The queer community has always been vulnerable as a marginalized group, but pharmaceutical drug corporations’ greed puts the lives of every queer individual in danger. All communities lose from unfair prescription drug prices; however, queer people face an even greater risk. Compared to the population at large, our community needs prescription drugs at a greater rate. Queer people are more susceptible to “abuse of alcohol, tobacco and illicit drugs, obesity, unprotected sex, mental disorders, Sexually Transmitted Diseases (STDs) such as HIV/AIDS, bullying, and cervical and breast cancer, as well as violent behavior” stemming from discrimination and abuse. All of those factors could necessitate prescription drugs and/or treatment, which is why we must take action to bring down drug prices and fight pharmaceutical corporations’ monopoly power.
The risk of disease and mistreatment poses serious risk to queer lives, amplified by a lack of insurance. Compared with the general population, gay and lesbian adults are twice as likely to be without health insurance. These rates prove even higher for bisexual and transgender people. The main culprit for such poor statistics is employment and workplace discrimination. There is no federal law prohibiting discrimination, and not every state has such a law. Given that the U.S. health insurance system is primarily employment-based, workplace discrimination bars queer people from access to health insurance. Even if employers do provide benefits to same-sex couples, we must out ourselves in order to claim the benefit, putting our jobs and health at risk.
The situation is even grimmer for transgender people. The Affordable Care Act (ACA) forbade discrimination based on gender identity, but the Trump administration is undoing that progress. Without the ACA, Medicare and Medicaid exclude people from coverage for transition-related expenses, as do many private insurance plans. Right now, the Trump administration is attempting to roll back those ACA protections. Even more insidious is that these exclusions can deny any health care services to transgender individuals. If queer people get through the already mentioned obstacles, we still face discrimination from health care providers. This causes us to avoid seeking preventative treatment or receive poor treatment.
Drug corporations take advantage of the lack of price controls and regulations in the U.S. to impose exorbitantly high prices on American consumers. Despite the industry’s claims, research and development spending does not explain the high prices of drugs, as evidenced in a recent report by Public Citizen. Moreover, in December 2016, the Department of Health and Human Services released a report that concluded drug manufacturers set prices to maximize profits.
You might wonder how prescription drug corporations have the ability to increase the prices of drugs virtually overnight. The whole process of pricing prescription drugs is murky because the data is secret . Brand name drug corporations often partake in backroom pay-for-delay deals, paying generic companies to delay entry to the market. Such settlements cost the American people $3.5 billion each year. Another strategy that drug corporations abuse is “evergreening,” or obtaining a patent for “new inventions” such as small modifications of their old drugs or a “new” use of an older drug. The practice prolongs the exclusivity that a corporation has for a specific product.
The consequences of price gouging are not theoretical; there are tangible examples of how unchecked pharmaceutical power disproportionately hurts the queer community. Due to competition, generic drugs tend to be much cheaper than brand name drugs. Truvada, which is prescribed in low doses as a pre-exposure prophylactic (PrEP) for HIV, costs roughly $18,000 a year in the United States, but can cost as low as $70 overseas as a generic prescription drug.
Another notorious example of price gouging involves Turing Pharmaceuticals’ drug Daraprim. The drug originated more than 60 years ago to treat toxoplasmosis, a parasitic infection found in individuals with suppressed immune systems, like those with HIV. Martin Shkreli, Turing’s CEO at the time, spiked the price of Daraprim by over 5,500 percent to $750 per pill. Shkreli received massive backlash in the media, but everything he did to raise prices was legal.
The Food and Drug Administration (FDA) has not approved any medications specifically for transitioning to reflect gender identities, leaving transition-seeking transgender people especially vulnerable to pharmaceutical monopoly power. Without FDA approval, insurance companies will not cover the cost of hormones, which cost about $100 a month, along with additional lab and office visit costs. Some people take hormones for two years, but some take them their entire life, racking up high costs. The effect is also amplified since the transgender community has four times the average poverty rate. As a result, many transgender people purchase black market hormones or face body dysmorphia, both of which could cause serious injury or death.
The Trump administration has focused on repealing the ACA, built a set of drug pricing goals that resemble the pharmaceutical industry’s wish list and set a decidedly anti-queer agenda. Despite that, there are many active bills designed to tackle drug pricing. The first is Senator Al Franken’s Improving Access to Affordable Prescription Drugs Act (S. 771, H.R. 1776). It aims to curb pharmaceutical monopoly abuses, create transparency for the pricing of prescription drugs and incentivize the production of prescription drugs for smaller, less profitable markets, like new lines of antibiotics. This would drive down prices by enhancing generic competition and reining in greed and monopoly abuses. Another bill is Senator Sherrod Brown’s Stop Price Gouging Act (S. 1369, H.R. 2974). It seeks to limit prescription price spikes or cumulative price spikes over five years. The legislation would increase marginalized communities’ access to prescription drugs by penalizing corporations that engage in price gouging.
These bills are vital to stopping corporate pharmaceutical greed and to ending corporate oppression for everyone. Currently, people are dying due to the enormous price of drugs. With our increased health risks and marginalized status, we as queer individuals cannot afford to stay silent on this issue. President Donald Trump is not on our side. His administration just filed a brief in court denying us protection under the Civil Rights Act of 1964, specifically to enable employment discrimination. We must take action to support drug pricing reform; without real change to make medicines affordable, queer people will continue to die.