September 25, 2009

Pricing and Utilization of Pharmaceuticals - Nonsense from Greg Mankiw

Greg Mankiw shared his wisdom with us in an editorial in the New York Times last week:
Imagine that someone invented a pill even better than the one I take. Let’s call it the Dorian Gray pill, after the Oscar Wilde character. Every day that you take the Dorian Gray, you will not die, get sick, or even age. Absolutely guaranteed. The catch? A year’s supply costs $150,000.

Anyone who is able to afford this new treatment can live forever. Certainly, Bill Gates can afford it. Most likely, thousands of upper-income Americans would gladly shell out $150,000 a year for immortality.
The true costs of pharmaceuticals are mostly incurred at the development phase. The actual cost of production is insignificant. No medication costs anything like $150,000 per year to produce.

So, if thousands of people are willing to pay $150,000 per year, then quite possibly tens of millions of people are willing to pay $150 per year, which would most probably bring many times the income to the drug company. Modern pharmaceuticals are simply not the hand-crafted luxury items that Mankiw is trying to portray them as. (Some of the more egregious items used in older traditions are a bit different.)

When it comes to the cost of the actual medication, any expansion of health care coverage only needs to increase the aggregate cost of medication by the price of the additional production, which really isn't very much at all. Wider utilization of a drug actually decreases the burden on individual users, as the cost of development is borne by more people.

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