Previously, I introduced you to many of the big pharmaceutical companies and factors influencing the high prices they charge for their medications. The effects of the high costs are highlighted below.
As many as 2 billion people (1/3rd of the world’s population) lack access to essential medicines. As I pointed out above, in America more than 25% of those prescribed a medication don’t take it and 23% cut their pills in half or skipped doses because of the high price of their medications. In developing countries the median prices for drugs are on average 2.7 times higher than international reference prices in the public health-care sector and 6.3 times higher in the private sector. Thus, you can imagine that in a place in developing countries where the prices are higher and income is lower, the even greater barrier to affording medications.
The inability to afford medication (meaning that people don’t take the right dose, skip doses, or don’t take their medicines) has an incredible cost to society. In the US alone, $100-300 billion is lost in decreased productivity from those who do not have access to medications. This does not account for the increased burden on households who may lose income to sick days. Nor does this account for the increased burdens on the health care system (especially if those who cannot afford their medicines end up in the Emergency Room). We cannot even begin to estimate the loss in productivity throughout the world.
Consider the impact of such medications:
– Life expectancy increased 40% with the introduction of medications for cancer and heart disease.
– From 1995 to 2002 medications for HIV/AIDS decreased deaths from 16.2 per 100,000 to 4.9 per 100,000.
– Antihypertensive medicines reduced deaths by 89,000 annually
– Vaccinations eradicated smallpox and nearly eradicated polio
I could go on and on. Let’s not underestimate the amazing contributions pharmaceutical companies make to society by bringing these medicines to market – saving lives. On the other hand, we cannot forget that these companies are not completely altruistic. They have other interests at heart, including (and perhaps primarily?) reaping profits. So while they contribute substantially to our health, they also create huge barriers through their pricing.
For instance, insulin used to treat type 1 diabetes was created in 1922, saving children from slow starvation. To supply 1 bottle of regular insulin costs roughly $10 per bottle of 1,000 units. However, retail price in the United States runs about $191. Granted, insulin today is better than insulin in 1922, there are synthetic insulins on the market now. Even then, the pricing is exorbitant.
Such high prices leave people desperate to save their lives. In the United States, this might mean going to Canada to get cheaper medications. In the other parts of the world, people turn to counterfeit medicines. Counterfeit drug sales alone will reach $75 billion globally in 2010, an increase of more than 90 percent from 2005. And who could blame someone for buying a cheaper counterfeit medicine wanting only to be healthy or to help their sick family members?
Unfortunately, these counterfeit medicines can actually make everyone worse off by cultivating resistance to treatments. Tuberculosis (TB) is the primary example of this, a disease that kills 1.8 million people each year, or 4,500 each day. This disease is the leading killer of people with HIV and is a disease of poverty. When TB is improperly treated because of low quality medications or skipped doses, drug resistance develops leading to (aptly named) multidrug-resistant TB (MDR-TB) and even extensively drug-resistant TV (XDR-TB). The World Health Organization (WHO) estimated 440,000 new cases of MDR-TB were reported last year in 60 countries. Again, who would blame someone for skipping medications they cannot afford or seeking cheaper drugs which may be counterfeit? And while we may think of TB (regular, MDR or XDR) as only affecting developing countries, this highly contagious disease affects the world.
(I may question though whether there might be confusion between drugs illegally imported or generics produced vs. how many are truly poor quality)
The costs of medicines aren’t just impressive when you think about the incredible profits pharmaceutical companies make and their incredible waste. The cost of medicines is most remarkable when you consider the costs of actual lives – people dying from chronic diseases, diseases that can be prevented through vaccinations, and diseases that could be treated with good quality medications.
To their credit, pharmaceutical companies will contribute to a deal between countries to share flu virus samples in exchange for access to affordable vaccines derived from them with the hope of saving lives if another flu pandemic arises. However, they’ve only agreed to provide about one-half of the vaccines needed. What will the other half of the world do?
A bit more remains to be discussed including some economics (in particular, the Trade Related aspects of Intellectual Property Rights) and human rights discourse (including how to ensure accountability). Domestically and internationally, much more remains to be done to ensure the right to health through access to affordable medications.
Continue the series:
The Costs to Live – Part 4