Why Prescription Drug Prices Keep Rising – and 3 Ways to Bring Them Down
Prescription drug prices have been rising at a blistering rate over the last few decades. Between 1980 and 2016, overall spending on prescription drugs rose from about $12 billion to roughly $330 billion, while its share of total health care spending doubled, from 5% to 10%.
Although lawmakers have shown renewed interest in addressing the problem, with pharmaceutical CEOs testifying before the Senate Finance Committee in February and pharmacy benefit managers (PBMS) scheduled to do so this week, no comprehensive plan to halt the relentless increase in prices has been proposed, let alone agreed upon.
Robin Feldman, a professor at the University of California Hastings College of Law, takes a look at the drug pricing system in a new book, “Drugs, Money and Secret Handshakes: The Unstoppable Growth of Prescription Drug Prices.” In a recent conversation with Bloomberg’s Joe Nocera, Feldman said that one of the key drivers of rising prices is the ongoing effort of pharmaceutical companies to maintain control of the market.
Fearing competition from lower-cost generics, drugmakers began over the last 10 or 15 years to focus on innovations “outside of the lab,” Feldman said. These innovations include paying PBMs to reduce competition from generics; creating complex systems of rebates to PBMs, hospitals and doctors to maintain high prices; and gaming the patent system to extend monopoly pricing power.
Feldman’s research on the dynamics of the drug market led her to formulate three general solutions for the problem of ever-rising prices:
1) Transparency: The current system thrives on secret deals between drug companies and middlemen. Transparency “lets competitors figure out how to compete and it lets regulators see where the bad behaviors occur,” Feldman says.
2) Patent limitations: Drugmakers have become experts at extending patents on existing drugs, often by making minor modifications in formulation, dosage or delivery. Feldman says that 78% of drugs getting new patents are actually old drugs gaining another round of protection, and thus another round of production and pricing exclusivity. A “one-and-done” patent system would eliminate this increasingly common strategy.
3) Simplification: Feldman says that “complexity breeds opportunity,” and warns that the U.S. “drug price system is so complex that the gaming opportunities are endless.” While “ruthless simplification” of regulatory rules and approval systems could help eliminate some of those opportunities, Feldman says that the U.S. doesn’t seem to be moving in this direction.
Read the full interview at Bloomberg News.
The 10 Worst States to Have a Baby
The birth rate in the U.S. is finally seeing an uptick after falling during the recession. Births tend to fall during hard economic times because having a baby and raising a child are expensive propositions.
Costs are not the same everywhere, though. Some states are better than others for family budgets, and health care quality varies widely from place to place.
A new report from WalletHub looks at the cost of delivering a baby in the 50 states and the District of Columbia, as well as overall health care quality and the general “baby-friendliness” of each state – a mix of variables including average birth weights, pollution levels and the availability of child care.
Mississippi ranks as the worst state to have a baby, despite having the lowest average infant-care costs in the nation. Unfortunately, the Magnolia State also has the highest rate of infant deaths and one of lowest numbers of pediatricians per capita.
Related: Which States Have the Most Unwanted Babies?
On the other end of the scale, Vermont ranks as the best state for having a baby. Vermont has both the highest number of pediatricians and the highest number of child centers per capita. But before packing your bags, it’s worth considering the frigid winters in the Green Mountain State and the amount of money you’ll need to spend on winter clothing and heat.
Here are the 10 worst and 10 best states for having a baby:
Top 10 Worst States to Have a Baby
1. Mississippi
- Budget Rank: 18
- Health Care Rank: 51
- Baby Friendly Environment Rank: 29
2. Pennsylvania
- Budget Rank: 37
- Health Care Rank: 36
- Baby Friendly Environment Rank: 51
3. West Virginia
- Budget Rank: 13
- Health Care Rank: 48
- Baby Friendly Environment Rank: 50
4. South Carolina
- Budget Rank: 22
- Health Care Rank: 43
- Baby Friendly Environment Rank: 49
5. Nevada
- Budget Rank: 39
- Health Care Rank: 35
- Baby Friendly Environment Rank: 46
6. New York
- Budget Rank: 46
- Health Care Rank: 12
- Baby Friendly Environment Rank: 47
7. Louisiana
- Budget Rank: 8
- Health Care Rank: 50
- Baby Friendly Environment Rank: 26
8. Georgia
- Budget Rank: 6
- Health Care Rank: 46
- Baby Friendly Environment Rank: 43
9. Alabama
- Budget Rank: 3
- Health Care Rank: 47
- Baby Friendly Environment Rank: 44
10. Arkansas
- Budget Rank: 12
- Health Care Rank: 49
- Baby Friendly Environment Rank: 37
Top 10 Best States to Have a Baby
1. Vermont
- Budget Ranks: 17
- Health Care Rank: 1
- Baby Friendly Environment Rank: 5
2. North Dakota
- Budget Rank: 10
- Health Care Rank: 14
- Baby Friendly Environment Rank: 10
3. Oregon
- Budget Rank: 38
- Health Care Rank: 2
- Baby Friendly Environment Rank: 14
4. Hawaii
- Budget Rank: 31
- Health Care Rank: 25
- Baby Friendly Environment Rank: 1
5. Minnesota
- Budget Rank: 32
- Health Care Rank: 5
- Baby Friendly Environment Rank: 12
6. Kentucky
- Budget Rank: 1
- Health Care Rank: 33
- Baby Friendly Environment Rank: 20
7. Maine
- Budget Rank: 25
- Health Care Rank: 10
- Baby Friendly Environment Rank: 15
8. Wyoming
- Budget Rank: 22
- Health Care Rank: 17
- Baby Friendly Environment Rank: 7
9. Iowa
- Budget Rank: 14
- Health Care Rank: 25
- Baby Friendly Environment Rank: 9
10. Alaska
- Budget Rank: 50
- Health Care Rank: 6
- Baby Friendly Environment Rank: 2
Top Reads From The Fiscal Times
- The 10 Worst States for Property Taxes
- Americans Are About to Get a Nice Fat Pay Raise
- You’re Richer Than You Think. Really.
