Drug Pricing, Pharmaceutical Markets, and Profit Distribution
Introduction
As health care is essential for the common good of the people, drug pricing then is a topic that matters to all citizens and not only to a specific group of people. Drug pricing is a long, multifaceted process that is not done by only one person or one organization. Rather, this process is a chain that includes drug manufacturers, then wholesalers, and finally pharmacies. All of these stakeholders have varying control over drug pricing. For instance, at the top of the production chain there are drug manufacturers who put a base price depending on their evaluations and suggestions. These evaluations include how crowded the market is and whether there are competitors or substitutes for the drug produced. Rather than for the sake of research, as the majority of pharmaceutical companies claim, most drug prices have increased rapidly and exponentially, mainly because of profit.
Therefore, this topic is the same as that of my synthesis of fact essay but with a narrower scope. Instead of writing about how drug pricing works in general terms, in this research paper my main focus will be why drug prices should not increase as dramatically as they are and how drug prices should be regulated. I will use most of the information from my synthesis of fact essay with the addition of more factual evidence to support my argument . For example, I will include the concrete examples I had of the dramatic increase of some drug prices over time, and I will add data investigating where most of this money goes. At the end of the day,” If the price is too high and the patient cannot afford the medicine, we have not fulfilled our reason for existence” (Vagelos).
Organizational Overview
The following is an outline for my research paper by incorporating the sources I cited in my annotated bibliography.
I. Introduction
a) Shocking example of drug price increase : The price of EpiPen from Mylan, which costs $100 in 2007, rose by over 500% in a decade to $600.
b) Brief explanation that multiple organizations are involved in drug pricing.
c) Thesis statement
II. Drug pricing process from the top level to the bottom level
a) Drug manufacturers deciding the base price
b) Sovaldi hepatitis drug : “This is what happened in the case of Sovaldi, a hepatitis drug by Gilead Sciences, which the company listed at $1000 each pill as it was the only working option in the market “(Entis).
c) Price negotiations and insurers
1- Government-based insurance: Medicare
2- PBM’s role
III. Counter arguments to my main idea
a) Research and Developments : “The companies argue that the high cost of drugs is due to cost incurred during research and development (R&D) and the short period given for patents before generic drugs are introduced “(Plant).
IV. Response to counter arguments
a) Percent of profits spent on R&D. : “It is estimated that pharmaceutical companies use 20% of their profits on R&D, which is even higher in smaller and research-specific companies” (Mikulic).
b) Tax credits for R&D
V. Effects of unregulated, high drug prices on people
a) Type 1 diabetes’ patients
1- Exponential increase : “A 2018 study commissioned by the Congressional
Diabetes Caucus found that the price of insulin has doubled since 2012; in
the 10 years prior, the price of insulin nearly tripled“(Meller and Hauwa).
2- Insulin rationing
i) ketoacidosis, a fatal condition :”Despite the dangers of insulin rationing,
which can lead to diabetic ketoacidosis, a fatal condition, many Americans
have no other choice”(Meller and Hauwa).
ii) Case for Antroinette’s daughter
VI. Government control over drug pricing
a) Monopolies in forms of patents : “We also need to reevaluate the manner and scope of the monopolies the 5 government grants to pharmaceutical companies in the form of patents and FDA exclusivities” (cummings).
b) Trump’s administration broken promises : “Trump made grandiose promises on drug pricing but almost three years later has only managed to deliver a handful of half-measures, illustrating his administration’s lack of commitment to lowering drug prices.”(Meller and Hauwa)
VII. Suggested solutions to the problem
a) Robust competition :”The core idea is this: In areas where there is robust competition, especially with generic drugs, prices are extremely affordable,
even in America. Where there are monopolies, legitimate or artificial, prices are high”(Mr. Roy).
b) Limiting pharmaceutical companies advertisements : “So the existence and the prevalence of direct-to-consumer advertising definitely increases pharmaceutical spending by driving patients and physicians toward higher—— “(Dr.Kesselheim).
VIII. Conclusion
a) Brief summary of the relation between better regulated drug prices and the common
Good of the people
b) Wrapping up the thesis statement
Problems
I think time management is essential for me to finish my research paper on time , especially in the next couple of weeks with a lot of other assignments beside it. One other problem that I may face is that somes drug spending estimates vary depending on the data providers. By using the university’s database, however, and comparing it to other popular sources, I will make sure that I provide my audience with the best information available. By doing so, I will establish my credibility while supporting my argument as well.
