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E-mail Print Price U.S. drugs for big picture
Health Care Op-Ed
By: Laura Dykes
7.7.2001

The Des Moines Register,July 7, 2001

From 1995 to 2010, the number of senior citizens is expected to increase from 33.5 million to 39.4 million.

Increased spending for prescription drugs is alarming to many senior citizens. No one doubts that. Unfortunately, some lawmakers are offering a solution to this problem without understanding the ailment—or basic economics.

Congressman Tom Allen, a Maine Democrat, introduced legislation that would base the United States price on the average price of a similar prescription drug sold in Canada, France, Germany, Italy, Japan and the United Kingdom.

Contrary to intent, this legislation would raise health-care costs, reduce research and development expenditures, and decrease patient access to new and innovative drugs. Changing demographics are a primary reason demand for such drugs is increasing.

From 1995 to 2010, the number of senior citizens is expected to increase from 33.5 million to 39.4 million. As these senior citizens age, many require new medications, like Cognex to treat chronic ailments such as Alzheimer’s disease. Newer cost-effective medicines are making more expensive and intrusive alternatives, such as hospitalization, unnecessary.

For example, one drug—tissue plasminogen activator—used to treat stroke reduces the need for rehabilitation and nursing-home care, and saves $ 4 million for every 1,000 patients.

Lawmakers should not only be aware of how these demographic changes affect prescription-drug use, they should also understand that efforts to contain spending have repeatedly failed in other countries.

To contain costs, various nations have used direct and indirect price- control strategies, such as reference pricing systems.

Although Germany, Japan and Canada employ different means, the results are the same. Higher health-care costs and decreased R&D expenditures are unintended consequences of price controls. Imposing this failure on the United States would not be prudent policy.

Reference pricing limits drug producers’ reimbursement to the price of the cheapest drug in a group. This makes drugs appear to be cheaper, encourages individuals to consume more than they would at a higher price, and boosts total expenditures. The German government operates a reference pricing system and has faced dismal results.

Increased spending due to overconsumption and the use of less effective medicines eventually forced Germany to remove patented drugs from reference pricing and reimburse them according to market prices.

When Dr. Baldur Wagner, Germany’s secretary of health, exempted innovative drugs from the reference price system, he explained that, “by correctly abolishing the reference price for patented drugs, more research is now taking place.”

It is particularly worthy to note that although market pricing increased providers’ spending, it reduced hospital costs because it boosted the usage of newer, more effective drugs that prevented hospitalization.

In Japan, the Special Committee on Drug Prices sets the price of drugs. This price-control mechanism actually increased spending on drugs. According to a Boston Consulting Group report, Japanese price controls cut prices by more than 60 percent. But lower prices and the use of less effective drugs intensified consumption, thereby increasing drug expenditures by 59 percent.

In the United States, it costs more than $ 500 million to develop a new drug. By reducing revenues, price controls harm innovation, essential to R&D for new, more effective drugs. Controls leave patients worse off since less R&D means fewer drug breakthroughs and new products.

The relative lack of restrictive price controls in the United States has made it the leader in pharmaceutical innovation. For example, 10 of the top 20 firms in the global industry in 1998-99 were based in the United States. The bulk of global R&D is also financed by U.S. companies.

The United States should reject price-control policies that would weaken R&D. Price controls have increased health-care spending and decreased R&D in Germany, Japan and Canada.

Lawmakers here should adopt policies based on market pricing that fuel innovation and R&D. These policies will benefit all Americans and patients around the world.

This article was distributed nationally by Knight Ridder News Service.


Laura Dykes is a public-policy fellow at the California-based Pacific Research Institute’s Center for Enterprise and Opportunity. She can be reached via email at hayward487@aol.com.

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