The High Price of Living: The History and Future of Equitable Access to Medications.

Between 2009 and 2018, average drug prices more than doubled for many Medicare patients, forcing millions of patients to skip doses or fail to fill prescriptions.  Unlike countries like Canada, whose Patented Medicine Prices Review Board applies a formula to ensure that its drug prices stay low, the US system of drug distribution and  pricing is complicated, opaque, and largely free of governmental price constraints.  

Pharmaceutical corporations charge essentially what the market will bear. Once patents expire on a brand-name medication, a lower-cost generic version —similar but bearing a lower price tag— may become available. Generics are often touted as the answer to high prices, providing essential medications within the reach of most.  

However, generics have not yielded the hoped-for lower costs, even for important essential medications like insulin and albuterol, medications that people with common chronic conditions depend upon to live. For instance, more than 8 million Americans require insulin to survive, but although it has been on the market for more than a century, there is no generic version, leaving one in four patients unable to afford their medicine. 

In response, in 2019, Maryland passed legislation to prevent price-gouging on essential medicines, like insulin. Other states followed suits. Still, legal challenges and cost concerns leave too many patients saddled with high medication costs. Generics are only part of the issue. Complicated the picture are the rise of more complex, expensive classes of drugs. 

Prescription drugs in the U.S. cost triple the price of other developed countries. How did this happen? And what is the solution? How can we best move forward to ensure medical access to all? To explain the history and discuss today’s ethical, financial and legal issues, the New York Academy of Medicine is convening an expert panel on Thursday, December 12: The High Price of Living: The History and Future of Equitable Access to Medicine 

Speakers

Jacob M. Appel MD JD MPH HEC-C DFAPA is currently Professor of Psychiatry and Medical Education at the Icahn School of Medicine at Mount Sinai in New York City, where he is Director of Ethics Education in Psychiatry, Associate Director of the Academy for Medicine and the Humanities, and Medical Director of the Mental Health Clinic at the East Harlem Health Outreach Program.   Jacob is the author of five literary novels, ten short story collections, an essay collection, a cozy mystery, a thriller, a volume of poems and a compendium of dilemmas in medical ethics.  He is Vice President and Treasurer of the National Book Critics Circle, co-chair of the Group for the Advancement of Psychiatry’s Committee on Psychiatry & Law, and a Councilor of the New York County Psychiatric Society and of the American Academy of Psychiatry & Law. 

Lynn Roberts, PhD has a BS in human development from Howard University (1984) and a PhD in Human Services Studies from Cornell University (1991).  Between 1998-2016, Dr. Roberts was a faculty member in the Urban Public Health Program and affiliated faculty member in the Department of Women and Gender Studies at Hunter College of the City University of New York (CUNY). In 2016 she joined the faculty in the Community Health and Social Sciences Program of the unified CUNY Graduate School of Public Health and Health Policy, where she now serves as Associate Dean of Student Affairs & Alumni Relations. Prior to CUNY, she oversaw the development, implementation and evaluation of several programs for women and youth in NYC, including a comprehensive program for substance using mothers and their families in Harlem.  She is an emeritus board member of the SisterSong Women of Color Reproductive Justice Collective and co-edited with Loretta Ross, Erika Derkas, and Whitney Peoples an anthology, Radical Reproductive Justice: Foundations, Theory, Practice, Critique (Feminist Press, November 2017). Dr. Roberts’ current activism and scholarship examine the intersections of race, class and gender in adolescent dating relationships, juvenile justice and reproductive health policies; as well as the impact of models of collaborative inquiry and teaching on civic and political engagement. Between 2015-2019, she served as a consultant to the New York City Department of Health and Mental Hygiene in support of their efforts to integrate a Sexual and Reproductive Justice framework in their work. She is honored to be the mother of four amazing human beings and is in constant awe of her six grandchildren.

Jeremy A. Greene, MD, PhD is William H. Welch Professor of Medicine and History of Medicine at Johns Hopkins School of Medicine, where he serves as Director of the Institute of the History of Medicine and founding Director of the Center for Medical Humanities & Social Medicine. In addition to his primary appointments, he serves as faculty and investigator in a variety of capacities at Hopkins.

Dr. Greene’s research explores the ways in which medical technologies influence our understandings of what it means to be sick or healthy, normal or abnormal, on personal, regional, and global scales. He has published The Doctor Who Wasn’t There: Technology, History, and the Limits of Telehealth (University of Chicago Press, 2022); Generic: The Unbranding of Modern Medicine (Johns Hopkins University Press, 2014); and Prescribing by Numbers: Drugs and the Definition of Disease (Johns Hopkins University Press, 2007). His newest research project, Syringe Tide: Disposable Technologies and the Making of Medical Waste, focuses on the shift towards disposable technologies in hospitals and clinics, with inevitable environmental consequences.

He received his MA in medical anthropology (Harvard, 2004) and the MD and the PhD degree in the history of science (Harvard, 2005). He completed his residency in Internal Medicine at the Brigham & Women’s Hospital in 2008 and practices medicine at the East Baltimore Medical Center, a community health center affiliated with Johns Hopkins. His work has been recognized by numerous awards, most recently the 2021 Nicholas Davies Award from the American College of Physicians for “outstanding scholarly activities in history, literature, philosophy, and ethics and contributions to humanism in medicine.” Dr. Greene received a Guggenheim Fellowship for study during the 2023–2024 academic year.