A presidential prescription could begin the process of healing the fractured American health care system. The only question is whether Congress will fill it.
Elements of Tuesday’s State of the Union address reignited raucous debate over immigration and foreign policy, but two points in President Donald Trump’s speech deserve unanimous bipartisan support — lowering prescription drug prices and making experimental medicines available to terminally ill patients.
“One of my greatest priorities is to reduce the price of prescription drugs,” Trump said in the speech. “In many other countries, these drugs cost far less than what we pay in the United States. That is why I have directed my administration to make fixing the injustice of high drug prices one of our top priorities.”
Countries with government-administered universal health care negotiate with drugmakers to set pharmaceutical prices. While that concept may rile free-market conservatives, medications are expensive here precisely because of government intervention, not laissez-faire economics.
Twenty-year patents on new name-brand drugs give companies a monopoly on medicine, using state power to delay the approval of generic drugs that would lower prices through the natural market force of competition.
Robust intellectual property protections are widely seen as an incentive for drugmakers to invest in promising new treatments, but a 2016 Harvard Medical School meta-analysis published in the Journal of the American Medical Association shows that research and development costs don’t justify Big Pharma’s price-gouging.
Federal grants and venture capital, not drug companies’ own R&D budgets, are the main sources of funding that lead to the production of new medications. If taxpayers are subsidizing drug development and regulatory agency-enforced patents keep prices sky-high, maybe too much government involvement — not the free market — is the problem.
Drug prices can be reduced through patent reform, federal price ceilings or some combination of the two. The method may matter to ideologues, but most patients won’t care how the sausage is made as long as they see savings at the pharmacy counter.
Americans spent nearly $374 billion on prescription drugs in 2014 and that figure is expected to climb to as much as $610 billion in 2021. A sharp reduction in drug spending means more money in taxpayers’ pockets.
Trump earned applause for endorsing a federal right-to-try law, which would allow terminal patients access to drugs still in the early stages of clinical trials for eventual Food and Drug Administration approval when available treatments have been unsuccessful.
The concept is widely popular, as 38 states — including North Carolina — have right-to-try laws on the books. A federal law would cut through FDA red tape in end-of-life cases where a delay has the same result as a denial.
Critics, including some well-respected physicians, say the legislation could create a loophole to FDA approval that will result in patients playing Russian roulette with dangerous drugs that may do more harm than good. They fear it also could weaken the FDA’s gatekeeper role and stringent safety requirements.
Those concerns simply aren’t as compelling as the ticking clock that terminal patients face. The time to wait for testing and FDA approval isn’t a luxury they have. Absent a biological miracle or a medical intervention, they will die.
It’s been not-so-slyly pointed out that the Koch brothers are a driving force behind the experimental drug rights movement, which could be a poison pill on the left. But progressives who support doctor-assisted euthanasia for terminal patients can’t credibly complain about the risks of untested medication that could kill.
If there’s a right to die, surely there’s a right to try.
If one patient in 10,000 is spared an untimely death, the legislation would be a success. We believe Americans must have the freedom to fight for their lives without bureaucrats standing in their way.
Conservatives and liberals can find common ground on these two health care reforms, both of which enjoy clear support among voters. Congress must act decisively to lower the cost of prescription drugs and recognize terminal patients’ autonomy to choose experimental treatments.
— The Wilson Times