Annotated Bibliography
Examining the Actions of Drug Companies in Rising Prescription Drug Prices: Hearing before
the Committee on Oversight and Reform, House of Representatives, One Hundred
Sixteenth Congress, First session, January 29, 2019. U.S. Government Publishing
Office, 2019.
The source is about the proceedings of a meeting by the Committee on Oversight and Reform during the 116th congress chaired by Hon. Elijah Cummings. They had a discussion on issues surrounding the decision by companies to raise the prices of prescription drugs, the involvement of the federal government in drug pricing, and how it affects the American families. This source is more detailed than the other four sources . This source is important to both the government and the players in the prescription drug market. It is also instrumental for anyone conducting research on the same subject. The article is important for the topic as it explains why companies raise the prices of drugs as well as how the government can intervene. Knowing that I share an opinion with people who can bring about the desired change feels good. This source will help me have a stronger argument as I present the opinion of some congress members. It has made me feel more aggressive towards my topic than the other four sources.
Meller, Abbey, and Hauwa Ahmed. “How Big Pharma Reaps Profits while Hurting Everyday
Americans.” www.americanprogress.org/issues/democracy/reports/2019.
pharma-reaps-profits-hurting-everyday-americans/.
This article examines how Trump’s administration has failed to lower the prices of prescription drugs and majorly blames corruption for that. It explains how large companies benefit from the government’s funded research and tax breaks while still charging high for drugs. It explains how the system hurts more that one million people who suffer from type 1 diabetes. The article explains how the big pharma companies maximize profits through pricing and how the president has failed in delivering as promised when it comes to the pricing issue. The article provides an insight on the pricing of prescription drugs, explaining why the prices are so high and how this hurts the American people.The article provides statistics which the government can use as well as people doing research in similar fields. However, it is not as detailed as the other four sources. The article explains the pricing is high due to corruption, which will help me explain my case. The high pricing is not necessary since it benefits a few individuals who are the producers and owners of the companies. It will help me explain that the pricing is high because of greed and negligence from the government. The article has strengthened my stand on why I think the pricing is absurd.
Yu, N., Preston Atteberry, and Peter B. Bach. “Spending on prescription drugs in the US: Where
does all the money go.” Health Affairs Blog. 2018.
This is an article that sheds light into the prescription drug market in the US. It looks at the supply chain which includes the processes which take place from production, distribution, retailing and consumption. It cuts across all the shareholders i.e. manufacturers, wholesalers, pharmacies, pharmaceutical benefit managers, providers, and insurers, explaining how much each gain from the business. The article is important in providing information on how much different stakeholders make in the prescription drugs business; therefore it is resourceful for my topic. It is a great source for people conducting research on similar topics and for the government ,as well as to help in regulation. The article will help me give a detailed explanation with figures that most of the money goes to the manufacturers who aim at maximizing profits. The article has made me feel that I have a compelling argument.
Vagelos, P. Roy. “Are Prescription Drug Prices High?” Science, vol. 252, no. 5009, American
Association for the Advancement of Science, May 1991, pp. 1080–84,
doi:10.1126/science.252.5009.1080.
This source describes not only how hard it is to control drug prices but also how important it is for drugs to be affordable for the people. It provides information about how patent protection affects drug pricing. Furthermore, It describes how hard and, therefore, expensive it is for a compound to get into the market. The source does so by providing statistical evidence, cited from Pharmaceutical Manufacturers Association Survey, Washington, DC, 1985, that for every 10,000 substances examined, 20 enter animal studies, and 10 enter clinical (human) trials–but only one gains U.S. FDA approval. This source also explains where the money goes by mentioning both sides of the argument: whether increases in prices go mainly for profits or for further exploration of more drugs that will help cure more people. It also provides solid examples for each side, by citing a lot of governmental credible sources. Providing detailed information from credible, reputable sources, This source will help me with its information on the counter arguments to my main point, establishing my credibility to my audience and engaging their minds to my research paper.
