Archive for May, 2018

Follow the Pharma Money

May 16th, 2018

President Trump indicated at his press conference on the pharmaceutical industry that a “tangled web of special interests” has conspired to keep drug prices high at the expense of American consumers.

Today I received an email reflecting the latest information about pharmacy costs for emergency rooms in the United States. The information was collected by IBM Watson’s Health Redbook which contains product information on more than 200,000 prescription and non-prescription drugs plus 8 of the 10 most frequently used emergency department drugs.

As a former hospital CEO, one of my most challenging aspects of budget season was predicting drug costs for the following year. Well, as most of us in the business know and Watson confirmed, within the past ten years, emergency department drugs have seen price increases of 50 percent or more.

Because I am neither a physician nor a pharmacist, many of these drugs mean little or nothing to me in terms of use or frequency of use, but as you will see, some of the more recognizable ones that are the most often used have had significant increases. Here’s just a few of them.

Ketoralac: 153 percent price increase (oral)

Morphine: 77 percent increase (injectable)

Albuterol: 69 percent increase

Hydromorphone: 81 percent increase (injectable)

Acetaminophen/Oxycodone: 90 percent increase

Lidocaine: 59 percent increase

Besides these drugs, another significant change has occurred that impacts thousands of patients annually. Depending on the manufacturer and quantity ordered, intravenous sodium chloride has increased in price by a whopping 162 to 328 percent.

What’s happening?

The pharmaceutical industry is a for-profit participant in what can only be described as the medical-industrial complex, and when you query them, they indicate that they have increased costs in producing their drugs, hence their higher costs to us, but their recent profits have been excellent.

I am also not an expert in the healthcare supply chain, but when it comes to things like IVs of saline solution increasing exponentially in cost, my head says, “Follow the money.” And following the money usually leads to lobbyists and politicians.

We know that drug companies have made billions of dollars by literally pushing opioids on our population. We consume 80 percent or more of the world’s production of these addictive pain meds. We also know that some of the most prominent supply chain companies were complicit in the illegal distribution of these drugs and were given only a financial slap on the wrist by our government for their involvement.

The current system of getting a new drug to market costs about a billion dollars, and the citizens of the United States are covering much of those research and development costs by paying more for drugs than any other country in the world. Is it a coincidence that the United States allows direct-to- consumer advertising for pharmaceuticals?

Follow the money.

In a private meeting, a top scientist from one of the pharmaceutical companies said to me, “You don’t understand the drug industry in the United States. We’re like the movie industry. We only want the blockbusters, a pill you have to take from age 5 until death that never makes you better.”

The big hammer the United States possess that could control these prices is the purchasing power of the federal government, something President Trump promised to enforce during his campaign. The U.S. government buys more drugs than any other entity in the world, but the President’s pharmacy speech touched on about 50 alternatives to that idea. He never came close to offering to bring that federal clout to the table.

In the EU, drug manufacturers are not permitted to set their own prices.

As securities analyst Ronny Gal, from Sanford C. Bernstein & Company said, “The President’s speech was very, very positive to pharma.” And he added, “We have not seen anything about that speech which should concern investors” in the pharmaceutical industry.

Follow the money.


What a weekend

May 13th, 2018
Nina had her piano lesson from the church music director, and when he walked into the room, three-year-old Pete yelled out, “I know him. He’s the guy who played the music when the Lord came out of his cave.”  (Pete and Joe were both at Easter mass.)

On Thursday evening we all went to the elementary band and choral concert at my grandkids’ school.  We were five minutes late and ended up parking illegally on the grass.  When we got inside the auditorium, the real fun began. Trying to keep Pete under control for 90 minutes of really good elementary music is, to quote Jerry Seinfeld, “Like putting a baby goat in a pillow case and hoping it behaves.” His mother ended up taking him into the hallway for at least twenty minutes, and as my long departed father-in-law would say, “ She took him out there to “blow the stink off.”  That kid  ran up and down the hall at Road Runner speeds until her head was spinning.

Friday evening was birthday party number three for the third grader in Pittsburgh. I’m not sure why, but kids seems to have a minimum of three birthday parties now: close family, full family, and family and friends. Of course there are always presents involved. There was also more cake, and, believe it or not, more Barbie Dolls. I’m happy to report that the dolls have evolved and are now representative of all shapes, colors, and forms.  Let your imagination run wild because there’s no limit to the ethnicities of these dolls. It may not be long before there’s a border wall built around the Mattel corporation to limit access to the United States.

On Saturday, Nina competed in the State gymnastics tournament and placed second in her age group for the whole State. Five hours to see five minutes!  Then the two Pittsburgh girls had their musical, a program they’ve been working on since last fall. This event involved feeding and then transporting every available family member to the show.  (Everyone, that is, except Pete.) We recruited our best relocated Johnstown to Pittsburgh friends for extra beds, food, and toys to hold this grand gathering together. The show was great, and, because she was going to miss her acting friends who were moving into seventh grade, Zoey cried for hours after the last curtain call. She had the staring roll as the leading lamb with one line, “Baaaaaaa,” and she managed to steal the show. And Lucy, well, Lucy’s always great.

Sunday morning was the Pittsburgh Marathon, and let’s just say that trying to get around in the City on marathon day is like trying to get out of East Berlin in the early ‘80’s.  You could drive in circles, but couldn’t get anywhere. We finally gave up and walked everywhere with a “hangry” little guy who didn’t care about the 40,000 plus runners, the clanging cowbells, or the people around him. He just wanted his mom, and the rest of us were clearly speed bumps in his way.The extenuating circumstance was his mom, big brother, and dad were all in the race and not near him.  It was our job to find them, cheer them on, and finally to reunite with them and get them back to the condo for showers.   They all did great, but I can only describe this experience as Arrrgh.

After the Johnstown kids were gone, we met the Pittsburgh kids for dinner at a restaurant where the wait would have been three days or longer. So, we headed off to another place, slammed down a salad and went to see our friend’s son, Matt, in “Hamlet.”  Truthfully, it brought back lots of memories of advanced high school English.  He was amazing.  I couldn’t help but think if they had only had psychotropic drugs, no one would have died.