Why Are Prescription Drugs SO Expensive?

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Why are prescription drugs so expensive in the United States? Why does the same medication cost significantly less in other countries around the world? Today Danielle examines the history of pharmaceutical regulation in America and how it lead to such disproportionately high costs.
Created and Hosted by Danielle Bainbridge
Produced by Complexly for PBS Digital Studios
#medicare #FDA #pharmaceuticals
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Origin of Everything is a show about the undertold histories and cultural dialogues that make up our collective story. From the food we eat, to the trivia and fun facts we can’t seem to get out of our heads, to the social issues we can’t stop debating, everything around us has a history. Origin of Everything is here to explore it all. We like to think that no topic is too small or too challenging to get started.
Works Cited:
98th Congress (1983-1984). “S.1538 - An act to amend the Federal Food, Drug, and Cosmetic Act to revise the procedures for new drug applications, to amend title 35, United States Code, to authorize the extension of the patents for certain regulated products, and for other purposes.: 09/24/1984 Became Public Law No: 98-417. www.congress.gov/bill/98th-co.... Accessed May 19, 2019.
Barr, Donald A. Introduction to U.S. Health Policy: The Organization, Financing, and Delivery of Health Care in America. Benjamin Cummings, Pearson Education: 2002.
The Canadian Online Prescription Guide.com. www.canadian-online-prescripti.... Accessed May 24, 2019.
Frakt, Austin. “Something Happened to US Drug Costs in the 1990s.” The New York Times. Nov. 12, 2018. www.nytimes.com/2018/11/12/up.... Accessed May 19, 2019.
Good Rx. www.goodrx.com/humira. Accessed May 24, 2019.
Kesselheim, Aaron S. Et. Al. “The High Cost of Prescription Drugs in the United States: Origins and Prospects for Reform.” Journal of the American Medical Association. August 23/30, 2016. jamanetwork.com/journals/jama.... Accessed May 19, 2019.
Morgan, Steven. “What’s Driving Prescription Drug Prices in the U.S.?” Commonwealth Fund, Nov. 14, 2018. doi.org/10.26099/sh3e-ac41. Accessed May 19, 2019.
Morgan, Steven G., et. al. “An analysis of expenditures on primary care prescription drugs in the United States versus ten comparable countries.” Health Policy, Volume 122, Issue 9, September 2018. www.sciencedirect.com/science.... Accessed May 19, 2019.
U.S. Food and Drug Administration. “A History of the FDA and Drug Regulation in the United States.” www.fda.gov/media/73549/download. Accessed May 19, 2019.
Irene Papanicolas, et. al. “Health Care Spending in the United States and Other High Income Countries.” Journal of the American Medical Association. March 13, 2018. jamanetwork.com/journals/jama.... Accessed May 19, 2019.
O’Neill, Phill and Jon Sussex. “International Comparison of Medicines Usage: Quantitative Analysis.” Association of the British Pharmaceutical Industry, 2014. www.lif.se/contentassets/a003.... Accessed May 19, 2019.
Pew Trusts. “A Look at Drug Spending in the U.S. Estimates and projections from various stakeholders.” February 27, 2018. www.pewtrusts.org/en/research.... Accessed May 19, 2019.
Rother, John. “Is Arbitration and Asnwer for High Drug Prices?” Commonwealth Fund. May 3, 2019. www.commonwealthfund.org/blog.... Accessed May 19, 2019.
Sood, Neeraj, et. al. “Flow of Money Through the Pharmaceutical Distribution System,” USC Leonard D. Schaeffer Center for Health Policy and Economics. June 16, 2017. healthpolicy.usc.edu/research... Accessed May 19, 2019.
Thrush, Glenn and Katie Thomas. “Drug Prices Will Soon Appear in Many TV Ads.” The New York Times. May 8, 2019. www.nytimes.com/2019/05/08/us.... Accessed May 24, 2019.
U. S. Customs and Border Protection Agency. “The Mexican-American War Brings Regulation on Drug Importation” www.cbp.gov/sites/default/fil...
Accessed June 12, 2019.

