Pursuing this example further, among the drugs that might reduce cardiovascular risk, some statins are now available as generic products at far lower cost than their branded counterparts.
Some commentators argue that this creates an ethical obligation on the part of the seller to not extract excessive profits—or perhaps in some instances even to suffer losses—in providing drugs to those who cannot refuse the seller's offer Valdman, The question is whether market forces in the biopharmaceutical sector work effectively enough to ensure true competition and prevent excessive profits that otherwise might have been passed on to patients.
They may instead pursue long-run shareholder value by sacrificing some short-run profit in the pursuit of the public interest, although most legal advisors suggest that doing so is not without risk to the firms and their managements Elhauge, Persuasive arguments have been made that corporate executives are not, in reality, obliged to maximize profits.
Most policy changes introduced to address these and other issues have been, at best, incremental and have often been subject to substantial compromise among the entities possessing market power and political influence.As described above, drugs become available only after a long process of discovery, development, approval, manufacturing, and marketing, and might be unavailable because they have not been discovered and developed or because of a failure in the supply system. Policy interventions can and often do advance one of these two objectives at the expense of the other. For many medical conditions multiple treatment options exist, often involving choices among different types of drugs. In severe financial circumstances, patients' health care expenses also adversely affect other members of their families. Please see Appendix B for a minority perspective. Presently, different patients pay different prices for identical drugs, with individual prices depending mainly on the specifics of their health insurance plans, which generally include cost-sharing features such as copays, deductibles, and coinsurance. Another line of reasoning is that providing access to health care that includes effective medicines is important to advancing other fundamental goals of social justice. However, such price controls could erode incentives and make drug companies less likely to make the investments necessary to pursue the research and development that leads to future therapies Maitland, ; Scherer, Alternative frameworks, such as principles of medical ethics, demand an absolute fidelity to patients' interests. Accordingly, the uninsured often depend on financial assistance programs from pharmaceutical companies or others.
Because biopharmaceutical companies incur substantial risk and invest considerable time, money, and effort in the development of new products, the argument goes, fairness in pricing implies that they should be able to reap the returns of their investments De George, The system intended to reward drug companies for their innovations, but eventually protect consumers, is systematically being broken.
NOTES: more Another unique characteristic of the biopharmaceutical supply chain relates to the number of intermediaries.
The money takes a more complicated route. How do you distinguish a genuine advance from a mild improvement?The problem: Endless patents To encourage innovation and allow pharmaceutical companies to recoup their expenses, the federal government grants year patents on new drugs that give companies the exclusive right to market the medication. Prescription drug expenses are covered under these parts if they are directly purchased and administered by the hospital or the clinician. After that, generic drugs could be made by competitors — at competitive prices. With the sudden price increase, we were forced to remove isoproterenol from our emergency crash carts. Drug Enforcement Administration collection sites. As one example, the backlog of applications for generic drugs at the FDA has at times resulted in situations in which one generic firm may be the sole manufacturer of a lifesaving drug. They can, however, add as many as 20 years or more to their monopoly periods. At one end, people and their health plans pay into the system; at the other end, the manufacturer gets paid. The answer to this question is hotly contested, with participants in the biopharmaceutical supply chain typically pointing at each other, while claiming that their own activities deliver substantive benefits to patients.