By Dr. Kate Scannell, Syndicated columnist
First published in print: 12/11/2011
We should not need to make certain laws. Without requiring state or federal legislation, we should automatically know that it's wrong to, say, kick a puppy. To bully gay students in public schools. To maliciously impersonate someone through social media with the aim of harmingthem. To not inform your customers when their personal information has been stolen from your company's computer databases.
Yet, admittedly, laws against these behaviors arose precisely because puppies were being abused, gay students were being harassed, people were ruthlessly slandered on the Internet, and unwitting consumers were falling prey to identity theft. And while such laws may fail to convince a puppy-kicker or cyberbully of their moral merit, still, they serve to discourage some bad behavior with threats of penalties and public sanction.
This brings us to current news about our nation's critical prescription drug shortage and a related bill being introduced next week in Congress. The new bill aims to penalize "unscrupulous drug distributors" w ho price-gouge hospitals for lifesaving medications in current short supply. If the bill is enacted, it would become a federal crime for distributors to demand hugely marked-up prices for these scarce drugs -- as many of them are now doing.
The majority of scarce prescription drugs are (or "were") inexpensive generic injectable medications usually administered within hospitals. Many were used to sedate and anesthetize patients for surgery, or to treat serious conditions such as cancers and infections.
A Prmier health care alliance survey released in August reported that "gray market" distributors had marked up prices for these drugs by an average of 650 percent. On the higher end the price-gouging spectrum, the heart drug labetolol and the sedative propofol (implicated in Michael Jackson's death) were priced higher by 4,533 and 3,161 percent, respectively.
Several of these scarce and opportunistically priced drugs represent first-line standard chemotherapies for cancers. Some oncologists and patients report having to resort to using less-effective or more toxic alternatives. The unavailability and newly prohibitive costs of such chemotherapies have not only disrupted cancer patients' care, they also have stymied research trying to establish safer and more effective new therapies -- a process requiring comparison against the standard drug.
It's stunning that we would need to invent a law to discourage entrepreneurs from taking such financial advantage of sick people during a national prescription drug shortage. You would hope that no self-respecting pharmaceutical distributor would want to be seen in such a sickening light.
Yet here we are again, trying next week to propose a new law to reinforce what ought to be obvious common morality. Here we are again, spending valuable taxpayer time and money on legislative efforts to reprimand egregiously bad behavior within the U.S. pharmaceutical market.
Our national prescription drug shortage -- which sets the dark stage for such successful price-gouging -- has been worsening for years in front of our politicians' blind eyes. The number of reported drug shortages each year has more than quadrupled recently -- from 61 in 2005, to more than 250 within the current year (so far).
You have to wonder why so little is being done to solve this national health care crisis. Appeals to patient care and safety don't seem to be motivating drugmakers and distributors to do the right thing. The skyrocketing medical costs attributed to the price-gouging don't seem to be mobilizing many politicians who claim an interest in taming health care expenditures. Where are all those people now who once shouted "rationing!" and "death panels!" at town hall meetings during the last election cycles?
One might reasonably ask: Well, why not just manufacture more drugs to meet the demands of this crisis, and increase the supply to drive down costs? Indeed, aren't drug companies generally happy to make and sell their products?
Obviously, the pharmaceutical industry has a different view. It cites several reasons why it has not been able to step-up drug manufacturing to help us out. And while all the production barriers it claims might be real, still, they also are somewhat irrelevant and misleading.
That's because the ultimate and definitive reason for the drug industry's inaction is that the scarce and majorly generic drugs are not profit-making, blockbuster drugs. Simply put, drug manufacturers would never allow any production barriers to exist if the drugs at stake for scarcity were billion-dollar moneymakers such as Lipitor or Zyprexa.
I don't think any law can force companies to manufacture lifesaving, cost-effective drugs in critical short supply. It is sad to resort to such desperate speculation. But for how long and at what personal and societal costs do we passively wait for something to change?
Chief Justice Earl Warren once famously remarked, "In civilized life, law floats in a sea of ethics." Unfortunately, looking through the lens of American health care, that sea is getting awfully glutted with laws that, in a certain kind of civilized society, would be viewed by many as lamentable flotsam.
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Kate Scannell is a Bay Area physician and the author, most recently, of "Flood Stage."
