Thursday, December 10, 2015

Big PhRMa Extortionists Exposed: Charging $10,000 A Month For Cancer Drugs


It is bad enough in these United States when an older person on Medicare,  like I am, has had to shell out nearly $797 over the past two months for assorted prescription meds, including one (colcichine) expressly for gout, and others for gum infection and ear antibiotic drops. Where the hell is the ability of Medicare to bargain for the lowest drug prices like the VA does?

Anyway, as tough as I may believe I have it (including the fact colcichine is listed as a "generic" in the drug formulary) it is nowhere near as bad as cancer patients, especially women with breast cancer. They are now faced with a $9,850 a month tab for a new Pfizer drug called Ibrance (see graphic).  The drug is touted as damned near a life saver given the extension of life it affords. The question is: Can a Walmart clerk earning about $10.50 an hour afford it? I doubt it.

Which makes the front page story in yesterday's Wall Street Journal almost make you want to puke. Because it describes blow by blow, tactic by tactic, exactly how Pfizer (which also makes Viagra) decided to arrive at that whopping drug price. I mean, the story almost reads like a crime or horror piece except that it's real, and the crime - massive price gouging - is legal.

Before we get to that, let's concede this drug IS remarkable. But that it should be priced at nearly $10k a month is debatable. According to the piece it was originally called PD-0332991 and "grew out of work on proteins that help regulate how cells form in divide". The research "won a Nobel Prize" and "set off a hunt by drugmakers to put the brakes on the overactive proteins called cyclic-dependent kinases."

Pfizer's specific novel compound "targeted advanced breast cancer fueled by estrogen  - a disease for which existing therapies offered only modest extension of life"

SO far so good, but the intriguing aspect was in setting the price for those advanced breast cancer patients. Originally some oncologists recommended the base price be near Herceptin (at $4,775 a month) but the Pfizer geniuses argued that it "wasn't a good benchmark" because it was so much older than Ibrance and "taken differently."

Who knew that "taking it differently" or the time available could translate to nearly $5,000 a month higher cost? I didn't!

Before getting on to how Pfizer exactly set their price, the WSJ author explodes one of the more common tropes, that costs are based on research. Forget that. In fact, as per the article (p. A1):

"Drug companies routinely raise the cost of older medicines and then peg new ones to these levels".


In other words, they game the system, and this is one huge reason medical costs are spiraling out of control.

In the case of Pfizer's pricing of Ibrance, it (p. A12):

"emerged out of a complex analysis of the new drug - with this one's particular set of benefits and risks, as well as the cost of potential competing drugs and the sentiments of cancer doctors."

Well, Pfizer's gurus adjudged the risks and benefits at least in line with others available such as Affinitor from Novartis AG. When Novartis raised Affinitor's price by 9.9% on Jan. 6, Pfizer briefly had second thoughts pricing its drug as high (Affinitor was then $687 above Ibrance).

There was then the issue of doctor acceptance and that hinged on not hitting the critical $10,000 a month  level "which would require physicians to document medical necessity."

Pfizer definitely wished to avoid that higher paper work threshold so priced its drug just below the $10,000 level, at $9,850.

The WSJ piece claims that:

"Sales are off to a strong start. The drug has been taken by 18,000 cancer patients so far"

And I will wager that nearly all those women taking it are one percenters at least. (Pfizer talks about "subsidies" for low wage people but this is hard to reconcile with their claim that Ibrance will "eventually bring in billions of dollars per year".)

Mainly on the backs of women at death's door who will feel like they have a gun to their heads if they don't cough up what these drug extortionists want!

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