Why Prescription Drug Prices Keep Rising – and 3 Ways to Bring Them Down
Prescription drug prices have been rising at a blistering rate over the last few decades. Between 1980 and 2016, overall spending on prescription drugs rose from about $12 billion to roughly $330 billion, while its share of total health care spending doubled, from 5% to 10%.
Although lawmakers have shown renewed interest in addressing the problem, with pharmaceutical CEOs testifying before the Senate Finance Committee in February and pharmacy benefit managers (PBMS) scheduled to do so this week, no comprehensive plan to halt the relentless increase in prices has been proposed, let alone agreed upon.
Robin Feldman, a professor at the University of California Hastings College of Law, takes a look at the drug pricing system in a new book, “Drugs, Money and Secret Handshakes: The Unstoppable Growth of Prescription Drug Prices.” In a recent conversation with Bloomberg’s Joe Nocera, Feldman said that one of the key drivers of rising prices is the ongoing effort of pharmaceutical companies to maintain control of the market.
Fearing competition from lower-cost generics, drugmakers began over the last 10 or 15 years to focus on innovations “outside of the lab,” Feldman said. These innovations include paying PBMs to reduce competition from generics; creating complex systems of rebates to PBMs, hospitals and doctors to maintain high prices; and gaming the patent system to extend monopoly pricing power.
Feldman’s research on the dynamics of the drug market led her to formulate three general solutions for the problem of ever-rising prices:
1) Transparency: The current system thrives on secret deals between drug companies and middlemen. Transparency “lets competitors figure out how to compete and it lets regulators see where the bad behaviors occur,” Feldman says.
2) Patent limitations: Drugmakers have become experts at extending patents on existing drugs, often by making minor modifications in formulation, dosage or delivery. Feldman says that 78% of drugs getting new patents are actually old drugs gaining another round of protection, and thus another round of production and pricing exclusivity. A “one-and-done” patent system would eliminate this increasingly common strategy.
3) Simplification: Feldman says that “complexity breeds opportunity,” and warns that the U.S. “drug price system is so complex that the gaming opportunities are endless.” While “ruthless simplification” of regulatory rules and approval systems could help eliminate some of those opportunities, Feldman says that the U.S. doesn’t seem to be moving in this direction.
Read the full interview at Bloomberg News.
Hoping for a Raise? Here’s How Much Most People Are Getting
Nearly all companies plan to give raises to their employees next year, with an average salary bump of 3 percent, the same increase workers received this year, according to a new survey released Monday by Towers Watson.
Raises for executives and management will be 3.1 percent.
“To a large extent, 3 percent pay raises have become the new norm in corporate America,” Sandra McLEllan, North American Practice Leader for Towers Watson said in a statement. “We haven’t seen variation from this level for many years.”
Related: The Real Root of America’s Wage Problem
While the average raise is 3 percent, companies plan to tie the amount of individual raises to worker performance. Employees with the best reviews will receive an average 4.6 percent increase in salary, while workers with below-average ratings will get less than 1 percent.
The survey also found that companies are shifting their compensation packages to include more short-term incentives and bonuses. Eighty-five percent of workers took home a bonus this year, up from 81 percent this year. Nearly 90 percent of exempt employees were eligible for an annual or short-term bonus.
Even as unemployment has finally fallen, wage growth since the Great Recession remains largely stalled. Last month, wages for civilian workers grew just 2.1 percent, according to the Employment Cost Index.
Fed Chair Janet Yellen, who is looking for economic growth before instituting a rate hike, has said that stagnant wages are one factor hampering such growth. After all, consumers can’t increase the amount of goods and services they can purchase if they aren’t increasing their pay.
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When Buying Car Insurance, Young Drivers Should Stick with Mom and Dad
The parents of young drivers have enough to worry about, but a new study from insuranceQuotes.com finds that those who add coverage for an 18-to-24-year-old can expect to see an average annual premium increase of 80 percent on their existing car insurance. The good news: That’s still cheaper than if the young drivers bought insurance on their own. If those young drivers were to buy individual plans of their own, they’d pay 8 percent more on average — and in some cases, over 50 percent more — than their coverage costs on a parental plan.
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Premiums can vary widely depending on the driver’s age and state. An 18-year-old can expect to pay an average of 18 percent more for an individual policy than he or she would if added to an existing policy. But in Rhode Island, an 18-year-old will pay an average of 53 percent more for an individual policy. In Connecticut and Oregon, the difference is 47 percent.
In states such as Arizona, Hawaii, and Illinois, it actually becomes cheaper, on average, for a young driver to get his or her own policy after turning 19. When it comes to determining premiums, Hawaii is the only state that doesn’t allow insurance providers to consider age, gender, or length of driving experience.
These are the five states with the greatest difference in premiums for young drivers buying their own coverage.
