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User:Tryptofish/Drug prices RfC draft 2

< User:Tryptofish

Draft only!

Please suggest revisions to the draft! Please feel free to edit directly, or to comment in talk. Thanks! --Tryptofish (talk) 21:59, 6 January 2020 (UTC)

In this RfC, you are asked to support or oppose two contrasting possibilities about how pharmaceutical drug prices and pricing might be presented on pages about medications.

Please do not comment within the propositions section; instead, comments should go in the RfC section, below. This RfC has been designed to determine community views about these two approaches, based on the decision at a previous discussion. Therefore, please do not post any new proposals at the top of the RfC page; discussion of alternative approaches, on the other hand, are welcome in the comments section.

The RfC will run for a full 30 days, and will be closed by a panel of three uninvolved administrators.

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Propositions

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Proposition 1

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Widespread inclusion of drug (medication) prices in drug articles is discouraged. Content about drug pricing should be included in articles only when reliable independent sources have written about issues that are specifically about the pricing of those drugs; simply taking drug prices from databases should be avoided. The content should be in paragraph text form, typically in a History or Economics section of the page.

Sample article text:

From Epinephrine autoinjector#Price:
Mylan's efforts to maintain its market dominance were aided when Sanofi's competing product was recalled in November 2015 and further when Teva's generic competitor was rejected by the FDA in March 2016.[1] By the first half of 2015, sales of EpiPen accounted for 40% of Mylan's profit.[2] Those profits were also due in part to Mylan's continually raising the price of EpiPens starting in 2009: in 2007, the wholesale price of two EpiPens was about $100; the price was about the same in 2009; by July 2013, the price was about $265; in May 2015, it was around $461; and in May 2016, the price rose again to around $609,[3] around a 500% jump from the price in 2009.[4] The last price increase sparked widespread outrage in the late summer as parents prepared to send their children back to school and went to pharmacies to get new EpiPens.[5][6] Some Americans responded to the high price by buying EpiPens online from pharmacies outside the US,[7][8] forgoing new EpiPens and relying on their expired EpiPen,[7] or forgoing an autoinjector altogether and having their children carry pre-loaded syringes.[9][10]
In response to criticism, Mylan increased financial assistance available for some patients to purchase EpiPens,[11] a gesture that was called a "classic public relations move" by Harvard Medical School professor Aaron Kesselheim.[12] The up to $300 saving cards can be used only by a small number of people who need the drug, and no one on Medicaid. They do nothing about the high price which is still being paid by insurers, who ultimately pass the cost on to consumers.[12] In October 2016, Mylan announced a settlement with the US Department of Justice over rebates paid by Mylan to states under the Medicaid Drug Rebate Program.[13] Questions had been raised by Congress and others about why EpiPen had been classified as a generic rather a proprietary product in the program since 1997; generic drugs have lower rebates (13%) than proprietary drugs (23%), and price hikes for generic drugs cannot be passed onto states, and a common form of pharmaceutical fraud involves misclassifying proprietary drugs as generic under the program.[14] Under the agreement, Mylan agreed to pay a $465 million payment and to a sign a corporate integrity agreement requiring it to perform better in the future;[13] the settlement also resolved cases brought by states related to the rebates.[15]

