Berks County Medical Society Medical Record Fall 2018 - 39

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or tax dollars for Medicaid and Medicare programs. In 2019
the projection is for 47% of the cost of patent medications to be
kickbacks.
Generic medications are also profoundly affected. Pay to
play arrangements make it so only one or two companies are
permitted to make certain drugs. So Mallinckrodt is the exclusive
manufacturer for acthar which makes a $40 1952 small molecule
generic molecule cost $40,000.00 per month. Baxter makes
salt water for $545 per bag and nitroprusside is $1245 per dose.
Mylan makes epi-pens with no competition for $850 per dose.
Sole source contracts compel companies to pay huge kickbacks.
In return no competitor is permitted. Sole Source Contracts are
the reason we have generic drug shortages. It is not really complex
at all.

Diplomate, American Board of Dental Sleep Medicine
Diplomate, American Academy of Pain Management
Fellowship, American Academy of Craniofacial Pain

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Restructuring the healthcare supply chain is the essential first
step in any plan to make healthcare affordable again. The Big Four
Group Purchasing Organizations write contracts for over 90% of
hospital drugs, supplies and medical devices. They offer companies
the opportunity to "Pay to Play" if the price is right for sole source
contracts. Sometimes two companies are allocated market share.
With only one or two manufacturers and only four buyers this
creates a fragile supply chain resulting in pervasive shortages of
hospital medications since 2006.
In 2017 there were 146 new drug shortages, mostly generics,
and many vital. Generic medications should be inexpensive
and plentiful. They are neither. Some drugs come off the
shortage list because contractually permitted companies increase
production. Other times the drug comes off the shortage list
because the permitted companies discontinue manufacturing.
Then the drug is gone altogether. This has happened frequently.
continued on next page >
3317 Penn Avenue West Lawn 610-750-7891 ReadingDerm.com
FALL 2018

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Berks County Medical Society Medical Record Fall 2018

Table of Contents for the Digital Edition of Berks County Medical Society Medical Record Fall 2018

Berks County Medical Society Medical Record Fall 2018 - 1
Berks County Medical Society Medical Record Fall 2018 - 2
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