First published in print: 12/11/2011
We should not need to make certain laws. Without requiring state or federal legislation, we should automatically know that it's wrong to, say, kick a puppy. To bully gay students in public schools. To maliciously impersonate someone through social media with the aim of harmingthem. To not inform your customers when their personal information has been stolen from your company's computer databases.
Yet, admittedly, laws against these behaviors arose precisely because puppies were being abused, gay students were being harassed, people were ruthlessly slandered on the Internet, and unwitting consumers were falling prey to identity theft. And while such laws may fail to convince a puppy-kicker or cyberbully of their moral merit, still, they serve to discourage some bad behavior with threats of penalties and public sanction.
This brings us to current news about our nation's critical prescription drug shortage and a related bill being introduced next week in Congress. The new bill aims to penalize "unscrupulous drug distributors" w ho price-gouge hospitals for lifesaving medications in current short supply. If the bill is enacted, it would become a federal crime for distributors to demand hugely marked-up prices for these scarce drugs -- as many of them are now doing.
The majority of scarce prescription drugs are (or "were") inexpensive generic injectable medications usually administered within hospitals. Many were used to sedate and anesthetize patients for surgery, or to treat serious conditions such as cancers and infections.
A Prmier health care alliance survey released in August reported that "gray market" distributors had marked up prices for these drugs by an average of 650 percent. On the higher end the price-gouging spectrum, the heart drug labetolol and the sedative propofol (implicated in Michael Jackson's death) were priced higher by 4,533 and 3,161 percent, respectively.
Several of these scarce and opportunistically priced drugs represent first-line standard chemotherapies for cancers. Some oncologists and patients report having to resort to using less-effective or more toxic alternatives. The unavailability and newly prohibitive costs of such chemotherapies have not only disrupted cancer patients' care, they also have stymied research trying to establish safer and more effective new therapies -- a process requiring comparison against the standard drug.
It's stunning that we would need to invent a law to discourage entrepreneurs from taking such financial advantage of sick people during a national prescription drug shortage. You would hope that no self-respecting pharmaceutical distributor would want to be seen in such a sickening light.
Yet here we are again, trying next week to propose a new law to reinforce what ought to be obvious common morality. Here we are again, spending valuable taxpayer time and money on legislative efforts to reprimand egregiously bad behavior within the U.S. pharmaceutical market.
Our national prescription drug shortage -- which sets the dark stage for such successful price-gouging -- has been worsening for years in front of our politicians' blind eyes. The number of reported drug shortages each year has more than quadrupled recently -- from 61 in 2005, to more than 250 within the current year (so far).
You have to wonder why so little is being done to solve this national health care crisis. Appeals to patient care and safety don't seem to be motivating drugmakers and distributors to do the right thing. The skyrocketing medical costs attributed to the price-gouging don't seem to be mobilizing many politicians who claim an interest in taming health care expenditures. Where are all those people now who once shouted "rationing!" and "death panels!" at town hall meetings during the last election cycles?
One might reasonably ask: Well, why not just manufacture more drugs to meet the demands of this crisis, and increase the supply to drive down costs? Indeed, aren't drug companies generally happy to make and sell their products?
Obviously, the pharmaceutical industry has a different view. It cites several reasons why it has not been able to step-up drug manufacturing to help us out. And while all the production barriers it claims might be real, still, they also are somewhat irrelevant and misleading.
That's because the ultimate and definitive reason for the drug industry's inaction is that the scarce and majorly generic drugs are not profit-making, blockbuster drugs. Simply put, drug manufacturers would never allow any production barriers to exist if the drugs at stake for scarcity were billion-dollar moneymakers such as Lipitor or Zyprexa.
I don't think any law can force companies to manufacture lifesaving, cost-effective drugs in critical short supply. It is sad to resort to such desperate speculation. But for how long and at what personal and societal costs do we passively wait for something to change?
Chief Justice Earl Warren once famously remarked, "In civilized life, law floats in a sea of ethics." Unfortunately, looking through the lens of American health care, that sea is getting awfully glutted with laws that, in a certain kind of civilized society, would be viewed by many as lamentable flotsam.
--------------------------------------------
Kate Scannell is a Bay Area physician and the author, most recently, of "Flood Stage."