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Prescription drug prices discussion

zork

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Incredulity

Incredulity 11555

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Posted
12 minutes ago, trauma babe said:

Are you saying this is a good thing but Republicans will ruin it if/when they return to office? Are you becoming self-aware?

I don’t believe price controls fundamentally are a good thing.  Given this timeline it likely won’t get proven out either way.

 

 

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gmr548

gmr548 16517

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Posted (edited)

It's partly a very significant change to the way business is done, for some which lead time is appropriate, and partly cynical political ploy that ensures that if Republicans kill it when they have the chance (2025 at the earliest), it will be done in the immediate lead up to the 2026 midterms.

The negotiation bit doesn't need three years of lead time. I wish it was being implemented sooner. But there is some consolation in seeing Democrats actually showing some political competence, and even ruthlessness, with this bill and the process that led to it. Incredulity's posts read weird because we're not used to seeing Republicans processing being caught in a political trap laid by Democrats; it's usually the other way around.

Now if only we'd see this to, oh I don't know, fortify democracy...

Edited by gmr548
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gmr548

gmr548 16517

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1 hour ago, Incredulity said:

I don’t believe price controls fundamentally are a good thing.  Given this timeline it likely won’t get proven out either way.

 

 

Evidently the penalties for price increases for patients on private insurance have been scratched by the Senate Parliamentarian, FYI.

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Biff Tannen

Biff Tannen 45499

Posted
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1 hour ago, gmr548 said:

Incredulity's posts read weird because we're not used to seeing Republicans processing being caught in a political trap laid by Democrats; it's usually the other way around.

It's not even a political trap, it's just good policy that a sane Republican (oxymoron) can see benefits them as well.

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Nice Guy Eddie

Nice Guy Eddie 13414

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Posted

We have all seen industries that have new rules or regulations imposed on them with a future date or a slow ramp up. The industries always cry when the date approaches they’re not ready and congress obliges by kicking the can down the road. Being unprepared is the plan, or at least faking it.

as Medicare negotiation dates are coming up, the pharma industry will either claim it will hinder future drug R&D, or they will toss a few sacrificial lamb drugs that are low margin anyway. “Let’s negotiate the price of aspirin by cutting its $0.002 cost in half”

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Anastasis

Anastasis 23394

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Posted

Here is the most recent top 10 drug list by Medicare spend. This is going to create some really strange market dynamics and unintended consequences. If you are going to do price negotiations, these half measures are not the way to do it efficiently, imo. Just go full on VA style formulary. 

 

image.thumb.png.63f172c125ca484b484905fcbf73fad2.png

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joe dirt

joe dirt 285

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Posted

my 15 yr old currently takes stelara to treat crohn’s. she takes one injection every two weeks. insurance is billed (and pays) $30K PER PRE-FILLED SYRINGE. 

i pay exactly $30 copay for this. it keeps me up at night thinking i can only carry her on my insurance for a little over 10 more years. 

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Fastbreak

Fastbreak 3959

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Posted
my 15 yr old currently takes stelara to treat crohn’s. she takes one injection every two weeks. insurance is billed (and pays) $30K PER PRE-FILLED SYRINGE. 
i pay exactly $30 copay for this. it keeps me up at night thinking i can only carry her on my insurance for a little over 10 more years. 

They make the injection from liquified gold, mixed with ground Honus Wagner baseball cards with a base of Macallen 75 year old cask scotch. The price makes sense.
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Incredulity

Incredulity 11555

Posted
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42 minutes ago, Satchel said:

Why are they working in Canada?

Because Canada’s pharma industry doesn’t invent the overwhelming majority of new drugs.

price controls create scarcity. 
 

this may well lower costs for current drugs.  Is the juice worth the squeeze?

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safe sex

safe sex 11684

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52 minutes ago, Incredulity said:

this may well lower costs for current drugs.  Is the juice worth the squeeze?

Yes. Diabetics are suffering and dying because they can't afford insulin anymore, which is necessary to, you know, stay alive. What's the percentage of drugs that are developed by universities and/or federal grants versus a pharma corp doing it on their own?