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23 сен 2019

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Комментарии : 130

@pbsorigins 4 года назад

Hey Originauts! Ill be down here in the comments for the next hour or two responding to your questions, so be sure to drop them below! Peace, love and learning, Danielle

@flymypg 4 года назад

Don't forget about the option of publicly-funded and non-profit drug development. This has been critical for many rare diseases, and to multiply the response to emergent illnesses (HIV and ebola come to mind). Once developed and certified, they are sold at net-cost.

@Kaede-Sasaki 18 дней назад

Question should be why do you pay anything for a solution (medicine)? Do you pay thousands of dollars to the fire department via fire insurance before they will provide the solution (fire suppressant)? Ridiculous.

@cvb4117 4 года назад

My mental health care is the most overwhelming. So expensive, so hard to find a doctor under my insurance that is close by. Near impossible. Then..the cost of meds..

@pbsorigins 4 года назад

Sorry to hear this and hoping it gets easier for you!

@ariaalexandria3324 4 года назад

When I was pregnant, I learned that insurance companies have to have someone who provides every covered service within a reasonable distance. I think that was something like 30 miles for me. Midwifery was a covered service, but some the nearest was farther away than the limit, they had to cover one of my choosing in that covered area. I paid only the same as if she was in-network, and they had to cover the rest.

@happyfacefries 4 года назад

Which just makes the mental health worse. It's a viscous cycle.

@PushedAside 4 года назад

smoke marijuana

@happyfacefries 4 года назад

@@PushedAside that doesn't solve anything. Plus it still costs

@Subparanon 4 года назад

You can lead a voter to the polls but you can't make them vote in their best interests.

@pakdiva21 4 года назад

💯

@PsAMermaid 4 года назад

I feel this on a spiritual level @Subparanon

@dramonmaster222 4 года назад

I never realized how expensive prescription drugs were until I got medical insurance and the price difference was RIDICULOUS!

@orchdork775 4 года назад

My mom used to take humira twice a month, and thankfully, her insurance covered it, so she didnt have to pay thousands of dollars every months for her medication. I never knew how expensive it was

@orchdork775 4 года назад

@The realest She actually took it for Crohn's disease. Humira shots are really painful, and they haven't been working as well as they used to, so my mom switched to a different biologic medication, Remicade. She gets infusions of the new medication at the doctor's office twice a month to help with her flare ups.

@cvb4117 4 года назад

Health care makes no sense to me and is overwhelming as hell not to mention I grew up with a mom that said things will just go away on their own and didn’t utilize the doctor much. I don’t even know where to begin and I’m 20. I still go to my pediatrician as my primary care until they kick me out because I’m comfortable with them and my moms insurance under her employer covers me until I’m 25. My sister kinda freaked out when she turned 26 and realized she had to figure out health insurance, won’t be me.

@fayejewell 4 года назад

Please, do not mention that only "other developed countries" are making changes to lower prices of medication. Developing countries such as Chile, Ecuador and Colombia have also being able to lower the prices of both prescribed and over-the-counter meds, so it is not only a matter of European nations. Even in Colombia for example, two well-known drug companies tried to sue the government, as this year the State obliged companies to lower their prices (again). Long story short, both companies lost.

@carla919 4 года назад

Socialized Medicine would be awesome

@Imperiused 4 года назад

Good breakdown of the issue. It'll be a useful video to share in the future!

@pbsorigins 4 года назад

Thanks for watching and sharing!

@eddon4108 4 года назад

"You can now add 'erosion of you bank account' to the list of side effects." 😂😂😂😭

@medueleaca 4 года назад

Watching this video makes me think about how we take for granted the healthcare sistem in my country (I'm from Uruguay), i am grateful. I hope people in the US can have the same soon. (Sorry for my broken english)

@nihouma11 4 года назад

Great breakdown. My sister is type 1 diabetic, and her insulin is really expensive, She uses biologics, her father, also type 1, used traditional insulins. The difference in lifestyle is staggering. Other than the fact she has to monitor her blood sugar and take insulin according to what she eats (which she gets by fine with guesstimates), my sister lives a very normal life. In comparison, her father, with traditional insulin, had to carefully measure food out, had to avoid anything like candy bars/sweets/carb heavy foods, and still had very spiky blood sugar, leading to many nights with paramedics over because his insulin was too low if he accidentally miscalculated. My sister on the other hand has far less issues and is much more laissez faire about her care, because the biologics are that much better. Sadly, they are expensive, so hopefully she never loses insurance and has to use traditional insulin, which she doesn't know how to use just because it is vastly different in how you take it, how much, and when.

