About Me

Name: Brian Koenig
Email: brianekoenig84@yahoo.com Biography
Loading...

Create Your Own Blog Find Other Townhall Blogs

Comments

Archives

Blog Roll

 

The FDA: Part 1

       The Food and Drug Administration (FDA) not only neglects American health care but prevents breakthrough drugs from reaching the market. The government-run organization is a barricade, with patients on one side and pharmaceutical companies on the other. The FDA discourages research and development by putting pharmaceutical companies through an exhausting “drug approval” process. Expanded regulations and longer clinical testing delay the time it takes new prescription drugs to enter the market; the average time for FDA drug approval nearly doubled from 8.1 years in the 1960s to 15.2 years by the 1990s. 

Costs have also nearly doubled, much due to indirect costs aroused by wayward FDA procedures; pharmaceutical companies currently spend $800 million to introduce a new drug to the public. Not to mention, less than one-third of all FDA-approved drugs recover their development costs. In 2002-04 a whopping 58 new drugs received FDA approval, a 47 percent decline since the 1996-98 period. 

FDA reviewers are trained to be risk-averse (which within reason isn’t necessarily a bad thing), so much that FDA Commissioner Alexander Schmidt admitted, “In all our FDA history, we are unable to find a single instance where a Congressional committee investigated the failure of the FDA to approve a new drug. But the times when hearings have been held to criticize our approval of a new drug have been so frequent that we have not been able to count them. The message to FDA staff could not be clearer.”  Poor management and strict regulation has made reviewers paranoid in their approval of new drugs, delaying—or refusing altogether—drugs that cure disease and illness. 

Henry Miller worked 15 years for the FDA and served as a founding director of the FDA’s Office of Biotechnology. Now he is one of the FDA’s most vocal critics. Miller’s frustration with bureaucracy, and the political red tape that prolonged drug approvals, gave him much distaste for the organization. Following his resignation, he expressed his discontent: “In spite of increasingly more powerful and precise technologies for drug discovery, purification and production, during the past twenty years development costs have skyrocketed. The trends are ominous: The length of clinical testing for the average drug is increasing, fewer drugs are being approved, and the number of applications to FDA by industry for marketing approval has been decreasing for more than a decade.” 
 
Miller observed the FDA’s bureaucracy firsthand, and walked away displeased. He watched idly while drugs that would undoubtedly save lives were hidden from the public. 

The FDA has a fatal track record. In August 2007, the D.C. Circuit Court of Appeals reversed a previous ruling that restricted a patient’s right to take investigational, FDA-unapproved drugs. The leukemia drug Gleevac passed its first phase of testing in 1998—ruling that it was both safe and effective—and when physicians requested the drug for treatment in June 2001, the FDA denied their request. Gleevac finally gained approval in March 2003, after 3,600 patients had been denied the drug, many of which died in waiting. The efficacy of Gleevac is displayed through the clinical trials: 80 percent are still alive today. 

The FDA has delayed many other cancer drugs, and thousands of people have died because of it.  Ronald Trowbridge and Steven Walker report the FDA’s deadly paradigm, relating to cancer patients, in the Wall Street Journal:

The American Cancer Society reports that some 550,000 cancer patients die annually, making the number of cancer deaths from 1997 to 2005 about 4.8 million. Over that same period, the FDA reports granting individual access to an investigational drug to not more than 650 people per year for all diseases and drugs—a pathetic, even cruel, pittance. A few thousand more patients managed to gain access by enrolling in relatively small clinical trials or exceedingly rare expanded access programs.

Email ItEmail It | Print ItPrint It | CommentsComments (0) | TrackbacksTrackbacks (0) | Flag as offensiveFlag as Offensive

Regulate, Regulate, Regulate!

       Health care regulation is the worst form of tax, as it confiscates wealth and prevents effective drugs and treatments—that save lives and provide physical relief for terminal patients—from entering the market. Christopher Conover of Duke University noted the social costs of regulation across 47 health care categories. In defining social costs as “the value of the goods and services lost by society resulting from the use of resources to comply with and implement the regulation, and from reductions in output”, Conover estimated that in 2002, health care regulation cost taxpayers $169 billion. “Spread across all households, health services regulation cost the average household an estimated $1,546 in 2002.” This is more than Americans spent on both gasoline ($165.8 billion) and pharmaceuticals ($162.4 billion).
 
Insurance providers are heavily regulated, as government places restrictions on pricing, cancellation terms, and administrative practices. Pricing regulation expels actuarial science in underwriting by preventing insurance companies from assessing premiums based on risk. This may appear equitable, but because it forces low-risk customers to subsidize high-risk customers, there exists a severe ethical dilemma. 
To regulate pricing in this way means that someone who postpones buying health insurance for 20 years, and is suddenly diagnosed with heart disease, pays the same premiums as someone who has carried insurance their whole life and has no severe health problems. Since providers must offset their premiums in order to compensate for price controls, low-income and low-risk individuals are denied insurance, because premiums have become unaffordable. It’s not compassion, but common sense that shows why this is unfair. In the quest for social justice, in theory, regulators produce a result that is unjust and unmerited.

Government also intervenes in what benefits insurance policies must cover. Part of the problem lies with crooked constituencies that arouse biased legislation. Lobbyists and advocacy groups invoke mandates by using constituencies that provide lush political contributions to politicians. The Council for Affordable Health Insurance found that state governments have legislated 2,133 benefit mandates that require insurers to cover services such as “acupuncture, massage therapists and hair prostheses (wigs).” Not surprisingly, supporters of such mandates, who lobby for heavy regulation, include acupuncturists, massage therapists, and chiropractors. 

In the 1960s there were only a handful of benefits that government mandated, and now there are a couple thousand.  It is no wonder health care costs have skyrocketed over the past couple decades. Mandated benefits may make insurance policies more comprehensive, but they also make them more expensive—at an expense that is not always beneficial. They force insurers to cover benefits that are usually paid out-of-pocket, oftentimes benefits that are not necessary in maintaining health quality. 

William Congdon, Amanda Kowalski, and Mark Showalter published a paper, “State Health Insurance Regulation and the Price of High-Deductible Policies”, that analyzed premium data from Golden Rule insurance and eHealthInsurance.com (one health insurance provider and one internet brokerage).  The study focused on four categories of state regulation:

(1) mandated health benefits, which require insur­ers to cover particular treatments or particular ser­vices; (2) “any willing provider” laws, which restrict insurers’ ability to exclude hospitals and doctors from their networks; (3) community rating laws, which require insurers to limit premium dif­ferences across individuals; and (4) guaranteed issue laws, which require insurers to sell insurance to all potential customers regardless of health or pre-existing conditions.

The analysis was consistent across both datasets: eliminating state regulation would lower annual premiums by $2,000 per individual. This study, along with subsequent studies, shows that on the national level states with heavy regulation have higher insurance premiums than states with looser regulatory standards. Accounting for 12 cents on every premium dollar, mandated benefits hike premium rates. The average state mandates 26 benefits that insurance providers must cover—mandates such as hair prosthesis, athletic training, birthmark removal, and pastoral counseling.  Statistically, individuals in states that mandate more than 26 benefits pay higher premiums than individuals in states with fewer than 26 mandated benefits.

 

Email ItEmail It | Print ItPrint It | CommentsComments (0) | TrackbacksTrackbacks (0) | Flag as offensiveFlag as Offensive
« Previous1Next »