{"id":100,"date":"2016-12-01T02:24:17","date_gmt":"2016-12-01T02:24:17","guid":{"rendered":"http:\/\/plutchaknews.com\/newsroom\/?p=100"},"modified":"2016-12-01T02:27:34","modified_gmt":"2016-12-01T02:27:34","slug":"investigation-costs-of-widely-prescribed-drugs-jumped-more-than-5000-percent","status":"publish","type":"post","link":"http:\/\/plutchaknews.com\/newsroom\/2016\/12\/01\/investigation-costs-of-widely-prescribed-drugs-jumped-more-than-5000-percent\/","title":{"rendered":"Investigation: Costs of widely prescribed drugs jumped more than 5,000 percent"},"content":{"rendered":"
\"Coburn
Coburn Dukehart \/ Wisconsin Center for Investigative Journalism
Jack Christensen, 8, has a snack at his home in Waunakee, Wis., after school on Oct. 5, 2016. His mother, Jess Franz-Christensen, logs his carbohydrate intake on a monitoring device. Jack has Type 1 diabetes and his parents wear watches to monitor his blood sugar level 24 hours a day to ensure his numbers are not too high or low. Rapidly rising insulin costs have prompted Franz-Christensen to become a parent activist pushing for lower drug prices.<\/em><\/figcaption><\/figure>\n

By Sean Kirkby, Dee J. Hall and Bridgit Bowden<\/strong><\/em>
\nWisconsin Health News, Wisconsin Center for Investigative Journalism, Wisconsin Public Radio<\/strong><\/em><\/p>\n

WAUNAKEE, Wis. \u2014 Jess Franz-Christensen did not realize the seriousness of her son\u2019s Type 1 diabetes diagnosis until staff in the doctor\u2019s office offered to call an ambulance to take him to the hospital.<\/p>\n

Her next shock: The cost of Jack\u2019s medicines.<\/p>\n

The drugs, administered through an insulin pump, cost $1,200 a month.<\/p>\n

\u201cWe\u2019re really fortunate. We\u2019re able to pay for stuff,\u201d said Franz-Christensen, whose husband, Scott, is a physicist, while she stays home to care for Jack, 8, and their daughter, Kendall, 11.<\/p>\n

\u201cBut there are people who are making decisions whether to feed their kid or get test strips \u2014 whether to pay rent or get a vial of insulin. It\u2019s heart-breaking.\u201d<\/p>\n

Prices for insulin products have nearly doubled in recent years, including Lantus SoloSTAR \u2014 one of the drugs that Medicaid and Medicare spent the most on in 2015. Its price increased by 81.5 percent between 2011 and 2014, according to data analyzed by the Wisconsin Center for Investigative Journalism. The data were provided by California-based First Databank, a supplier of U.S. commercial drug pricing information.<\/p>\n

Overall, the price of insulin nearly tripled between 2002 and 2013, prompting calls this month for a federal investigation by former Democratic presidential candidate Sen. Bernie Sanders from Vermont.<\/p>\n

\u201cThey (drug companies) are making billions and billions of dollars on people who literally can\u2019t afford it,\u201d said Franz-Christensen, who has joined #MyLifeIsNotForProfit, a national grassroots parent movement.<\/p>\n

Recent nationwide news coverage has focused on the rising cost of EpiPens, which counteract potentially fatal allergic reactions to peanuts, bee stings and other triggers. But the $600 cost for a two-pack of that medicine is just one example of lifesaving drugs with skyrocketing prices.<\/p>\n

The costs of seven widely prescribed antibiotics, cancer drugs, arthritis medications and other prescriptions have escalated between 29 percent and 5,241 percent in recent years, according to a joint investigation by the Wisconsin Center for Investigative Journalism, Wisconsin Health News and Wisconsin Public Radio.<\/p>\n

The investigation examined the impacts of and reasons behind the overall rise in prescription costs, including drug price increases since 2011, using proprietary First Databank data.<\/p>\n