@TheTwick 4 года назад

Another great one, Doc. This should be seen by a lot more people.

@tomaszwida 4 года назад

wait a minute so you are telling me high drug prices are became of private insurance do not have a huge bargaining power? I'm shock!

@getnkosi 4 года назад

I think it's worth mentioning drug companies pay doctors billions of dollars for various services. In 2015, 48% of physicians received some pharmaceutical payment. It's illegal for doctors to prescribe the drug in exchange for kickback payments from a manufacturer. Pharmaceutical company payments to doctors are not unique to opioids, but I'm sure it plays a huge role in the "crisis" America faces today.

@elizabethdavis1696 4 года назад

Can you do a video on the lead poisoning problem? Like why we have so many lead pipes?

@stagnantfox3027 4 года назад

This video needs more views. Thanks Danielle

@carolh.849 4 года назад

Hi! This is a little off-topic, but I'm not American and something I've noticed is that medication in the US is bigger than in my country for the same medication (I mean common things like pain killers, cold medication, etc), and that people are used to taking two pills, that brands often package their formulas for people to take two instead of one pill. Since it's the same substances that I'm used to seeing here in Brazil (and even other places I've been to), it seems like a cultural thing. That would be really interesting to know more about.

@nathansheth8986 4 года назад

A great explanation of the multi-faceted nature of how we got here. I would offer that the market does not really set a price for new therapies because a patented therapy is immune from competition and is largely price inelastic (there is an infinite willingness to pay for a pill that prevents death). Most other countries seem to navigate this much more effectively than the US, so there's lots of room for improvement.

@pakdiva21 4 года назад

That's just what they tell us to make us forget that it's the CEOs that make the millions. Not the scientists that come up with these breakthroughs. Thats where the money goes.

@nathansheth8986 4 года назад

@@pakdiva21 Huh? I'm not sure what you are referring to when you say, "that's what they tell us". What is "that" referring to? Who is they? My comment is describing how market pricing does not work for price inelastic monopolies. Where the excess goes is inconsequential. If all the profit went to a family of tabby cats that would be unfavorable as well. It's not where the excess goes that is the problem but that there is not a good mechanism to set price and constrain the excess in the first place.

@lorenandloisstevenson3858 4 года назад

Always informative, love y'all

@ooples 4 года назад

This is exactly why we need a single payer system like Medicare for all

@proppergentleman8690 4 года назад

@Big Tyler doctors would not work for free, this is entirely inaccurate. Doctors would make the same wages, maybe even more because hospitals wouldn't have to pay for so much insurance paperwork to be done.

@proppergentleman8690 4 года назад

@Big Tyler basically how insurance works is everyone with said insurance pays money every month to their insurer. Then when the person with insurance needs to get medical care, their insurance provider pays some or all of the bill to the hospital. Single payer is the exact same in this regard, the government agency (medicare) pays the hospital what is owed. The only thing that would change is instead of paying your insurance provider, you pay the government instead. The doctors will get paid the same if not more, the only thing drastically impacted are health insurance companies. And I can explain why medicare is way more efficient than private insurers if you'd like.

@proppergentleman8690 4 года назад

@Big Tyler Medicare as it functions rn provides health care to every us citizen above 65. They provide these services and 99% of the money that is paid into the program gets spent on care (hospitals bills, ambulance bills, etc), meaning only 1% goes to administration (filing paperwork). Most insurance companies before the ACA (affordable care act) only spent 80% on care, that's a whopping 20% going to admin, advertising, etc. After the ACA, they were required to spend a minimum of 90% on care. This is still an extreme waste of money. Health insurance executives make millions of dollars a year, this is money that could be spent to cover people. The way insurance companies make money is by charging people more than gets spent on care. So they're incentivized to charge more and pay less for care.

