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.
McDonald’s Slims Down in the U.S. for the First Time
For the first time in at least 45 years — and maybe the first time in its history — McDonald’s says that this year it will close more restaurants in the U.S. than it opens.
An Associated Press review of McDonald’s filings with the Securities and Exchange Commission found that the company hasn’t slimmed down the number of restaurants it operates in the U.S. since at least 1970. McDonald’s as we know it was founded in 1955 and grew quickly in its early years, making it likely that 2015 will be the first time it takes down more Golden Arches than it puts up in the U.S.
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McDonald’s does shutter underperforming locations every year, but up until now the number of closings has been outweighed by new openings. The world’s biggest hamburger chain has been struggling to grow sales as consumers turn to chains like Chipotle and Five Guys Burgers and Fries, which market themselves as serving better food and ingredients.
McDonald’s is still growing globally, though. It has about 36,000 locations across the globe and plans to expand that total by about 300 this year. In addition, the chain is still indisputably the country’s largest hamburger chain, with more than twice as many restaurants as its main rival, Burger King.
McDonald’s spokeswoman Becca Hary told the AP that relative to the roughly 14,300 U.S. locations, the net reduction in U.S. stores would be “minimal,” though she declined to give an exact number.
More Money Coming Out of 401(k)s Than In
The amount of money withdrawn from 401(k) plans exceeded the amount contributed to the retirement funds for the first time in 2013, according to a report in The Wall Street Journal.
The shift reflects demographic changes as more Baby Boomer retire from the workforce and begin tapping their savings, and young millennial workers put smaller amounts in.
Consumers may benefit from the trend as fund managers begin cutting fees and changing services in order to entice young workers to sock away more. “It changes the dynamic of the business itself,” J.P. Morgan Chase analyst Ken Worthington told The Journal.
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Company-sponsored 401(k) plans had $4.6 trillion in assets last year, according to the Investment Company Institute.
The average 401(k) balance at the end of the first quarter was $91,800, up 0.5 percent from the fourth quarter of 2014 and up 3.6 year-over-year, according to Fidelity. For employees in a plan for 10 years or more, the average balance was $251,600, up 12 percent year-over-year.
Workers can contribute up to $18,000 in pre-tax dollars to their 401(k) plans in 2015, but most workers—especially younger ones—save far less each year. There are lots of reasons millennials are lagging in retirement savings: large numbers of them are still unemployed or underemployed in jobs that don’t have retirement benefits, and they’re diverting all their extra cash to student loans. Plus, retirement may not be top-of-mind for 20-somethings, no matter how many times they hear about the benefits of compound interest.
Why a Woman Will be on the $10 Bill and Not the $20
The announcement that the Bureau of Engraving and Printing will add a woman to the portrait of Alexander Hamilton on the $10 bill has stirred a lot of conversation as to why the Treasury was not redesigning the $20 bill instead.
It turns out there is a very simple explanation: The move is based on recommendations from the Advanced Counterfeit Deterrence (ACD) Steering Committee.
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"Currency is redesigned to stay ahead of counterfeiting," the US Treasury says. "The ACD Steering Committee recommended a redesign of the $10 note next. The ACD will make its next recommendation based on current and potential security threats to currency notes."
The ACD bases those recommendations on the "current and potential security threats to currency notes," and it turns out that the $10 bill is at a greater threat of being counterfeit than the $20 bill.
Secretary of the Treasury Jack Lew announced the change in a statement on YouTube: "I'm proud to announce today that the new $10 bill will be the first bill in more than a century to feature the portrait of a woman.”
Hamilton will share the note with a woman who Lew is expected to choose by the end of the year. The new bill will enter circulation after 2020.
This article originally appeared on Business Insider.
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FCC Slaps AT&T with $100 Million Fine for Throttling Internet Users
The FCC on Wednesday slapped AT&T hard, proposing a $100 million fine — the largest the agency has ever handed down — for what it described as the phone and broadband giant’s misleading customers about its “unlimited” data plans.
