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    A physician’s tale of irrational drug prices

    Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Stephen C. Schimpff, MD, a quasi-retired internist, professor of medicine and public policy, former CEO of the University of Maryland Medical Center, and author.  The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.


    We've all heard the outrage over the sudden rise in the price of the EpiPen. What we hear far less often is how common the sudden and dramatic rise in many other pharmaceutical prices has become in recent years. It can be easy to forget issues like this until they affect us personally.  My own minor encounter with irrational drug price increases was a good reminder of how pervasive this problem is today. Here's my story.  


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    I have rosacea, a skin condition that affects about 16 million Americans’ noses and surrounding skin with redness from dilated small blood vessels. For many, it can be debilitating and of real concern with no clearly known cause or consistently effective treatment. While generally not too annoying for me, every six weeks or so it flares up. Years ago, a dermatologist prescribed tetracycline, an inexpensive generic that worked with no appreciable side effects. About a decade ago, doxycycline was prescribed in its place, another generic off-patent medication. Initially, it was also inexpensive, but over the years the price has consistently risen much faster than inflation. The last refill cost $68 for 30 pills.

    About that same time, my doctor recommended trying metronidazole topical gel, another long-time generic. Although some people have good results, it did not work for me; however, to learn that it was not effective, I spent over $100 for a small tube.

    About five years ago, the dermatologist recommended a lower dose of doxycycline, and gave me a sample of a new version of this drug that combined fast and slow release. That seemed like progress until I learned the price—$10 per capsule ($300 a month and $3,600 per year). No surprise—my Medicare Part D drug insurance did not cover it. I stuck with the regular doxycycline.


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    Recently, I learned that there is a new compound recommended for rosacea that acts on the theory that rosacea might be caused by mites—1% ivermectin cream. As a topical agent, it would have the potential benefit of not harming the GI tract bacteria like doxycycline. Ivermectin has been on the market in pill form for many decades and costs less than 25 cents per treatment course in developing countries. The World Health Organization classifies it as one of the essential medications—used especially in developing tropical countries for diseases like river blindness.

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    • [email protected]
      Riley Elijah I was diagnosed with herpes since I was a child. My mother has them too, and does nothing to stop the spread. it was hard to not kiss my children all the time, but they grow up knowing that "when mommy has a lip owie, she can't kiss." They give me kisses on my forehead instead and we have extra hugs. It was also very painful to not kiss my husband. However, I was 100% determined to not pass this on to anyone, especially those I love.I mostly want to thank those who feel the way I do. Good health herbs home helped me and my family to find happiness and peace ,their herbal remedies for herpes works like miracle,i was totally cured of herpes virus within 5 weeks of usage,please if you are out there searching for herpes cure contact good health herbs home via ww w .goodhealthherbshome .com
    • UBM User
      (1) Dr. Schimpff was one of my Professors at Univ. of Maryland [Grad in 1976] - I ended up in Rheumatology. (2) RE: Rosacea - (outside the box, I know) Try a Gluten Free Diet for 4 -6 Months. I had a patient who felt she was 'Gluten Sensitive' (various non-specific complaints) and on a Gluten Free Diet her Rosacea Improved ! ( ? Coincidence ??) (3) There appear to be some folks who report improvement in their Rosacea off Gluten, including a family member - but it took about 5 - 6 months to report a Robust Improvement. (4) Not the topic of the article - but what did You Expect ? (5) A Proposed Mechanism of Action by altering Diet - The Gut "Microbiome" . David A Shaller, MD

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