Synthroid, which is used to treat hypothyroidism, is the most commonly prescribed medication in the United States and has been on the market for more than 60 years. In just the past six years, it has nearly doubled in price, according to the Center\u2019s analysis. The generic version of Synthroid, levothyroxine, has gone from 14 cents to 46 cents per pill, an increase of 231 percent between 2011 and 2016, the analysis shows.<\/p>\n

A single two-week dose for Humira, a medication that treats conditions including rheumatoid arthritis, plaque psoriasis and Crohn’s disease, has increased 129 percent since 2011, to $2,000. Price increases have made Humira and other anti-inflammatory drugs among the most costly in the country, according to insurers.<\/p>\n

The price increases, which continue to mount, place economic and emotional pressure on patients and their families, squeeze the budgets of health care providers and raise costs for taxpayers in Wisconsin and nationwide, the joint investigation found.<\/p>\n

Lack of competition raises costs<\/h2>\n

Spending on medications is rising for a variety of reasons:<\/p>\n

Some pharmaceutical companies have taken action to extend the patent protections on their products, blocking cheaper generic versions from being developed.<\/p>\n

As some companies stop making certain low-cost drugs, other companies gain monopolies over the market.<\/p>\n

Companies are introducing more high-cost \u201cspecialty\u201d drugs such as Humira that treat lifelong conditions.
\nAs the nation\u2019s population ages, the demand for prescription drugs increases; more than half of Americans now use them.<\/p>\n

One practice is known as \u201cproduct hopping,\u201d in which a company makes changes to a drug to extend its patent protections, keeping others from entering the market with cheaper alternatives.<\/p>\n

Wisconsin Attorney General Brad Schimel filed an antitrust lawsuit in September alleging that the makers of Suboxone, a drug used to treat opiate addiction, changed their product from a tablet to a film that dissolves in the mouth to block alternatives and \u201cmaintain monopoly profits.\u201d<\/p>\n

The lawsuit alleges actions by Indivior and MonoSol Rx, beginning in 2009, helped generate $1 billion a year in sales of Suboxone. Indivior said it takes \u201cthese allegations seriously\u201d and \u201cintends to defend this and other related actions.\u201d<\/p>\n

There also have been fewer brand name drugs coming off patent and being replaced by lower-cost generics, said Larry Levitt, senior vice president for special initiatives at the California-based Kaiser Family Foundation.<\/p>\n

According to a report from health care information company QuintilesIMS, in 2014, spending on medications increased at the highest rate since 2001. The increases were driven by \u201cinnovative\u201d new medicines, a lower number of brand name drugs losing patent protection and price increases.<\/p>\n

\u201cAs long as drugs are on patent protection, manufacturers at that point have monopoly pricing ability and they can price their products at levels that the market will bear,\u201d said Chuck Shih, who leads Pew Charitable Trusts\u2019 specialty drugs research initiative. \u201cWhen that\u2019s the case, they\u2019re free to increase the prices of their products year over year.\u201d<\/p>\n

In addition, as competitors drop out of the market, the remaining companies are \u201craising prices significantly and earning substantial profits,\u201d Levitt said.<\/p>\n

For instance, he noted that an EpiPen competitor temporarily ceased production after a complete recall of its product. Levitt also pointed to the pharmaceutical company Valeant, which raised the price of two cardiac care drugs by 525 percent and 212 percent shortly after acquiring them.<\/p>\n

Outgoing Valeant CEO Michael Pearson acknowledged to a U.S. Senate committee in April that his company had been \u201ctoo aggressive\u201d in raising prices.<\/p>\n

\u201cSo you have a limited group making these materials,\u201d explained Mel Weinswig, former dean and professor emeritus at the University of Wisconsin-Madison School of Pharmacy. \u201cAnd with that, the price has just skyrocketed.\u201d<\/p>\n

The price jumps have caught the attention of Congress, which held hearings after Turing Pharmaceuticals increased the price of a drug that treats toxoplasmosis \u2014 an illness that can cause brain damage, blindness, miscarriage or birth defects \u2014 by 5,000 percent shortly after acquiring it.<\/p>\n

The increase in the price of EpiPens has also drawn congressional scrutiny. Between 2010 and 2016, the price has more than quadrupled, according to data from First Databank.<\/p>\n