1. Rhode Island: 19 percent
2. Connecticut: 16 percent
3. North Carolina: 14 percent
4. Vermont: 14 percent
5. Maine: 14 percent
Related: Now 16-Year-Olds Can Double Your Car Insurance
And these five states have the smallest difference:
1. Hawaii: No difference
2. Illinois: No difference
3. Arizona: 2 percent
4. Mississippi: 5 percent
5. South Carolina: 5 percent.
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Vladimir Putin’s Cheesy Act of Defiance
The United States and European Union have been squeezing Russia with sanctions since it annexed Crimea, a territory that previously belonged to Ukraine, in March 2014. In response, Russian President Vladimir Putin established a ban on U.S. and EU foodstuffs a few months later as a snub to the West.
On Thursday, Russia commemorated a tightening of that year-old ban on Western agricultural products by bulldozing bright yellow blocks of cheese. The country also streamrolled fruit and set piles of bacon ablaze. By midday, 28 metric tons of apples and tomatoes from Poland had been demolished, as well as 40 tons of apricots from an unknown country, according to The Wall Street Journal.
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The Western sanctions and a plunging ruble have caused Russian food prices to spike this year. Some politicians, religious leaders and other Russian citizens denounced the destruction of the food, noting that millions of Russians are living in poverty. More than 285,000 people signed an online petition that asked Putin to distribute the food rather than destroy it.
The Kremlin has promised to help develop Russia’s own agricultural industries and to promote domestic food products that the middle-class generally ignore in supermarkets in favor of status symbols like French cheese and Italian meat. In addition, the Kremlin announced that any contraband foodstuffs found would be destroyed. Russia’s Agricultural Minister Alexander Tkachyov said on state TV that the quality of Western food products could no longer be guaranteed.
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This May Be the Best Frequent Flier Perk Ever
Forget about getting bumped up to first class. Delta Airlines is now bumping its best customers off commercial flights entirely -- and onto private jets.
The program got off the ground last week, according to Bloomberg, with its first flight traveling from Cincinnati to Atlanta.
To be eligible for the upgrade, fliers must have at least 125,000 miles in travel and $15,000 in annual spending with the airline. The bump costs an extra $300 to $800.
In addition to improving the loyalty among some of Delta’s best customers, the program has a side benefit for Delta, allowing it to get some value from positioning flights, known as “empty legs,” which make up about 30 percent of industry flying.
Delta and other airlines have been shifting their loyalty programs in ways that make it easier for elite flyers to earn rewards and more difficult for more irregular customers.
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Starting in June 2016, Delta will issue rewards based on the amount of money spent rather than miles traveled, and the airline may change the number of miles necessary to book a flight based on demand and other factors.
Analysts say that other airlines may follow suit. Airline reward programs have been unsuccessful in fostering loyalty among patrons, many of whom book flights based on cost and convenience rather than brand preference. Only 44 percent of travelers and 40 percent of business travelers fly at least three-quarters of their miles on their preferred airline, reports Deloitte.
Delta’s reward program ranked 9th on U.S. News’ annual ranking of the best airline rewards programs, released this week, receiving 3.1 stars out of 5. Alaska Airlines was ranked first.
You’ve Got to See This GOP Hawk’s Grisly Ad Opposing the Iran Deal
A group led by John Bolton, the aggressively hawkish Republican insider who served as George W. Bush's ambassador to the United Nations, has released an unusually grisly ad that vividly portrays a nuclear attack on the United States.
The 30-second video was produced by the Foundation for American Security and Freedom, which Bolton leads. It shows an all-American family of four sitting down to a dinner of pasta and red sauce. The father kindly asks, “How was your day?” As his wife and children enthusiastically reply, a blinding flash rips through the scene to the sound of burning and destruction. The screen fades to black, and then we see and hear Sen. Rand Paul speaking, with his words also written on the screen: “Rand Paul: ‘our national security is not threatened by Iran having one nuclear weapon’.” The screen fades to black again, and then we see a nuclear explosion, with the words: “It only takes one.” As the nuclear cloud boils up into the sky, we see the final message: “A nuclear threat is a threat to our national security.”
The 30-second video seems to consciously mimic Lyndon Johnson's infamous "Daisy" ad from the 1964 presidential election. That ad was widely criticized for using a nuclear explosion to frighten the audience into believing that, if elected, Republican nominee Barry Goldwater would risk all-out war with the Soviet Union. The ad was shown only once (on September 7, 1964) but that proved to be enough.
Several differences between the Bolton group’s ad and “Daisy” stand out. For one, the new ad shows a family being destroyed by a nuclear blast. By contrast, the Johnson ad implied the death of a small girl and many others, but without showing the blast and its victims together.
Another difference is the target. The “Daisy” ad took aim at a hawkish Republican candidate for president, implying that an aggressive attitude toward a major enemy could lead to the destruction of the world. The Bolton group’s ad takes aim at a dovish Republican candidate — and, by implication, a dovish American president — while suggesting that a diplomatic approach toward a major enemy could lead to war on American soil.
A final difference: The Johnson campaign withdrew the “Daisy” ad as the criticism poured in. The Bolton group’s ad is on the Internet, where it can be seen over and over again. And thanks to the dynamics of social media, it will likely reach a larger audience than “Daisy” ever did — though to what effect, it remains to be seen.
Here’s the Daisy ad: