R and D, and pays their top 5 executives an average of $25,000,000 (yes, million) per year. And the only thing they did to earn their pay was to raise prices on drugs. They invested nothing to produce a new drug!
This is not just limited to this company or these not-so-commonly-used drugs. Every brand name drug (and probably generic, too) in the U.S. is priced at 10-15 times the price in every other developed country. The widely used inhaled medications for asthma cost on average $300-400 per month in the U.S., but only about $30.00 per month in Europe, from the same manufacturers:
And the same goes for medical devices:
See these two articles on Valeant from the Oct 4 2015 edition of the New York Times:
It is time we regulate drug prices in the U.S.
Stephen W. Smith, MDFaculty Emergency PhysicianHennepin County Medical CenterProfessor of Emergency MedicineUniversity of Minnesota School of Medicine


  1. Wow, thats... Fascinating in some sense of the word... That kind of profiteering wouldnt be possible where I come from. For the sake of your patients, I hope your letter will have impact on the politicians.

    MD Sweden

  2. Great letter, Steve! After tweaking it a bit to make it more appropriate for my locale, I sent copies to my US representative and one of our senators (the other one can't be reached through my server which is just as well since he is likely a big supporter of the drug companies.) Hope you don't mind.

    Jerry Jones MD FACEP FAAEM


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