by elberto34 on 3/12/17, 7:05 PM with 117 comments
by e15ctr0n on 3/12/17, 8:32 PM
The articles dances around the details of who these players are and how they conspire to push up drug prices in America. This article captures the dynamics very well: http://www.diabetesforecast.org/2016/mar-apr/rising-costs-in...
and the accompanying graphic is the picture that is worth a thousand words: http://www.diabetesforecast.org/2016/mar-apr/images/insulin-...
A good summary from a more recent article on insulin prices: https://medium.com/insulin-report/why-does-insulin-cost-so-m...
Drug manufacturers make insulin available to insurance companies at a much lower price via middlemen called pharmacy benefit managers. The difference between the list price and the lower price negotiated by the pharmacy benefit managers is called the spread. Part of the spread is pocketed by the pharmacy benefit managers, leading to a perverse incentive in which the higher the list price of the drug, the higher the earnings of the pharmacy benefit managers. The price rise affects the uninsured and under-insured the most, many of whom can no longer afford to buy insulin at its list price any more.
by cloakandswagger on 3/12/17, 8:33 PM
The vast majority of healthcare spending goes to hospitals and doctors, yet the political environment hyper focuses on drugmakers. Why isn't there a larger focus on reducing the costs of hospitals and healthcare professionals?
[1] http://www.pfizer.com/files/about/Position-Role-of-Pharmaceu...
by awinter-py on 3/12/17, 11:03 PM
Lasik is an out-of-pocket procedure. It has the highest satisfaction rate of any surgery and the price has gone steadily down since it was introduced.
Should all healthcare be out of pocket? Maybe not. But if most consumers purchased most health services retail instead of via invisible negotiated prices, insurance would get cheaper too. (And until that happens, prices will continue to go up).
Medicare set a cap on the first 30 days post heart-attack care in the 90s and hospitals respected it -- but day 31 got a lot more expensive.
by mikeyouse on 3/12/17, 7:59 PM
http://cen.acs.org/articles/95/i9/Pushback.html
It's long but a very thorough treatment of the problem. The existing pharma system is very, very profitable and there is a ton of resistance to anything to rock that boat. Lately profitability has been coming from price increases instead of innovation but pharma is okay with that as long as it lets them pay billions in dividends.
by wmccullough on 3/12/17, 8:57 PM
by justinph on 3/12/17, 8:33 PM
by tcj_phx on 3/12/17, 9:29 PM
Anyone who might need to deliver these drugs -- to their allergic kid, addict friend, etc -- ought to learn how to use a syringe, and skip the price gouging. Someone on the opiates subreddit sent me a couple vials of naloxone and some needles - I sent a donation to cover shipping & handling.
Naloxone is $0.50/mg, when you buy a gram at a time: http://www.sigmaaldrich.com/catalog/substance/naloxonehydroc... - I tried to buy some naloxone powder from a different company, but they wouldn't sell it to me. I wonder if Sigma Aldrich would...
I think more attention should be drawn to prescription drugs that harm patients. For example, the caller to a NPR Science Friday segment [1] was annoyed that her doctor made her "manic and suicidal" with the depo-provera injection, and that this awful drug is still on the market.
[1] http://www.sciencefriday.com/segments/looking-beyond-condoms... (The first caller was at 8min30sec)
by rayiner on 3/12/17, 8:56 PM
Just in my adult life there has been enormous advances in treating HIV, Hep-C, and various cancers. When I was a kid in the 1990s, HIV was a death sentence people talked about in hushed tones. With modern anti-retrovirals:
> What did this do to life expectancy? In 1996-97 the life expectancy at age 20 of an HIV-positive person was 19 years, in other words they could only expect to live, on average, in the absence of any improvement in treatment, till they were 39. By 2011, this had improved to 53 years, i.e. death on average at 73.
(http://www.aidsmap.com/Life-expectancy-in-HIV-positive-peopl...)
What is the value of living to 73 versus living to 39? Big enough where the $10-12k annual cost of anti-retrovirals is a bargain in comparison. Probably a way better bargain than a $700 iPhone.
When you make something that creates a ton of value for people, you are able to charge a lot for it and make a big profit. There is nothing nefarious about that, and indeed those outsized profits are essential to making the system work. Turning drugs into a price-regulated ghetto is going to do nothing more than drive investors to areas like advertising where nobody will blink when they see a 30% profit margin. Unless you're willing to replace that private investment with public investment (as we have done in the defense industry), that's a terrible idea.
by gist on 3/12/17, 10:22 PM
Ok so what is happening here if it's not clear is this. People in the US are subsidizing so that people in those countries don't pay as much. Point being if people in the US paid the same price (in theory) the drug companies wouldn't make enough money to support their operations. As a result prices would rise for everyone and drugs in the US would cost less. I guess it's to simple for our government to enact some kind of 'most favored nation' clause whereby the discounts given to other countries must be given here. My guess is that that doesn't happen simply because it works in the favor of the drug companies (who will lobby) to have the current system.
by maxxxxx on 3/13/17, 12:49 AM
Of course they didn't but I think this needs to be pointed out repeatedly.
by CamperBob2 on 3/12/17, 8:38 PM
by imaginenore on 3/12/17, 8:23 PM
2) We're in a free market, companies can charge a billion dollars a pill if they want to.
by randyrand on 3/12/17, 8:28 PM
the value of a drug is the amount someone is willing to pay for it. different for everyone.
while im a big proponent of lower drug costs and agree drugs cost more than they should/could,
drugs are typically very underpriced compared to their actual value. a drugs actual value to the a person can be tremendous. if we charged people the same amount as the value it brings them, they would not buy it! it would be a wash! since lots a people are buying lots of drugs, we know drugs are typically priced under their real value; that's a good thing!!
in other words, talking about the value of a drug if you're arguing to lower their cost is the last thing you want to do!
