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To continue on with Drug Pricing day here on the blog, commenter JPE explains that the situation is more complicated than I give it credit for. A bunch of the pricey drugs on tier four are so-called "biologics," and they're protected from generic competition:
What's missing from this ongoing discussion on Tier Four drugs is acknowledgment of the need for generic biologics. Unfortunately, biologic drugs will never go generic under current law even after patent expiry. This means that biopharma companies can continue to charge the high prices that drive the need for a fourth tier indefinitely.Although bipartisan legislation to create a process through which the FDA can approve generic versions of these biologic drugs has been proposed (the "Access to Life-Saving Medicine Act" sponsored by Reps. Waxman, Emerson and Pallone and Senators Schumer and Clinton), there has been quite an industry backlash against the creation of a process to approve generic biologics (industry fearmongering in the guise of safety concerns). Doing so, however, would likely save billions of dollars and increase access to the Tier Four drugs that are so desperately needed by tens of thousands of Americans with chronic and life-threatening conditions.Seems like sound policy. Many of the Tier Four biologics are really the worst of all possible worlds: Necessary drugs at immense cost with no possible alternatives. The New York Times made the insurers the enemy here, but it seems that the pharmaceutical companies, and our patent system, are the central problem. If the drugs were cheaper, than they would be cheaper. There's not a whole lot the insurers can do about that. Conversely, there is a whole lot Congress could do about it.Update: When it comes to biologics, my medical community commenters really are smarter than I. Read through the comments, particularly from Wisewon and Weboy.
