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    Out-of-control drug pricing requires creative solutions


    On a more personal level, as most readers of this blog know, my wife delivered two beautiful twin baby girls last fall. As they were less than 32 weeks gestation and required oxygen for many months, our pediatrician recommended that they receive a course of palivizumab (Synagis). Synagis is a monoclonal antibody that has been shown to significantly reduce the risk of hospitalization associated with respiratory syncytial virus (RSV). It has few side effects and is simply a shot given once a month for 5 months.

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    This seemed like a no-brainer given that my girls are at high risk of contracting RSV (we have two other girls who go to school) and are certainly at high risk of complications from RSV given their prematurity. The surprise came when the specialty pharmacy called to arrange delivery and asked how we wanted to pay our portion of the bill; the $2,615.99 per shot per child bill. That’s right, this shot costs more per shot per child than I charge for a robotic prostate removal.

    How do we properly incentivize pharmaceutical companies and investors to do the hard and risky work of drug development while preventing cases such as the Turing Daraprim case, which can best be described as price gouging? I don’t claim to have an answer for this problem, but I’m confident that smarter people than me are working on it.

    The best article I read that actually proposed a solution appeared in Forbes. The writer, Matthew Herper, suggests that increasing transparency, allowing Medicare to negotiate prices, and giving the FDA the right to treat a significant price increase for off-patent drugs as a shortage (which allows foreign drugs to be imported and increases competition) are among the steps that would help control costs while not eliminating the incentive to pursue new drugs.

    I'm open to your ideas for solutions, and I welcome any money-making ideas as well. I have lots of Synagis to pay for.

    More from Dr. Rosevear:

    Maintenance of certification: Working to understand why

    Practice ‘efficiency’ is not a dirty word but a noble goal

    After the patient fall: How to save your back

    Subscribe to Urology Times to get monthly news from the leading news source for urologists.

    Henry Rosevear, MD
    Dr. Rosevear, a member of the Urology Times Clinical Practice Board, is in private practice at Pikes Peak Urology, Colorado Springs, CO.


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    • Anonymous
      You seem surprised/perturbed that Synagis costs more than a prostate removal operation? It took scientists years to develop that drug; anyone can train to cut out a prostate. Also, Turing just did what any capitalist would do; increase price to what the market will tolerate. If people complained urologists charged too much, would you lower your rates?
    • Anonymous
      Duplicate post, delete please.