It has been estimated that one third of the cost of a drug is related directly to marketing. Therefore, New West Physicians has decided that it will no longer be part of the problem, but rather part of the solution. As of February 1st, 2016, every New West Physicians’ office has adopted a new policy prohibiting any pharmaceutical advertising or marketing including the use of “free samples”. Our goal is to reach 90% use of affordable medications, which will allow us to continue to provide our high quality of care while also improving the economic health of our patients, and secondarily help stem the increasing cost of both new drugs and health insurance premiums for everyone.
Below is summary of the issue:
Although there have been some important pharmaceutical industry gains in biomedical research, pharmaceutical costs in the U.S. are escalating rapidly out of proportion to the rest of the healthcare sectors. The pharmaceutical portion of the entire United States healthcare budget will soon reach 20%. You have all undoubtedly heard the stories where a drug patent is purchased and the pharmaceutical company raises the cost by several orders of magnitude. Other sectors in healthcare are rapidly transitioning to “Value Based Care”. This means that the magnitude of the improvement in one’s overall health and wellbeing clearly justifies the cost of the physician visit, operation, procedure, etc. There is currently however, no value based proposition in pharmaceutical pricing. The cost of a medication quite simply is priced as high as the market will bear, regardless of the magnitude of the health benefit. The most outrageous example is a new topical medication for toenail fungus that has a cure rate of 18% and costs up to $20,000 yearly. No wonder it is profitable enough to the pharmaceutical company to afford the $4 million ads during the Superbowl.
A somewhat new development being used by the pharmaceutical companies is the “copay assistance program”. This makes the drug appear free to the patient since patients are shielded from the true cost of their medications through the use of these “co-pay assistance programs”. The truth however, is that free market economics just do not apply to pharmaceutical pricing. With these copay cards, the pharmaceutical company gets to “write off” the small patient copay and charge the rest of the full cost of the drug to the patient’s insurance company. These costs then go to drive up health care premium costs for the patient as well as the rest of the healthcare system. One new medication released in 2015 that will be used only for a small group of patients is projected to increase the health insurance cost of every American by $130 yearly. The sad truth is that for the majority of these medications, there are alternatives that are markedly less expensive.
Thank you for entrusting New West Physicians with your care and being part of the solution.
Ken Cohen, MD, FACP, CMO