
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: MONDAY, October 17, 1994                   TAG: 9410180037
SECTION: EDITORIAL                    PAGE: A4   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

DRUG PRICING

NOT TO demonize the pharmaceutical industry, which has saved millions of lives - but Carter-Wallace Inc.'s plan to reformulate a drug used by asthma and emphysema sufferers, call it by the same name and sell it at the same price, at least borders on the unethical.

That problem is not, however, what's most telling about this sordid story. The more significant moral is its illustration of how differently "the marketplace" operates when the commodity being bought and sold is health care.

The manufacturer had to change the drug, Organidin, used to clear the lungs of mucus. Tests had shown its main ingredients caused cancer in laboratory rats. The main ingredient of the new drug, which doctors say will be less effective, is the same as that of numerous over-the-counter cough and cold medicines.

The thing is, the prescription drug Organidin still will cost $50, while the over-the-counter varieties sell for about $5 a bottle.

The Food and Drug Administration regulates drugs' safety and effectiveness, not their price or marketing. So it has no responsibility, or authority, to order the company to sell the reformulated drug at a lower price, or to change the name.

The drug company believes it is being above-board because it is stating clearly on its packaging and instructions to physicians that the drug has been reformulated.

Physicians say the drug has long been widely prescribed - close to a million prescriptions for it were written last year alone - and that doctors may or may not read instructions enclosed with a drug they think they are familiar with.

But here's the telling part: The only benefit to patients, they say, is that the $50 prescriptions might be covered by health insurance, whereas over-the-counter remedies are not.

Ideally, the marketplace would drive out a product that sells for $50 if it is no more effective than one that sells for $5. But in the health-care marketplace, buyers often lack sufficient knowledge to seek out bargains without fear of getting inferior quality for something that is essential.

A person will pay an extra $45 if he thinks the difference in price will mean the difference between breathing and not breathing.

But if the publicity about this drug educates a lot of physicians and patients in this one case? Many buyers still are likely to pick the overpriced prescription. A $50 charge paid by a third party is cheaper than $5 out of one's own pocket.

Well, isn't it?

by CNB