The National Center for Biotechnology Information reports that anaphylaxis, a severe or even life-threatening allergic reaction, affects over fifty million people in the United States. Many of these men, women, and children heavily rely on an epinephrine auto-injector, or EpiPen, to alleviate the symptoms of anaphylaxis. However, their dependence on EpiPens seems to have caused their ultimate demise. Over the past few decades, the prices for life-saving and life-preserving medications such as epinephrine auto-injectors and insulin have gone from necessities to luxuries as prices have skyrocketed.
The monopolization of prescription medications in the United States by big pharmaceutical companies, such as Mylan Pharmaceuticals and Valeant Pharmaceuticals, and the trend of prescription prices increasing by hundreds of percentages has resulted in millions of people having to pay outrageous prices for medications they do not want, but need in order to live a remotely normal and manageable life.
The Issue at Hand
It is no secret that the prices of medications such as insulin, epinephrine, blood pressure lowering pills, and other forms of medicines have increased substantially over the last ten to twenty years. The essence of the problem lies in the fact that the companies that produce and distribute the medications are basically government-sanctioned monopolies. Because they are monopolies, more issues arise.
In the United States, drug manufacturers are able to set their own prices, which is not the case globally. According to the European Commission, “In the EU, national authorities are free to set the prices of medicinal products and to designate the treatments they wish to reimburse under their social security systems.” Individual corporations do not get to set prices which allows governments to regulate and intercede on behalf of patients and healthcare providers, such as emergency medical technicians, who might have to purchase medications for themselves and their organizations. Because American-based companies are allowed to set their own prices, however, what has been observed is the exploitation of the everyday consumer.
Behind the Prescription
In regards to exploiting the population, Valeant and Mylan have been notorious for taking two routes:
1. Acquiring smaller, failing generic companies
2. Drastically increasing the prices for prescription medications
3. Both 1 and 2
As a part of the market sector, a pharmaceutical company, such as Valeant or Mylan’s, main goal is to maximize resources and bring in profit. With profit as a priority, Valeant and Mylan had to come up with quick, inexpensive, and smart ways of increasing their revenue. These two pharmaceutical corporations are notorious for their grand acquisitions of hundreds of smaller pharmaceutical companies. In an effort to completely destroy any competition at all, big pharmaceutical companies will often buy out smaller companies that produce similar prescription drugs or prescription drugs that they would like to produce as well. Because these big companies are able to operate as monopolies and basically eliminate any market competition, generic versions of drugs are not allowed into the market and the patients suffer for it.
Valeant Pharmaceuticals, has raised the prices of three of its drugs substantially. Nitropress and Isuprel, two drugs used to lower blood pressure, had its price raised by 212%. The price of Glumetza, a diabetes pill, was raised by about 800% (“Valeant’s Drug Price Strategy Enriches It, but Infuriates Patients and Lawmakers”). In their article, “EpiPen Price Rise Sparks Concern for Allergy Sufferers”, Tara Parker-Pope and Rachel Rabkin Peachman outline just how much of a tremendous price change EpiPens have undergone with Mylan’s acquisition of drug in 2007. At the time “pharmacies paid less than $100 for a two-pen set.” By May of 2017 “the price spiked again to $608.61.”
For many Americans, there are no substitutes for drugs such as the ones produced by Valeant and Mylan simply because these companies have managed to either buy out or drive out any competitors who could take away their profit. This means that they are required to pay hefty amounts of money for prescriptions that should not cost nearly as much as they do. This forces consumers who have inelastic dependencies on drugs such as epinephrine and insulin to buy the drugs, regardless of how inhumanely expensive they are. In “Valeant’s Drug Price Strategy Enriches It, but Infuriates Patients and Lawmakers”, Pollack and Tavernise write of 68-year-old Bruce Mannes, a retired carpenter, who has to pay almost $1,800 a month for Cuprimine, a Valeant drug used to treat Wilson disease. This article was written in October of 2015. In the same year, only five months before in May, he had to pay $366. Mannes wife, Susan, says, “My husband will die without the medicine, we just can’t manage another two, three thousand dollars a month for pills.”
Social Impact and Social Obligation
With the ability to change prices in whichever fashion they deem, American pharmaceutical companies have to take into account the impact of their prices. Is it ethical to be charging a 68-year old man, who is living with a condition that can cause acute liver and nerve damage almost two thousand dollars a month for a medication that was worth 391.8% less five months prior? Does profit transcend a person’s physical, financial, and emotional well-being?
