My Sources (10 of Them!)

There's no quick reference guide without prior research. The purpose for this post is to start annotating a list of works cited, and to get a feeling for which sources are most useful and reliable. I'll begin by listing and assessing the 10 best sources for my project that I've found so far:


Source #1

• Where? This paper by Jacquelyn Bainbridge was found while searching Google Scholar. This is a published review of a roundtable discussion among economic experts. The article itself is hosted on a '.com,' and the proceedings appear to be published without peer review. This makes the source less reliable than a journal publication, but better than a typical website source.
• Who? Although the website host's credibility might be questioned, the author's credibility is secure. She is a Pharm.D who is summarizing a discussion centered around professors at the University of Tennessee who are experts in their field. Researching Jacquelyn Brainbridge reveals that she is now a pharmacology professor at the University of Colorado, and has published several manuscripts regarding MS.
• When? This publication came out in October, 2007. It is a bit before MS prices truly started to balloon in 2010 and onwards. Thus, it misses the latter half of that exponential rise. However, it reveals how health care economists were already predicting unnecessary price increases as newer MS drugs were introduced to the marketplace.
• What? The article establishes how extreme MS price increases truly have been, and how expensive MS drugs are relative to treatments for comparably serious diseases. It identifies exactly how much MS treatments cost in the US per year ($7B), and that the average MS patients costs $20,000 per year. It also explains why indirect costs are so high: namely, MS patients are typically young (20-50) and have severely diminished lifetime earning potential once diagnosed. 

Source #2

• Where? This brief, issued by United Healthcare, was found while searching for how drug cost increases have affected insurers. The slides are posted directly on the United Health Care site, indicating that United Healthcare approves its message. In addition, it cites primarily research journal articles which undergo rigorous peer review. Still, it is located on a '.com' site and is not reviewed or edited by anyone outside of United Healthcare. 
• Who? The brief is supposed to represent the view of UH, and there is no individual author attributed to the article besides the insurance company itself. UH is an insurance company who must shoulder the cost of drugs for their insureds It is a fairly biased source representing the interested of a company looking to minimize these expenditures.
• When? An exact publication date is not given for this article, although it must have been after 2013, since research conducted in 2013 is referred to in the brief. In 2013, new orally ingested MS drugs came out to market that were several thousand dollars more expensive than earlier intravenous sources. This publication was aware that such drugs were coming out to market, but could not yet predict whether these new medications would reduce the cost of old medications or increase them. 
• What? The article shows how specialty drugs are taking up an increasing portion of healthcare costs. It establishes the big picture problem: drugs are taking up a bigger and bigger share of overall GDP every year. Many of these drugs are not providing cures, but rather slowing down the progression of degenerative, incurable diseases. This also implies that such drugs are taken for years and have an enormous overall cost. 

Source #3

• Where? NPR did a radio segment as part of their morning commute show called Morning Edition. The link above provides an online re-broadcast of that original show. NPR is a government and listener-supported public broadcast whose primary purpose is to provide educational entertainment. The site is a '.org' and has a stringent editorial and fact-checking process.
• Who? Richard Harris was the actual commentator on the show, and he interviewed a patient with MS as well as a journalist who was following MS patients. As seen here, Richard Harris is a science desk correspondent for NPR. He has no particular attachment to the story of MS patients, but he merely covered it for a single NPR episode. 
• When? The segment was released on May 14th, 2015. By this point, it was no secret that specialty drugs for MS were obscenely expensive. It had been reported extensively in the media. This is partly why the segment focuses on how these prices affect patients rather than simply recapping the story of rising drug costs. 
• What? This radio broadcast focuses on MS patients and how rising costs affects them. It detailed the stress and complications many go through when trying to get reimbursed for the exorbitant copays associated with the medications. This is our first example of the story being told from the perspective of the MS patient who must simultaneous deal with a debilitating illness and the financial costs of treating it.