Seventeen senators, including Democratic Wisconsin Sen. Tammy Baldwin, sent a letter to EpiPen maker Mylan in early November requesting more information. They wrote that the \u201cmajority of EpiPen’s cost increases appear to have been borne by taxpayers, via higher costs for programs like Medicare and Medicaid, and by employers and insured patients, via higher premiums.\u201d<\/p>\n

Some lawmakers on the state and federal level are calling for new regulations to rein in drug prices. A dozen states have enacted laws requiring greater transparency in drug pricing and other measures, but no state has enacted price controls.<\/p>\n

California voters rejected a proposal earlier this month to implement their own price control system, which would require state agencies to pay the same rates negotiated by the U.S. Department of Veterans Affairs. The two sides poured more than $100 million into the effort, most of it from pharmaceutical companies opposed to the measure. Ohio residents are set to vote on a similar measure in 2017.<\/p>\n

Holly Campbell, spokeswoman for the Pharmaceutical Research and Manufacturers of America, attributed the increase in EpiPen prices to a U.S. Food and Drug Administration backlog in approving new generics and a \u201clack of competition\u201d in the market.<\/p>\n

Some drugmakers draw a distinction between the actions of Mylan and Turing and other drug companies. Tim Cunniff, executive vice president of drug development at Illinois-based Marathon Pharmaceuticals, which develops drugs for rare conditions, said at a BioForward summit in September that \u201csome of those actions are giving the rare disease drug developers a black eye.”<\/p>\n

Erik Eglite, vice president, chief compliance officer and corporate counsel for Marathon, told attendees at the meeting of Wisconsin\u2019s biotechnology trade association that drug companies \u201coffer wonderful products to the world.\u201d<\/p>\n

\u201cI hate to say it, but people do things for either gold or for glory,\u201d he said. \u201cGreed spurs innovation. People go out there and do things, and they create, they develop. They make these fantastic companies, and all of society benefits.\u201d<\/p>\n

\"1201_epipen-static-chart\"<\/p>\n

Working poor hit hard<\/h2>\n

For those without insurance or who cannot afford their share, the rising cost of medications has left them facing hard choices.<\/p>\n

Kathryn Drexler, a registered nurse and certified diabetic educator at the free Living Healthy Community Clinic in Oshkosh, said some of her patients ration their insulin. So many are asking the clinic for medication help \u201cthat it\u2019s draining our budget,\u201d she said.<\/p>\n

\u201cI think it\u2019s hitting the working poor the hardest,\u201d Drexler said. \u201cThey can\u2019t afford their co-pays, and they can\u2019t afford insulin out of pocket.\u201d<\/p>\n

Free clinics provide care and drugs to the roughly 323,000 people, or 5.7 percent of state residents who lack insurance, as well as some people who are underinsured. And while drug companies offer free prescriptions to certain low-income people with no insurance, generic medications, which comprise eight out of every 10 prescriptions, do not qualify.<\/p>\n

Most people who are living in the country without legal permission do not qualify for subsidized health care, such as Obamacare or BadgerCare, or for patient drug assistance programs.<\/p>\n

University of Wisconsin pediatric endocrinologist Dr. Ellen Connor said the price increases have thrown some of her patients into despair.<\/p>\n

\u201cFamilies \u2014 this is what they agonize over,\u201d Connor said. \u201cThey lose sleep over it. I have parents sobbing in the office over this. They feel like failures because they had lost jobs and couldn\u2019t afford $500 of medications a month. It breaks your heart. There\u2019s no way to drive home at night and not have that on your mind.\u201d<\/p>\n

For the insured, drug price hikes have contributed to higher health insurance costs, said Dr. Tim Bartholow, chief medical officer for the not-for-profit insurer WEA Trust in Madison.<\/p>\n

\u201cIncreases in the cost of health care have risen more quickly than wages, leaving the patient to pay more in the form of deductibles and co-pays,\u201d said Bartholow, adding that too often, the construction of \u201credundant facilities\u201d and the introduction of new medical devices have also boosted health care costs.<\/p>\n

