On Sept. 11, the California legislature passed health care bill SB 17, which requires pharmaceutical companies to release critical information on how major drugs are priced. SB 17 — although not yet signed by Gov. Jerry Brown — received support from both Republicans and Democrats in the waning hours of the 2017 legislative session. Many proponents from both sides believe that the bill could revolutionize national health care policy, as it would check the power of an increasingly monopolized business.
Specifically, the measure requires that pharmaceuticals make three important pieces of information public: the 25 most commonly prescribed drugs, the 25 most costly drugs and the 25 drugs with the largest annual increase in price. In addition, SB 17 forces manufacturers to report any increase in the cost of their products at least 60 days in advance if it exceeds a certain threshold.
Unsurprisingly, drug manufacturers are not pleased. If SB 17 goes into effect, big pharmaceutical companies would no longer have the power to raise the price of major drugs without receiving at least some kind of backlash. Public silence is what these companies feed on, allowing them to get away with limiting free enterprise and maximizing profit on their products.
Pharmaceutical companies’ ability to take advantage of that monopoly is highlighted in a 2014 Express Script report, which states that Americans consume 80 percent of the world’s supply of opioids despite representing only 5 percent of the population. Powerful painkillers are, undoubtedly, addictive and have serious side effects, and the fact that most Americans have a full bottle stocked in their cabinets at home is not to be taken lightly. In fact, the opioid epidemic, now deemed a national emergency by the Trump administration, was responsible for 28,000 American deaths in 2014, according to the Centers for Disease Control and Prevention. Most of these fatalities were from prescribed medications.
The issue is indicative of most manufacturers’ reckless disregard for public health; knowing that doctors over-prescribe drugs without properly weaning patients off of them, pharmaceuticals have made a business out of creating potentially harmful products and selling them to consumers who likely did not need the medication in the first place. Indeed, the more money rolls in from the hordes of drug-abusing Americans, the easier it is to push ethical boundaries in the industry. Put simply, big manufacturers undermine national health care policy by shifting the focus from the well-being of American citizens to the potential profits that can be made by big business.
The aforementioned evils of Big Pharma are personified in one formidable public enemy: Martin Shkreli. Those familiar with his name might remember him as the former CEO of Turing Pharmaceuticals, a manufacturer that primarily markets the drugs Daraprim and Vecamyl. In 2015, Shkreli — otherwise known as the “most hated man in America” — sparked national uproar after he raised the price of Daraprim, which treats malaria and AIDS, by over 5,000 percent. Shkreli was later arrested for fraud.
Like Shkreli, a large number of these companies do not care about meeting public health needs because they have more important things on their minds — like money. In other words, major manufacturers can sleep well at night knowing that they jeopardized the health of millions if it meant making a quick billion. And, while it is true that some pharmaceuticals may be unfairly demonized by a bad apple, the impersonality embodied by Shkreli is still largely characteristic of the direction the industry is going in.
The California legislature should be commended for its decision to tackle pharmaceuticals like Turing during this year’s session. In addition to SB 17, lawmakers introduced measure AB 265, which cuts discounts to pricier drugs when more affordable alternatives are available. If successful, the bill would limit manufacturers’ ability to manipulate consumers by tempting them with seemingly less expensive brands. Also notable is AB 315, a bill that focuses on regulating pharmacy benefit managers, who are largely responsible for driving up the cost of prescription medication.
Missing from the equation in these measures, however, is public knowledge of the situation — which is why SB 17 will be critical if signed into law. In matters as important as healthcare, each citizen deserves to know how his or her access to essential medication is being impacted by big pharmaceutical companies. College students, and those transitioning into a life of self-sufficiency, should be able to know much their EpiPens might cost in a few years.
While insurers usually take much of the blow from rising drug prices, SB 17 is a step in the right direction. Our legislators cannot have informed, productive conversations with pharmaceuticals if there is not at least some level of transparency. As mentioned before, drug companies have too long been held unaccountable for the prices of their products, and measures like SB 17 are necessary checks on their power, albeit small ones.
If Brown signs this bill, perhaps other states will follow suit — and the nation can take back public health for the sake of health.