In a more ominous twist of what may become a standard practice, consider the recent legal maneuver made by one company that is trying to extend its patent protection for its cyclosporine eye drops. They sold the drug’s patents to the St. Regis Mohawk tribe in upstate New York. Their aim is to block rivals from challenging the patents for the dry-eye drug at the U.S. Patent and Trademark Office based on the tribe’s special legal status as a sovereign government, which the tribe says provides it immunity from patent-office review.14 Should this strategy succeed, the company will avoid a pending hearing before a patent-office panel, and it would continue to reap the bulk of the profits from the sale of the drug, since the proposal would have the tribe receive a paltry $15 million annually in royalties as the drug continues to rake in $1.4 billion annually.
Simple Simon’s Solutions
Healthcare is a complicated subject. And our system has a proclivity for sometimes making things far more complicated than they ought to be. Drug reimbursement costs, physician fees, rules regarding access to specific drug coverage all seem to require a deep understanding of linear algebra coupled with a doctor of laws degree. It may be worthwhile trying a far simpler approach. Here are a few unsolicited suggestions:
To EHR developers, take a lesson from Steve Jobs: Style, form and function matter! He was obsessed with font style; people laughed then, but not now. You should know who uses your systems and listen carefully to their opinions. Don’t just rely on information technology experts for advice. When have they used your systems to order prescriptions or look up lab results?
To PBMs, employ some common sense: Stop treating prescribers as fools. Acknowledge that your working model does not always serve patients fairly. Understand that the uncommon diseases that constitute much of rheumatology often require innovative therapeutic approaches. So adopt a more rational approach to drug coverage. Be nice to us—you’ll need all the friends you can get when you testify before Congress.
To the biopharmaceutical industry, it’s time to get real! Your astronomical drug pricing models will eventually buckle under their own weight, and when they collapse there will be considerable collateral damage. American biotechnology is a cutting-edge industry, but this prominence should not allow it to price your products with impunity. How about dropping one digit when calculating the annual cost of new products? It’s not such a crazy idea given that the average annual retail cost of specialty drugs used to treat cancer, rheumatoid arthritis and multiple sclerosis now exceeds the median U.S. household income.15
