The Economics of Prescription Drugs
"Drugs never cure disease. They merely hush the
voice of nature's protest, and pull down the danger signals she erects. Any
poison taken into the system has to be reckoned with later on even though it
temporarily eliminates present symptoms. Pain may disappear; but the patient is
left in a worse condition, though unconscious of it at the time.”- Daniel H
Kress M.D.
Pharmaceutical companies are not into business for the purpose of charity. Prescription drugs are a multi-billion industry. We have all been sick. We have all had to visit the doctor who after diagnosis usually sends us off to the pharmacy with a prescription. In fact some of us have had to make that painful decision to choose which medication to purchase in cases where multiple drugs are prescribed and our financial resources are limited to fill the entire prescription. The economics of prescription drugs is real and serves as a clear and present danger to maintaining good health. Data provided by QuintilesIMS which tracks prescription drug data, states that global spending on prescription medicine will reach $1.5 trillion by 2021. I stand corrected, prescription drugs are a trillion dollar industry. According to President of Pembroke Consulting Adam Fein, retail pharmacy is a $400 billion industry in the United States of America (USA). According to Fein, the top fifteen (15) pharmacies in the USA including Walmart, CVS and Walgreens accounted for three-fourths of all prescriptions by revenue in 2016. The lack of health insurance is a global concern. Unfortunately, many people do not have this cushion and are required to cover the total cost of their prescriptions. It bares thought that the poor and working poor who live from pay cheque to pay cheque suffer the most.
Concerns of Drug Subsidy Programmes
In Jamaica, the government has in place the National Health Fund (NHF), as well as the Jamaica Drugs for the Elderly Programmes (JADEP) which assists to offset Jamaicans with their prescription drugs. In order to qualify for the drug subsidy JADEP programme Jamaicans must be at least sixty years, however, the National Health Fund is not age-specific. The cost for the drugs covered under the JADEP is $40 per item The JADEP programme covers selected chronic diseases. These chronic diseases include diabetes, hypertension, asthma, glaucoma, arthritis and high cholesterol. Over the years the JADEP programme has had a number of concerns and continues to have a number of concerns for patients who rely on this health care initiative. The concerns include the unavailability of the prescription drugs at the participating pharmacies. Many elderly patients become frustrated when they visit their pharmacy only to be told that the JADEP drugs have not arrived as yet or have been deleted. The frustration becomes heightened due to the fact that not all privately owned and operated pharmacies are part of the government drug subsidy programme. Another issue regarding the drug subsidy programme is the inadequate supply of chronic disease drugs which are made available to pharmacies. The authorities must use the available data which indicate that an increasing number of Jamaicans are diabetic and hypertensive. It is not uncommon for some elderly patients to go without their medication simply because they are unable to afford the full cost of the prescription drugs. Notwithstanding the concerns highlighted the JADEP programme also suffers from the frequent switch of the brand of the drugs the government makes available. This frequency regarding the change of the brand of prescription drugs is clearly due to what the government can source at the time, however, this can be, and in fact is very confusing especially for many elderly patients. In some cases patients are unable to read and they depend on the shape and colour of the prescription drugs to know which drug is for what ailment. Undoubtedly, with the frequent switch in brands of prescription drugs this can, and indeed cause frustration and even panic among the significant portion of the population who are illiterate. In many instances the patient who is suffering from one non-communicable disease usually has accompanying health issues and require multiple prescription drugs. The concerns surrounding the JADEP programme is not only confined to patients as pharmacists too have voiced their opinions on many aspects of the drug subsidy programme. One such concern is the restriction which is placed on pharmacies regarding the ordering of JADEP drugs. These drugs can only be ordered twice per month. In a number of instances some pharmacies run out of some drugs especially for diabetics and those patients who are hypertensive. It must be noted that the JADEP drug subsidy programme offers only generic drugs. We are all aware that despite the similarity of the base properties of the generic drugs they are different from the brand. Some patients