At issue is the practice of “throttling,” or limiting download and upload speeds for some users on those data plans.
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AT&T’s throttling policy had been in place since 2011, according to an FCC statement, and it led to a barrage of complaints to the agency. AT&T targeted users who surpassed a certain data threshold over the course of a month, and consumer complaints argued that AT&T’s limiting of download speeds was directly at odds with the nature of the marketed “unlimited” plans.
AT&T, which is also pursuing government approval of its pending acquisition of DirecTV, says it will “vigorously dispute” the decision. In a statement, the company said that its practice is well documented and shared by many — if not all — service providers, and a legitimate method of managing their network’s resources. The FCC disagrees, claiming that AT&T violated transparency rules by falsely calling these plans unlimited.
"Broadband providers must be upfront and transparent about the services they provide,” said FCC Chair Tom Wheeler in a statement. “The FCC will not stand idly by while consumers are deceived by misleading marketing materials and insufficient disclosure."
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AT&T has 30 days to respond before the FCC issues its final decision.
The Federal Trade Commission sued AT&T for $3.5 million in October last year, for the same alleged violation. That case is still ongoing.
The 2016 Presidential Debates Could Become a Slugfest
Few could doubt the impact of nationally televised presidential debates after Republican Mitt Romney set President Obama back on his heels in their first encounter in October 2012.
Romney was articulate and aggressive while Obama appeared frazzled and very much off his game. Romney’s commanding performance helped the former Massachusetts governor briefly energize his floundering campaign and regain its momentum.
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Moreover, with home viewership topping 67 million, the debate -- moderated by Jim Lehrer, the former news anchor for the PBS News Hour – broke a 32-year gross viewership record dating back to the first debate between Democratic President Jimmy Carter and Republican challenger Ronald Reagan in 1980.
Yet amid dramatic changes in political campaign tactics and fundraising and the way Americans consume the news, these televised general election presidential debates actually are suffering from diminished reach.
A new study issued on Wednesday by the Annenberg Public Policy Center at the University of Pennsylvania seemed to compare presidential debates to TV entertainment. Their assessment: the more than two-decade old debate format is to blame for the low viewership among millennials, although baby boomer viewers have increased.
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So what to do? In an era when large audiences pay far more attention to “Game of Thrones,” “House of Cards,” “Master Chef” and “So You Think You Can Dance” than to increasingly lengthy presidential campaign seasons, how can the political parties and the National Presidential Debate Commission jazz up the debates to attract and keep a wider audience?
The Annenberg panel, of course, stops well short of recommending the equivalent of no-holds barred political mudwrestling to heighten audience engagement and sustained interest. The goal, the group says, is to expand and enrich debate content and produce a better informed group of voters.
To that end, the advisory group appears anxious to get rid of the moderator or middle man as much as possible and allow the two candidates to set the agenda and duke it out. They want to get rid of the one or more prominent journalists who set the ground rules and determine the pace and course of the evening’s discussion.
Related: GOP Prunes the 2016 Primary Debates Down to Nine
If, for example, Hillary Clinton were to slam, say, Marco Rubio in a debate, Rubio shouldn’t have to wait patiently for his opportunity to reply but should be allowed to jump in with a rejoinder. Think of it as the resurrection of CNN’s Crossfire.
To add a smidgeon of Jeopardy to the proceedings, each candidate would have a total of 45 minutes to spend to make their case or defend it.
While the candidates would have plenty of opportunity to get their political messages across, they would also have to respond quickly to attacks. A well-scripted candidate wouldn’t necessarily do well in that setting, and the possibility of “oops” moments would be increased. Welcome to reality TV, Beltway style.
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Ah….but dead air is not an option, so a filibuster is off the table. No answer, rebuttal or question could exceed three minutes, according to the panel. When a candidate runs out of total time, he or she has exhausted the right to speak. Remaining time at the end of the moderator-posed topics can be used for a closing statement.
The recommendations are advisory only and it will be up to the presidential debate commission and the national parties to iron out the final ground rules next year.