Talking About the Cost of Drugs

In the model of a broken clock being correct twice a day, President Trump announced a campaign to dramatically reduce the cost of drugs. It’s a vital and valuable effort, but as we all know, the proof of the pudding is in the eating.

Two days ago, the fabulous NPR radio program “Fresh Air” interviewed a reporter, David Armstrong, who had contracted a condition called Multiple Myeloma several years ago. As recently as the 1990s, this condition was invariably fatal within a very short period of time–from a few months to a year after diagnosis. Since the early 2000s, the prognosis has greatly improved. Although it is still almost always a fatal condition, people can now live for many years with a drug regimen.

The primary drug now prescribed for the condition is called Revlimid, currently sold by Bristol Meyers Squibb, who acquired it from a company called Celgene. The drug is actually a form of Thalidomide, which became infamous for causing serious birth defects. But as it turns out, if you have Multiple Myeloma, it is a life-extender.

Celgene admits that the cost of the drug is minuscule, just $.25 per dose. That’s twenty-five cents, and that’s not a tossed-off figure. That’s all it costs to make this drug. But if you live in the United States, and if you need this drug, it will cost you (or your health plan) $1,000 per dose.

Drug companies often justify their huge markups by claiming that they had enormous costs to develop and test the drug. In this case, those costs were practically non-existent. The scientist who first realized that Thalidomide could treat Multiple Myeloma is a physician practicing in Arkansas, and he has not received one thin dime for his discovery. A group of physicians in Massachusetts was involved in testing the drug, and the University they worked for does receive a very small portion of the sales revenue. But the pharmaceutical company is not even circumspect about admitting that they could market it for a tiny fraction of its current cost, and as you might expect, it costs far less in every other western democracy.

The full report is available here:

https://www.propublica.org/article/revlimid-price-cancer-celgene-drugs-fda-multiple-myeloma

And if you’d like to listen to an interview with that author:

https://www.npr.org/2025/05/14/1251284830/pharma-prices-investigation

As it happens, I am taking a drug which has a similar history, it’s a weight control drug called Wegovy, which you may have seen heavily advertised on TV. The chemical component of Wegovy is inexpensive, but the manufacturer is collecting about $1,000/month from my health plan. In Canada, the same drug costs about $100. This phenomenon is replicated for hundreds of drugs, and we, American consumers, are paying the price for what can only be termed the rapacious greed of the pharmaceutical industry.