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    A physician’s tale of irrational drug prices

     

    I imagine it was not that difficult for the pharmaceutical firm to figure out how to manufacture it as a cream. Of course, to obtain FDA approval, they had to conduct a clinical trial to demonstrate efficacy and safety. While such trials can be expensive, it would not have been exorbitant. So, imagine my surprise when I learned that the cost for a tube about the size of a medium tube of toothpaste was $358. And, no surprise, my insurance did not cover it.

    Of course, I don't even know if this cream will work. The metronidazole did not. Trying it would be an expensive experiment. I decided to skip the experiment and the cost of the drug and stick with the less expensive but still pricy doxycycline. But wait, the pharmacist checked his computer and found a manufacturer’s coupon that would lower the cost of my first purchase of ivermectin cream to $75 instead of $358. That is still a lot of money for what is essentially a cosmetic issue, and it will be a $75 experiment to see if it works or not for me. Incidentally, while researching prices, I found on the internet that an ivermectin paste for horses costs $1.69.

     

    HOT TOPIC: How can physicians combat industry shortages and meet patient demand?

     

    As a believer in capitalism, I think that drug companies should be able to earn a fair profit and recoup their research and development expenses not only for a specific drug but for the many drugs that never make it to market. Without such a return, there would be no incentive for innovation. But over $100 for a tube of metronidazole, $300 per month for sustained release doxycycline and $358 per tube for ivermectin cream are all well beyond reasonable—as is the current price of standard doxycycline. It strains credulity to think that these prices are reasonable. These are drugs that have been off-patent for many years, readily available, easy to manufacture and should be inexpensive or at least not exorbitant.

    Fortunately for me, my rosacea is relatively minor and I have options. Those with significant, sometimes cosmetically inhibiting and sometimes quite disabling rosacea, however, face the issue of irrationally high drug prices when they have few options. Clearly, something is broken in our current system. Drug prices are currently responsible for the highest growth trajectory in our pricey healthcare system. Medicare has no ability to negotiate with drug manufacturers to lower drug prices.  

    Next: 'Price controls do not work and should not be considered'

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    • 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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