@proppergentleman8690 4 года назад

@B dub You obviously don't know much about hospitals, insurance forms, claims, bills, etc. lol. If there was just one provider (the federal govt.) and everything was free at the point of service (which m4a does) the only thing you'd need to do is present id, and maybe sign a liability waiver.

@VideoChasca 3 года назад

I believe private insurance should be an option, but not a mandation. Medicare for all who wants it

@therealnoodles7638 4 года назад

Prescription drugs in australia is so cheap. I remember getting one month supply for $4 , instead of paying $30.

@thisisatonofbs 3 года назад

A nice and level-headed presentation. Some of this I was aware of from research I had done for a job, but there were details I wasn't aware of that helped fill in some gaps. Interesting how an "interest group" like PBMs can be manipulated by their own self-interest to use more expensive drugs that can/do give higher kickbacks, which results in more revenue for the same volume of drug sales going back into their own coffers. I also think there are some rules/regulations that prevent the federal level of the US government to negotiate prices for drugs used by medicaid/medicare, that forces each state to have to do their own negotiations. And each state has their own rules and regulations on top of the federal level. So, really the US is like the European Union, and a given state might be more akin to a single country within the EU when trying to compare the two entities.

@LukeM912 4 года назад

PBMs also sign NDAs with the manufactures so that the true price of meds isn’t revealed, it makes it where they can make huge mark ups before selling to the insurance companies. “Orphan drugs” are a whole other racket- you should do a video on those as a companion video to this one 👍

@diegorodriguesdesouza7389 4 года назад

Answer: capitalism

@bobmfthomp 4 года назад

This video should be one minute. Why is the cost of prescription drugs so high, greed.

@happyfacefries 4 года назад

I'm glad to have a reference video to use to show people. I have 8 prescriptions I take on a regular basis and 3 for as needed. Ive felt the affects of prices and it's frustrating to covey these things to other people. Now I have something that is a mutually agreeable excellent and trustworthy source to show these problems. Unfortunately, I don't see these fixed any time soon. So many of these pharmaceutical companies fund campaigns of which they request basically immunity in return. Some Orrin Hatch's biggest contributors to his campaigns was pharmaceutical companies. Even though he created CHIP with Ted Kennedy, over the years he took less and less away and in his last year in office wanted to defund it. I'm grateful he's no longer in office, but he's not the only one who has this going on.

@noellewatts2609 4 года назад

Even with insurance it can be next to impossible to pay, especially if you have an outrageous deductible.

@Pharmacychecker 3 года назад

Vetted international online pharmacies are just as safe as domestic ones - but a lot cheaper. In many cases, the exact same medicine sold here, such as those you may find at a local Walgreens or CVS, costs 90% less from an international online pharmacy.

@meadowspring1 4 года назад

The Humira pack with 2 doses through Blue Cross Blue Shield a week ago was 15,000... where did you find a pack for 5K????

@limalicious 4 года назад

Because they want you to have to choose between eating and paying rent and not being miserable or dying from an illness. The war on opioids has been affecting my mother. She uses opioid painkillers for her multiple arthritis conditions. She's tried a number of other medications but has been proven unable to take them because of: her heart, her kidneys (caused damage), her liver (caused ischemia), a nearly fatal allergic reaction, heavy metal poisoning, etc. She was told she could take TYLENOL for a while. For DEBILITATING, DEGENERATIVE ARTHRITIS. She could barely move and was constantly crying. She has never abused her tramadol, has never run out of it early. =/

@JanitaShowaars 4 года назад

I don’t know I still say corporate greed

@Kaede-Sasaki 18 дней назад

@masonadams194 4 года назад

I'm lucky. I live in Canada, and my family has drug insurance. But had my parents not had drug insurance, I would have just paided 160$ for 15 days worth of one of my meds... so some of the costs in Canada are still crazy

@virgoblue1392 4 года назад

The question should really be, why are so many Americans taking prescription drugs. Either we have a very unhealthy environment or we're being prescribed unnecessary prescriptions due to Doctor kickbacks.