react differently to generic drugs than they do when taking the brand name drug. For example, some diabetics have a challenge controlling their diabetes when taking generic drugs. Strangely, this does not occur when the same diabetic patient takes the brand name drug. Of course this speaks to the economics of prescription drugs and government policies both of which do not necessary work for the benefit of the patient. It would be useful if the government could try to remain as long as possible with the same pharmaceutical company in sourcing the drugs on the JADEP programme. The limitation stipulated by JADEP regarding the number of tablets which can be dispensed is also another concern. Usually JADEP will only give 30 tablets per month. However, there are some patients who based on their medical condition are required to take their medication twice per day. As a result such patients will have to find an additional sum of money to purchase the remaining medication. The time has come for JADEP to be responsive to the needs of their clients and adjust their policy and allow for more tablets per month as prescribed by the attending physician. One has to wonder whether these huge pharmaceutical companies try to influence doctors to push certain prescription drugs over another brand, however, this discussion is for another time. Due to the burgeoning cost of health care, governments are forced to be creative in arriving at solutions to offset health care costs including prescription drugs. We must be mindful that governments are limited by the economic reality of each country in an era of structural adjustment programmes, as well as, the limitations placed on numerous governments by multinational lending facilities, such as the World Bank and the International Monetary Fund regarding debt support. As more and more patients try to meet their monthly needs for prescription drugs we are likely going to see a corresponding increase for prescription drugs on the black market. Recently one of our local media outlets did a story sometime ago where prescription drugs were being sold openly in urban centres all across the country. It is indeed a delicate balance between providing affordable costs for prescription and the economics of prescription drugs. The society needs to pay more attention to counterfeit drugs as this creates another layer of problems not only for the patient who falls prey to this but the society who will have to provide health care services due to complications from taking counterfeit drugs. The society needs to hear from the Jamaica Association of Private Pharmacy Owners on this, as well as on other related matters. A country with a sick population cannot expect to reap economic growth. Irrefutably, both the JADEP and the National Health Fund are good programmes. It is critical however, that the society incorporates all stakeholders as we try to improve these and other issues surrounding health care delivery. The United Nations Sustainable Development Goal #3 speaks to the promotion of good health and well being. According to the United Nations the promotion of well-being for all at all ages is essential to sustainable development. In the authoritative words of Dr. William Olser, “the person who takes medicine must recover twice, once from the disease and once from the medicine”.
Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues.
waykam@yahoo.com
@WayneCamo
#prescriptiondrugs #healthcare #drugsubsidy #counterfeitdrugs #SDGs #chronicdisease #noncommunicablediseases #genericdrugs
©
Pharmaceutical companies are not into business for the purpose of charity. Prescription drugs are a multi-billion industry. We have all been sick. We have all had to visit the doctor who after diagnosis usually sends us off to the pharmacy with a prescription. In fact some of us have had to make that painful decision to choose which medication to purchase in cases where multiple drugs are prescribed and our financial resources are limited to fill the entire prescription. The economics of prescription drugs is real and serves as a clear and present danger to maintaining good health. Data provided by QuintilesIMS which tracks prescription drug data, states that global spending on prescription medicine will reach $1.5 trillion by 2021. I stand corrected, prescription drugs are a trillion dollar industry. According to President of Pembroke Consulting Adam Fein, retail pharmacy is a $400 billion industry in the United States of America (USA). According to Fein, the top fifteen (15) pharmacies in the USA including Walmart, CVS and Walgreens accounted for three-fourths of all prescriptions by revenue in 2016. The lack of health insurance is a global concern. Unfortunately, many people do not have this cushion and are required to cover the total cost of their prescriptions. It bares thought that the poor and working poor who live from pay cheque to pay cheque suffer the most.
