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Their Day Will Come

Their Day Will Come

The race for the next elected President of the United States is officially started with the Democrat candidates debating issues this past week. I did not have the time to watch the debates, but I have read several articles on some of the issues relating to healthcare.

There appears to be a divide between those who want pharmaceutical drug prices to go down and those who wish to keep them as high as possible. It is amazing to me to see who comes creeping out of the woodwork to express their opinions on this issue at a time when there is so much change in the health industry. In case you have not noticed, the diagnostic codes that are used for billing purposes for medical services rendered have been changed to the new ICD 10 codes. The new codes are vastly different from the old codes and are much more complicated. At the writing of this blog, I am not sure who engineered them and for what purpose, however there is definitely a tick in the wood pile. The change benefits someone, just not the patient nor the physician. Back to the subject of pharmaceuticals.

Last month, I prescribed a medication to a patient which I thought would be covered by her pharmacy benefit management plan. It matters not what the medication was for, just that it is a relatively common medication for her ailment. I told the patient to call around and see what the medication would cost. I advised her that Costco usually has the lowest prices on drugs in the area. She smiled and said, "That's odd. I don't have a Costco card." I told her that she could just go to the pharmacy without being a member. She said she would call all over the city before she dropped the prescription off.

Another patient came to my office that week and at the end of his visit he pulled out a Wall Street Journal, pointed out two specific articles, and he asked me to read them, then throw the paper away. He is a ninety-two year-old man who has lived a full life. When I asked him what he wanted for Christmas, he smiled, "Christmas? Heck I just wanna get up tomorrow. Live another full day!" We laughed. I put the news paper on my desk thinking I would read the articles when the dust settled a little bit more that day.

It turns out that several of the Democrat candidates want to regulate the wholesale price of drugs. They seem to focus on cancer and chemotherapy drugs the most, citing that these invaluable medications have the power to prolong life and they should not be so expensive or withheld from a cancer victim's treatment due to their costliness. I am amazed at the ignorance of the public on these complicated medical issues and the ability of the politician to seize the moment based on fear.

As I sat in my office on Thursday evening after the staff had left and the phones were quiet, I looked at the articles from the Wall Street Journal. The first one was about the loss of investment capital that the biotech industry had encountered due to Hillary Clinton's comments about instituting price regulation on pharmaceuticals. The second one was an editorial view point about the price of cancer drugs written by a Professor of Hematology and Oncology from Harvard Medical School.

First and foremost, the price of medications all across the board have skyrocketed. These are not just rises in prices due to the cost of living or prices of ingredient increases, these increases are beyond any rational understanding regardless of the situation. Secondly, total cancer chemotherapy costs probably amount to less than 2% of the total drug expenditures in our healthcare system. Chemotherapy has an outrageous price tag, but the drugs used for common everyday ailments and infections are the ones breaking the patient's piggy bank. Two years ago I could buy a five hundred pill bottle of one hundred milligram doxycycline capsules, a commonly prescribed antibiotic, for about twenty dollars. Now the price is as high as two thousand dollars or more. As a result of the price gouging, I buy the bulk powder and encapsulate the medication in our office for patients who need it and cannot afford to buy it at their local pharmacy.

The Wall Street Journal articles were bias toward healthcare as an inflation proof industry with great returns on investment before Hillary Clinton and the other Democrats revealed their thoughts about drug wholesale price controls. The Harvard cancer physician gave his opinion about the costs of medications used to treat cancer, trying desperately appeal to the notion that if a cancer patient survives a month or two after their diagnosis and chemotherapy was the reason why, the extension of life should be considered priceless. Any expense is cheaper than priceless. I am pretty sure that I am not going to Harvard to get any advice about my health, much less some guy's opinion about his inflated worldview on the costs of medications.

No one should have to go bankrupt to live two more months of their life in a state of agony, suffering and pain. All too often these Hierophants in medicine create a standard of practice that serves everyone in the medical industry but the patient. His second appeal was that if these drug companies cannot recover their investments for drugs that were developed but failed to reach the market due to their lack of efficacy, cancer treatment as a whole will suffer and there will be no advance in chemotherapies. I wish I had a nickel for every time I heard that tune from those who benefit greatly from the dollars put into research that leads nowhere. I would rival Bill Gates for the richest American.

If anyone wishes to really understand the pharmaceutical industry, buy a copy of the book entitled Our Daily Meds. It was written by an award winning New York Times investigative journalist after four years of research. It will open your eyes to the money trail and shut your ears to Harvard hematologists who consult for the pharmaceutical industry.

Last week my patient who called around for the prices of her medication to the local pharmacies returned for her one month follow up appointment. "Hey Doc. Sure glad I called around for my meds. Called Walgreen's. Two hundred fifty-five dollars. CVS. Two hundred twenty-five dollars. Rite Aid. One hundred seventy-five dollars. Kroger. One hundred fifty dollars. Target. Two hundred twenty-five dollars. Costco. Twenty dollars. I went to get the medication. Thought they quoted me wrong. They charged twenty dollars. That's messed up. How did you know that Costco would be the cheapest?"

I smiled, "Just figured they would." As you can see, there's another demon in the medical industry that needs to be exorcised: pharmacies. They are the ones that mark the prices up beyond comprehension and hold the patient hostage. We prosecute purveyors of gasoline who price gouge, it's about time we focus on the drug stores. These are the real drug lords who are driven by greed and corruption and hide in the shadows of the pharmaceutical giants. No one even considers them as being crooked until they call around and find out the prices of their prescription medication. They all price fix but Costco. Then the light bulb goes off.

Their day will come. Soon I suspect.

Doc
Posted by Amanda Sanders at 9:46 AM
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