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Satchel

Satchel 6908

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1 hour ago, Incredulity said:

Because Canada’s pharma industry doesn’t invent the overwhelming majority of new drugs.

price controls create scarcity. 
 

this may well lower costs for current drugs.  Is the juice worth the squeeze?

Price controls create a manufactured scarcity that is not the result of prescription price negotiations. See Canada

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Incredulity

Incredulity 11555

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11 minutes ago, trauma babe said:

Yes. Diabetics are suffering and dying because they can't afford insulin anymore, which is necessary to, you know, stay alive. What's the percentage of drugs that are developed by universities and/or federal grants versus a pharma corp doing it on their own?

https://www.science.org/content/blog-post/where-drugs-come-numbers

 

58% from pharmaceutical companies.
18% from biotech companies..
16% from universities, transferred to biotech.
8% from universities, transferred to pharma.

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Incredulity

Incredulity 11555

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6 minutes ago, Satchel said:

Price controls create a manufactured scarcity that is not the result of prescription price negotiations. See Canada

Wtf is “manufactured scarcity”?

Are you suggesting anyone who won’t manufacture drugs and sell them below cost is acting in bad faith?

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Dbeasy

Dbeasy 14970

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Posted (edited)

With ObamaCare plans a typical diabetic likely would have to pay $800-1000 per month for short acting and long acting insulin until their deductible is met, which is usually $8-12k right now. $10k per year in expenses just for the insulin. That is completely unaffordable for most people. In every other major country in the world it is typically 1/10th that cost.

Edited by Dbeasy
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gmr548

gmr548 16517

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2 hours ago, joe dirt said:

my 15 yr old currently takes stelara to treat crohn’s. she takes one injection every two weeks. insurance is billed (and pays) $30K PER PRE-FILLED SYRINGE. 

i pay exactly $30 copay for this. it keeps me up at night thinking i can only carry her on my insurance for a little over 10 more years. 

Why are you a communist?

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safe sex

safe sex 11684

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35 minutes ago, Dbeasy said:

With ObamaCare plans a typical diabetic likely would have to pay $800-1000 per month for short acting and long acting insulin until their deductible is met, which is usually $8-12k right now. $10k per year in expenses just for the insulin. That is completely unaffordable for most people. In every other major country in the world it is typically 1/10th that cost.

In every other major country they don't have to fucking pay for it

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Satchel

Satchel 6908

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1 hour ago, Incredulity said:

Wtf is “manufactured scarcity”?

Are you suggesting anyone who won’t manufacture drugs and sell them below cost is acting in bad faith?

Why is there no scarcity in Canada where drug prices are negotiated? And is the scarcity of monkey pox vaccines the result of negotiated prices?

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Anastasis

Anastasis 23394

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1 hour ago, trauma babe said:

Interesting and illuminating article from 2020 about public funding of private research

Reading this just made it even more infuriating that they pretend to be put out by all of the money it costs to research new drugs. Fuck outta here.

The gravy train is long. Universities love those royalty rights. Pharma gets fat after commercializing through the regulatory complex. And the line of industries with their head in the trough goes on and on. 

The US tax payer gets fucking hosed over and over again. We should be getting our own royalty payments off the innovation when it is founded and based on NIH/etc. dollars.  Let the people adding value along the way get their cut, but so should we.   

 

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Incredulity

Incredulity 11555

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Posted (edited)
3 hours ago, Satchel said:

Why is there no scarcity in Canada where drug prices are negotiated? And is the scarcity of monkey pox vaccines the result of negotiated prices?

Scarcity in this context isn’t as simple as the availability of drug A, B or C.

It’s also about developing new drugs in the future.  Also, access to the most cutting edge drugs, which as I understand it are delayed in availability to countries that have implemented drug price controls.

Edited by Incredulity
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Satchel

Satchel 6908

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4 minutes ago, Incredulity said:

Scarcity in this context isn’t as simple as the availability of drug A, B or C.

It’s also about developing new drugs in the future.  Also, access to the most cutting edge drugs, which as I understand it are delayed in availability to countries that have implemented drug price controls.

From whence does your understanding come?

