DIGGING DEEPER: Price of a Pill - KWWL - Eastern Iowa Breaking News, Weather, Closings

DIGGING DEEPER: Price of a Pill

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Here’s a question that might be tough to answer:  Can you put a price tag on a life-saving pill?

If the answer is ‘yes’ – then what is the price tag?

If the answer is ‘no’ – understand that your insurance premium might go up to cover the cost of medicine for someone you’ll never meet.

Linda Rodrigues is taking a pill that she believes is saving her life.

Rodrigues, from Dubuque, takes Ibrance to treat her stage 4 breast cancer.

“It keeps it from spreading into your organs because once it spreads into your organs, you’re pretty much dead,” said Rodrigues.

Each month, she takes one pill a day for 21 days.

Ibrance was approved by the FDA two years ago this month.

Initially, the price was $9,850 a month.

It’s now listed at $10,963.

That means the price for a year’s supply of Ibrance is almost $132,000.

This spring, Linda is retiring from her job as a math teacher at Dubuque Hempstead and will go on Medicare to help pay for Ibrance.

She says the cheapest plan she could find requires a $3,000 co-pay the first month, $700/month for the next 11. That’s about $11,000 out of pocket.

“It’s either, ‘Do I get food or do I take the medicine,’” said Rodrigues.

That’s not the only question she’s asking.

“How much does it really cost to develop this drug?” asked Rodrigues.

That’s something KWWL has been digging deeper into recently.

Sales of Ibrance, through Pfizer, hit $1.5 billion in the first 9 months of last year.

“I don’t mind a CEO making decent money, but I don’t want to pay for a yacht on my life,” said Rodrigues.

KWWL reached out to Pfizer, asking how much it costs to produce one pill of Ibrance.

“We don’t break out the cost to develop individual medicines, but the industry trade organization PhRMA (the Pharmaceutical Research and Manufacturers of America) estimates that the current cost to develop a medicine is over $2.6 billion, which PhRMA estimates takes more than 10 years on average,” said a Pfizer spokesperson.

Pfizer says a large chunk of the development cost reflects what goes into clinical trials. (More than 6,000 women are now enrolled in a clinical trial focused on Ibrance.)

Pfizer also said the list price ($10,963/month) comes before discounts and rebates kick in, which are commonly negotiated between a pharmaceutical company and a health plan.

“We should be negotiating, I think, with the large companies to get the prices down,” said Rep. Rod Blum, (R) 1st District.

Congressman Blum, who represents the district where Rodrigues lives, says it’s time to examine why the government doesn’t negotiate with drug companies.

“I want to research it.  Maybe there are some great reasons why we don’t do it, but I want to know what they are,” said Blum.

Senator Chuck Grassley, who’s been investigating the cost of prescription drugs, disagrees with his fellow Republican.

“Unless data from CBO (Congressional Budget Office) or other credible sources emerges to the contrary, I don’t see a reason to consider changing the current policy on negotiations,” said Grassley.

As Republicans like Grassley and Blum hammer out a replacement for Obamacare, Rep. Blum says lawsuit reform and more competition in the market could also drive down the cost of health care, but that’s not all he’s thinking about.

“I job shadowed in the Emergency Room at Allen Hospital in Waterloo for 6 hours.  At least 90% of the patients we saw should not have been in the Emergency Room.  We had a person who came in with a headache.  A headache.  The Emergency Room physician prescribed 4 Tylenol.  That was an $800 bill for the taxpayers,” said Blum.

“We’re not quite sure where he came up with the ‘90%’ figure as the percentage of ED (Emergency Department) patients who are admitted to Allen Hospital alone is much greater than 10%,” said a spokesperson for Allen.

KWWL also asked about the patient with a headache Rep. Blum talked about.  The Allen spokesperson said they could not provide any details because of patient privacy.

Patient privacy is something Linda Rodrigues waived so we could interview her oncologist about the cost of prescription drugs and the impact on patients.

Linda’s doctor at Dubuque Medical Associates told KWWL they are strongly discouraged from doing interviews about things like this, so they did not answer questions on camera.

Answers are hard to come by, but here is one big development.

After KWWL spoke with Pfizer, they encouraged Linda to apply for one of their programs that offers discounts.  The company says it has helped hundreds of thousands of patients receive prescriptions for free or at a savings.

Linda did apply and was told she qualifies for help based on her income, but she doesn’t know yet how much she will save on her co-pays.

For now, she is grateful for Ibrance, but her thoughts are also with those who need expensive prescription drugs who might make too much money to qualify for help.

“It makes me upset that the middle class is the one that suffers the most,” said Rodrigues.

Right now in Congress, there’s a new bill that would let the government negotiate drug prices.

KWWL asked several Iowa lawmakers if they would support it.

You can read their answers here:

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