With much wringing of hands and gnashing of teeth, a Greek chorus of managed care executives is chanting a recurrent refrain: Prescription drug costs are spiraling out of control. Customers are demanding treatments that will raise their quality of life and keep them out of hospitals. What happened to the "good old days," when there simply were no treatments for conditions that pharmaceuticals can manage today, when patients either died -- the cheapest outcome -- or bit their lips and did without?
Drug expenditures were decidedly lower in those days -- and so were life expectancy and the quality of life. Now medicines enable arthritis patients to go to work and take care of their families, lower blood pressure and prevent heart attacks and strokes, and help millions of people get on with their lives. Doesn't the incomparably greater value that medicines give today warrant spending more on them?
To patients and their families, this is a "no brainer." Take my own family. My son and daughter have cystic fibrosis. When they were born, the life expectancy for people with this genetic disease was about 18. Today, thanks to breakthrough medicines developed within my children's lifetime, life expectancy has doubled. Yes, the health care system is spending more on medicines for cystic fibrosis, but for patients and their families, the value of these drugs is beyond rubies.
Managed care executives seem unable to see beyond the narrow confines of their ledgers. They are so tightly focused on drug budgets that they often fail to see the value of increased drug utilization -- both for patients and for health care's bottom line.
In many cases, innovative medicines save money. Stroke is a good example. The third leading killer of Americans, stroke costs more than $ 45 billion a year, in treatment expenditures and loss of earnings -- in addition to enormous human costs. But clot-busting medicines are revolutionizing stroke treatment, yielding economic and human savings. A study found that treating stroke patients promptly with a clot-busting medicine nets average savings of $ 4,400 per patient by reducing the need for hospitalization, rehabilitation, and nursing home care. The National Institutes of Health estimates that greater use of this medicine could save more than $ 100 million a year. For patients and their families, the drug means being saved from the agony of permanent brain damage.
If we can keep up the momentum of research, we may be able to reduce the $ 100 billion annual cost of Alzheimer's disease -- which is expected to triple by the middle of the next century -- unless we come up with a cure. Fortunately, pharmaceutical companies are researching 23 new medicines for Alzheimer's, and researchers at one company recently identified a key enzyme in the disease.
Not all innovations will save dollars. Some promising cancer research, centers on medicines that may be able to turn cancer into a manageable disease -- one that would require lifetime treatment with innovative medicines. While this would be wonderful news for anyone who has -- or will ever get -- cancer, the economic implications could cause heartburn in managed care executives.
Perhaps it's time to stop listening to the doomsday dirges of the insurance industry. The explosion in pharmaceutical innovation is good news, not bad. Health care has undergone a sea change -- the hospital bed and the surgeon's knife are no longer its primary tools. They've been eclipsed by pharmaceutical therapies that open a whole new world of hope for better, healthier lives. Our thinking needs to undergo a sea change too -- if we want to realize these hopes. We need to encourage the research that will lead to more innovative medicines, not discourage it with pound-foolish laments about spiraling drug costs. The future of health care is too important to be left to the folks with the green eyeshades.
Alan F. Holmer is President of the Pharmaceutical Research and Manufacturers of America, which represents the country's leading research-based pharmaceutical and biotechnology companies.