In an era of cures, price-prohibitive drugs are an even harder pill to swallow

It’s an incredible time for the life sciences, panelists at a Biotech Showcase session on Monday agreed. However, it comes with a catch: The greater the miracle, the greater the anguish when a patient can’t afford or can’t access the drug.

Money pile and medicine pills representing medical expenses

San Francisco couldn’t shake the rain on day one of the 2018 J.P. Morgan Healthcare Conference and the life sciences industry couldn’t shake the perennial debate around the price of prescription medicines.

The topic quickly hijacked a plenary session at the Biotech Showcase, innocuously titled: “The future of biotechnology and life sciences sector: Are we at a tipping point?”

Yes, scientific progress is accelerating. The panelists all agreed that the sector is fast-approaching an “era of cures,” citing new gene therapies and advances in HIV and cancer.

It’s a healthy climate for innovation, said moderator Sara Radcliffe, CEO of the California Life Sciences Association (CLSA), and businesses are energized.

“As I walk into the JPM conference, I think broadly speaking there is a sense of enthusiasm and optimism on both fronts,” Radcliffe told the audience during the introductions.

The sun may be shining on the sector, but that doesn’t mean there aren’t gray clouds looming. Healthcare costs are rising and more patients are struggling to pay their out-of-pocket fees — even for longstanding drugs such as Humira, as The New York Times highlighted last week.

It’s an issue the field can’t innovate its way out of. In fact, progress may be straining the relationship further, said Ron Cohen, CEO of Acorda Therapeutics.

“The fact that we have so many better and better medicines coming out is exacerbating the problem,” Cohen declared.

Twenty years ago, oncology was dominated by highly toxic chemotherapies, he explained. If a patient couldn’t access them, it wasn’t as much of a blow. The benefits were marginal and the side effects were extreme.

Nowadays, targeted cancer drugs and immunotherapies can literally save lives. And more “miraculous treatments” are on the way, Cohen told the crowd. So for patients that can’t afford the copays or gain access to the therapies, it’s salt in the wound. They are being denied a “miracle.”

“That is a collision course. That’s a freight train going this way and a freight train going this way,” he said, gesturing in opposite directions. “Before they completely collide we need some solutions.”

But wait a minute; is it drug companies’ mess to fix? Yes. Because right or wrong, the public conflate sky-high list prices with their out-of-pocket costs. Whether or not the real issue lies with pharmacy benefit managers (PBMs), insurers, or anyone else, the onus is on drug developers to clear their name.

“We are not in a position of luxury to sit at our lab benches, at our clinical benches, and do great science… without also spending just as much of our intellectual capital on addressing those other issues,” Cohen said, pointing to everything from politics, to reimbursement models, to healthcare inequalities.

As CEO of the industry advocacy group BIO, Jim Greenwood has been working to improve the industry’s image for 13 years. Along with lobbying key politicians, his organization has worked to change the mainstream conversation — subtle shifts, such as focusing on the ‘value’ of drugs, not their hard cost. And he’s not done pointing fingers.

“The technical problems are not difficult,” Greenwood said. “What is difficult is the political problem. And that stems from the fact that members of Congress, and there are many of them, and politicians at the state level as well, look at us so unfavorably right now that they’re just not willing to help us. Especially when we say ‘We need some help figuring out how to charge a million dollars for this drug, would you be there for us?’ They’re not going to say yes.”

It’s a tough situation. If politicians eventually force the industry to be more transparent, to negotiate prices, or to cap drug price increases, the sector would be left reeling. In the meantime, it’s permanently grimacing in anticipation of a regulatory blow.

Photo: gerenme, Getty Images