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Cost of generic levofloxacin in the United States is $2,300 per treatment course, while in Canada it is $12,700 and $14,600 respectively ($7,100 in India, $5,900 Malaysia, $4,400 Thailand, $2,300 in Australia, $1,900 New Zealand). As the price of generic levofloxacin increases across the board, physicians become less likely to prescribe it, and the incidence of levofloxacin-resistant cases in the U.S. and Canada increases.
How is it that a drug has been on the market for more than 80 years, has been proven safe as well effective for more than 2 billion people around the world, and has even been approved by major governments such as the World Health Organization and U.S. Food Drug Administration, is now being overpriced or not available in many countries. The reasons for this are complex, and include:
Increasing generic companies' profit margins
Lack of generic competition
The rise of generic drug price negotiation, and a decrease in drug price disclosure laws (especially regarding the generic competition process)
Rising drug prices are a global issue
The rising cost of prescription drugs is a global issue. Between 1970 and 2005, the average global price increase for an oral medicine increased from 5.1%, to 20.2%. (Note that the inflation rate in U.S. was 2.1% from 1970-2005.) For injectable drugs, prices increased more rapidly: from 3.1%, to 14.8% in less than 15 years, and 18.3% from 1990 to 2006. The difference in these increases is mainly explained by the increasing prices of medicines in developing countries, as these countries are less likely to have competition for their generic drugs.
Globalization has been responsible for much of the pricing medicines globally, and in particular this has been the case for oral medicines, in which the U.S. and Europe have been major players. The average price increase on a generic tablet of medicine drugstore shampoo hair loss marketed in Europe between 2008 and 2012 was 22.9% in France, compared to 10.2% the U.S. Although two countries have somewhat different healthcare systems in terms of access to healthcare services, the U.S. has a greater pharmaceutical spending than France. The high costs of developing drug therapies in other countries, as we will discuss later, plays a small part, but in the U.S. there is also competition for these drugs, with the introduction of generic competition in the 1990s.
It is well documented that generic competition works well and is crucial to maintaining the availability of medicines that can be generic drug for levofloxacin used by millions of people (see the sidebar "Why competition is so important"). Unfortunately, this has also been observed in the pharmaceutical sector U.S. U.S., a very competitive market has resulted in price escalation. The U.S. spent $20 billion more on medicines per year in the period 2012-13 than other advanced countries spent on their healthcare. This is an average increase of more than $800 per year, with a range from $300 to more than $1,200 in 2012-13. 2012, France spent $21 billion more on healthcare than the U.S. spent on drugs.
Price escalation is not new for pharmaceuticals. Indeed, price escalation has been a concern in the U.S. since 1980s, with generic competition only coming into play in 2002, and no new generic products entering the global pharmaceutical market until 2014. In 2011, the U.S. Congress passed Generic Pharmaceutical Protection Act to address the concern of generic competitors, but has now been defeated in the courts several states. Generic Pharmaceutical Protection Act requires drug manufacturers to notify the FDA of any new drug, or drug used for human veterinary purposes that was developed without using a previously approved, generic chemical counterpart. The act also requires generic manufacturers to disclose certain costs and other data.
In 2012, the FDA issued its first order requiring a generic company to publicly announce the price of its product. This has been challenged in a number of courts, including in the Supreme Court of
levofloxacin 750 mg buy state New York, which ruled that this requirement violates the First Amendment, and in District of Columbia Circuit Court, which upheld the requirement. In 2012, FDA also issued an order to require companies report the cost-effectiveness of their generic drug products. In 2014, the FDA expanded requirement to include price-comparison studies.
It is now well documented, not only by generic manufacturers,
Oxybutynin buy online uk but also independent researchers, that price escalation is a big problem in the U.S. Healthcare costs are high, and rising. For example, a recent report (see "Is drug pricing in the U.S. driving up overall healthcare costs?") finds that the average American spends $8,100
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