Let’s start talking about pharmaceutical costs

William Hager, 86, was arrested Monday night in Florida and charged with premeditated, first-degree murder and there’s no doubt he did it. He says he did it, although he apologized for taking so long to call the deputies; he wanted to tell his kids first. Normally, this is all enough for the rest of us to move on to the next forgettable story.

But Hager’s stated reason for killing his wife is pretty jarring.

He told deputies he didn’t have money for her medication, WPBF reports.

“Obviously based on our conversation it was very personal to Mr. Hager. He felt that he was at a point that this was his only course of action,” said Chief Deputy Garry Wilson.

Clearly, lots of people are having difficulty paying for prescriptions and almost none of them are killing their spouses because of it.

But the story also reminds of what we’re missing in this presidential campaign: A discussion about problems facing people trying to live their lives.

The news media have taken a pass on anything but the horse race, and the candidates have… you know what the candidates have done.

Unsurprisingly, Congress has been unwilling to do anything about the problem of rapidly escalating drug prices.

“It goes to a too-cozy relationship between one of the country’s most powerful special interest groups and the Congress and also to a too-cozy relationship with this administration,” U.S. Rep. Lloyd Doggett, D-Texas, said last week.

Doggett is running into walls within his own party, too, and that includes the current occupant of the White House, the San Antonio Express-News reports.

Doggett noted in a letter to government agencies that the drug, sold in Japan and Sweden for $39,000 for a year’s treatment and in Canada for $30,000 is priced in the United States at $129,000.

“The NIH has a powerful tool to hold companies accountable for barriers to access to drugs developed through support of U.S. taxpayers, including price,” he wrote in a letter signed by a dozen members of Congress, half of them senators.

The federal agencies have not been receptive. In a response addressed to Doggett, Health and Human Services Secretary Sylvia Burwell was noncommittal, saying the march-in authority “is strictly limited” and that its use had been rejected three times since 2004. She added that she did not believe additional guidance is needed as a message to companies.

National Institutes of Health director Francis Collins, pressed on the matter by Sen. Dick Durbin, D-Ill., at a Senate hearing last month, said he worried that invoking the authority would harm his agency’s relationship with drug manufacturers.

Durbin replied that doing nothing “sends the message that it’s fair game, open season, for whatever price increases they wish.”

Why isn’t the issue getting much traction on the campaign? One health care consultant tells the Washington Post it doesn’t affect that many people.

Bob Laszewski, a health-care consultant, expressed skepticism that drug prices would have legs as a political issue.

He said only a small proportion of voters is being affected because Medicare and private insurers are paying most drug claims.

“It’s not a consumer issue yet, so it’s not a political issue yet,” he said. In the meantime, he said, drug companies are coming up with breakthrough medications, especially for cancer, and “insurers should just pay for it and stop whining.”

Writing today on the Health Affairs blog, Leigh Purvis and Crystal Kuntz would appear to disagree, saying this is the new normal, and it will be as long as drug makers are free to charge whatever desperate people will pay for drugs that are “exclusive.”

Spending increases driven by high and growing drug prices will eventually affect all Americans in some way. Higher prescription drug spending is usually passed along to everyone with health coverage in the form of increased health care premiums, deductibles, and other forms of cost sharing. Prescription drug spending growth also increases costs for taxpayer-funded health programs like Medicare and Medicaid; this translates to higher taxes, cuts to public programs, or both.

More importantly, an increasing number of Americans will be unable to afford the prescription drugs that they need to stay healthy, which will lead to poorer health outcomes and higher health care costs in the future.

With the primary campaign season drawing to a close, now wouldn’t be a bad time for someone to step up and lead a national conversation about the problem.

Related: The Complex Math Behind Spiraling Prescription Drug Prices (New York Times)