Source #4

• Where? This peer-reviewed journal article in Neurology broke down MS drug costs by the different treatment options. The article was found in PUBMED, a database hosted by the National Health Sciences Library. The website host is extremely reliable, and is a frequent pit stop for researchers looking for scholarly sources.
• Who? The authors are Daniel Harteung and Dennis Bourdette. Daniel is a Pharm.D, MPH and Dennis is an allopathic doctor. Dr. Bourdette has a background in MS treatment, whereas Dr. Harteung has a background in the economics of drug distribution.
• When? The article was published on April, 2015. Due to its recent release, it was able to include orally ingested medication into its cost analysis. Also, it looked at how prices increased over 20 years, allowing us to graphically interpret how the release of new interferon blockers in 2011 affected drug prices.
• What? This article provided an objective outsider's perspective--it doesn't present the biased perspective of any particular stakeholder. The authors sought to determine to what extent new interferon blockers affected the price of older drugs 

Source #5

• Where? This news article was published in Healthline News, a healthcare-oriented news site. The source is designed for health care providers, advertisers, and publishers. Since it targets healthcare industry insiders, it is not necessarily objective. However, it does undergo an editorial process prior to publication.
• Who? Jeri Burtchell is a freelance writer and patient activist. Thus, she likely write from a perspective oriented against large pharma companies. 
• When? The article was published on July 19, 2013. This is right when new interferon blockers were coming out at over $60,000/yr prices. Thus, MS drugs were again a hot topic at this point, and several other news articles about the topic came out at the same time. 
• What? This is essentially a quick reference guide on Big Pharma and how patent protection rights and imperfect market competion can dictate the price of new drugs. It is a good guide for how to structure the QRF for these types of subjects, although it focuses more generally on all specialty pharmaceuticals. 

Source #6

• Where? This news article was published in the New York Times' Business Day section, and was published directly on the nytimes.com website. Although it is a '.com' website, the NYT is well-known for having a rigorous fact-checking and editorial process. 
• Who? Andrew Pollack, the author of the article, covers the business and science behind biotechnology for the NYT. He has been writing for the NYT since 1981, and has focused on biotech the entire time. He has a background in environmental engineering. His experience as a biotech writer increases the chance that fact-checking was thoroughly conducted by both the author and the editors. 
• When? The article was published on July 23, 2015, around the same time as the Health Line article. Again, this coincided with the introduction of new MS drugs that induced a flurry of news activity. There is also a presidential primary race beginning at this time, and several presidential candidates are quoted saying that these prices required justification.
• What? This article captures the public shift in mood during the mid-2015 era. At this point, many public figures come out against high drug prices and there are quotes from Hillary Clinton demanding accountability and explanation for why prices should be so high for life-improving treatment. 

Source #7

• Where? OptumRx, a pharmacy benefits manager, hosts its own website. This presentation, posted on their site, is a strategic guide for how to control costs in the future. This source is heavily skewed in favor of insurers and script providers, who wish to minimize drug costs. 
• Who? There is no individual author, as the presentation was designed to represent the views of OptumRx. However, OptumRx is a frequent publisher of briefs and presentations highlighting the procedures and strategies necessary to control escalating health expenditures.
• When? The presentation was created in 2014. At the time, there was little going on in MS drug pricing. It is one of the few presentations between early 2013, when interferon blockers were introduced, and mid-July when the issue was hyped up during presidential primaries. 
• What? The presentation shows that disease-modifying therapies (as all MS drugs are), represent about 73% of treating MS. Thus, most of the direct costs of MS don't stem from outpatient or inpatient doctor stays and hospitalizations. Instead, they come from medications that don't even cure the chronic disease.

Source #8

• Where? The National Multiple Sclerosis Society is a self-help website for those with MS. The website is a patient advocate, but it also included a lot of general information about MS and the ongoing research. It is a relatively objective source.  
• Who? The website is maintained by many authors The guides I specifically used did not have individual authors listed.
• When? The site was last updated on Feb. 4th, 2016. This is at the heart of the primary election season, when the debate over whether drug prices were too high was revitalized as a political issue.
• What? The website explains how MS develops and the current ways the disease-modifying therapies work.

Source #9

• Where? WebMD's page on multiple sclerosis provides an objective outlook on the symptoms that may indicate that MS is present. Although it is a '.com' website, the source is universally known and considered fairly reliable. 
• Who? The primary author, Dr. Tracia Chatman, is a physician who has practiced for 27 years. She is considered an expert on managing care for patients with MS. 
• When? The article was written in October 2014. This is a bit before the primary season started, and less than a year after the first introduction of oral drug DMTs. 
• What? The website provides an overview of the symptoms typically felt by MS patients. It also divides the disease into four subcategories, and explains how many MS patients experience occasional relapses.