Welcome to the second in a PLOS BLOGS six-part series, Talking about Drug Prices & Access to Medicines. To borrow a phrase from one of our bloggers, “Rage and public outcries are not a rational way to manage high drug prices.” We agree, while also acknowledging that the recent public and media uproar over the 5000% price hike and subsequent “roll back” of a 40 year old medicine by Turing Pharmaceuticals may have opened a useful window on larger issues, including misaligned incentives around drug R&D efforts and the related unavailability of necessary medicines to people around the world.
Each post presents a different point of view on these issues, and we encourage you to read all six parts — with titles and authors listed at the bottom of this post. For the series, PLOS BLOGS Network benefited from the involvement of PLOS Medicine Chief Editor, Larry Peiperl. — Victoria Costello, PLOS BLOGS Network
This Blog Post Will Cost You
By Jessica Wapner
There is a cost for reading this post.
Let’s agree to a baseline of $100. That’s less than ten cents per word, so a pretty good bargain. This post won’t cure what ails you, but it might relieve some symptoms. Side effects will probably be minimal.
I wrote and scrapped several other blog posts before writing this one. Creating one post required dozens of failed attempts. That’s quite an investment, and I need to make sure that my costs are covered. So I’m raising the price to $150.
Also, the Research & Development for this post was extensive. I’m not just talking about Googling stuff. The effort that made this post possible stretches back over years, even as far back as college. Before that, I had to learn to read and write. All of that costs money, and I need to be recompensed accordingly. That brings the price tag of this post to $225.
Lucky for you I went into the science writing business. Not so lucky for me. If I had gone into drugs and biotech, I could have been making millions. But instead I am earning less because I must give the people what they want. I need to factor in what I’m not earning from doing other, more lucrative work. Make it an even $250.
Alas, there’s another problem. I could have invested the money spent on Research & Development in the financial markets instead. I need to account for that loss. $300. (As long as I’m doing imaginary investing, it might as well be lucrative.)
There are going to be people who can’t afford to read this blog post, so I need to charge you more in order to cover the expense of providing it to them for free. $325.
Readers outside of the U.S. won’t pay as much, so I need to make sure I’m covered for that loss, too. $350.
Remember, I only get $350 for as long as this blog post is patented, and there’s no guarantee that I’ll have another blockbuster success of a post in the future. I will need the money from this post to see me through future Research & Development until I finally create another masterpiece. Once the patent expires the price will plunge, so I have to earn as much as I can while I can. Without profits, I can’t continue to work. We all agree that new blog posts are vital and necessary. In fact, the posts are so vital and the years until success so unknown, I had better raise the price a bit more. $600 should do it.
Say the patent expires in eight days. If this post turns out to be a huge money maker—and really, who among you doubts that it will?—probably many people will create generic versions. They’ll use the generic name, something like “esomeprazole magnesium” or “armodafinil,” and will charge you just $1 for the read. Maybe less. My strategy is to pay each generic blogmaker $100 to delay their posts, thereby securing my role as the sole provider of these therapeutic words for at least a few more days. If you don’t like this tactic, you can sue me.
It’s true that public school was largely responsible for the basic research that went into this post. But I’m not going to give any of the money I earn from this post to the public school system. Also I won’t pay the same tax rate as you because of the Research & Development tax credit.
Bascially if you want blog posts, you have to pay. If you want me to provide full accounting details for all the money that went into this post, sorry, I won’t disclose it. You’ll have to just trust me.
Anyway you only have to pay $10. Your insurer is covering the rest.
This post just scratches at the surface of the complicated world of drug pricing. There are rebates, discounts, negotiations (or lack thereof), traffic-jammed routes from wallet to wallet, and a deliberate obfuscation of actual costs. We all value life-improving and lifesaving medications. But the runaway profits, the legal loop-holing, and lack of transparency are all symptoms of money trumping humanity. It seems like the only way to have a system to that puts humanity first is to create a new system.
Update! I just sold my blog to an investor who is going to increase the cost of this post to a kabilliontrillion dollars. He saw how few readers this post had and figured it must be for a rare disease.
Jessica Wapner is a freelance science writer whose work covers a range of issues surrounding disease and medicine, from genes and proteins to socioeconomics and health disparities. Her work is published in Discover, Newsweek, Scientific American, Mosaic, Aeon, Slate, and The Atlantic, among others. Her first book, “The Philadelphia Chromosome – A Genetic Mystery, a Lethal Cancer, and the Improbable Invention of a Life-Saving Treatment,” was named a top-ten nonfiction title for 2013 by the Wall Street Journal. She is a former PLOS Blog Network contributor. Jessica’s work can be found online at jessicawapner.com. Follow her @jessicawapner.
Opinions expressed in this post reflect solely the views of its author, and not necessarily those of PLOS.
Pt. 1. Only a radical overhaul can reclaim medicines for the public interest By Els Torreele
Pt 2. This Blogs Post is Going to Cost You by Jessica Wapner
Pt 3. If you play with scorpions, don’t be surprised when you get stung By Atif Kukaswadia
Pt 4. Drug pricing is out of control, what should be done? By James Love
Pt 5. Double billed: Why we’re paying high prices for drugs — and why we shouldn’t need to By Manica Balasegaram
Pt 6. In drug development, openness can compete with secrecy, given the chance By Mat Todd