In November, 2007, I reported in a Chapel Hill News column that a prescription for Spiriva, which was supposed to aid my breathing, instead took my breath away when I found that a minimum supply would cost $171. Because this drug was frequently advertised on TV, it seemed reasonable to assume that costly TV advertising played a part in its price. I decided to explore what was being presented on TV, and to determine the costs of each medication.

I rather quickly found 40 prescription drugs. I took the list to my Rite Aid pharmacist, who provided costs for a 30-day supply of each for 32 of the medications. I reported:

"Those who respond to such TV advertising should know that prices ranged from $59.06 (Viagra) to a whopping $1,609.09 (Embrel). Six of the 32 drugs were priced in the $50 to $99 range, 13 in the $100 to $149 range, nine in the $150 to $199 range, and four over $200. The median (or middle value when prices are ordered from lowest to highest) obviously falls in the $100 to $149 range."

I went back to the TV over the recent Thanksgiving holiday, this time finding only 21 prescription drugs advertised. I found nothing for the allergenic Embrel, for which a 30-day supply was now priced at $2,039.99 at Rite Aid, a 27 percent increase over two years earlier. Twenty-three of the drugs advertised in 2007 were not found, and there were a couple of newcomers. As in the case of Embrel, prices for the 19 drugs still advertised were generally substantially inflated. For the entire group of 21 drugs, prices for a30-day supply ranged from $118 (Latisse) to $284 (Restasis), with the median price now about $192, and the arithmetic mean $196

With coverage by Medicare and good insurance, costs for my wife and me for prescription drugs and insurance in 2008 exceeded $14,000. Although I would have rather spent that money elsewhere, we could afford it. I am more concerned with the many in our society who cannot afford such costs, leaving death or undue suffering the only alternative.

Physicians should know what medications are suitable, without being asked about something for which the patient was prompted by TV. That the advertisements continue is testimony that they work - and costs are passed on to the consumer, who suffers even though the drug companies' profits do not. My appeals to political leaders have no impact, almost certainly because of their lavish treatment by the pharmaceutical industry - again, with costs passed on to the consumer. What a sweet deal for the congressmen and the drug makers! But what a tragedy for the sufferer who cannot afford these prices.

While the probable decrease in number and frequency of drugs advertised on TV is encouraging, the escalation in prices is not. The welfare of the people continues to take a back seat to profits for the pharmaceutical industry and financial support for the political decision makers.

Thus, for both Congress and the pharmaceutical industry, it is business as usual: political parties and their elected representatives are each putting their own welfare before that of their constituents, and big business is controlling government, rather than the other way around. And poor people may not be able to afford needed medicine.