Pictac/iStock/Thinkstock(NEW YORK) – When Tricia Salese called her local pharmacy for a price check on her next prescription refill, she was stunned when the pharmacist told her the cost of her generic-brand pain medication had gone up again.
Salese, 49, started talking fentanyl citrate, the generic version of Actiq, a powerful painkiller, in 2010, and she takes three doses per day. Back then, she said, the price per dose was 50 cents. Now, the pharmacist told her, it was going to cost her $37.49 per dose.
“I thought $25 [per dose for generics] was a lot. $37 is just — what is this stuff made of? I mean, this is ridiculous,” Salese said.
Salese takes fentanyl citrate to help her function with endometriosis, a chronic disease where the lining of the uterus grows outside of the womb and causes lesions that can worsen over time. The condition leaves her in constant, crippling pain and this medication is not covered by her insurance. With the cost going up, Salese said she’s had to dip into her retirement savings to pay for her prescriptions.
The staggering cost of some generic brand drugs has led patients and pharmacists across the country to ask questions about alarming price increases on certain drugs — the once reliably low-cost copies of the more expensive branded products.
In the span of one year, from 2012 to 2013, the cost of the generic blood pressure medication captopril jumped more than 2,700 percent, the asthma drug albuterol sulfate went up more than 3,400 percent and the antibiotic doxycycline jumped a whopping 6,300 percent, according to National Average Drug Acquisition Cost (NADAC) statistics.
“My customers walk away silent, in shock,” said Aniedi Etuk, who has been a pharmacist for 12 years. “Some of them have to choose between taking their drugs and buying food for their family.”
In the past, when a branded drug lost its patent, generics entered the market and prices plummeted, saving the American health care system billions of dollars. Generics have served to help make drugs affordable, but now, prices are trending the other way.
Jonathan Alpern is the chief resident of internal medicine at Regions Hospital in St. Paul, Minnesota, and was one of the co-authors of a New England Journal of Medicine article that helped bring the issue to light.
“One of the things that’s difficult with all of this is transparency,” Alpern said. “So when the prices go up, it’s nice for providers and patients to know first of all — what drugs are going up and why. It was really hard to find out that information… [and] I was initially shocked and when we started to see that this was happening to multiple other common drugs.”
Sen. Bernie Sanders, I-Vt., a Democratic presidential candidate, places the blame for rising costs on drug makers and the robust prescription drug lobby.
“The short answer is greed,” Sanders said. “They can do it. They can get away with it. They can make outrageous sums of profits and money on this and that’s what they’re doing.”
Last week, Sanders, along with Rep. Elijah Cummings, D-Md., introduced a new bill aimed at curbing generic drug prices.
“Our job in Congress is to say to these drug companies, ‘You can’t keep ripping off the American people,’” Sanders said. “’You can’t force folks to be in a situation where they can’t purchase the medicine they desperately need.’ That’s what we should be doing.”
The U.S. is currently one of a few developed countries that doesn’t negotiate prices with the pharmaceutical industry, Sanders said. Current federal law prohibits Medicare from negotiating lower prices with drug companies. Although Sanders’s new proposal won’t give the federal government the power to do so, it will require generic drug makers to pay Medicaid a rebate any time prices rise above and beyond inflation. Brand name drug makers already do this.
Profit is no doubt a driving force in the recent price spike of generics. But experts say prices can also rise for other reasons, including raw material shortages, manufacturing disruptions because of factory closings or violations, or companies leaving the market or merging with competitors. All of those factors reduce supply and competition. Drug companies argue that another factor is that the FDA has been slow to approve the thousands of generic drugs currently in its backlog.
Ralph G. Neas, the president and chief executive of the Generic Pharmaceutical Association, told ABC News’ Nightline in a statement that “some short-term cost fluctuations may occur for individual products facing unique circumstances,” but that the generally lower cost of generic drugs brings value that is “consistent and irrefutable.”
There are signs that regulators are cracking down on rising prices. Last year, the U.S. Department of Justice issued grand jury subpoenas to three drug makers in relation to price spikes and, just last month, the Department of Health and Human Services also agreed to investigate price spikes.
Watch the full story on “Nightline” Thursday night at 12:35 a.m. ET
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