The price increases are hitting hospitals too, costing University of Wisconsin Hospitals and Clinics an additional $14 million in the past year, according to Steve Rough, pharmacy director. That increase is due mainly to antibiotics and drugs used to treat cancer, rheumatoid arthritis and multiple sclerosis, Rough said. He also pointed to the rising prices of generic drugs with no competitors that, he said, \u201chistorically cost pennies.\u201d<\/p>\n

\u201cI call it generic price-jacking, where companies purchase the rights to a low-cost generic drug that is routinely used in the care of many patients, just for the sole purpose of raising the price to make money, because they can,\u201d he said. \u201cAnd patients suffer, health care providers and insurers pay more. It just increases the price of health care.\u201d<\/p>\n

Taxpayers left with hefty tab<\/h2>\n

Prescription drugs are a growing portion of health care spending nationwide, accounting for 16.7 percent or $457 billion of total U.S. health care spending in 2015 \u2014 about double the percentage from the 1990s, according to a report released in March.<\/p>\n

The U.S. Department of Health and Human Services report found the number of prescriptions is rising, but most of the spending growth is due to higher prices and a shift toward more expensive medications.<\/p>\n

Shih, of Pew, added that part of the increase in overall spending has to do with an aging population, which is leading to more prescription drug use. And part has to do with more expensive drugs coming on the market to treat lifelong health conditions such as arthritis.<\/p>\n

That trend is expected to continue. The report projected 7.3 percent spending growth annually through 2018, outpacing the growth in prices of other health care services.<\/p>\n

The state\u2019s Medicaid program \u2014 which receives both federal and state funding \u2014 spent $329.4 million in the fiscal year between July 2011 and June 2012 on prescription drugs, according to the Legislative Fiscal Bureau. By July 1 of this year, annual spending had grown to $427.7 million \u2014 a 30 percent increase. The amount can vary year to year because of rebates the program receives from drug manufacturers.<\/p>\n

Elizabeth Goodsitt, Wisconsin Department of Health Services spokeswoman, said Medicaid must pay for drugs manufactured by companies that sign rebate agreements with the federal government, even if those medicines go up sharply in price.<\/p>\n

She said the program has taken numerous steps to address growing costs, such as requiring patients to get prior approval before receiving more expensive medications.<\/p>\n

Meanwhile, a September poll from the Kaiser Family Foundation found that 55 percent of Americans nationwide reported taking prescription drugs. About 26 percent of them \u2014 or 14 percent of the U.S. population \u2014 found it somewhat or very difficult to pay the cost of their prescription medication.<\/p>\n

Even generics now too expensive<\/h2>\n

Retired allergist Dr. Marcus Cohen of Madison was shocked by the cost of drugs for patients at the clinic where he volunteers. (Disclosure: Cohen and his wife, Sheila, have donated $3,000 to the Wisconsin Center for Investigative Journalism since 2013.)<\/p>\n

\u201cIt used to be that pharmaceutical companies would develop drugs for the good of, the health of people, and they should be expected to make a reasonable profit,\u201d Cohen said. \u201cThat’s not what’s happening anymore.\u201d<\/p>\n

Paul Hoffmann, manager of the Bread of Healing Clinic in Milwaukee, said his free clinic can no longer afford to provide some generic medications. He provided a list of half a dozen drugs that used to cost $10 for 100 doses whose prices are now \u201coutrageous.\u201d<\/p>\n

\u201cI\u2019ve been a pharmacist for 35 years, and this is a phenomenon that we never saw,\u201d Hoffmann said. \u201cAll these long-standing generics that have been generic for some 20, 30 years are going up in astronomical prices.\u201d<\/p>\n

He cited doxycycline, used to treat infections. First Databank figures show the price skyrocketed by 12,024 percent from 2011 to early 2013 because of drug shortages. The price has dropped, but the antibiotic is still 5,240 percent higher than in 2011 \u2014 or more than 50 times more expensive.<\/p>\n

Hoffmann said such price hikes can lead patients to skip their medications. Patients who cannot afford drugs for rheumatoid arthritis will become symptomatic again, leading to joint pain. That, in turn, could cause them to lose their jobs because they are unable to work, he said.<\/p>\n

