The AAO meeting is always a great time to catch up with friends and learn about new technologies. To be sure, this meeting had some exciting new approvals, like Shire’s Xiidra for dry eye, Alcon’s CyPass micro-stent for glaucoma, and the AMO Symfony implant—the first extended depth-of-focus implant in the U.S.
While technology is great, I was most impressed with Allergan's announcement by CEO Brent Saunders of the company's new social contract.
Like all drug and device companies in the eye care space, Allergan has long had a commitment of social responsibility to patients and physicians. Historically, this has meant providing training, discounted or free products to patients in need, and grants to community organizations that share in those companies’ values.
But Allergan’s new social contract addresses head-on one of medicine’s most concerning trends: the practice of substantially raising prices without delivering new value to patients. The reportedly most egregious example of this was when Martin Shkreli’s Turing Pharmaceuticals raised the price of Daraprim (pyrimethamine) from $13.50 to $750 per tablet immediately after obtaining the manufacturing license for the life-saving antiparasitic drug that is much needed by immunocompromised patients.
Many of us shake our head in disgust at Turing’s alleged irresponsibility. Some want to see U.S. drug prices under governmental regulation, as they are in most other countries. At the same time, we wonder who will innovate if the reward disappears in a summary legislative action.
Allergan’s social contract, which attempts to address these concerns, has four parts.
The first is to invest and innovate, which means embarking on research to create bold innovation in patient care — new drugs and new devices — despite the costly risk of failure. Some of these will come from research projects that begin at the company itself, and others may be acquired from other companies. In an uncertain world where the cost and the risk of innovation rises each year, this commitment alone is worthy of praise.The second principle is responsible pricing and patient access. This means working with third-party payers to make drugs available and providing discounts to those pharmacy plans where necessary. It also means raising prices no more than once a year and in increments of no more than low to mid single-digit percentages, just slightly above inflation. Certainly, this is the most newsworthy and most laudable of Allergan’s newly stated commitments, and it is the reason for this blog.
Allergan’s third and fourth commitments are to drug quality/safety and physician education — two areas where most of us would agree that all companies in the eye care drug and device industry have always excelled.
At a time when lawmakers are fixing their sights on regulation of drug prices, the best place where responsible behavior can originate is indeed from the companies themselves. I hope that all manufacturers in eye care will take a good look at Allergan’s bold commitment and proudly publish their own social promises to the patients that we all collectively treat.