Recently, Malcolm Gladwell published an article on rising prescription prices in the New Yorker. I'm a big fan of his, so I dutifully read it on a recent ride into the office.
In brief, it questioned who is to blamed for the rising cost of drugs. He talks about how drug companies will make small changes to existing drugs, right around when they can go generic, and rerelease them (Prilosec and Nexium were his examples). Still, he places the blame on the doctors, health care providers and consumers as well, since there are often very capable generic drugs available but people just aren't buying them as much as they should be.
Last night I was talking to Jori's dad and brother -- one is a doctor and the other works for a drug company, in that order -- about this very issue. We talked about Nexium and Prilosec specifically. They both explained to me that they have patients and customers who started out using Priolec and later moved to Nexium and said there was a world of a difference. Gladwell explains things differently.
In the political uproar over prescription-drug costs, Nexium has become a symbol of everything that is wrong with the pharmaceutical industry. The big drug companies justify the high prices they charge—and the extraordinary profits they enjoy—by arguing that the search for innovative, life-saving medicines is risky and expensive. But Nexium is little more than a repackaged version of an old medicine. And the hundred and twenty dollars a month that AstraZeneca charges isn’t to recoup the costs of risky research and development; the costs were for a series of clinical trials that told us nothing we needed to know, and a half-billion-dollar marketing campaign selling the solution to a problem we’d already solved.
Jori's father said the exact opposite. He's had patients who have dropped Nexium for over-the-counter Prilosec, due to high costs, only to find that it takes as much as five of the OTC Prilosec to match Nexium's effectiveness, thus nullifying any savings. So, I'm curious how much research Gladwell did.
I'd love to hear from more doctors and researchers to see which side is telling the real story. I don't think Jori's family is lying, but I'm not sure if Gladwell has unearthed information that they don't have access to. So, if you have any thoughts of your own, or know where to turn, I'd love to hear from you.