Worried About a Recession? Here’s When the Next Slump Will Hit
The next recession may be coming sooner than you think.
Eleven of the 31 economists recently surveyed by Bloomberg believed the American recession would hit in 2018, and all but two of them expected the recession to begin within the next five years.
If the recession begins in 2018, the expansion would have lasted nine years, making it the second-longest period of growth in U.S. history after the decade-long expansion that ended when the tech bubble burst in 2001. This average postwar expansion averages about five years.
The recent turmoil in the stock market and the slowdown in China has more investors and analysts using the “R-word,” but the economists surveyed by Bloomberg think we have a bit of time. They pegged the chance of recession over the next 12 months to just 10 percent.
Related: Stocks Are Sending a Recession Warning
While economists talk about the next official recession, many average Americans feel like they’re still climbing out of the last one. In a data brief released last week, the National Employment Law Project found that wages have declined since 2009 for most U.S. workers, when factoring in cost of living increases.
A full jobs recovery is at least two years away, according to an analysis by economist Elise Gould with the Economic Policy Institute. “Wage growth needs to be stronger—and consistently strong for a solid spell—before we can call this a healthy economy,” she wrote in a recent blog post.
Top Reads from The Fiscal Times:
- This CEO Makes 1,951 Times More Than Most of His Workers
- Seven Reasons Why the Fed Won’t Hike Interest Rates
- $42 Million for 54 Recruits: U.S. Program to Train Syrian Rebels Is a Disaster
The 15 Most Valuable NFL Teams
The New England Patriots may be reigning Super Bowl champs and have the most successful quarterback-coach pair in NFL history -- Tom Brady and Bill Belichick each have four championship rings with the Pats -- but they’re missing something nevertheless.
As they kick off the season tonight against the Pittsburgh Steelers, the Pats aren’t at the top of the NFL in terms of team value. That title still goes to the Dallas Cowboys, according to an analysis at Forbes.
Related: 10 Big Money NFL Draft Busts
Dallas must be feeling pretty good about beating New England at something. They had the same regular season record as the Patriots last year, with 12 wins and 4 losses, but ended the season with a loss to the Green Bay Packers in the divisional playoffs, while the Pats went on to win Super Bowl XLIX (that’s 49 for all you non-Romans out there).
Even though the Washington Redskins have been playing pretty pathetically for the past decade, they still come in third. Washington’s NFC East rival, the New York Giants, rank fourth at $2.1 billion.
Here are the 15 most valuable NFL teams:
- Dallas Cowboys - $3.2 billion
- New England Patriots - $2.6 billion
- Washington Redskins - $2.4 billion
- New York Giants - $2.1 billion
- Houston Texans - $1.85 billion
- New York Jets - $1.8 billion
- Philadelphia Eagles - $1.75 billion
- Chicago Bears - $1.7 billion
- San Francisco 49ers - $1.6 billion
- Baltimore Ravens - $1.5 billion
- Denver Broncos - $1.45 billion
- Indianapolis Colts - $1.4 billion
- Green Bay Packers - $1.38 billion
- Pittsburgh Steelers - $1.35 billion
- Seattle Seahawks - $1.33 billion
Top Reads from the Fiscal Times:
- After the Fiorina Fiasco, What Insult Will Trump Fling Next?
- $42 Million for 54 Recruits? U.S. Program to Train Syrian Rebels Is a Disaster
- A Military Coup in the U.S.? A Surprising Number of Americans Might Support One