Unlike other countries, the United States does not regulate prescription drug prices. Instead, about 40 years ago, policymakers came up with another idea to make prices more affordable: harnessing the forces of the free market.
They thought that by making it easier for companies to copy brand-name drugs and sell them at much lower prices, generic drug makers would flood in and drive prices down.
And it worked for a long time. the Americans saved trillions of dollars Over the past few decades.
But there are signs that this system could be in serious trouble.
The check-up question is: why is that and are policymakers doing anything about it?
Lizzy McGrevy, community engagement specialist at Side Effects Public Media, spoke with Leslie Walker, senior producer at health policy news organization Tradeoffs. Tradeoffs has released a special series called. race to the bottomexamines vulnerabilities in America’s generic drug supply system.
This transcript has been edited for length, style, and clarity.
McGready: Hey Leslie, so how important are generic drugs to our health care system and why are they in serious trouble right now?
Walker: These pharmaceuticals are truly the backbone of American medical care.
Now they fill 9 out of 10 prescriptions we receive. They lower our cholesterol and manage diabetes and depression.
However, this essential industry is currently under pressure from two sides.
On the other hand, there are very old generic drugs available. Critical things like antibiotics and cancer drugs, economists told me, have become almost too cheap.
This has forced some companies to cut corners or exit the market altogether, causing shortages and quality problems.
And on the other hand, there are some very expensive new branded drugs that have no generic competition and remain in use for 15 or even 20 years, again to the detriment of patients.
McGreevy: And while this is 100% bad news for consumers, I can’t help but think that it might not be such bad news for Big Pharma, the brand name drug companies. Are they involved in these issues?
Walker: No doubt, when it comes to these new and very expensive branded drugs, big pharmaceutical companies are honing some pretty ingenious strategies to suppress competition.
play a patented gameA few examples include paying intermediaries who buy drugs on behalf of insurance companies and employers to give their products preferential treatment over cheaper generic drugs.
McGready: And Leslie, let’s talk a little bit about the other big issue that you highlighted…the shortage and quality issues of these cheap generic drugs.
We hear all the time about shortages in the U.S., especially since the pandemic. Are there any signs that this situation will get worse?
Walker: You’re right, Lizzie, that’s Drug shortages have been a long-standing problem It’s been going on for a while, but there are signs that it’s getting worse.
A recent report found that the number of medicines in shortage is the highest it has been in a decade, and shortages are lasting for an average of three years.
Furthermore, the supply chain for these medicines is also becoming more vulnerable.
These very low prices are driving companies to cut more corners and move more manufacturing to countries like India and China.
economist Marta Wosinska The Brookings Institution said this is creating a whole new mess about quality and reliability in the United States.
“Are we prepared for supply chain disruptions caused by natural disasters? What if there is a conflict with China? We are not truly addressing these types of vulnerabilities,” Woshinska said.
McGready: Are policymakers doing anything to strengthen this important industry?
Walker: There is a lot of activity going on in Washington. The Federal Trade Commission trying to crack down on above some of those games Branded companies try to fend off competition.
And there’s a bipartisan bill in Congress targeting cheap drugs that are often in short supply, essentially trying to make a volatile market more attractive and reliable for manufacturers.
That said, most of the movement we’re seeing is fairly modest.
And some experts say they believe more fundamental reforms are needed.
For that, Alfred Engelbergone of the original authors of the 40-year-old law known as Hatch-Waxman methodwhich gave rise to the modern generic industry.
“It was the right thing to do at the time,” Engelberg said. “We got a lot of public benefits from this law, but we set it aside and made it a kind of untouchable law. But times have changed. A new paradigm for new times. I have to find out.”
McGreevy: Thank you for this valuable information, Leslie. You can listen to Leslie’s special series on trade-offs. it is called race to the bottom Available wherever you get podcasts.
The Checkup by Side Effects Public Media is a regular audio segment of WFYI’s daily podcast. Current WFYI news.
Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations in the Midwest and surrounding areas, including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio, and WFPL in Kentucky.
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