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  • Writer's picturerbm

My Letter to Amgen CEO regarding their cholesterol-lowering drug, Repatha



Repatha, added to a full-dose statin, has pruned my LDL cholesterol from 108 to 18. I thank you and your employees for developing this life-prolonging product. Unfortunately, the price is steep for those of us who must pay cash. I propose that Amgen sell Repatha directly to patients.


When I switched to part-time employment at age 60, I became uninsured for the first time in my life. Finding all the available insurance products overpriced, my wife and I joined Liberty HealthShare, a Christian cost-sharing service. We save $850 per month, but without prescription drug coverage, I am responsible for Repatha's $542.79/month retail price.


Pharmacies, insurers, wholesalers, and pharmacy benefit managers (PBMs) together siphon off up to 60% of drug payments. The third party payment system inflates the cost of everything in our health care system. If we know what we need, and are prepared to pay cash, why must we pay these inflated prices? Others get rich, and the consumer-patient gets bilked. I propose that you allow anyone with a prescription from their physician to purchase products directly from Amgen for 50% of the average retail price: cash only--no insurance, no copay coupons, no prior authorizations to mess with. As the manufacturer, there is no moral or medical reason why you cannot do so.


The pharmacies, PBMs, wholesalers, and insurance companies will object for fear that their massive profits will plummet if consumer-patients gain the opportunity to pay a reasonable cash price. The public wants price transparency and fairness. We abhor costly insurance programs that inflate the cost of prescription medication. The PBM scheme would be illegal in any other industry. If the impediment is the FDA or Congress or some state law, I know many who would lobby to get that fixed. If you cannot escape the tentacles of the PBM's, and every possibility for a free market in medicine is dead, then this is a sad day for America and for freedom.


I affirm to all my friends, family, and patients the wonders of Repatha, but I do not hide my scorn for the American prescription price scam.


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