  1. ^ Carly Helfand for FiercePharma Mar 1, 2016 FDA swats down Teva's EpiPen copy, putting Mylan in cruise control
  2. ^ Cynthia Koons and Robert Langreth for Bloomberg Businessweek. September 23, 2015 How Marketing Turned the EpiPen Into a Billion-Dollar Business
  3. ^ Tara Parker-Pope and Rachel Rabkin Peachman for the New York Times. Aug 22, 2016 EpiPen Price Rise Sparks Concern for Allergy Sufferers
  4. ^ Bartolotta, Devin (18 August 2016). "Cost Jumps Nearly 500-Percent For Life-Saving EpiPens". CBS Baltimore. Retrieved 19 August 2016.
  5. ^ Goldberg, Kenny. "People With Food Allergies Say Life-Saving Drug Too Expensive". KPBS Public Media. Retrieved 8 June 2016.
  6. ^ Walker, Joseph; Winslow, Ron; Steele, Anne (30 August 2016). "Mylan to Launch Cheaper Generic EpiPen Alternative". Wall Street Journal.
  7. ^ a b Tuttle, Brad (Aug 22, 2016). "5 Signs That EpiPen Prices Are Completely Out of Control". Time/Money.
  8. ^ Lamble, Kate (25 August 2016). "Drug company stung by criticism of 'outrageous' EpiPen price rises". BBC.
  9. ^ Khazan, Olga (August 24, 2016). "Have You Ever Tried to Buy an EpiPen?". The Atlantic.
  10. ^ Ginger Skinner (August 11, 2016). "Can You Get A Cheaper EpiPen?". Consumer Reports.
  11. ^ Kasperkevic, Jana (2016-08-25). "Mylan to provide EpiPen cost assistance as CEO is asked to testify on price hike | Business | The Guardian". The Guardian.
  12. ^ a b Carolyn Y. Johnson (August 25, 2016). "Why Mylan's 'savings card' won't make EpiPen cheaper for all patients". Washington Post. Washington Post.
  13. ^ a b Thomas, Katie (7 October 2016). "Mylan to Settle EpiPen Overpricing Case for $465 Million". The New York Times.
  14. ^ Thomas, Katie (2 September 2016). "Is EpiPen a Brand-Name or a Generic Drug? Mylan Casts It Both Ways". The New York Times.
  15. ^ Mole, Beth (7 October 2016). "For ripping off Medicaid, EpiPen maker Mylan pays Feds $465 million". Ars Technica. Retrieved 8 October 2016.

Rationale:

  1. Presenting the information this way is entirely encyclopedic.
  2. The use of multiple independent sources assures that there is significant interest in the practice of pricing a given drug or class of drugs.
  3. In contrast, simply listing prices goes against WP:NOTPRICE.
  4. When listing prices in isolation, there are problems with systemic bias: US or UK price? First world or third world? In contrast, extended article text provides needed context.
  5. Prices change over time, which can be better addressed in extended text.
  6. A problem with the approach shown in Proposition 2 is that a brief summary often requires WP:SYNTH:
    • Price per tablet (etc.) or price per defined daily dose? Some sources give one, and other sources give the other.
    • Wholesale or retail? With or without health insurance? What if the drug comes in many different forms at different prices?
  7. Although the issue of drug pricing is an important one, it is not Wikipedia's role to expose information, but rather, to document what independent sources say about it.

Proposition 2

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Drug (medication) prices should be widely included in drug articles, often as brief statements of price. It is reasonable to obtain price information from sources that are databases of drug price information. Appropriate sources include: International Drug Price Indicator Guide, Centers for Medicare and Medicaid Services, and Drugs.com.

Sample article text:

From Ethosuximide (lead section):
The wholesale cost in the developing world is about US$27.77 per month as of 2014.[1] In the United States the wholesale cost of this amount is about US$95.97 per month.[2]

  1. ^ "Ethosuximide". International Drug Price Indicator Guide. Retrieved 8 December 2016.
  2. ^ "NADAC as of 2019-11-27 | Data.Medicaid.gov". Centers for Medicare and Medicaid Services. Retrieved 3 December 2019.

Rationale:

  1. Although there is nothing wrong with the approach shown in Proposition 1, there is no need to restrict content to that.
  2. The sources are reliable sources.
  3. Readers want this information, even if some approximation is needed. It is important both to patients and to health practitioners.
  4. Drug prices have been identified as an important issue in society: [1], [2].

RfC comments

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Note: alternatively, this could be formatted as a single section, instead of supports and opposes.

Proposition 1, support

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  1. Support 1. My reasons are: reason, reason. --Editor 1
  2. etc.

Proposition 1, oppose

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  1. Oppose 1. My reasons are: reason, reason. --Editor 2
  2. etc.

Proposition 2, support

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  1. Support 2. My reasons are: reason, reason. --Editor 3
  2. etc.

Proposition 2, oppose

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  1. Oppose 2. My reasons are: reason, reason. --Editor 4
  2. etc.

Extended discussion

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