Prescription Musical Chairs Part I

Have you had enough of sky-high prescription prices? Are you tired of insurance plans that won’t cover them? Does the whole process make you want to scream? Do you feel like you are the one left without a chair in a game of musical chairs? Well if your answer is yes, then read on. I really can’t imagine anyone saying, "no, I think they should charge more for that drug" (intended sarcasm). It just isn’t done. In a perfect world, all our medications would be covered and cost the same amount each time we refill them. But, as you know, we don’t live in a perfect world. This two-part article hopefully will shed some light into the process of prescription drug pricing and hopefully offer tips on how to legally navigate the system. As a point of reference, I used to work for several insurance companies. I learned many things from my customers over the years through listening and asking relevant questions. Plus, I’ve done a few years of research into the matter, considering I have Parkinson's which entitles me to a lifetime membership in the pharmaceutical industry or what I refer to as "club meds".

Why are prescription drugs so expensive?

I am in no way justifying or taking the pharmaceutical (Pharma) companies’ side on the pricing of their products. In fact, it is my belief that the system is flawed and in serious need of an overhaul. That being said, millions of dollars are spent on pharmaceutical research. Very often initial phases of this research result in failure, wasted time, and resources. When the subject of a study is identified, such as Parkinson’s Disease (PD), the initial hypothesis can be very complex. In other words, PD is too big and vast to solve for x where x equals a cure. So if Pharma is focused on drugs to treat our individual symptoms, how will a cure be discovered? Trust me, the scientific community is on it. There are collaborative efforts all over the world doing extensive research into finding a cure for PD but the here and now is important to our daily functioning. I cannot tell you how close they are to finding a cure for PD and I’d be lying to you if I said there will be a cure in 5-10 years. False hope is a road you don’t want to go down! All this research takes years of various clinical trials and in those that involve human studies, unfortunately, volunteers are lacking. The Food and Drug Agency (FDA) is involved in application approval and oversight of the development and advancing research of prescription medication.

Bottom line

The bottom line is after all the applications, approvals, fees and expenses (which includes all the resources and failed clinical trials) the average Pharma company has invested millions of dollars and 10 – 15 years to bring one prescription drug to market and there are no guarantees.

Why does the process take so long?

From beginning to end, the drug approval process is a journey that is lengthy and obstacle-laden. As I mentioned before, the whole process can take 10 – 15 years. There is usually an exploratory phase whereby a basic or sometimes complex question needs to be answered. One example, how can we stop motor symptom fluctuation with the least amount of side effects most effectively? Next, an abstract presentation is usually developed to define further what you are trying to solve for. This can be a single person or a collaboration of researchers anywhere in the global scientific community (kind of a more minds scenario). Then there is the greater issue of securing funding for the project. You need to continue to identify necessary resources, staffing needs, equipment and recruiting volunteers for clinical trials. There is a lot of planning involved in this process before any experiments are performed in a clinical setting. The failure rate is also extremely high for Pharma companies to provide for a drug that is both safe and effective. This leads to delays and re-planning, changing resources, and sometimes bringing in additional personnel. All of these things add to the bottom line.

Medication price

So, the next time you pull up to your pharmacy don’t freak out if the price of the medication wasn’t what you expected. In part two of this series, we will discuss further the drug development process and ways in which you as the consumer can be empowered in tackling the high cost of prescription drugs as well as helpful tools to unburden you from having to pay out of pocket.