We should stop acting as if Big Pharma is the big villain in American health care

Boston Globe

17-03-2025

tPA is a regular staple of medicine, given to people within hours of suffering a stroke. Scientists discovered tPA's existence in animals in 1947. Over the course of four decades, through continued research, the pharmaceutical industry turned tPA into a life-saving drug for stroke victims.
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In 2016, after a massive influx of blood clots into my lungs, doctors gave me tPA. The results were rapid and life saving. Having been given 24 hours to live, I am still here, now taking Xarelto, a pill that daily thins my blood without the bruising associated with Coumadin, the most common blood-thinning medication.
Tagrisso received expedited approval from the Food and Drug Administration in 2015, just months before doctors confirmed my wife had epidermal growth factor receptor mutations that caused her to have a genetic form of lung cancer. Her doctor, who also helped develop Tagrisso, fought to get my wife on the medicine. At the time, he concluded, backed by research, that my wife would have two years before the cancer started growing again. She is still here, one of the longest surviving patients on Tagrisso. Researchers have used her case as evidence to expand the drug's availability.
It is easy to vilify the industry. Americans get expensive medical bills and regularly battle insurance companies for drug approvals. Sometimes drugs are approved, then declined. Some have embraced the conspiracy that doctors and drug makers collude to put people on medicines. In reality, virtually every doctor wants patients to make lifestyle changes, but many patients just want the pill. This is not the fault of drug makers. We are the problem when we would rather take the injection or the pill than make the lifestyle change.
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I am fortunate that I have really good insurance. But even with good insurance, my wife and I experience the frustrations so many Americans share. When the new year turns over, the headaches return. This year, my Xarelto went from $10 to $580 per month for 30 pills. It will be that much the next few months until I have met a deductible.
My wife's Tagrisso is roughly $22,000 a month. With her quarterly cancer scans, just recently adjusted to every four months, we meet her and our family deductible quickly, and insurance has never charged us more than $100 in a month for her Tagrisso. Normally, we pay $20 a month.
But every year, as soon as January rolls around, my wife struggles to renew her prescription with the specialist pharmacy that has a contract with our insurance company. Every year, my wife's anxiety builds as she gets denied the medicine she needs to live and then has someone find an error in her claim, before she finally receives the medicine. For eight years, she has fought this battle annually.
Health insurance likewise causes me anxiety. We need it and, as a result, my job is important. As a conservative talk radio host known to openly criticize the president, I have faced organized mobs of online activists that have tried to get me fired, at the cost of my health insurance. The mobs have not deterred me, but I do understand the anxiety others have over losing their insurance. Every few years, as my job contract is up for renewal, my family's anxiety goes up. I am, to a degree, deprived of negotiating flexibility with my job because without it, our access to life-saving drugs would become vastly more costly.
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Americans tend to pay more for prescription drugs than people in other countries. Those countries often subsidize drug costs. To Americans this is unfair. Big Pharma gets blamed. Newly confirmed Health and Human Services Secretary Robert F. Kennedy Jr. has, in part, gained traction among many Americans for capitalizing on and advancing attacks against the industry, building on American distrust of the health care system. The problem, however, is not really Big Pharma but the convoluted mess of American public and private insurance systems.
Many Americans cheered for
A free-market system could and should provide a saner, more streamlined, and affordable system. But the public, like the political parties, is divided over more or less government control and fewer or more mandates. The government cannot provide clarity or direction for private insurance and medical and pharmaceutical costs because Americans themselves cannot agree.
Government should at least be willing to provide multiple avenues that could, through each path, provide simplicity and more humanity to a system that is too often needlessly faceless and Byzantine.
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