Nonprofit, nonpartisan journalism. Supported by readers.


UCare generously supports MinnPost’s Second Opinion coverage; learn why.

High cost of medications for common illnesses puts U.S. patients’ lives at risk

A troubling article published over the weekend in the New York Times describes how the high price of medications used for common illnesses is not only imposing a huge financial burden on the U.S. economy, but also putting patients’ lives in danger.

Written by reporter Elisabeth Rosenthal, who trained and worked as a doctor before joining the New York Times’ staff in the late 1990s, the article focuses on medications used to treat asthma, a common chronic medical condition that affects 40 million Americans.

Asthma is a serious and potentially life-threatening illness. It kills about 3,300 Americans each year, including many, as Rosenthal points out, who “skimped on medicines or did without.”

“The thing is that asthma is so fixable,” one doctor told Rosenthal. “All people need is medicine and education.”

But in the United States, being able to afford medication for asthma “often requires top-notch insurance or plenty of disposable income, and time to hunt for deals and bargains,” Rosenthal reports.

The annual cost of asthma treatments in the United States, including millions of potentially avoidable hospital visits, is more than $56 million, she adds.

Competition is ‘often a mirage’

Last year, the pharmaceutical and health-products industry spend $250 million lobbying Congress to make sure that drug prices — and the companies’ profits — stay high. Writes Rosenthal:

Unlike other countries, where the government directly or indirectly sets an allowed national wholesale price for each drug, the United States leave prices to market competition among pharmaceutical companies, including generic drug makers. But competition is often a mirage in today’s health care arena — a surprising number of lifesaving drugs are made by only one manufacturer — and businesses often successfully blunt market forces.

Asthma inhalers, for example, are protected by strings of patents — for pumps, delivery systems and production processes — that are hard to skirt to make generic alternatives, even when the medicines they contain are old, as they almost all are.

The repatenting of older drugs like some birth control pills, insulin and colchicine, the primary treatment for gout, has rendered medicines that once cost pennies many times more expensive.

“The increases are stunning, and it’s very injurious to patients,” said Dr. Robert Morrow, a family practitioner in the Bronx. “Colchicine is a drug you could find in Egyptian mummies.”

Pharmaceutical companies also buttress high prices by choosing to sell a medicine by prescription, rather than over the counter, so that insurers cover a price tag that would be unacceptable to consumers paying full freight. They even pay generic drug makers not to produce cut-rate competitors in a controversial scheme called pay for delay.

Unable to negotiate

Rhinocort AquaIn addition, writes Rosenthal, “Lawmakers in Washington have forbidden Medicare, the largest government purchaser of health care, to negotiate drug prices. Unlike its counterparts in other countries, the United States Patient-Centered Outcomes Research Institute, which evaluates treatments for coverage by federal programs, is not allowed to consider cost comparisons or cost-effectiveness in its recommendations. And importation of prescription medicines from abroad is illegal, even personal purchases from mail-order pharmacies.”

The result: U.S. consumers pay jaw-droppingly higher costs for their medications than do consumers in many other areas of the world. Rosenthal offers these three asthma-related examples:

  • Pulmicort, a steroid inhaler, generally retails for over $175 in the United States, while pharmacists in Britain buy the identical product for about $20 and dispense it free of charge to asthma patients. [Most countries with national health systems provide inhalers to asthma patients either free of charge or very inexpensively. They do this because the inhalers keep people out of hospital emergency rooms.]
  • Albuterol, one of the oldest asthma medicines, typically costs $50 to $100 per inhaler in the United States, but it was less than $15 a decade ago, before it was repatented.
  • Rhinocort Aqua, a prescription drug that was selling more than $250 a month in Oakland pharmacies last year but costs under $7 in Europe, where it is available over the counter.

Serious consequences

The high cost of these drugs has real consequences for real people.

“At the Breathmobile clinic in Oakland, the parents of Bella Buyanurt, 7, fretted about how they would buy her medications since the family lost Medicaid coverage,” reports Rosenthal. “Barbary Wolf, 73, a retired Oakland school administrator covered by Medicare, said she used her inhaler sparingly, adding, I minimize puffs to minimize cost.”

