Healthcare costs keep going up with fingers often pointed at drug companies. At the same time, the pharmaceutical industry has decades of success delivering safer and more effective drugs to prevent and treat diseases that previously accounted for debilitating sickness and often death.

What we seem to have lost in the complexities and lack of transparency of healthcare costs is the significant cost savings that should have resulted from drug treatment and prevention.

In other words, where has all the money gone? What happened to healthcare costs associated with drug treatment of hundreds of millions of patients who previously required specialist care, hospitalizations, ICU monitoring, isolation or surgery?

What about the costs associated with fewer and less expensive physician office visits and treatments from all the cases of childhood diseases, influenza, pneumonia and shingles that have been prevented with relatively inexpensive vaccines? What about reductions in cardiovascular, gastrointestinal or dermatologic diseases that previously required expensive long-term treatment, specialist care and frequently surgery with all the associated collateral costs?

What happened to all the savings from cancer treatments that now either cure or significantly mitigate the need for expensive surgery or specialist care they might have previously required? Even cheap antibiotics are shortening hospital stays if not keeping patients out of the hospital entirely. And, what about the billions of dollars that we should be seeing as generic drugs replace "expensive" brand name drugs?

What has happened to the billions of dollars that we should be realizing from the cost savings generated by drug treatment?

Hepatitis C treatments (Sovaldi and Harvoni) from Gilead have raised concerns about prescription drug prices because they might "bankrupt the healthcare system." This implies that curing Hepatitis C with Sovaldi or Harvoni will cost more than traditional treatments and liver transplants.

But what happens to all the savings that will be generated by Sovaldi and Harvoni as a result of fewer physician visits, less long-term treatment costs, and fewer hospitalizations and liver transplants? Sure, more Hepatitis C patients will probably be treated now that these effective treatments are available, but that would also imply that the healthcare system (government and private insurers) never intended to treat all the hepatitis C patients in the first place.

Healthcare is a business, and as long as it is a business there will be a desire and need to grow the business. For healthcare providers, this means that if there is a loss of revenues from one area, it must be made up for in another and then some.

From physicians to hospitals to insurance companies, any decline in revenues (cost reductions) produced by effective and safe drug treatment must be offset by charging higher fees in other areas. So, the cost benefit (cost savings) of drug treatment — or any other treatment option — is meaningless except that it creates a business revenue problem for healthcare providers.

As long as the business inertia for growth exists in healthcare, there is no way to decrease the cost of healthcare. There is little hope for any initiative to reduce healthcare costs if the tens (or hundreds) of billions of dollars in collective cost savings delivered by effective drug treatments can't do it.

Here is a prediction: Because there will be fewer liver transplants as a result of treatments with Sovaldi and Harvoni, I predict the price of liver transplants and associated costs will increase dramatically.