Real IUDs Are Cheaper Than Novelty IUD Earrings Everywhere But America; Americans Too Preoccupied…

Real IUDs Are Cheaper Than Novelty IUD Earrings Everywhere But America; Americans Too Preoccupied To Notice

If smart, critical, feminist activists can look at a 25-cent piece of plastic and copper without asking why it should cost $1,000, what hope does America have of ever getting the affordable health care it wants?

Intrauterine Device (IUD) earrings are the latest in political fashion statements. And why shouldn’t they be? The lawmakers and supporters who wear them are only trying to draw attention to what Colorado has recently learned — and what reproductive researchers have known for years — that every $1 invested in contraceptives can save between $3.52 to $4.02 in public funds.

It is fantastic that there is so much momentum around reproductive rights right now, and a country that professes equality of opportunity as a national ideal should absolutely support anything that makes family planning every woman’s right and not just a privilege of those who can afford it. However, at the risk of being one of those Debbie Downer feminists you hear so much about, when are we going to get around to talking about why IUDs cost 31 cents in Chile and $1,000 in the US?

Okay, maybe I’m exaggerating a little bit. The copper IUD (generic name TCu380a, brand name ParaGard) doesn’t cost $1,000, more like $932 in the American private sector. And it’s considerably cheaper to public entities, between $325 to the VA and $588 to everyone else. And after all, Chile’s 31-cent price should not be directly compared to our $932 price tag because it is just for public entities, not the private consumer. But I’d still like to note that the cheapest price in the entirety of the United States is still over a thousand times higher than Chile’s price, while their GDP is only one-third of ours. Incidentally, CENABAST, the public entity which negotiated that price, has been described as, “straightforward, efficient, and transparent.” Has that ever been said about American health care? Kinda makes you jealous, doesn’t it?

Why is this important? If you don’t already know the name Victoria Hale, you will soon. She is the social entrepreneur who is trying to bring affordable IUDs to the United States, in the form of the newly FDA-approved Liletta. Hale’s previous project was the nonprofit pharmaceutical company OneWorld Health, which developed a treatment for visceral leishmaniasis — a disease which kills 200,000 people a year — for $17 million dollars. That’s not chump change, but it’s significantly lower than the $802 million figure that most people claim it costs to bring a new drug to market. It should be noted that this $802 million figure has been criticized for using unverified industry-supplied data, but most importantly for factoring into the cost of not just direct expenses but also the loss of unmade profits that maybe could have been earned if the money had been invested elsewhere — something economists refer to as “opportunity cost.”

It’s both unprecedented and unreasonable to factor in hypothetical unmade money to the question of how much it costs to develop a new drug, and the truth is, with so many people in the industry — basically everyone but Victoria Hale — unwilling to give specific figures, no one really knows much much it costs to bring a new drug to market. On the subject, Donald W Light and Rebecca Warburton have said:

“Industry executives, well supplied with facts and figures by the industry’s global press network, awe audiences with staggering figures for the cost of a single trial, like tribal chieftains and their scribes who recount the mythic costs of a great victory in a remote pass where no outside witnesses saw the battle.”

IUDs can also be quite useful as Outer Uterine Devices. Replacement buttons, for example. Photo Credit: Florian Blumm

So lets bring this back to IUDs. People are wearing IUD earrings to support a program in Colorado which managed to reduce teen abortions by 40%, reduce teen pregnancies by 30%, and save public funds with the reduction in Medicaid-funded births. It’s hard to find a reason not to support this program..

But can we please also discuss the fact that, because no one questions why American pharmaceuticals are often subject to monopoly pricing, which means that there’s nothing stopping them from costing as much as people are willing to pay for them, and because the government is legally forbidden from negotiating lower prices on our behalf, purchasing a fairly insignificant amount of contraceptives (30,000 for $23 million) is currently more expensive than developing a new treatment that can save over ten times as many lives (200,000 people die per year of visceral leishmaniasis, and developing the treatment cost $17 million — 25% less than the amount of money Colorado spent on monopoly-priced contraceptives).

Don’t say that so loudly, you’ll give them ideas! From Rodriguez, 2010

On the subject of opportunity cost, how many lives are squandered every time we obsequiously throw our money at the people who have convinced us that $1,000 for a piece of plastic with copper wrapped around it is a bargain — and the story stops there, no more questions, and hey, by the way, cute earrings sweetheart.

I’ll admit, I was quite naive when I wrote my book about the effects of monopoly-priced contraceptives last year. I thought this information was so shocking, all I had to do was put it all one place, and someone else would come and solve America’s problem. It turns out it’s actually quite difficult to get people to look at a copper IUD and see it for what it is: a safe, reliable, and effective contraceptive, yes, but also a symbol for the smoke and mirrors behind the pharmaceutical industry, for how foolish we are to assume that it’s all so complicated we couldn’t possibly understand it. It’s not. We can. But we’re not even trying, and our collective tunnel-vision flummoxes me.

Most people can agree that America is a far cry from having the health care that it wants. But I submit for consideration that until we can look at a 25-cent piece of plastic with a thousand-dollar price tag and ask why, Americans already have the health care they deserve.