Sales hit the billion dollar mark as pharmaceutical companies apply creative approaches to increase earnings. For instance, “salami slicing”: Dividing diseases into smaller and smaller categories based on genetic and biomarker differences so that the product can achieve the coveted orphan drug status.
In some respects, the 1983 Orphan Drug Act is a success story. But high prices and allegations that some drug companies have twisted the law to their advantage have made it controversial. Here are some of the main points in the debate.
Sales of orphan drugs are forecast to grow 11% over the next five years, to $209 billion. That growth rate is twice as fast as the expected increase in sales of all other prescription medicines. They may account for more than 21% of brand-name prescription drug sales by 2022.
Venture philanthropy and the move toward investment of not-for-profit dollars in for-profit companies started about 10 years ago. One expert argues that it’s a little like calling someone an amateur-pro athlete. You can’t be both. Proponents, however, point to some initially impressive results especially for niche diseases.
Someone should check up on high-risk patients, make sure they are healing, taking their medications, and getting to their follow-up medical appointments. The question is, who? Health plans, hospitals, drug companies all have their methods. The result is too often confusion.
One in five elderly patients returns to the hospital within 30 days of leaving. These rehospitalizations are a common and costly occurrence. A program developed to address problems in post-acute transitional care seems to be effective in reducing 30-day readmission rates for some Medicare fee-for-service beneficiaries.
And health plans can’t be caught flat-footed. They need to keep pace with the introduction of new treatments and be ready with strategies that address patient needs and manage costs. Using objective clinical data to guide dosing and working to redirect care to a patient’s home is a place to start.