Feb 7, 2019
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Comment on Part D prior authorization and cost sharing rise for MS treatments by Robert J. Sobel, M.D.

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When the annual cost of a chronic drug is 30 x my annual fee as a concierge physician, it is to be expected that every tool in the book will be utilized to obstruct the patient and physician. The incentive for new drugs is not something we want to obstruct, but we need to amortize the return over time. Otherwise, we cannot expect any kind of stability of costs while we also hope to advance new diagnostics and therapeutics. With news that quality is a problem in generics, that price fixing is prevalent, and that shortages persist; it is time to realize that a price regulated, brand vs brand open-formulary provides the only true structure that will allow patient-physician autonomy, eliminate the administrative waste (by destroying its whole basis), control costs, and allow for continued improvement in our tools of care.



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