Saturday, October 31, 2009

The point is right

I read this and thought (sorry, I need to do that sometimes) and then have some thoughts. It is very sad that anyone is reaching the point where their insurance has maxed out or just won't cover specialized drugs. This is wrong. If you have insurance, it should pay for your medications. That's the whole point of insurance isn't it? That you pay in case you get sick and then the doctor prescribes something to make you better and your insurance pays for it. I mean that is the whole reason we all get health insurance in the first place. No it shouldn't pay for things like a trip the ER for a sore throat or a bottle of tylenol for your headache but it should pay for the big deals in life like cancer, arthritis, heart conditions, etc.

But then I thought some more. I realize that development costs are expensive and that drug companies are seeking compensation for years of development overhead but if a drug costs thousands of dollars per dose, isn't this a problem? Shouldn't there be a maximum dose cost that drug companies need to adhere to or something? Let's do some math here. If a drug company develops a life saving drug that costs a billion dollars to get to market (which is actually a low figure - see this reference), they clearly want to be compensated some how. Which is clearly within their rights. They are there to make money (and save lives). But is it right to pass along these costs directly to insurance companies or patients and expect them to pay for it? I am not sure.

The problem is that the people who are receiving these expensive life saving drugs are often not working and very ill so they can't afford to pay very much out of pocket. But drug companies have huge costs of waiting for years of development through trials to make sure they are effective and not potentially harmful. However is it right to pass along development costs, not just production costs to a small group of patients? I am not sure what the answer is, but I think a few sick people can't pay for development of something that will eventually save the lives of many more. So I guess the point is right of the original article but the answer is still murky.

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