Transcriber: Ivana Krivokuća Reviewer: Ellen Maloney
Has your life ever been changed by one question?
Maybe it was, "Will you marry me?" or "Do you want the job?"
For me,
working as a pharmacist eight years ago,
that question came from a sick, elderly woman named Betty.
She asked, "Which two of my eight prescriptions can I skip this month?"
I became a pharmacist to help people,
so when I confess to you that I didn't get why she was asking me this question,
I still feel naive.
I knew that she was diabetic,
with high blood pressure and high cholesterol.
So I asked her why she would endanger her life
by skipping any of her medications.
We all know why she would do that; she couldn't afford them.
Did you know that 30 percent of prescriptions written
are never filled?
The reason for that is nearly always cost.
Prescription drug prices are rising more than four times faster
than wages in this country.
I know, because I've spent the last eight years of my life
hacking the system, turning it upside down
and trying to shake money out of its pockets for consumers.
And the reason I do that, instead of dispensing drugs as I used to do,
is because of Betty.
Betty left my pharmacy that day with enough medication to get by,
and I spent that night researching her problem.
Six hours later, I had some answers,
but my research had raised many more serious questions.
How is it that the two people in the best position to help the patient,
- the prescriber and the pharmacist -
have so little power to do so?
Is the system rigged, deliberately complex and opaque?
Trying to solve Betty's problem was like trying to solve a Rubik's cube,
when you can only look at one of its sides.
I was sure her doctor would be as surprised as I was
to learn that the cost of an oral blood pressure medication
that could be used to treat her condition
could range in price
from as low as four dollars a month on one end,
to on the high end more than 577 dollars a month.
Other variables combine to present more than 100,000 different potential outcomes
at the pharmacies near her home.
I've seen mothers coming to the pharmacy so relieved,
finally having gotten the diagnosis for a problem with the sick child,
only to find out that they can't afford the prescribed medication.
People's lives can be transformed
by getting the right medication at the right time.
And the difference between them isn't just economic status;
it's often just luck.
One family prescribed an affordable drug, one family not.
And with no clear way on how to get better information,
a better shake from the system.
We live in a world where institutional capital
can wield information like a weapon.
Remember a few years ago, when The Wall Street Journal reported
that Orbitz was caught steering its users to price your hotel rooms
if they booked using a Mac rather than a PC?
They assumed that Mac users weren't as price sensitive
and they used that information to target them.
But more than bad profits in the healthcare system,
I just see a lack of innovation.
Why is it that we can book travel to any city in the world,
find every flight and price in a matter of seconds,
but we can't just as quickly and easily compare options and prices
for managing a medical condition?
For example, a few months ago, I had a rash on my arm,
and my doctor prescribed a generic cream that had two active ingredients in it.
Shortly after he electronically sent that prescription to the pharmacy,
my phone buzzed with a text message telling me
that it was going to cost me 103 dollars,
which seemed way too high to me.
Now, what if I've received a second notification,
letting me know that these two creams
with the exact same ingredients sold separately
could be purchased for six dollars,
and if I apply the two creams the same way, I get the same result,
and I'd save 94 percent of my money?
But we've set up this system like a hardware store,
where you could buy a bolt for a dollar and a nut for a dollar,
but then somebody packages the nut and the bolt together,
and now the price is 50 dollars.
And you can't find that old dollar display anywhere.
If we flip back to the travel analogy for a moment,
when booking a flight from say, Kansas City to New York,
there are many routes that you can choose from.
You can fly direct; you can stop in Chicago, or Atlanta,
or Cincinnati; you can even fly west, clear around the globe to New York City.
You can pay more or less for things like business class,
exit rows, or seats with varying legroom.
Similarly, how you make your pharmaceutical journey
from illness to wellness should be your choice.
And you should be able to see your options quickly and clearly.
It shouldn't take you six hours,
like it did the first time I went looking for answers.
Betty, by the way, followed through on my suggestions,
went through them all with her doctor, and came back to tell me
that she could afford all of her medications.
She would now be able to save more than 3000 dollars a year on her medicines.
She no longer had to choose between paying rent
and buying her medications.
Her life changed, and my life changed.
Having seen that it could be done,
I saw an opportunity to help so many others with the same problem.
Ending the unsustainable rise in prescription drug cost
requires turning patients from passive consumers
into active, informed participants.
It means giving people like Betty the power
to see all of their medication options
and the associated prices in seconds,
without ever stepping foot in a pharmacy.
It's why I was inspired to start a company dedicated to serving this need.
Today, people in all 50 states are saving money using this software.
The research I did for Betty over a six-hour period
now happens in a tenth of a second.
And it works.
Using our tools,
Berkshire Hathaway Media Group reduced their pharmacy spend
despite record levels of drug price increases nationally.
The company and its 5000 health plan members
save more than 515,000 dollars in the first 18 months of use.
And while some may focus on just the institutional savings,
I think about one of our members,
a mother of a fifth grader who wrote and told me
about the day she was finally able to afford the medication
prescribed to treat her child's ADHD.
She shared her story,
that they were able to celebrate a positive report card
that just a few months before had seemed impossible.
Like this mother,
with access to the right information at the right time,
our healthcare system can be simpler, cheaper, and more effective.
It should be.
It needs to be.
And I'm going to stay mad that it's not until it is.
Thank you.
(Applause)