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Missing the Forest in the Drug Price Debate

BY BRYCE WILLIAMS – Here we go again. Recent approval by the U.S. Food and Drug Administration of two new cholesterol medications is re-igniting the controversy over sustainable drug prices. The drugs, Praluent and Repatha, appear to be clinically effective at lowering cholesterol values.  However, they come with hefty price tags exponentially higher than today’s widely used “statin” medications.

A recent article the Journal of the American Medical Association highlights challenges physicians will face given the drug’s high costs and lack of long term efficacy data on reductions in heart attack and stroke. Last week, the Institute for Clinical and Economic Review released an analysis concluding that the drugs were significantly overpriced relative to the clinical value they delivered.

All valid points but with one glaringly obvious omission – the entire clinical and media discourse is myopically focused on drugs. So what’s missing? For starters, the wealth of scientific literature demonstrating that diet and lifestyle changes can significantly improve not only cholesterol levels but a host of other cardiovascular risk factors leading to improved quality of life, fewer cardiac events and greater longevity.

Dr. Dean Ornish and colleagues have demonstrated lifestyle can reverse even severe heart disease, often without the need for drugs or invasive cardiac surgery. Recently, Wellvolution – Blue Shield’s wellness program for employees – partnered with leading California providers to offer the Ornish Program to qualified members.

Don’t get me wrong – cholesterol lowering medications can provide measurable clinical value for certain individuals. But ignoring lifestyle medicine that consistently demonstrates improved health, little risk or side effects and minimal cost does those we serve a disservice.

Bryce Williams is vice president of wellness at Blue Shield of California.