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Researchers address the cost of healthcare in America: focusing on pharmaceutical prices

Pulmicort, a steroid inhaler that is one of the foundations of asthma treatment, costs $175 in the U.S.  Pharmacists in Great Britain buy it for $20.00 and dispense it free under Britain's health care system.  Perhaps the oldest mainstream asthma medication and the primary emergency airway relief is the Albuterol inhaler:  it cost $15.00 ten years ago but now costs between $50.00 and $100.00, after it was repatented with a different propellant.

Rhinocort Aqua, a nasal steroid that helps prevent airway spasming, cost $250.00 per month in California in 2012, but less than $7.00 per month in Europe wherer it is avialable over the counter.  These standard treatments for asthma, which turn a life-threatening illness into a condition that minimally interferes with normal life, cost more than $56 billion dollars last year.  Asthma kills 3300 people in the U.S. each year--usually victims who are undermedicated--and results in thousands of avoidable E.R. visits if patients cannot afford proper medication.

Drugs in general account for ten percent of the U.S.'s annual health bill.  They are a primary reason why this country pays far more, per capita, for health care than other developing countries pay--even though consumers in France and Canada take more prescription drugs than Americans do, according to Johns Hopkins University's Gerard Anderson. In 2012, the average generic drug increased in price by five percent in the U.S. while the average brand-name medication increased in price by 25%.  Republicans in Congress asserted themselves to deny the Medicare program the freedom to negotiate pharmaceutical prices, and the U.S. Patient-Centered Outcomes Resaearch Institute is not allowed to consider cost comparisons or cost-effectiveness in its recommendations. 

By other means, including paying generic manufacturers to not produce drugs, refusing to make medications available without prescription, litigation to stall competition, manipulating patent protections, and even creating artificial shortages, the pharmaceutical industry has sustained its exhorbitant profit-making in the U.S., despite the theoretical availablility of competition when a patent expires and generics could become available. 

Although the drug companies argue that these unusual and exhorbitant U.S. profits are necessary to support research and development, critics like Dr. Aaron Kesselheim of Harvard University and Dana Goldman, director of the Center for Health Plicy at USC, reject that explanation.  They point out that many of the most expensive drugs are old-line medications protected by patents on new additives or propellants or market-contract restrictions.  In many prominent cases, the U.S. drug companies spend more on marketing their drugs to consumers (legal only in the U.S.) than they spend on research. This year, more than 100 top cancer-treating specialists signed a public protest against the criminal rise in the cost of previously avaialable cancer treating medications.

The prices and facts cited here are from the Centers for Disease Control and Prevention, IMS Health, and the New York Times article of October 14, 2013.

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