Just the facts, ma'am

On our last day in San Miguel I decided to walk down the hill to the pharmacy to get a refill of my Atorvastatin, the medication formerly known as Lipitor. For some reason, I like to have an extra prescription period of all my drugs just in case. In case of what I’m not sure. Maybe the Chinese will stop exporting the drugs we know and love. I have a cushion of ninety days on my other two meds but not my cholesterol fighter.

There was something faintly clandestine about my mission. I had no prescription though I did have the pill canister. I skulked into the farmacia, took a big breath and whispered, “¿Puedo comprar esta medicina?”  The pharmacist gave me a furtive glance, went into the stacks and returned with a 90-dose box of the stuff. I asked, “¿Cuanto?” She told me, “171 pesos.” That’s $9.00 to you, gringo. Then came the dawning. A month earlier I had posed the same question at my local Walgreens and was told $342. I passed. I did not pass at $9.00.

When I had my annual check-up this week, I told the story to my primary care physician who launched into a dissertation on the price of drugs in Los Estados Unidos and the hammerlock Big Pharma has on drug prices and our complicit congress. Back in 2003 when the Republican congress created the Medicare drug benefit it allowed drug companies to set their own prices and denied the right of Medicare to negotiate lower ones for its 40 million clients. Makes perfect sense if you're in somebody's pocket.

Between 2006 and 2016 drug companies spent $2.3 billion, yes that’s a ‘b’, on lobbying and made $30 million in contributions per election cycle to both political parties. It's roughly 60% to Republicans and 40% to Democrats for the bean counters among you. In 2017 alone drug companies and their trade groups spent $171.5 million on lobbying and deployed 882 lobbyists into the backrooms of congress. So, we can predict with high confidence that drug prices will continue to rise despite pledges from both houses of congress and from the White House to rein in prices and though 80% of Americans believe that drug prices are unreasonably high. The means to rein in costs exist, of course. The will to do so does not, of course. Did you know that the drug companies employ consulting firms to tell them how high they can raise prices before patients can’t or won’t pay?

The standard drug industry excuse for high prices is the cost of research which proves to be a specious argument since the industry spends far more on marketing than on R&D.

I know this. There’s something seriously awry when you can get a garden variety medication like Atorvastatin for $9.00 in Mexico and pay $342 in the US.