

There are a thousand ways that healthcare is different than other economic sectors; those differences keep the market from working to keep care affordable.
Better-known causes include: insured consumers don’t directly pay the full price of their own care; prices have nothing to do with quality; there isn’t enough science about which treatments work; and providers can drive demand for their services.
It’s important to point out that consumers pay all healthcare bills, either directly from our wallets but also indirectly through taxes and lost wages. These factors and many more distort the healthcare market, so it doesn’t work.
An important way the healthcare market fails is that industries have powerful tools to drive the prices and use of their products that most consumers aren’t aware of. ProPublica’s latest analysis of payments by drug and medical device companies to physicians finds that despite substantial bad press around the problem since 2010, not much has changed.
Between 2014 and last year, total payments to doctors for promotional talks and consulting have remained between $2.1 and $2.2 billion. This is a widespread issue; over the last five years, about a million of the 1.1 million doctors in the US have received industry payments. Over 700 doctors received more than a million dollars each from the drug and device industries and over 2,500 received more than $500,000.
Connecticut doctors and teaching hospitals are well-represented in the database. Just last year, drug and device companies paid Connecticut physicians $27.3 million. Four doctors received over $500,000 each and another 64 received over $100,000. Specialists are over-represented among the 10 highest-paid Connecticut doctors. Teaching hospitals in Connecticut received payments of over $1.5 million last year. You can look up your own doctor’s payments here.
There is strong evidence that the payments are working. Physicians often claim they aren’t influenced by industry payments, but doctors who receive funding from pharmaceutical companies are more likely to prescribe brand-name drugs. A study found that the drugs most promoted directly to physicians are less likely to be effective, safe, affordable, or innovative.
Many of the most promoted drugs — Xarelto, Eliquis, Latuda, Invokana, Humira, Aubagio, Victoza, Otezla, and Repatha — will sound very familiar to TV watchers.
In more bad news for consumers, the Institute for Clinical and Economic Review (ICER) just released its first innocuously-named report on Unsupported Price Increases for US Prescriptions. ICER is an independent non-profit research institute that evaluates the evidence on the effectiveness and value of drugs and other medical treatments. The report identifies seven drugs with substantial price increases last year on already high costs but with “no new important evidence [of clinical benefit] to support their price increases.”
Together, the seven drugs cost American consumers over $5.1 billion extra last year without any added benefit. Topping the list is Humira, which cost US consumers $1.9 billion more. A growing number of payers use ICER reports to control healthcare costs.
Support authentic, locally owned and operated public service journalism!
Prescription drugs are the biggest driver of rising healthcare spending in Connecticut and rising healthcare costs are crowding out other important government and family priorities. Too often, discussions about lowering healthcare costs devolve into arguments about denying care for people who need it, but it doesn’t have to be that way. Ensuring we are prescribed the most effective drugs, and only the drugs we need — at a fair price — is critical to controlling costs. We need to stop paying higher prices for medicines that aren’t worth it, and doctors need to refuse industry money.
Ellen Andrews, PhD, is the executive director of the CT Health Policy Project. Follow her on Twitter @CTHealthNotes.
DISCLAIMER: The views, opinions, positions, or strategies expressed by the author are theirs alone, and do not necessarily reflect the views, opinions, or positions of CTNewsJunkie.com.
More Health Care News & Analysis

6 Common Barriers Men Face When Seeking Mental Health Support
The outward effects of mental illness can often be dismissed as a sign of weakness or personal failure. For men, this type of social stereotyping can be especially hard to escape — being told to “man up” is a common refrain that can be reductive and stigmatizing.
Keep readingMedical Examining Board Fines Doctor $10,000
The state Medical Examining Board on Tuesday fined an Oxford doctor $10,000 for fraudulently using another doctor’s name and Drug Enforcement Agency registration number to prescribe controlled substances to a family member.
Keep reading
Clinical Trials With Immunotherapy Drugs Are Source Of Hope And Challenges In Treating Aggressive Breast Cancer
Joshalyn Mills of Branford and Nancy Witz of Kensington had the best possible results after being treated in clinical trials with immunotherapy drugs for aggressive breast cancer: Their tumors were eliminated. But while there are dramatic successes with immunotherapy drugs, there are also many failures, and researchers are trying to find out why in hopes…
Keep reading
Coalition of Health Insurers Questions Viability of Connecticut Partnership Plan
Members of Connecticut’s Health Care Future, a coalition of health insurers, hospitals, and businesses, are questioning whether Connecticut lawmakers have done enough this year to protect teachers and municipal employees from increases in health insurance premiums. “Despite repeated bailouts from taxpayers, the Connecticut Partnership Plan continues to be a fiscal Titanic that demonstrates why government-controlled health…
Keep reading
AG’s Tackle Mental Health Parity
Attorneys General in Connecticut and Rhode Island threw their support Monday behind a coalition of mental health advocacy groups asking a federal appeals court to revisit a recent ruling giving insurance companies more flexibility to deny mental health claims.
Keep reading
Budget Green Lights Psychedelic Therapies
Buried in the budget Gov. Ned Lamont signed this week is a provision that would create a pilot program to allow Connecticut to be the first-in-the-nation to study the impact of psychedelic drugs like psilocybin and MDMA on patients with depression and PTSD. The budget now creates a pilot program within the Department of Mental…
Keep reading