US health system: the will to survive is priced in
The pharmaceutical industry is hardly regulated, the patients have little choice: Who in the US needs medication, often despairing on the bills. Or go to Canada.
When blood sugar shoots up, it feels like dragging cement around in your own body, says Desralynn Cole. "Everything blurs in front of your eyes, your mouth is dry, your brain is not working properly and you can barely formulate thoughts." The 36-year-old knows this feeling well. Cole suffers from type 1 diabetes. Diagnosis always requires personal restrictions, although the treatment options are good. But in the US, diabetes can mean financial ruin for sufferers. The reason for this is the horrendous drug prices, which are many times higher than in all other industrialized countries.
Desralynn Cole learned about her condition in 2010. "Since then, my life has been centered around the question of how to finance my medications," she says. $ 500 a month costs the two types of insulin and the blood glucose levels they depend on. Cole's insurance pays almost nothing, because her deductible is $ 4,000 a year and even above this amount, a supplement is due. In addition to her job at the Minneapolis City Council, she had to take a side job in a homeless shelter to cover her drug costs.
The tall woman with the soft voice tells her story with no apparent grudge - as if the daily financial struggle for one's own health is a normal part of life.
Medical tourism across the Canadian border
Cole stands in a parking lot in Detroit. Only a few hundred meters from here, hardly anyone can imagine what it's like to be unable to afford survival-critical medicines. The driveway next door leads to the Ambassador Bridge, which connects the US state of Michigan with Canada via the Detroit River. There insulin costs about 90 percent less than in the United States.
Therefore, medical tourists cross the border to stock up on vital medicines. Cole and 14 other diabetic patients plan to travel by chartered bus to neighboring Windsor, Ontario, for the same reason. In small quantities and for their own use, the authorities tolerate the import of medicines. Various organizations offer such tours to the north.
The trip is headed by US Senator Bernie Sanders today. Almost 20 years ago, the Socialist presidential candidate accompanied cancer patients across the border to Canada to buy cheap medicines and denounce the profit appetites of the US pharmaceutical industry.
The mercilessness of the market
But why is insulin so expensive for just under 1.25 million Type 1 diabetics in the US? There are mutliple reasons for this. While most highly developed countries are setting strict drug pricing standards for healthcare, the US industry is largely unregulated. Between 2012 and 2016 alone, pharmaceutical manufacturers doubled the price of insulin, according to a recent study by the Health Care Cost Institute. Also for other vitally important medicines, for example to combat cancer, prices have risen sharply. The profits were used by the companies mainly for share buybacks to increase the stock market price and for dividend payments to shareholders.
In addition, patents prevent other manufacturers from offering cheaper versions of a drug. Anyone who has developed a new drug may, according to US law, produce it exclusively for 20 years. To further protect expiring patents, companies often file additional patents for the same drug. Instead of real developments, however, often only the dose or the dosage form is slightly changed. According to a study by the non-profit organization I-Mak, US companies have received an average of 71 patents for the 12 best-selling drugs in the US. And even after the exclusive right ends, corporations can pay other companies to refrain from competing. So the industry leaders keep the competition from the body and can drive up prices unhindered.
The corporations argue that patents and high prices are necessary to finance the expensive drug research and development. In fact, the development of a new drug sometimes costs several billion dollars. However, according to an 2016 research by researchers at Harvard University, "there is no indication of a link between research and development costs and prices." The prices for prescription drugs would depend primarily on market conditions. That means in plain language: the patients become the plaything of the ruthless market mechanisms. Because when a drug - such as insulin - is indispensable, people are forced to pay any sum for it. The will to survive is priced in.