Entis, Laura. “Why Does Medicine Cost So Much? Here’s How Drug Prices Are Set.”
TIME, 2019, https://time.com/5564547/drug-prices-medicine/.
This source describes how the chain of drug pricing works from the topmost level of drug manufacturers to the bottom level of consumers. It explains how drug pricing is a long process that is affected by multiple stakeholders. This source mentions the aims of all these stakeholders involved and their deals with each other. These aims and deals are what make drug prices too high. The source provides a lot of examples of soaring drug prices, such as Insulin. It also mentions that there are no regulations on pricing, clarifying that this is a reason why public anger is reaching a boiling point. The source also includes testimonies from healthcare professionals on the issue, making it a reliable source to its audience. By providing a comprehensive overview of the drug pricing process and many examples to clarify it, this source is a great reference for introducing the topic to my audience in my research paper to get them to fully understand my main argument.
RESEARCH ESSAY (20% of course grade)
Purpose: The research aspect of this essay requires you to synthesize additional information with your thesis
which allows you to focus your approach to or argument about the topic or texts. It should also illustrate your
ability to express your ideas in written form while analyzing information and presenting conclusions. Academic
Research essays do not just report facts you have found in secondary sources (books, journals, articles,
websites). At times you create data through surveys, interviews, observation, experimentation, and
documentation (primary sources).
Your thesis should argue a view or position or course of action related to your topic that you have chosen from
the initial ideas presented in your argument of fact or a different topic related to The Common Good in some
way.
Requirements:
• A thesis statement developed around a topic connected to The Common Good in 8-10 pages
• Support of the thesis throughout the work using specific examples from your research sources
• Citations from at least 6 sources that are academically strong and/or relevant to your topic
• MLA8 formatting of the paper (10-12 pt type, double-spaced, 1” margins on all sides, etc.), works cited,
and in-text citations
• Illustration of the understanding of text(s) used and logical argument/idea development
• Writing that displays support skills, organization of ideas, clarity, and general grammatical and academic
style
Process: Using the plan you set up in your proposal, conduct more research, determine if parts of your
argument of fact can be used, and begin refining and writing the organizational overview you proposed.
Starting with your focus and thesis, continue researching to be sure that you can explain to your audience of
peers the general material they need about the field or narrowed focus in which you are working. This may
mean a part of your essay is a Review of Literature or Background section, whether labeled as such or not.
You will also need to find reliable sources to support additional claims, sub -points and examples. Synthesize
new material and research in ways that still inform but also support your thesis. Persuade your audience that the
argument you present is valid.
Determine if document formatting and/or visuals are relevant to your topic and beneficial for your audience. Use
of Headings and Subheadings, visuals and a Methods section is dependent on your research, your topic, and
your choice. Any material included needs to support the thesis and should be cited.
Goals: Practice research skills and evaluation; development of a general topic to a more narrowed focus; argue
a side or stance persuasively; support arguments through claims and evidence; manage multiple sources and
synthesize information; use proper and correct documentation and citation format; fine tune writing voice and
style; practice academic genre of research essay.
Rubric
Focus Description Points
Rhetorical Skill
Effectively contextualized in response to scholarly conversation,
audience, and genre conventions for an academic research paper.
10
Synthesis of complex sources found through critical research process.
Opening
Opening identifies purpose or goal of essay.
10
Thesis clearly states a view of the topic that will be argued.
Body/
Synthesis
Essay successfully combines and synthesizes information from
multiple sources to explain and support argument of thesis.
55
Each point is argued and supported with examples which are
explained. Clarity of ideas matches audience.
Body quotes, paraphrases, and summarizes source texts accurately
and appropriately and provides necessary descriptive information.
Organization of essay is clear and logical with appropriate transitions.
Conclusion
Effectively develops sense of closure for the essay. 10
Persuasively argues for the thesis view again.
Format &
Style
Accurately uses MLA8 style guide to format essay, cite and document
sources.
Few if any major errors in grammar, spelling, usage, etc. 15
Meets minimum requirements specified in project guidelines.
Demonstrates rhetorically appropriate tone, voice, and style.
Total 100
Note: You will be allowed to revise the research essay, but not the proposal, if it is turned in on time.
You will be using the research essay as the focus of essay #4 Argument of Evaluation