@girlgamergear3260 4 года назад

You totally miss that single payer systems, like Britain and Canada, make it so difficult to get biologics, that by the time you can get them, they are mostly useless. They also have 2 and 3 year waiting lists for joint replacements. Here in the US you can get them much quicker to hold off crippling damage and keep a person able to work longer. And the fact that companies, like the one that make Humira, provide copay assistance or even wave the costs for people that need them. Like the cost being reduced to as a low as $5 on monthly basis. Embral has a similar copay assistance.

@edwardbranca54 4 года назад

I don't pay anything for the many medications that I must take and I don't pay anything for my other healthcare. This is because I have Medicaid. I have many medical conditions, so I must see doctors about once a week. I was hospitalized three times in 2019. I am 69 years old and I have been disabled for my entire life.

@SnoopyDoofie 4 года назад

Too long of an answer. I'll summarize: Greed!

@skybluskyblueify 4 года назад

Other countries have greed too.

@KevinRMoore 3 года назад

This still doesn't explain how they justify charging $300.00 for 10 cents of powder! This is like charging $100.00 for a gallon of gasoline just because they know how much people need it.

@margaritam.9118 4 года назад

All I can do is to save on regular everyday things like headache, stomachache and pills for menstrual cramps. I don’t get big branded ones, just look at the contents and buy same things separately, as they are cheap. My mental health is another thing. The only antidepressant that doesn’t make me sleepy costs a lot. Also, antibiotics.

@Beryllahawk Год назад

3 years later and nothing has changed :( it doesn't help that because their profits are threatened by many of the suggested changes, the industry itself - or i should say, the corporate arm of the drug industry - is waging a propaganda war, trying to discredit data and anecdotes alike, and really leaning on the myth of "but if you really wanted to get your medicine you'd just work a little harder" and other such tricks. It's insanely frustrating. My husband is on dialysis (he's type 2 diabetic) and if we could have afforded medicine, there's every reason to believe he would NOT be: in 2018 doctors told him he might have five years before losing his kidney function. but that was IF he took meds and got regular care. we couldn't do that. and now he's disabled, nearly died (again), and tho he has coverage it puts me in deep fear to know that I don't. so if (or when) i can't afford medicine - if/when i have a stroke - yeah, the whole family is screwed. But of course, the rhetoric around low income health care is super rancid to begin with so...

@Chris-top-her 4 года назад

Doesnt insurance for the drugs though?

@RudieObias 4 года назад

Because the USA values profit over human life.

@Delgen1951 4 года назад

as an aside the word potion and poison have the same root that means medicine. Also poison things are poison in one dose size and medically active in a smaller dose, see disatailus or extract of Foxglove, which in one dose is a heart med, in an stronger dose it can kill. this is not new problem.

@bodiesbydefinition 4 года назад

"Hospitals don't create cures. They create customers." ~ Anonymous

@thoughtsofanobody 4 года назад

Your watch needs a new battery. or a wind up if you're posh.

@Anita_Dick 4 года назад

The background gives me anxiety

@timclark7507 3 года назад

The reason the costs are so high is because there are people willing to pay for them.

@fraudexposed5486 Год назад

Other countries negotiate drug prices for everyone in the country, guaranteeing affordability

@chloejohnson6861 4 года назад

That moment when you're in an entire supermarket aisle full of painkillers and sleep aids, and you realize that there used to just be one drug for that.

@chloejohnson6861 4 года назад

@B dub Good point.

@joyceneville9214 4 года назад

My insurer, BCBS of Texas is unable or, more likely unwilling to tell me in advance what the copays would be on different birth control pills. These copays vary wildly from $4 to $30. Also the production team needs to read Bottle of Lies by Katherine Eber. This piece was weak in that I’d didn’t get into foreign made pharmaceuticals that don’t measure up to what consumers deserve. You were NOT close to hard enough on the pharmaceutical industry or the insurance companies. PBMs are truly horrible and as my mom used to say “more crooked than a dog’s hind leg!!”

