When to Say No

Lynn R Webster, MD, The Painful Truth, chronic pain, lawmakers

An article called “7 Words That Could Have Biotech and Big Pharma Very Worried,” written by Sean Williams and recently posted on The Motley Fool, tells both sides of the story.

Pressure on price for pharmaceuticals is a real concern. Affordability is important. A drug can only work if patients can afford to pay for it.

So, on the one hand, the price of drugs must be kept in check.

Biotech and pharma can’t just raise the price of a lifesaving drug by 5,500% overnight. That isn’t reasonable, and that isn’t a good decision for anybody.

But the other side of the story is this:

Strong prices drive innovation. It encourages research. Biotech and pharma need to be paid to find solutions to our diseases. And, like all of us, they deserve to paid for their work and their products.

Many cancer cures would not have been possible without the profits to produce the drugs. Investors look for places to earn the greatest returns.

Pharma has produced great returns for investors over the years. This has spurred the research that has lead to major advances in disease control and cures.

However, most drugs are unaffordable for most people if insurance does not pay for the drugs. Of course, people without insurance are out of luck. They could die, with or without Obamacare.

Yet there has to be a limit to what a society can afford for drugs or even better health. I don’t know where that inflection point occurs.

Do we prolong the life of a terminal patient at the cost of being unable to treat a hundred other people who have a chance to recover? A thousand other people?

Where do we draw the line?

When do we say “no?”

When do we say, “I wish we could, but we can’t. We just can’t.”


Purchase my book The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us (available on Amazon) or read a free excerpt here.the painful truth, lynn webster, md, chronic pain
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Copyright 2016, Lynn Webster, MD


  1. NightSong on February 21, 2016 at 5:11 pm

    Dear Dr. Webster,

    I have purchased your book and am beginning to read it with my partner. I am one of those statistics who, because of a staffing change in a big pharmacy chain similar to Walgreen’s, no longer am able to fill my much needed opioids and valium that I needed for full body a partial body muscle spasms. along with a whole hosts of painful symptoms. I am a former holistic practitioner who can no longer work due to my excruciating pain.

    I had been with that pharmacy for 7 1/2 years until the new arrogant and completely lacking in compassion pharmacy manager decided he would no longer fill my hydromorphone and valium rxs. He did this completely without notice and without giving me time to find another pharmacy. Without these meds in physician regulated amounts, I cannot function at all or get out of bed. I have no quality of life. In fact, I can die from a heart attack or lower respiratory failure given the diagnosis I live with. I wouldn’t wish any of this on my worse enemy.

    This all affects my relationship with my husband, which has been put to the test by this pharmacist as my husband has had to sit quietly in the car at the drive-through and watch me being treated like a drug seeker, only to pull over a 100 yards away, as I sob hysterically from his inhumane mistreatment. The cocktail of meds I’m on has helped me have a better quality of life, but if I undertreat myself subtracting even one dose throughout the day, as I’ve had to do due to the shenanigans of this manager, I suffer and need to go to the ER for treatment there after my husband calls the ambulance (it takes all my focus just to breathe through the pain so I am unable to even use the phone); sometimes we can get through it without calling the ambulance because I know how to meditate, etc. We just never know how bad my spasms will be.

    All that just to share a little of my story, to thank you for bringing compassionate and kind attention to those of us living with chronic pain, and to ask you to please continue fighting the good fight. As you clearly understand, those of us on opioid tx don’t want to be, but I would rather be able to function with my cane or in my wheelchair (for longer trips I used to easily make) than lie in bed all day in tears considering suicide so I no longer burden my loving husband and other family members no longer living at home (I’m an empty nester).

    I would ask you one thing. Could you please not use the term Obamacare (I know even Obama uses it at times)? We all need to begin to refer to it by its proper name, which is the Affordable Care Act (ACA) Mitt Romney brought a version to Massachusetts which is not referred to as Romneycare but is called MassHealth. Just a small change to otherwise excellent writing that I greatly appreciate.

    Thank you for the validation and support I am finding in your book.

    Oh, btw, since I so abruptly had to leave the big chain pharmacy, I am now working with a small independent pharmacy who knows all the meds I’m on and has agreed to work with me to sync my meds monthly and deliver them for free. Their pharmacy is run by two sisters, whose father and grandfather opened it in 1969, when I was 9 years old. It feels so good to be treated with respect and dignity.

    I am lucky to have found this pharmacy and the compassion that both sisters share towards all their patients. This is my wish for all chronic pain sufferers – that they find an increased quality of life and compassionate carers.

  2. Martin Lemieux on February 22, 2016 at 7:43 pm

    As a patient who is forced to take many different kinds of medications, I’ve found that over the years, the more educated I become, the less I rely on medications to keep me alive.

    Patient Advocacy is so important to reduce costs on medications.

    Far too many patients say “yes” to anything prescribed to them and over time develop their own personal drug mart at home.

    I’ll bet that if there was a program in place in the US & Canada, which offered patients the ability to list their drugs in order to examine their medications vs. Illnesses, I’ll guarantee patients would need less meds than prescribed to them.

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