February 12, 2020
Mystery hospitalization bills and soaring drug costs present favorite targets on the presidential campaign trail, and while the Iowa Caucus may have ended in a fog of confusion over which candidates scored knock-out victories, health was the undisputed winner among the issues that held the most concern for Hawkeye-State residents. Whether voters look left or right for a presidential savior, the constant rallying cry among leaders, blue or red, on the stump and in the halls of Congress, is to arrest the shocking cost of healthcare.
But we can’t forget that we are a super-sized, soda-guzzling, sugar-craving society, and that some time ago, we abandoned the cheapest and best primary prevention path of good diet and exercise for the easiest path to save lives — “write a scrip and take a pill.” When illness presents, we expect biopharma to save the day and address our arterial plaque and elevated Type 2 diabetes A1C levels at bargain-basement, discount prices. However, drugs don’t create disease, nor do they drive the eyepopping price tag of US healthcare; they are often overall response to urgent patient need.
State-by-state, prescription drug price controls are already a priority and on the Federal level, there is bipartisan agreement that prices must be addressed. Candidates vie to show their constituents that if elected, they will take a heavier hand in punishing biopharma companies for not slashing prices.
Consumer Reports, that bastion of smart purchasing for cars and home appliances, writes in its 2019 national survey that “Thirty percent of Americans who currently take prescription medicine say their out-of-pocket cost for a drug they regularly take has increased in the past year,” and of those, 12 percent saw their drug’s prices increase by $100 or more. Those who saw spikes in their out-of-pocket costs were nearly “twice as likely to not fill a prescription, forgo other medical treatments or tests, cut back on groceries, or get a second job. One contributing factor: No Federal law or regulation effectively keeps drug prices in check.”
That Federal law — in some form or another — could become a reality post-2020 Presidential elections. What actually happens if our elected representatives succeed? Does placing a bullseye on the ripe biopharma target meaningfully lower overall healthcare costs? The American voter has been led to believe so, and yet, despite desires from both sides of the Congressional aisle to claim a legislative victory, it will not resolve the bigger problem driving up US healthcare costs.
We are a nation that has neglected investment in preventing the biggest chronic-illness factors. Those most influential in reducing healthcare costs — the voters — receive diet advice that is often not supported by science. At the same time, the primary-care prevention model we’ve relied upon for decades has morphed into a network of impersonal walk-in convenience stores. And finally, investing in healthy lunch and exercise and sports programs at the primary- and secondary-education level has undergone belt tightening even as our children’s waistlines expand.
When we examine costs, those illnesses that impact society the most in suffering and household dollars seem to be the easiest to prevent. Non-communicable diseases (NCDs) are the leading causes of death and disability, killing more than three in five people worldwide and responsible for more than half of the global disease burden. WebMD reports the top six include: arthritis, back pain, heart disease, cancer, depression and diabetes. Four of these six top the NCD list.
Here are the epidemiological facts: In the United States, NCDs account for 89 percent of all deaths and have now passed infectious disease as a leading cause of death. US stats for the leading NCDs (cancer, heart and respiratory diseases, and mental health conditions) are higher than other developed nations. Across all NCDs, mental and substance use disorders result in higher fatalities in the United States than in other nations. Mental health conditions are 3,725 per 100,000, 1.7 times the global average. Our national leadership must consider a new path that looks unflinchingly at underlying cause of our healthcare costs and answers: “Why is our nation getting sicker?”
Spoiler alert! After political candidates drive down drug costs and discourage investors from backing game-changing science that will lead to treatments for noncommunicable and rare diseases, they will see health costs continue to climb unabated. They will have ignored the bigger problem and their responsibility to their constituents: NCDs perpetuate poverty and contribute to it by hindering economic development in low- and middle-income regions. NCDs will cause a cumulative loss of output of $47 trillion between 2011 and 2030. That’s the cost sinkhole we refuse to see.
It is essential that candidates seeking the highest office of the nation cease fencing with pharma advocates and innovators and put aside parry and thrust strategies. That’s a losing fight, and while it grinds on, our nation gets sicker. By avoiding the looming disaster of preventable disease and instead, picking away at less meaningful targets, our leaders will never truly reduce healthcare costs or increase their constituents’ wellbeing. Drugs prices are a symptom of a bigger problem. Let’s go after the real culprit and attack the disease — not part of the cure.
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