A corporation’s voluntary decision to engage in what can only be described as predatory pricing implies that there is no respect or interest in their stakeholders and societal institutions. As a part of the healthcare sector, it would not be the most outrageous assumption to think that a pharmaceutical corporation, tasked with developing and providing breakthrough medication that can be the difference between life and death for millions, would want to provide for the greater good.
Jeremy Bentham’s motto of “the greatest good for the greatest number” is one that is visibly unheard of to companies such as Valeant Pharmaceuticals and Mylan Pharmaceuticals. The principle of utilitarianism holds that “the morally right course of action in any situation is the one that produces the greatest balance of benefits over harms for everyone affected. (“Calculating Consequences: The Utilitarian Approach to Ethics”).
It is immoral to raise prices of medications that are people need in order to have a bearable quality of life. The idea of utilitarianism calls for the greater good to be placed above what is good for self. Jeremy Bentham’s motto of “the greatest good for the greatest number” should ring true because, if anything, they carry a greater social responsibility than other institutions in the market sector. Therefore, it is important to hold them accountable for their actions as an institution whose purpose is to provide for the public and to ensure they act in an ethical matter.
Medical expenses are already leading causes of debt amongst Americans, so allowing big pharmaceutical companies to dominate how much life-saving medications cost, rather than the Food and Drug Administration is a pressing matter that needs to be discussed.
The actions of the pharmaceutical industry are not only business matters, but also ethical matters. Dominating an industry that could easily have multiple alternatives to the same drug and pushing out competing business does not allow for consumers to make choices, it pushes them to desperation. How does a first world country such as the United States, with a mixed economy in which the government is always ready to step into business matters, allow pharmaceutical companies to set their own prices? Rather than promoting a level playing field where there is competition and consumers can choose from at least more than one or two companies, the state sectors have turned a blind eye.
Pharmaceutical companies having the ability to set prices and exploiting that privilege to make more profit is an attack on the consumer and is also an issue of when government regulation needs to step in. A lot of times, companies blame the issue on research and development, but experts and investigations have shown that this is not typically the case. The lack of initiative to develop new drugs results in big companies taking shortcuts and buying smaller companies that can produce what they cannot and then jacking up prices in order to regain the money they spent purchasing the smaller companies. In the end, the consumers, the people who need the medications in order to survive, people like Bruce Mannes, suffer in the name of profit.
The Possible Roles of Other Societal Institutions
In addition to the need for pharmaceutical industries to be ethical and socially responsible, it is crucial for state sectors, such as the federal government, to regulate how they operate in the market sector. As previously mentioned, many companies operate as monopolies by buying out companies that produce similar medications and driving out companies that do not want to be bought out. Healthy monopolies can occur to some extent, but when there is a monopoly in an area in which they are taking advantage of consumers, the government needs to intervene to protect the consumer from being exploited. Because there are monopolies, consumers have to stick with one pharmaceutical company to produce their medications, regardless of how expensive the medications become. Government intervention can allow for the consumer’s ability to choose which product he/she prefers to stay intact.
What is being observed through the actions of “big pharma” is an instance in which supposed beneficiaries, in this case the patients of the health care sector, do not actually receive any benefits and end up being the benefactors. People living with serious allergies that could be triggered at any moment, people living with Type 1 diabetes that can only be managed with insulin, and millions of other Americans living with thousands of different health conditions, these people are the ones saving the pharmaceutical industries. They have become an institution in themselves. Without them, there is no healthcare sector and there is no pharmaceutical industry.
It is easy to forget just how big of a role the patients play, but they are the primary stakeholders. They drive the demand in the pharmaceutical market. It would be unwise to underestimate their power. As their own society, they have the power to stand up and stand out against the predatory pricing of companies such as Valeant and Mylan. Until that moment of realization comes, the fact of the matter is that this is an uphill battle.
Code Blue
The reality of the issue of overpriced medications is that it that cannot be fixed unless legislatures and the chief executive officers of corporations, such as Valeant Pharmaceuticals, are able to see the effect of just how harmful raising prices to unreasonably and extortionate amounts can be to the American people. This becomes increasingly difficult when stories of people such as … do not gain the same amount of traction as gun reform and immigration. Healthcare in the business world is so grossly underrepresented that matters such as these are seen as trivial when issues such as fake news and Russian probes are taken into account, and that is unfair to the hundreds of millions of Americans who are paying outrageous money they might not have to companies that have net-worths in the billions. CPR will not stabilize this crisis. Rather, CAR needs to be implements: Communication, Attention, and Regulation.