LCHM Summer 2017 - 28

PRACTICE
MANAGEMENT

S
Walking in
Freeman's Footsteps:

PHARMA'S
ROLES
IN PRICE
HIKES
BY ALEESHA SHAIK,
FOURTH-YEAR MEDICAL STUDENT AT
DREXEL UNIVERSITY COLLEGE
OF MEDICINE

28 Lehigh County Health & Medicine | SUMMER 2017

ovaldi. Daraprim. Isuprel. Nitropress. EpiPen. And now, insulin. These are just
a few medications that have brought pharmaceutical companies and their drug
pricing practices into the spotlight over the past few years. Daraprim was the most
egregious with a price increase by 5,455%1; however, the others are no less serious,
with the widely-used EpiPen coming in at a 548% increase.2 While drug companies often
try to avoid outcry by pairing these with patient assistance programs, the people who get
hit the hardest by these increases are those who are uninsured and can't benefit from the
programs anyway or those whose insurance doesn't cover the medication. Furthermore,
since Medicare and Medicaid are the nation's largest insurance providers and government
programs are not allowed to negotiate with pharmaceutical companies, patients don't have
much of a choice about giving into these prices. At some point, pharmaceutical companies
need to be honest with themselves about whether they are following their moral obligations.

What is the moral obligation of a pharmaceutical company?
In order to define the moral obligation of a pharmaceutical company, we must first
explore their stated purpose. A cursory perusal of the mission statements and values of
multiple drug companies revealed a couple of common themes: innovation and integrity.
These organizations highlight their commitment to producing "innovative therapeutics"3
in order to improve patient care while purporting to have an "uncompromising ethical
stance" where they promise to "behave responsibly, even when nobody's looking."4 I would
argue that such responsibility also encompasses an obligation to provide quality affordable
medical care to everyone, not just the wealthy few who can afford an $84,000 price tag,5
the cost of the complete 12-week regimen of Sovaldi, a Hepatitis C drug. Commitment
to patient care involves more than just producing therapies to cure diseases. It also involves recognizing the effect that unaffordable medications have on psychosocial health.
If a patient doesn't get a medication that they need, their condition will deteriorate. If a
patient does get the medication despite the price, then they may be spending less money
on other important things, such as rent, also affecting their overall health. Therefore, if a
pharmaceutical company is truly dedicated to patient care, they must realize the domino
effect that high drug prices have and make every effort to keep them as low as possible.
How would it hurt society to go against this obligation?
This is no longer a hypothetical situation, but a reality. In 2014, the U.S. spent over
$3 trillion (17.5% of our GDP) on national health expenditures. 9.8% of that was spent
on prescription drugs.6 Pharmaceutical companies argue that this is necessary because of
the expenses associated with research and development. However, 9 out of 10 of the big
pharmaceutical companies spend more money on marketing than on R&D. Johnson &
Johnson, for example, spent $17.5 billion on marketing and only $8.2 billion on R&D.7

Table of Contents for the Digital Edition of LCHM Summer 2017