I think it is very important to keep studying medications and their efficacy. Those studies should be done by researchers that are without conflicts of interest. With that being said, I am concerned about this new trend affecting the prices of drugs:
Deals being negotiated between drugmakers and the insurers who buy medicines now sometimes include extra rebates – or even full refunds – if drugs don’t help patients as expected.
It’s part of an effort driven by insurers and government health programs to align the cost of care with the quality of care, and slow the relentless growth of prescription drug costs.
This is a typical soundbite put out by the PR groups of these organization to make it seem they are on our side and they care. Stop laughing. The intention is there. We all want drug prices to be lower. Got it. The execution is where I have a problem. Quality metrics on doctors have failed over and over again. Quality metrics on drugs will do the same. Humans are not widgets and there is a ton of other factors that makes us healthy or unhealthy. For them to dive into cases and pull a drug for not preventing a fatal heart attack or fatal asthma attack is not easy. Maybe the patient still smoked? Maybe he or she wasn’t complaint in taking the medication? These are instances where other variables are critical. In other works, the data will be murky and that is where this concept will get sticky.
So here are my questions and my hypothetical answers:
- Will a drug be pulled by the insurance company because it doesn’t meet their numbers? Yup.
- What if it works for you? They don’t care.
- And who is saving this money, the patient? Nope, the insurance company.
- And how will they get this data? By hyper-analyzing your data without you knowing.
It really doesn’t matter what I think because insurance companies and Big Pharma will do what they want and have been doing this stuff for years. They have ALWAYS made backroom deals on their drug deals. That is why one month your medication is preferred and the next month it is not. You may have thought that was due to efficacy of the drug. It never was. With this new plan they will state your drug was denied due to poor metrics. I, for one, won’t trust these groups and their research. This is about business. Oh, let’s not forget that they will never release their data and methods for other to see.
Though not perfect, I would rather have neutral researchers study medications the right way. Call me old-fashioned.