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Saturday, March 22, 2003The country's prescription drug bill, $82 billion in 1996, climbed to $192 billion last year Unfortunately, most of that cost is not born by the people who use the drugs, but by insurance companies and employers: "It's already a crisis. It's hurting the bottom line," says General Motors health czar L.L. (Woody) Williams. Drugs now account for 31% of the $4.5 billion a year General Motors spends on health care. Verizon Communications expects to spend $600 million on drugs in 2003. At Eastman Kodak prescription drugs will eat up $100 million of the company's $320 million health budget this year. "Employers can't sustain this," says Karen Ignagni, president of the American Association of Health Plans. This disconnect does its greatest damage at the point of drug promotion. No ad campaign could go wrong when it’s touting a product that is essentially free for its target audience: Drugmakers spend $2.3 billion a year on ads aimed at consumers, up from virtually nothing in 1990. This is on top of the money they spend sending 90,000 salespeople out to call on physicians and the $12 billion worth of free samples they hand out. (The numbers come from market researchers NDC Health, IMS Health and Verispan.) [Not to mention the money they spend on toys and food and fancy exhibits to entice doctors -ed.] But if the anti-free-market types think that the nation's newfound attention to price will quell the advertising volume, they're probably going to be in for a surprise. It is not too hard to get doctors, who have not a nickel of their own at stake, to prescribe lavishly. Persuading patients to dig into their own pockets, in contrast, is going to demand some intense salesmanship. Take, for example, the ulcer drug, Prilosec: AstraZeneca's famed purple pill, Prilosec, and other so-called proton-pump inhibitors are the most effective heartburn drugs ever invented, so potent that Prilosec has been nicknamed "purple crack." Proton-pump inhibitors are the top drug category, with 2002 sales of $13 billion. A lot of those pills, skeptics say, went to people who have little more than a few bouts of heartburn and could get by on generic versions of Zantac. "Drug marketers have convinced every American who belches occasionally and has a little heartburn after their third cannoli that they must immediately begin taking the little purple pill." I can attest to this. Before Prilosec came on the market, I had few people who failed therapy on Zantac. Now, it seems to be the norm. Many people come in requesting Prilosec. They turn away my offer of Zantac, and say they would rather have that purple pill they saw on television. Zantac, you see, has an over-the-counter version as well as a higher dose prescription version. As a result, Zantac gets equated with older, less effective antacids such as Maalox. When I tell them that Prilosec is much more expensive, the reply is always the same - a shrug and an “It only costs me $5.” Now, how do you argue with that? So, although I put on a sympathetic face when my patients complain that their insurance companies are making them accept greater responsibility for their drug costs, I applaud the change. It’s the only way that costs are going to be controlled. posted by Sydney on 3/22/2003 08:04:00 AM 0 comments 0 Comments: |
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