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Drug prices and fast approvals can harm patients

Martha Rosenberg
Meds
November 23, 2023
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An excerpt from Big Food, Big Pharma, Big Lies.

Few fail to be shocked at the rising prices of some prescription drugs. “Drug companies have raised prices relentlessly for decades while manipulating the patent system and other laws to delay competition from lower-priced generics,” reported the House Committee on Oversight and Reform in December 2021.

The price of insulin rose by 54 percent between 2014 to 2019, and the anti-parasitic drug Daraprim was repriced from $13.50 to $750 in 2015 by Turing Pharmaceuticals founder Martin Shkreli. Mylan raised the price of EpiPen to $600 from $100 with no warning.

And then there were the hepatitis C drugs which cured the condition for the first time. Gilead Science priced Sovaldi, one of the first such hepatitis C drugs, at a shocking $1,000 a pill or $84,000 for a course of treatment. Lawmakers worried that the opportunistic prices would sack entitlement programs, and they did;  in 2014 alone, Medicare and Medicaid spent over $5 billion on Sovaldi and Gilead’s follow-up hepatitis C drug, Harvoni.

In 2017, Harvoni ad campaigns on TV, in broadcast, and on posters along train commuter lines unabashedly stressed screening, warning people that if they were born between 1945 and 1965, they could have hepatitis C and not know it.

The shift to scare tactics and a push for screening—sometimes called disease mongering— was not a coincidence. According to the pharmaceutical trade website Fierce Pharma, Gilead’s hepatitis blockbusters at the time were “in freefall, and its pool of eligible patients has shrunk dramatically thanks to the success of its meds.” If “all baby boomers got tested for the virus, though? That could help stem the tide—and it’s exactly the move the company is recommending with its latest awareness push,” continued the site.

Some of the ads for hepatitis C drugs included the Centers for Disease Control and Prevention (CDC) logo which instantly increased marketing credibility but also raised questions about Gilead donations to the CDC foundation and quid pro quos. Few realize that the CDC foundation boasts many drugmaker donors like Abbott, AbbVie, Bayer, AstraZeneca, Merck, Pfizer, GlaxoSmithKline Biologicals, Eli Lilly, Amgen, Genentech and, as we noted, Gilead which raises questions about monetary conflicts of interest.

And, when it came to hepatitis C drugs, “there was more,” as the infomercials say. The drugs had been rushed to market so quickly, the their penchant for reactivating pre-existing hepatitis B was completely overlooked and add post hoc warnings had to be added to the label by 2016.

In 2017, the New York Times reported additional, undisclosed risks with the hepatitis C drugs. Of  250,000 patients treated with them, 524 experienced liver failure and 165 died wrote the newspaper. “An additional 1,058 had severe liver injury, and in 761 the drugs appeared not to work.”

Thomas J. Moore, a senior scientist at the Institute for Safe Medication Practices, echoed what many were thinking as the hepatitis drug risks unfolded: does the rush to bring a new drug treatment to market come at an unforeseen cost to patient safety? Were they approved too quickly? Clearly, fast approvals, like ever-increasing drug prices, can and do harm patients.

Martha Rosenberg is a health reporter and the author of Big Food, Big Pharma, Big Lies and Born With a Junk Food Deficiency.  

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