Concerns of Drug Subsidy Programmes
In Jamaica, the government has in place the National Health Fund (NHF), as well as the Jamaica Drugs for the Elderly Programmes (JADEP) which assists to offset Jamaicans with their prescription drugs. In order to qualify for the drug subsidy JADEP programme Jamaicans must be at least sixty years, however, the National Health Fund is not age-specific. The cost for the drugs covered under the JADEP is $40 per item The JADEP programme covers selected chronic diseases. These chronic diseases include diabetes, hypertension, asthma, glaucoma, arthritis and high cholesterol. Over the years the JADEP programme has had a number of concerns and continues to have a number of concerns for patients who rely on this health care initiative. The concerns include the unavailability of the prescription drugs at the participating pharmacies. Many elderly patients become frustrated when they visit their pharmacy only to be told that the JADEP drugs have not arrived as yet or have been deleted. The frustration becomes heightened due to the fact that not all privately owned and operated pharmacies are part of the government drug subsidy programme. Another issue regarding the drug subsidy programme is the inadequate supply of chronic disease drugs which are made available to pharmacies. The authorities must use the available data which indicate that an increasing number of Jamaicans are diabetic and hypertensive. It is not uncommon for some elderly patients to go without their medication simply because they are unable to afford the full cost of the prescription drugs. Notwithstanding the concerns highlighted the JADEP programme also suffers from the frequent switch of the brand of the drugs the government makes available. This frequency regarding the change of the brand of prescription drugs is clearly due to what the government can source at the time, however, this can be, and in fact is very confusing especially for many elderly patients. In some cases patients are unable to read and they depend on the shape and colour of the prescription drugs to know which drug is for what ailment. Undoubtedly, with the frequent switch in brands of prescription drugs this can, and indeed cause frustration and even panic among the significant portion of the population who are illiterate. In many instances the patient who is suffering from one non-communicable disease usually has accompanying health issues and require multiple prescription drugs. The concerns surrounding the JADEP programme is not only confined to patients as pharmacists too have voiced their opinions on many aspects of the drug subsidy programme. One such concern is the restriction which is placed on pharmacies regarding the ordering of JADEP drugs. These drugs can only be ordered twice per month. In a number of instances some pharmacies run out of some drugs especially for diabetics and those patients who are hypertensive. It must be noted that the JADEP drug subsidy programme offers only generic drugs. We are all aware that despite the similarity of the base properties of the generic drugs they are different from the brand. Some patients react differently to generic drugs than they do when taking the brand name drug. For example, some diabetics have a challenge controlling their diabetes when taking generic drugs. Strangely, this does not occur when the same diabetic patient takes the brand name drug. Of course this speaks to the economics of prescription drugs and government policies both of which do not necessary work for the benefit of the patient. It would be useful if the government could try to remain as long as possible with the same pharmaceutical company in sourcing the drugs on the JADEP programme. The limitation stipulated by JADEP regarding the number of tablets which can be dispensed is also another concern. Usually JADEP will only give 30 tablets per month. However, there are some patients who based on their medical condition are required to take their medication twice per day. As a result such patients will have to find an additional sum of money to purchase the remaining medication. The time has come for JADEP to be responsive to the needs of their clients and adjust their policy and allow for more tablets per month as prescribed by the attending physician. One has to wonder whether these huge pharmaceutical companies try to influence doctors to push certain prescription drugs over another brand, however, this discussion is for another time. Due to the burgeoning cost of health care, governments are forced to be creative in arriving at solutions to offset health care costs including prescription drugs. We must be mindful that governments are limited by the economic reality of each country in an era of structural adjustment programmes, as well as, the limitations placed on numerous governments by multinational lending facilities, such as the World Bank and the International Monetary Fund regarding debt support. As more and more patients try to meet their monthly needs for prescription drugs we are likely going to see a corresponding increase for prescription drugs on the black market. Recently one of our local media outlets did a story sometime ago where prescription drugs were being sold openly in urban centres all across the country. It is indeed a delicate balance between providing affordable costs for prescription and the economics of prescription drugs. The society needs to pay more attention to counterfeit drugs as this creates another layer of problems not only for the patient who falls prey to this but the society who will have to provide health care services due to complications from taking counterfeit drugs. The society needs to hear from the Jamaica Association of Private Pharmacy Owners on this, as well as on other related matters. A country with a sick population cannot expect to reap economic growth. Irrefutably, both the JADEP and the National Health Fund are good programmes. It is critical however, that the society incorporates all stakeholders as we try to improve these and other issues surrounding health care delivery. The United Nations Sustainable Development Goal #3 speaks to the promotion of good health and well being. According to the United Nations the promotion of well-being for all at all ages is essential to sustainable development. In the authoritative words of Dr. William Olser, “the person who takes medicine must recover twice, once from the disease and once from the medicine”.
Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues.
waykam@yahoo.com
@WayneCamo
#prescriptiondrugs #healthcare #drugsubsidy #counterfeitdrugs #SDGs #chronicdisease #noncommunicablediseases #genericdrugs
©
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