Finally! Medicine costing you too much? Many drug companies got together to launch MAT.ORG, a free site that matches under/uninsured Americans to programs that lower out of pocket costs. Aside from comprehensive insurance reform, this is next best thing. Try it.
Here’s some context. It’s not ok with anyone in the drug development industry that there are patients who can’t afford their medicines. The scientists and others who created these drugs intended for them to be made available by insurance. That insurance companies have...
...increasingly been cutting back on their coverage by raising out of pocket costs is a source of considerable suffering. Consider: insurance will confirm a drug is appropriate but still demand some patients pay more than they can afford? What are they nudging patients towards?
Insurance plans aren’t discouraging over-utilization of drugs. They are discouraging APPROPRIATE UTILIZATION! Is that even insurance? Why don’t they just say “pay us our premiums but we won’t make treatments affordable to you.” Because that’s what they have done to many patients.
If your doctor prescribes a medicine for you, insurance is supposed to make it affordable to you. If it fails to, then it’s not insurance. It’s a con. And Congress must pass reforms like it did to stop descrimination based on pre-existing conditions.
Not all patients have insurance and that too must be fixed. Nothing about American healthcare is affordable without insurance. If we charged people whose houses are on fire full price for fire department to show up, that wouldn’t be affordable either. Homes would just burn down.
But we don’t (anymore) pay for fire protection w/ copays & deductibles. We pay for it collectively. Anyone who needs assistance gets it. Well cancer & MS are fires. We recognize COVID is a fire and are appalled at indecency of insurance not covering covid care. Same for diabetes.
We need universal insurance. Not same as Medicare for all, but could start with “Medicare for those who have nothing better”. There are millions of older Americans that Medicare sticks with high out of pocket costs & cruelly blocks from even receiving help with their copays...
...from drug companies. Some rock-hearted policy makers decided that a patient was more likely to fake needing a cancer drug if the drug company that made it helped them afford it. So if a company tries to help them with copays that Medicare saddles patients with...
prosecutors call that a “kickback”. Yet we’re taking about cancer patients getting a drug, not money in their pocket. So drug companies donate funds to non-profits that circumvent Medicare’s heartless rules against helping patients.
But w/ all that complexity, patients get confused, especially if they take multiple drugs, change their plans, move between states, etc. So MAT.ORG makes it simpler. Enter drugs you take, some basic info, & you get list of programs you can apply to w/contact info.
Someday we’ll have comprehensive insurance reform that just allows patients to get what they need. Then the cost of drugs will be borne by all of society, without too much falling on just the sick among us. For those wondering if that means America as a whole....
...will overpay for drugs, answer is an emphatic NO. Drugs have their own price control built in- they go generic. In fact, drugs are only thing in healthcare that go generic. Hospitals, surgery- those don’t. They are rent, forever. Branded drug costs are finite mortgages.
Once a drug goes generic, they are a public good forever. A few types of drugs don’t go generic and those indeed aren’t a bargain, but we can fix that with a targeted reform called “contractual genericization”. The McSally bill in Congress proposes it. Good idea.
As the world can see in the rapid covid response, the biotechnology industry is amazing. America especially is really good at biomedical innovation. We can solve so many healthcare problems with new medicines that will all someday be generics.
Our generic armamentarium is a permanent, inexpensive upgrade to human health. Those are drugs paid off by our parents (who paid their branded prices via insurance) & now branded drugs we pay for will be generics someday. Investing for ourselves, kids, & grandkids.
America spends $271B on branded drugs per year. But if we’re still spending $271B in 15 years, it’s because all current branded drugs have gone generic and we’ve invented a whole new set. At 30-40 new drugs approved each year, that’s around 500 new drugs we’ll have in 15 years.
Hopefully some for covid, and many others for cancer, Alzheimer’s, breast cancer, and other diseases. And then those will go generic and the industry will keep working to invent invent invent. All those scientists solving problems, upgrading health. Heroes!
And despite so much talk of price gouging, it’s uncommon. You can see it in industry’s modest profit margins, in low teens. A 20-30% price cut would not make most branded drugs affordable to an uninsured patient but would render the industry a non-profit (w/ no executive pay).
You can’t accuse an industry of price gouging when its profits margin is so modest, lower than software & dozen other industries (don’t just look at most successful companies- look at whole portfolio, including those spending cash every year on R&D with no revenues).
So let’s recognize that this ingenuity and productivity should be nurtured, not scapegoated for the sins of insurance. Biotech will save us from covid & so much other suffering. We nurture it with incentives & funding, same as what’s now proposed to stimulate covid vaccines.
That innovation can be affordable if we pay for it collectively, from taxes & premiums, w/o burdening the few among us who need care today with high out of pocket costs. Drug development is 1.3% of our GDP, a small yet vital part of our economy. Let’s celebrate it.
The concepts I’ve laid out here are discussed in more detail in thegreatamericandrugdeal.com
And don’t forget that if you or anyone you know is ever struggling with out of pocket costs for drugs and considers not filling a needed prescription, go to MAT.ORG to look for financial help. Some programs even provide free drug.