\u201cWe always prided ourselves on the fact that we could take somebody who was, say, a liability to the community, and make them an asset by making them healthier,\u201d Hoffmann said. \u201cNow we\u2019re facing certain disease conditions that we can\u2019t offer treatment for because of the price.\u201d<\/p>\n

Such free clinics are also pushing the federal government to join the 340B Drug Pricing Program, which requires drug manufacturers to provide outpatient medications at a discounted price to certain health care facilities, said Katherine Gaulke, executive director of the Wisconsin Association of Free and Charitable Clinics. Currently children\u2019s hospitals, tribal facilities and AIDS clinics can qualify.<\/p>\n

\u201cFor us, at the free clinics, it\u2019s really the rising cost of generics that makes it more difficult to provide the care for our patients,\u201d she said.<\/p>\n

Lawmakers eye transparency initiatives<\/h2>\n

Some state lawmakers are looking for ways to curb drug prices. Rep. Debra Kolste, D-Janesville, plans to introduce legislation next year requiring the Office of the Commissioner of Insurance to collect information about the cost of drugs to public health care programs and develop a strategy to reduce prices. She said the bill asks companies to \u201csimply give us information, help us decide if there\u2019s any reality in any of this pricing.\u201d<\/p>\n

\u201cPrices don\u2019t occur in a vacuum,\u201d she said. \u201cThese are taxpayer dollars that are going to pay for these drugs, and it\u2019s not a never-ending source of revenue.\u201d<\/p>\n

J.P. Wieske, deputy insurance commissioner, said in May that the agency does not have the authority to control drug prices and had no way of \u201ccompelling\u201d information on why drug prices have increased.<\/p>\n

Kolste is also looking at other legislation, including a proposal that would allow first responders and emergency medical technicians to administer epinephrine from a glass vial or by syringe, similar to an Illinois law that takes effect next year. An Illinois fire protection district that spends $2,400 on EpiPens could pay $50 when the law goes into effect.<\/p>\n

Meanwhile, Baldwin has introduced legislation at the federal level with Sen. John McCain, R-Ariz., and Rep. Jan Schakowsky, D-Ill., requiring pharmaceutical companies to submit a report to the federal government a month before increasing a product\u2019s price by 10 percent or more.<\/p>\n

\u201cDrug corporations are sticking it to American taxpayers with soaring prescription drug prices,\u201d Baldwin said in a statement. \u201cThis bipartisan reform will require transparency and accountability for drug corporations who are jacking up costs for families in need of affordable lifesaving treatments.\u201d<\/p>\n

PhRMA spokeswoman Campbell called the proposal \u201ca thinly veiled attempt to build a case for government price setting.\u201d<\/p>\n

\u201cWe should work together on pragmatic solutions to engage and empower patients and families with the information they need, \u201d she wrote in an email.<\/p>\n

A Center for Public Integrity\/Associated Press investigation published in September documented the political strength of the pharmaceutical industry. It found that drug companies and their advocates spent more than $880 million on lobbying and political contributions over the past decade, contributed to 7,100 candidates for state-level offices and employed 1,350 lobbyists each year covering all 50 state capitals.<\/p>\n

But observers say the conversation around drug pricing has changed.<\/p>\n

\u201cI don\u2019t think I\u2019ve ever seen the level of public concern like we have now,\u201d said Levitt, of the Kaiser Family Foundation. \u201cYou have these very high profile seemingly outrageous price hikes that have focused the attention of policymakers in a way that I haven\u2019t seen before. There\u2019s a window where we could see some policy changes.\u201d<\/p>\n

A Kaiser poll released in late October shows 74 percent of Americans said ensuring that high-cost drugs for chronic conditions such as HIV, hepatitis and cancer are affordable should be a top health priority for Congress and the next president.<\/p>\n

Franz-Christensen hopes Congress will fix the problem.<\/p>\n

\u201cThe people that can\u2019t afford it, they\u2019re so overwhelmed,\u201d she said. \u201cThey can\u2019t fight. \u2026 If it\u2019s hard for us, people who have everything, imagine the people who don\u2019t.\u201d<\/p>\n

