By Barbara Kavanagh
My husband has lived with multiple myeloma, a rare blood cancer, for three decades. As his caregiver, I know how vital it is to have access to the latest medicine.
That’s why I’m concerned about a bill recently reintroduced in the U.S. House. Proponents of the proposed law, HR 3, present it as a solution to high prescription drug costs. Like similar bills, it uses a concept known as “foreign reference pricing,” in which the United States would set prices based on how much drugs cost in other countries.
The lawmakers behind this bill no doubt have good intentions. Too many families struggle to afford medicine. But a clear-eyed look at foreign reference pricing shows what it would really do: restrict access to new treatments and stunt research into future cures. Ultimately, the more than 30,000 Arizonans diagnosed with cancer every year could pay the price.
When my husband was diagnosed with multiple myeloma a month before our wedding, there were few treatments available. Fortunately, we found one that worked, but it was a frightening time.
Today, thanks to steady medical advancements, multiple myeloma patients have access to a wide range of treatments, and as a result, long-term survival rates are much better. Since 1991, the total cancer death rate in the United States has fallen by more than 30%.
I’m afraid, though, that a foreign reference pricing bill would arrest this steady progress. It comes down to how government price controls affect drug access and innovation.
HR 3 would impose price limits on a broad range of medicines. A drug could not be sold in the United States for more than 120% of its average price in Great Britain, France, Germany, Japan, Australia, and Canada.
These six “reference” countries all have government-run health care systems in which federal authorities set prescription drug prices below market value.
Acting as bulk buyers for entire populations, federal authorities in those countries have to make harsh decisions about how to control costs. Drugs that do the most good for the greatest number are typically authorized. But if a medicine works wonders for just a few, or doesn’t improve quality of life by a bureaucratic definition of “enough,” the government may simply choose not to make it available.
As a result of factors like these, patients are left without access to potentially life-saving treatments. Consider that, of all new cancer medications introduced globally between 2011 and 2019, patients in the United States could access a full 96% of them, according to health analytics firm IQVIA. In Great Britain, by contrast, only 71% of new drugs were available. In Canada, patients could access just 59%, while in Australia the figure was less than half.
And, as so many cancer patients and their loved ones know, time is of the essence when treating disease. So, it’s disturbing that even when new drugs do make it to price-control countries, it takes longer. In the United States, it takes between zero and two months from initial launch for a new cancer medicine to be introduced in the United States. But in Germany, the average wait is 11 months, and in Great Britain 12. Patients in Japan and Australia wait close to two years.
If we tie our drug prices to these other nations, I worry that we will adopt drug scarcity and delays as well.
The long-term effect on future patients would also be grave. On average, drug companies spend about $3 billion to develop a single new medicine. Artificially low prices in a vast market like the United States would make it much harder to earn a return on such large investments. Research into new treatments — the cures of the future — could stall. In fact, if a foreign reference bill like HR 3 is enacted, 61 fewer new drugs would come to market in the next 10 years, according to the health consultancy Vital Transformations.
We all want to make sure medicine is available and affordable to those who need it. But HR 3 would just put patients like my husband at risk. Soon, Arizona’s congressional representatives will have to vote on foreign reference pricing. I’m counting on them to do the right thing.
Barbara Kavanagh of Glendale is founder, president, and chief executive officer of the Arizona Myeloma Network.