I spend less than $1,000 a year for supplies, so
giving them out gratis is no sacrifice. Two or three times a year, I place an
order at a pharmaceutical web site. It’s easy, but sometimes I get a jolt.
I hand out doxycycline, an old antibiotic and the
recommended treatment for the most common pneumonia and the most common
sexually transmitted disease. In 2012 I paid $50 for a bottle of five hundred.
That’s twenty-five treatments which works out to $2.00 for each. When I ran low
in 2014 I decided to reorder. Checking the web revealed that five hundred
seemed to cost $1,655. That couldn’t be right, so I looked around, but it
wasn’t a typo. So I ordered azithromycin, effective and about $4.00 per
treatment.
This happens regularly. Remember penicillin? You
may think it’s obsolete, but it remains a superb antibiotic and the best
treatment for common infections from strep throat to syphilis. Twenty years ago
it was as cheap as aspirin. I could buy a thousand for $30. Now the price is $130
and rising.
Here’s what happens. As a drug gets older and
older, it gets cheaper and cheaper. But doctors like newer drugs. Everyone (you
included) believes they are immune to advertising, but you’re not, and doctors
are no different.
It’s a good rule that any drug in an ad is wildly
expensive and not superior. Look at the ad: if it doesn’t say the drug is the
best, it isn’t. A few years ago Avelox or Levoquin would cure your pneumonia as
well as doxycycline at forty times the cost. Doxycycline at $1655 a bottle
still costs less but not by as much.
As doctors incline toward a new drug, they
prescribe the older one less. Pharmacies buy less. Pharmaceutical companies
stop making it. Eventually the remaining companies notice the absence of
competition, and the free market works its magic.
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