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TwiceHorn

TwiceHorn 31285

Posted
Posted
7 hours ago, joe dirt said:

my 15 yr old currently takes stelara to treat crohn’s. she takes one injection every two weeks. insurance is billed (and pays) $30K PER PRE-FILLED SYRINGE. 

i pay exactly $30 copay for this. it keeps me up at night thinking i can only carry her on my insurance for a little over 10 more years. 

Well, in partial consolation, any patents likely will have expired by then.  But, thanks to the FDA, that doesn't mean free competition in the formerly patented product.

I would expect the price to come down significantly by then.  But it still may be godawful expensive.

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TwiceHorn

TwiceHorn 31285

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2 minutes ago, HRSchenker said:

Will this end brand names being enforced on the PBM formulary? It's bullshit that they force me to dispense expensive brand name drugs when the cheaper generic is on the market 

I'm not 100% on what drives inclusion on the formulary, but sometimes generics are available only for certain treatments.

While docs are free to prescribe off-label, which also means patent-infringing, more formal, organized things like a formulary can contribute to patent infringement when a generic is clear for some treatments, but not all.   And there's probably shenanigans involved.

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TwiceHorn

TwiceHorn 31285

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1 minute ago, Hank Scorpio said:

But how will we create new innovative drugs?! If only the vast majority of drug companies didn’t spend more on marketing than R&D. 

When you get down to it, the patents, which give them exclusive rights to sell for the greater part of 20 years, should be enough.

That gives them monopolistic pricing power, but not the freedom to refuse to negotiate with their biggest customers based on the actual benefit the drugs provide.

The incremental costs of most medicines are fairly negligible, it's all fixed costs, so volume absolutely matters.  It's why they don't kick much about being chiseled outside the US.  And I don't think there are price controls, per se, outside the US, but there's really just one or a very few customers, so you have monopoly vs. monopsony.

Let them keep patents, mostly the way they are.  Unfuck some of the things at the FDA that create barriers to entry for generics and competitors.  Don't let them advertise to consumers, and let the market operate on their prices by having Medicare negotiate, and we're probably at least 50% there, maybe more.

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Satchel

Satchel 6908

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50 minutes ago, Incredulity said:

Paying attention in economics class and reading a variety of business news publications(WSJ, Economist, Fortune…) over the years.

Did these publication cite examples of countries wherein scarcity ruled the day because price negotiations morphed into onerous price controls?

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Incredulity

Incredulity 11555

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5 minutes ago, Satchel said:

Did these publication cite examples of countries wherein scarcity ruled the day because price negotiations morphed into onerous price controls?

Have you read anything about this bill?

Whats the penalty for failing to agree to the “negotiated” price?

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Satchel

Satchel 6908

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16 minutes ago, Incredulity said:

Have you read anything about this bill?

Whats the penalty for failing to agree to the “negotiated” price?

Interesting answer.  If it is true that drug scarcity can occur for many reasons, including manufacturing and quality problems, delays, and discontinuations, why would price negotiations that happen everywhere else in the 1st world be a bridge too far here, especially considering the net positive that could redound to millions who are on fixed incomes?

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Chico_SA

Chico_SA 521

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Posted

TLDR....but..

Cleanest I ever felt...

The day I left a high paying pharma rep job to go teach and coach. 

Hated pushing expensive diabetes drugs to doctors treating poor patients, knowing that Metformin and other options would do the job.  

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Incredulity

Incredulity 11555

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18 minutes ago, Satchel said:

Interesting answer.  If it is true that drug scarcity can occur for many reasons, including manufacturing and quality problems, delays, and discontinuations, why would price negotiations that happen everywhere else in the 1st world be a bridge too far here, especially considering the net positive that could redound to millions who are on fixed incomes?

This has already been addressed above

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Chico_SA

Chico_SA 521

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2 hours ago, Incredulity said:

Scarcity in this context isn’t as simple as the availability of drug A, B or C.

It’s also about developing new drugs in the future.  Also, access to the most cutting edge drugs, which as I understand it are delayed in availability to countries that have implemented drug price controls.

Source for this? I'm curious. But skeptical. 

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