Letters to the Editor 2019

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To the Editor:

Recently Alex Azar, secretary of Health and Human Services, was asked by a congressional committee about the cost and affordability of possible vaccines to combat the coronavirus (one by Sanofi and one by Johnson and Johnson).

Azar said that the vaccines might not be affordable to all, rejecting the idea of price supports to ensure access for all. After receiving an unsurprising amount of negative press, Azar backpedaled. (statnews.com. Gavin Yamey, March 5, 2020; Ed Silverman, Feb. 27, 2020)

After reading the letter to the editor recently criticizing drug price controls, here's a fact, that much of the money flowing into pharmaceutical research is taxpayer-funded money from the government.

One could also argue that an unaffordable vaccine or therapeutic is a short-sighted and foolish health policy decision. Remember standing in line for "sugar cubes" containing the Sabin polio vaccine? The vaccine program which saved countless lives was paid for under the Vaccination Assistance Act (Section 317 of the Public Health Service Act) with grants from the federal government made to state and local health departments in June 1963.

The federal government negotiated vaccine prices with manufacturers at significant savings. We already have one federal entity that negotiates drug prices and that's the Department of Veterans Affairs. When we have vaccines or therapeutics for the coronavirus, why should this be any different?

So why do drugs cost so much? One reason is when a company brings a drug to market; it is awarded an exclusive license or patent to sell the drug. As a result, what a drug company charges for a drug is entirely up to the company. How much we pay for a drug depends on what the market will bear.

I remain a capitalist. I don't begrudge any company making a reasonable profit. But do we think people should die because the price of a drug is unaffordable?

Likewise, there are other life-saving drugs whose prices have skyrocketed. For example, the opioid overdose reversing drug, naloxone, aka Narcan, administered in New Jersey in 2019, 15,104 times (see nj.cares.com), has seen a huge spike in price, sometimes as high as $4,500 for the injectable variety. Even the nasal spray can cost upwards of hundreds of dollars.

 So what needs to be done about this? As for the upcoming vaccines or therapeutics for the coronavirus, the government, which funded the research using taxpayer funds, can negotiate a deal with the drug companies. The government then issues a limited, not an exclusive license, to ensure affordability and access for us all.

For drugs already on the market, like naloxone, the federal government can use its powers to rein in the ridiculously high costs by implementing a little known, little-used part of federal law, 28 U.S.C. section 1498(a). This provision authorizes other manufacturers to make competing drugs or devices, circumventing the exclusive patent rights of the pharmaceutical company, so long as the company holding the patent is fairly and reasonably compensated.

 Remember the anthrax scare after Sept. 11, 2001? The federal government threatened to use this obscure section of the law to force the manufacturer of the antibiotic, Cipro, manufactured by Bayer, to lower its prices. Just the threat of it worked because Bayer voluntarily reduced the price by half

Although the high cost of prescription drugs is a problem for many Americans, the coronavirus shines even brighter light on this issue. With so many pharmaceutical companies working feverishly to come up with coronavirus vaccines and/or therapeutics, we need to make sure that sooner than later these and other life-saving drugs are available and affordable to all who need them.