Obama asks Congress to enable Medicare to negotiate drug costs

As his precision medicine initiative takes off, President Barack Obama has asked Congress to change a law to allow Medicare officials to negotiate prices with drug manufacturers, according to the New York Times.

The precision medicine initiative, run through the National Institutes of Health, intends to develop personalized medical treatments tailored to the genetics of individual patients to more effectively treat illnesses like cancer and cystic fibrosis. The cost of such therapies can amount to $50,000 to $100,000 a year, according to the report. President Obama announced the initiative during his State of the Union address. The $215 million proposal has received bipartisan support and is now under review in Congress.

Scientists are optimistic the initiative — if it is successful — could lead to new diagnostic tests and treatments for some of the most complex diseases , including cancer, heart disease, diabetes, Alzheimer's and others.

However, the high costs associated with personalized medicines pose a significant point of concern, especially because patients often pay much of the expense out-of-pocket. As researchers continue to discover genetic factors that contribute to the onset of certain diseases, the costs of specialty drugs rise, according to the report.

More than 40 million people have insurance for prescription drugs through Medicare. While the cost has turned out to be significantly less than future projections made in 2003, the Medicare Payment Advisory Commission warned Congress in March that the "use of high-cost drugs poses a big challenge" both for the government and Medicare beneficiaries, as they are typically responsible for 25 to 33 percent of the cost of specialty drugs, according to the report.

"Planning for the precision medicine initiative is going like gangbusters," Sharon F. Terry, CEO of the Genetic Alliance, an advocacy group for patients, told the New York Times. "But I have grave concerns about the cost of medicines that will be developed. The prices that we’ve been seeing for these treatments are just not sustainable."

During his State of the Union address, President Obama said, for example, that cystic fibrosis was being effectively treated with a certain specialty drug, but he did not mention the cost of a one-year supply of the drug, Kalydeco, is $311,000, according to Vertex Pharmaceuticals, the manufacturer.

Some drug companies, including Vertex, Amgen, Pfizer and Novartis, have patient assistance programs to provide financial support or free medication to patients who cannot afford to pay for them, according to the report.

Regardless, John D. Bennet, MD, president of the Capital District Physicians' Health Plan, which serves approximately 460,000 in upstate New York, told the New York Times, "The rising cost of specialty drugs has the potential to bankrupt our health care system. What good is a miracle drug if you can’t afford it?"

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