spent most of my career in the context
of HIV and AIDS and I’m really proud of
what we’ve accomplished there but today
I want to tell you a story about a new
challenge I’ve taken on involving
hepatitis C roughly 4 million people in
the United States are infected with Hep
C so that’s roughly four times as many
people because who are infected with HIV
Hep C infects the liver and leads the
liver failure and death and 40,000
citizens a year and that’s about twice
as many people who’s died of AIDS
now HIV and Hep C are similar in many
ways both viruses were discovered in the
1980s both viruses are transmitted
through blood sex and from mom to her
baby and both both viruses are pretty
nasty but the big difference is this Hep
C is curable
readily curable over the last 36 months
about a dozen new drugs have been
created that cure 98% of people with one
pill once a day for 12 weeks that’s it
98% cured virus gone oh and as a bonus
once someone’s cured they don’t transmit
the virus to anybody else so we have the
potential to eradicate Hep C from the
United States all we have to do is
identify all four million people get
them into care give them one pill once a
day and it’s gone but there’s a catch
the new Hep C drugs came to the market
wearing a price tag of ninety thousand
dollars per treatment course so if we’re
going to cure four million people that
runs up a cost of about three hundred
and sixty billion dollars which is more
than we spend
annually in the United States on all
prescription medicines now compare this
90,000 to what it costs in other
countries say Egypt $900 1/100 or
sub-saharan Africa $300 in the former
Soviet country of Georgia a drug company
is giving that country free drug and
they will eradicate Hep C from the
Soviet country of Georgia by the year
2019 so these that this you’re sitting
here wondering well how can this be well
let me help in the United States
medications are regulated but but prices
are not so you can have the
pharmaceutical companies will come out
and they can set their prices at
anything they’d like so the usual
rationale for this is that research and
development will pay for or justify the
cost but in reality R&D costs are only
about 15 or 12 percent of a
pharmaceutical company’s budget now the
issue is that when the companies charge
this amount you sit there and wonder
because as evident on television every
time you see a golfer pitching for a
high-priced drug or a celebrity or
perhaps to a couple sitting in bathtubs
holding hands
the sunset you know their marketing
costs are quite a bit higher than their
R&D costs so it’s a fallacy to say that
the R&D costs therefore prices must be
high now these are not alternative facts
or fake news these are
honest-to-goodness realities and a
healthcare system run amok another
fallacy a belief held by many is that
the market will control the costs now
this may be true if there are multiple
options for any single disease roughly
comparable to when we buy a car or TV or
a cell phone but this is often not the
case if you want to live you need to buy
what keeps you alive and the competitive
options that would ordinarily keep
prices in check simply don’t exist
what’s worse we as providers patients go
to buy drugs and the price is hidden
from them and even hidden from the
provider who prescribes a drug say what
that’s right
providers prescribe and patients buy
without knowing the price tag not
exactly like buying a car or TV or cell
phone where you can find your prices on
the Internet so you’re probably
wondering how that can happen well
here’s how it works
drug prices are negotiated but the
negotiated price is kept under a shield
a confidentiality or I call it a cone of
silence where only the drug company and
the agent of the pharmaceutical
are the ones who know the price the the
actual price is hidden from the consumer
patient and the providing position now
if this sounds to you like theater the
absurd when you heard it correctly it is
theater and it is absurd we call it
health care
but for the four million people with Hep
C it’s what keeps us from getting them
into care and curing them because at
these prices we can’t afford it the
system is rigged by pricing doesn’t
promote health care it promotes disease
and welcomes death let me offer an idea
or two for you to you for consideration
first let’s get rid of the law that
prohibits the federal government from
negotiating lower prices with Pharma in
case you missed that there is a law that
prohibits Medicare from negotiating from
lower prices with the federal government
so let’s get rid of that once we’ve got
negotiated prices we the people should
be able to see those prices so let’s
require the government to publish the
prices for all of us to see as a
provider the government tells me what
they’re going to pay me for my services
and that service cost is published let’s
have the government tell Pharma what
they’re going to pay for drugs and
publish the price and while we’re at it
let’s have them demand that all
insurance companies publish the
negotiated price for all of us to see
this would create downward pressure so
that the price of drugs would go lower a
simple solution would be to open our
borders to the importation of generic
drugs now these drugs are produced
safely cleanly and effectively all over
the world given a borderless market and
open negotiations in public public
published pricing patience providers and
payers alike will have access to the
lowest cost medicines and finally let’s
get rid of laws and loopholes in the law
that allow drugs that like daraprim
which cost about $10
a few years ago and in one day went from
ten dollars to 750 dollars in one day or
remember EpiPens though that drug was a
hundred dollars a few years ago now it’s
600 dollars so let’s get to that get rid
of that loophole that allows these
renegade companies to charge ridiculous
prices for life-saving medicines
crippling our ability to keep them alive
so what can we do to enact this change
what can we do let me offer you a couple
suggestions number one get informed
there are tests what you’ve what I’ve
just told you and see if it’s true there
are ample websites that give you
accurate deep information on this topic
one of my favorites is the families of
Kaiser Family Foundation which is a
phenomenal website for all things
related to health care and financing or
just simply Google drug pricing in the
US and we’ll be flooded with reliable
websites that can inform you even
Wikipedia has a great page on this topic
if you found that I misled you in any
but if you found that I told you the
truth
join me on this issue number two right
and call your congressmen and women
write them call them visit them when
you’re in DC tell them that you’re
embarrassed by the facts of this matter
tell them that you want negotiated lower
pricing by the government those prices
to be published get rid of those
loopholes that allow epi pens and
daraprim to be product priced at
ridiculous levels and create competition
by opening our borders to the
importation of generic drugs what could
be more American than that and finally
believe in the possibility of change is
evident through our political season
there’s no question that change is
possible
and whether I agree with the change or I
oppose it the evidence is mounting that
an informed and motivated public can
enact change believe it act on it and
join me in saving costs but more
importantly in saving lives this is one
example where the old adage is
absolutely true the life you save may be your own thank you