Meanwhile, global sales of the two best-selling asthma inhalers, Advair and Symbicort, reached $8 billion and $3 billion, respectively, last year. The inhalers typically last a month, notes Rosenthal, and retail for $250 to $350 in the United States.

A spokesperson for Astra Zeneca, the maker of Symbicort and other asthma drugs, told Rosenthal that the company’s drugs were competitively priced. She also said that low-income patients could apply for free drugs with the company.

What a way to run a health-care system.

You can read the article on the New York Times’ website. This is the latest article in an ongoing investigative series by Rosenthal on the high cost of health care in the United States. Previous articles in the series have focused on colonoscopies, childbirth and hip replacements.

Comments (7)

  1. Submitted by Greg Kapphahn on 10/14/2013 - 12:29 pm.

    Let Us ALL Remember, ALWAYS

    that the high holy principle of “free market” economics:

    maximizing shareholder value (and executive compensation),…

    has zero consideration for what good, decent people used to call morality.

    When your only ethical perspective is the teleological goal of making the highest profits possible,…

    “teleological,” for the uninitiated being summed up in the phrase, “the ends justify the means,”…

    meaning that the goal is so important that any and all means can and even must be used to accomplish it,…

    human life doesn’t even gain a place on the balance scale,…

    nor have a number representing it on the corporate balance sheet.

    In an earlier time, before the American media, most American politicians, and a sizable minority of American citizens were seduced into worshiping money and those who have the most of it, today’s corporations (and some endlessly dishonest, weaselish “news” organizations) would more easily have been seen for what they are:


    • Submitted by Dennis Tester on 10/14/2013 - 02:12 pm.


      The “high holy principle” of free market economics is consumer choice.

      If you want to ensure that the price of anything keeps rising out of sight, make sure that it’s only available from one source or that the government subsidizes it, or both.

      If you want to ensure you get the best product for the lowest price, let multiple providers in the marketplace compete for your business.

      It’s just amazing and amusing that the people who complain about prices in an open marketplace are the same people who want the government to own and run everything. There’s no accounting for folks who were absent from school the one day they taught how capitalism works.

      • Submitted by Steve Hoffman on 10/14/2013 - 03:55 pm.

        Bought, again

        So, the pharmaceutical companies are getting good value for the millions they spent on buying their own congressthings. In other countries, the government, being a large if not the largest customer of drugs, can negotiate better deals on them (the “free market” you know). Here, they’re explicitly forbidden to do that, for no reason but the fact that legislators can be bought. Good for the drug companies’ bottom line; catastrophic for the American consumer. There’s really no amount of lipstick that can make this situation look like anything other than what it is.

      • Submitted by Paul Brandon on 10/14/2013 - 04:54 pm.


        The current state of patent law in the United States means that we do NOT have a free market for pharmaceuticals.
        We have monopolies granted by our legal system, not by our government.
        The VA is a good example of how a government agency can provide a service such as health care far more efficiently than private monopolies.

        • Submitted by Dennis Tester on 10/14/2013 - 08:47 pm.

          You’re joking right?

          Have you ever been a patient in the VA system, or even know someone who has? Of course not, your comments tell us that. As a veteran, If I had my way the VA system would be shut down in its entirety.

  2. Submitted by mark wallek on 10/15/2013 - 08:14 am.

    Modern ideas

    Modern healthcare has much more to do with excessive profit than it does with actually producing health. The doctor may want you to get better, but the Industry cannot make money on you if you are, so get used to being fleeced. It’s the American way. Profit Uber Alles.

    • Submitted by Dennis Tester on 10/15/2013 - 08:40 am.

      Modern health care

      involves more pharmaceuticals than surgeries. The introduction and use of more and better pharmaceuticals has actually reduced the cost of health care in this country because so many more ailments can be treated with drugs that used to require surgery to correct.

      The American way is to continually look for better, faster, cheaper solutions. You must be new here.

Leave a Reply