Cara Lombardo and Andrew Hahn of the Wisconsin Center for Investigative Journalism contributed to this report.<\/em><\/p>\n

Sean Kirkby reports for Wisconsin Health News, an independent, nonpartisan, online news organization serving Wisconsin health care professionals and decision makers. Dee J. Hall is managing editor of the Wisconsin Center for Investigative Journalism. Bridgit Bowden is a reporter for Wisconsin Public Radio. The nonprofit Center (www.WisconsinWatch.org) collaborates with WPR, Wisconsin Public Television, other news media and the University of Wisconsin-Madison journalism school. All works created, published, posted or disseminated by the Center do not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

By Sean Kirkby, Dee J. Hall and Bridgit Bowden Wisconsin Health News, Wisconsin Center for Investigative Journalism, Wisconsin Public Radio WAUNAKEE, Wis. \u2014 Jess Franz-Christensen did not realize the seriousness of her son\u2019s Type 1 diabetes diagnosis until staff in the doctor\u2019s office offered to call an ambulance to take him to the hospital. Her […]<\/p>\n","protected":false},"author":2,"featured_media":101,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6],"tags":[],"yoast_head":"\nInvestigation: Costs of widely prescribed drugs jumped more than 5,000 percent - Community News Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/plutchaknews.com\/newsroom\/2016\/12\/01\/investigation-costs-of-widely-prescribed-drugs-jumped-more-than-5000-percent\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Investigation: Costs of widely prescribed drugs jumped more than 5,000 percent - Community News Network\" \/>\n<meta property=\"og:description\" content=\"By Sean Kirkby, Dee J. Hall and Bridgit Bowden Wisconsin Health News, Wisconsin Center for Investigative Journalism, Wisconsin Public Radio WAUNAKEE, Wis. \u2014 Jess Franz-Christensen did not realize the seriousness of her son\u2019s Type 1 diabetes diagnosis until staff in the doctor\u2019s office offered to call an ambulance to take him to the hospital. 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Hall and Bridgit Bowden Wisconsin Health News, Wisconsin Center for Investigative Journalism, Wisconsin Public Radio WAUNAKEE, Wis. \u2014 Jess Franz-Christensen did not realize the seriousness of her son\u2019s Type 1 diabetes diagnosis until staff in the doctor\u2019s office offered to call an ambulance to take him to the hospital. Her […]","og_url":"http:\/\/plutchaknews.com\/newsroom\/2016\/12\/01\/investigation-costs-of-widely-prescribed-drugs-jumped-more-than-5000-percent\/","og_site_name":"Community News Network","article_published_time":"2016-12-01T02:24:17+00:00","article_modified_time":"2016-12-01T02:27:34+00:00","og_image":[{"width":1000,"height":670,"url":"http:\/\/plutchaknews.com\/newsroom\/wp-content\/uploads\/2016\/12\/1201_christensens1.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Written by":"Staff report","Est. reading time":"16 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebSite","@id":"http:\/\/plutchaknews.com\/newsroom\/#website","url":"http:\/\/plutchaknews.com\/newsroom\/","name":"Community News Network","description":"Dan Plutchak's news blog of people, places and events","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/plutchaknews.com\/newsroom\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"ImageObject","@id":"http:\/\/plutchaknews.com\/newsroom\/2016\/12\/01\/investigation-costs-of-widely-prescribed-drugs-jumped-more-than-5000-percent\/#primaryimage","inLanguage":"en-US","url":"http:\/\/plutchaknews.com\/newsroom\/wp-content\/uploads\/2016\/12\/1201_christensens1.jpg","contentUrl":"http:\/\/plutchaknews.com\/newsroom\/wp-content\/uploads\/2016\/12\/1201_christensens1.jpg","width":1000,"height":670,"caption":"Coburn Dukehart \/ Wisconsin Center for Investigative Journalism Jack Christensen, 8, has a snack at his home in Waunakee, Wis., after school on Oct. 5, 2016. His mother, Jess Franz-Christensen, logs his carbohydrate intake on a monitoring device. Jack has Type 1 diabetes and his parents wear watches to monitor his blood sugar level 24 hours a day to ensure his numbers are not too high or low. 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