@fernidad135 4 года назад

Medicare for All (Single payer system = leverage for negotiations) + cap on drug prices + allow medicines to be imported + Sanders 2020 to make all that happen

@InfectionFever 4 года назад

me: *confused and shocked in non-american*

@r.joyceentertainment3490 4 года назад

I just had the thought today about the WNBA....could we get a history of women in sports??

@lovingkat5 3 года назад

because they have to pay the politicians and they don't work cheap

@bodiesbydefinition 4 года назад

"The pharmaceutical industry doesn't create cures, they create CUSTOMERS". ~ Anonymous

@Lee-70ish 3 года назад

Just for your information as an example: Acular Eye Drops or US Generic Ketorolac In the USA 10 ml $46.59 In the UK under the NHS £ 9.18 irrespective of the amount, so one months supply will still cost £9.18 if its issued by the doctor on the same prescription. These exceptions mean you get it for free 60 or over. Under 16. 16 to 18 and in full-time education . Pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx) . Have a specified medical condition and have a valid medical exemption certificate (MedEx) . Have a continuing physical disability that prevents you going out without help from another person and have a valid medical exemption certificate (MedEx) . Hold a valid war pension exemption certificate and the prescription is for your accepted disability . Are an NHS inpatient.

@rogerhinman5427 4 года назад

In other words, it's not a real problem until it can be proved some number of people have died as a direct result.

@woodyhwy1776 3 года назад

Ask urself y was there a war n what was the war about....

@EvanLovesWhiskey 4 года назад

This just reminds me our government and accountability and oversight is fick all

@TealCheetah 4 года назад

short answer: greed

@juliamelone8109 4 года назад

But why tf don't patents expire for biologics smh

@astroch 4 года назад

As an European, i can't understand. I dont speak murican

@Agaettis 4 года назад

Generics can mess you up. I've had trouble switching between generics and switching from name to generic. Sadly they can contain up to 20% more or less of the active ingredient

@nicollaney 4 года назад

The only solution is Medicare For All.

@Tank_Amos 4 года назад

Anyone need humira????

@woodyhwy1776 3 года назад

Usa is a corporation....

@ashildrdorchadon3258 4 года назад

I consistently pity America's populus, for reasons like this and a few others. Your medicine is soooooo expensive, it's actually horrifying and a little ridiculous....

@michaelcrockis7679 4 года назад

I know who Danielle stole the globe from. :)

@MichaBerger 4 года назад

However... This crazy drug pricing system in the US is also what funds drug research, and what insentivizes that research. If the US were to join the rest of the world in having nationalized medicine payments, there would be a lot fewer new drugs. Anywhere in the world. On the other hand, if the Americans weren't spending this money that ends up motivating drug research, everyone on the planet would be paying higher taxes to pay for public funding for that research. In other words, a small part of what makes socialized medicine possible in other countries is the fact that we don't have it in the US.

@adamalexander1611 4 года назад

Great point. I'd add that publicly-funded research spread across multiple countries would hopefully create better price parity while guiding research to focus on drugs that most benefit the public (e.g. cheaper drugs with similar efficacy). There is relatively less incentive for private research to focus on products that could cannibalize existing revenue. Since these are for-profit manufacturers providing products that are supposed to be a significant public good, effective regulation seems to be very challenging, if not politically impossible.

@kageisuke 4 года назад

This is partially true. We pay higher prices that help to fund R&D for new drugs that other countries can use cheaper because of their purchasing power. But are we really funding R&D? Or are we paying for the advertisements and the lobbyists?

@ariaalexandria3324 4 года назад

Not really. Who gets the financial windfall in the US? The CEOs and investors. What if the CEOs and investors were also the people who write the checks for their own pay? There wouldn't be an incentive to pay more.

@happyfacefries 4 года назад

I'm not entirely sure about that when the top people in the companies are multi millionaires and heavily continue to campaign funds.

@MichaBerger 4 года назад

@@kageisuke I wasn't trying to make it sound noble, just because it works. Our overpaying is what motivates drug companies to continue trying. They want to make money, and the more money a new drug can make them the more they'll invest in research. Yes, only part of that money pays for the research. But all of it insures the research happens.