There are many reasons that Americans spend so much on prescription drugs. The obvious ones are the costs of developing new drugs and then navigating the Food and Drug Administration’s labyrinth for new drug approvals. Pharmaceutical companies also employ various maneuvers that effectively extend patent protection on popular drugs beyond their expiration date, which gives them more years free of price competition. What’s more, many other countries negotiate much lower prices at the national level, which effectively means that they do not share in any of the development costs, leaving U.S. residents shouldering the burden.
Debates on how to reduce the cost of prescription drugs typically focus on these top-line issues, but there is not a single silver bullet that can magically reduce the cost of prescription drugs. There are too many policies, market failures, and flaws in the system that conspire to push drug prices upward.
But there are lots of ways to nibble around the edges of the problem. For instance, improving the eyedropper could save government spending on drugs by over $2 billion per year.
No, really.
The typical eyedropper is inexpensive, easy to use, and durable. But it is also incredibly inefficient. The human eye can only absorb seven to ten microliters of liquid at a time. A person administering his or her drugs via an eyedropper typically applies five times more liquid than the human eye can absorb. What’s more, if the dropper creates tearing—which invariably occurs if a person administers too much—then virtually all of the medicine is washed out of the eye. Such an occurrence is potentially harmful to the patient–since their medicine doesn’t go where it needs to go–and also an example of the kind of hidden waste that contributes to the cost of purchasing medicine.
In fact, you can put a number on that cost: U.S. drug companies alone sell about $3.4 billion in eye drops each year, mostly for glaucoma and dry eyes. Researchers estimate that patients waste at least half of all of this eye drop medications. A study by University of Michigan researchers estimate that the Veteran’s Administration alone would save over $1 billion a year from the use of a precise eye dropper—as would Medicare Part D.
The idea of a precise eye dropper isn’t new. Alcoa developed such a device in the 1990s but corporate leadership quickly surmised that it would reduce sales. So they shelved it.
Today, a startup called Eyenovia has taken that technology—which resembles the mechanism used in laser jet printing—and improved upon it; the company is in the process of obtaining FDA approval for the technology.
However, obtaining that approval would not be enough to foment change: The largest health care providers—namely Medicare, the VA, and the large insurance companies—would have to also recognize the potential gains and insist that their patients be provided with the improved eye dropper as well, a task that is easier said than done. And so the drug companies who stand to see profits fall from reduced sales are setting up roadblocks to challenge this new technology, and many patients—most of whom are insulated from costs—will resist change and hold onto their old eyedroppers. Surmounting these obstacles would be no little task.
No amount of policy tinkering will change the simple fact that developing drugs is a complicated, labor-intensive process that will always be costly. And (expensive) failures will always be a part of that process.
But there are many other places where we can find savings in the provision of prescription drugs, and we need to be diligent in pursuing all such opportunities, even if it only amounts to a billion dollars here and there. Like extra eye drops, those wasted dollars adds up.
