Talk Story
SO FAR, I'm lucky. The drugs I depend on are over-the-counter Chlor-Trimeton for mango-pollen sneezing fits and Advil for aches and pains. The allergy pills cost $.21 each and the painkillers $.12. Generic versions are even cheaper. The prescription-drug
headache gets worseIt could be much worse. Many sinus allergy sufferers pay about $71 for a 30-day supply of 60 Allegra tablets. Add a Beconase AQ inhaler for about $52 and the tab for being an allergy-free American can come to $123 a month.
Canadian allergy sufferers get off much easier. A Canadian online drugstore advertises generic inhalers for $29.99 apiece and sells 60 Allegras for $16.30. That's a savings of almost $77.
Why should some popular drugs cost 167 percent more in the U.S. than in Canada?
MOST reasonably healthy Americans don't know or care -- yet. Our health insurance plans cover prescriptions, keeping prices paid at drug counters low. My co-pay at Kaiser is a mere $5 per prescription, while my wife pays $20 each on her plan. Those co-pays can add up, but they keep drug price inflation off most front pages. They shift the burden to health insurers, who get the bad press instead.
For example, Kaiser boosted premiums an average of 8.7 percent this year after adding 4 percent in 2001. HMSA premiums for Hawaii's small businesses increased by an average of 9 percent last year and will jump another 5 percent starting next month.
Meanwhile, while plan membership increased by just 2.4 percent, HMSA spent more than 30 percent more for drugs in the first quarter of this year than it did in the same quarter of 2001 -- $53 million compared to $40.7 million.
BUT BACK to the question: Why are Americans getting soaked while Canadians and Europeans get off easy?
According to the Wall Street Journal, pharmaceutical companies are offsetting price cuts negotiated or mandated by foreign governments by raising prices here. Caught in a profit squeeze, they take advantage of the fact that the U.S. is the only first-world country without government drug price controls.
The United States, which has fewer people than Europe, now accounts for 60 percent of pharmaceutical company profits while American taxpayers also subsidize much of the basic research for new drugs done by the National Institutes of Health.
"Step by step, the profitability of European markets is decreasing and we're depending on the U.S. more and more," a French drug manufacturer complained to the newspaper. "It's a disaster."
Accordingly, a 20 mg Prilosec capsule, used to treat ulcers, costs $3.69 here, while the same pill costs only $1.31 in Great Britain, $1.34 in Italy, $1.39 in Germany, $1.22 in France and $2.60 in Canada.
Americans with high cholesterol pay $1.88 per 10 mg dose of Lipitor, while the British pay $.86, Italians $.74, Germans $.69, French $.60 and Canadians less than a buck.
OLDER Americans are especially vulnerable, particularly those who don't have health insurance or pay their own premiums. As Baby Boomers approach both retirement and their prime drug-consuming and voting years, expect to see prescription-drug costs gather momentum as a political issue.
Free markets keep prices under control by allowing the forces of supply, demand and competition to work. Government price controls, patents and the need to offset research and development costs complicate and distort the pill picture.
Manufacturers are starting to fight back, withholding new treatments from European markets or offering them without price cuts -- and without approvals for reimbursement by state-run health systems.
There's no easy solution. Privatizing national health care systems isn't likely and imposing price controls in the United States while maintaining incentives for research and development requires a delicate balancing act.
Say, hand me that bottle of Advil, eh?
John Flanagan is the Star-Bulletin's contributing editor.
He can be reached at: jflanagan@starbulletin.com.