The government is behind the high drug prices in the United States!

Translated from: health industry / article / Li Jingjing / editor in chief: 2016-09-06 high drug prices in the United States have become an indisputable fact Recently, the price of Epipen, an adrenaline drug, has increased five times in 10 years, which has caused a great stir in the United States Epipen has become the "No 1 public enemy" of the United States However, this is only the tip of the iceberg with high drug prices In order to find out the reasons for the high drug prices, Harvard Medical School (HMS) studied thousands of relevant materials published from January 2005 to June 2016 It is found that the monopoly of drug companies supported by the government is the primary reason for the extremely high price of prescription drugs in the United States The problem of drug price crisis is complex, so it is not easy to solve it completely The main problems are as follows: 1 Prescription drugs in the United States are priced by pharmaceutical manufacturers themselves, while drug prices in other countries are negotiated by government departments or regulated by adjusting the coverage of medical insurance In 2003, the Democratic Congress introduced Medicare drug benefit, and since then Medicare has lost the right to agree on drug prices At the same time, Medicaid must unconditionally cover all drugs approved by the food and Drug Administration (FDA) Third party pharmacies such as express scripts and CVs health, the American interlocking pharmaceutical giant, bribed prescription drug regulators to adjust market share artificially according to their orders Other enterprises could not participate in pricing at all 2 The government supports drug companies to monopolize drugs and forbid generic drugs from entering the market to drive down prices In order to encourage innovation, the U.S has introduced a patent system Pharmaceutical companies can monopolize drugs with patent years of 20 years or more, and have exclusive rights to rare disease drugs Research shows that pharmaceutical companies sometimes take improper measures to maintain monopoly There are a lot of tricks, but they are mostly related to improving the non therapeutic properties of drugs, such as adding sugar to pills to cheat patents In addition, it is also a common trick to extend the exclusive sales time of the expired patented drugs by using "pay for delay settings" (the original drug manufacturer pays high compensation to the generic drug applicant) This is a very bad practice, because if there are two producers in the market, the drug price will drop by nearly half, if there are five producers, the drug price will drop by nearly 70% 3 FDA's approval time for non patent drugs is too long It is found that the food and Drug Administration (FDA) lags behind in the approval Generally, generic pharmaceutical companies need to wait three or four years to be approved to produce expired patent drugs 4 State laws and federal policies limit the impact of generic drugs on drug prices In many states of the United States, pharmacists are required by law to obtain a patient's license to switch to generic drugs In 2006, Medicaid spent $1.98 million on simvastatin, the brand name Zocor, for this reason alone, according to reports Shujiang is an expensive brand medicine, and many generic drugs can replace it, and it is cheaper Because the pharmacist did not apply for the patient's change license to continue to use the brand medicine, Medicaid could only pay for the expensive "brand medicine" 5 High R & D cost is just a cover When it comes to the inflated price of prescription drugs, pharmaceutical companies always prevaricate with "high research and development costs" And research and development costs are not the real reason Research and development of new drugs are generally funded by the National Institutes of Health (NIH) through government subsidies, or invested by venture capital For example, the late development of sofosbuvir, an anti hepatitis C drug, was funded by Gilead sciences Enterprises only need to provide 10% to 20% of the profits as research and development funds, and the price of drugs mainly depends on the market tolerance It's not hard to see that the reasons for the false high drug prices in the United States are complex The lobby of drug companies (major drug companies will buy some lawmakers to fight for favorable medical policies) has a great influence in the parliament, and there is no internal deadlock in the parliament Medical insurance can't interfere with the price of prescription drugs at all There is a long way to go to get the drug price on the normal track, and it is not a one-sided approach Policy makers need to make more stringent policies to regulate patent protection and exclusive rights At the same time, doctors should not be onlookers Original source: KHN original title: government protected 'monocolies' drive drug prices higher, study says