Healthcare going forward

[KaraBulut]

I think controls are not needed. Healthcare providers will leverage drug prices just as they do with coverage. Prices will be negotiated.

There was a discussion earlier in the thread about how as part of the negotiations on Medicare D (the outpatient drug program ) and the ACA, the industry lobbying group Phrma got agreements written into the legislation that prevents the government from negotiating pricing on medications.

Medicaid is allowed to negotiate. The VA is allowed to negotiate. Unless Congress passes new legislation, Medicare and Obamacare cannot negotiate.

 

[Benvolio]

There was a discussion earlier in the thread about how as part of the negotiations on Medicare D (the outpatient drug program ) and the ACA, the industry lobbying group Phrma got agreements written into the legislation that prevents the government from negotiating pricing on medications.

Medicaid is allowed to negotiate. The VA is allowed to negotiate. Unless Congress passes new legislation, Medicare and Obamacare cannot negotiate.

The problem is that Medicare and Obamacare will control such a large part of the market that the bureaucrats who negotiate will have all the bargaining power. A decade ago, the government negotiated the price of vaccines so low that most American companies got out of the vaccine business. The liberals on this forum are hostile to drug companies and begrudge their advertising and profits etc, as was Obama.. It illustrates a mind set which could be very damaging to future drug development here and in other countries.

 

[gsdx]

Query. Sometimes, at the end of a commercial for some drug, the announcer says that the company may be able to help people who can't afford their prescriptions.

How does this work? Is it a temporary thing to get them hooked? Do they get the drugs free or at a discount?

 

[ballcaphair]

There was a discussion earlier in the thread about how as part of the negotiations on Medicare D (the outpatient drug program ) and the ACA, the industry lobbying group Phrma got agreements written into the legislation that prevents the government from negotiating pricing on medications.

Medicaid is allowed to negotiate. The VA is allowed to negotiate. Unless Congress passes new legislation, Medicare and Obamacare cannot negotiate.

Yeah, that's a dent that needs to be hammered out. I believe that big pharma had a huge seat at the table when ACA was written. Oh yeah. Thanks for the link, too.

 

[thewiz]

Price controls are not necessary; group purchasing is. The reason Canada and most all of the developed world enjoy cheaper prices is that the single payer system bids for the prices and the drug manufacturers supply for that given price. Does Ben really think that they do so at a loss? What they don't do is flood the airwaves with commercials, wine and dine doctors and hospitals, send out bulk samples, and likely claim losses on wherever they choose to show their headquarters for tax purposes. More and more of the pharmaceutical companies have been moving off-shore and to low tax havens in order to save even more while enjoying huge supports from places like the US through NIH, teaching institutions, and other direct subsidies.

 

[gsdx]

Does Ben really think that they do so at a loss?

Of course he does. He says that our system is failing and the drug companies are going belly-up because of it. We can't seem to convince him that both have been going strong for over a half century even with pharmaceutical advertising being banned. We get enough of them on American programmes.

 

[Stardreamer]

Query. Sometimes, at the end of a commercial for some drug, the announcer says that the company may be able to help people who can't afford their prescriptions.

How does this work? Is it a temporary thing to get them hooked? Do they get the drugs free or at a discount?

My understanding is this is part of the way that companies use in lobbying and public relations to take some heat off of them and the idea of government regulation. They promise to provide some give aways to show that they really care for the needy. Just how generous these programs really are I can't say.

 

[gsdx]

^ So, it's really more for their benefit than for the buyers. Then again, they announce that, if you can't afford to pay for the medication, the drug company "MAY be able to help". That doesn't necessarily mean that they will.

 

[KaraBulut]

Query. Sometimes, at the end of a commercial for some drug, the announcer says that the company may be able to help people who can't afford their prescriptions.

How does this work? Is it a temporary thing to get them hooked? Do they get the drugs free or at a discount?

My understanding is this is part of the way that companies use in lobbying and public relations to take some heat off of them and the idea of government regulation. They promise to provide some give aways to show that they really care for the needy. Just how generous these programs really are I can't say.

There's a reason that pharmaceutical salespeople are paid the big bucks.

You're exactly right- a few years ago, there was a big backlash against drug prices. The drug companies had the option of lowering the price in the US market to make the price more in line with the price paid outside the US.

Instead, they got smart.

The first thing they did was start covering copays. Say for example, that your insurance company puts a $40 copay on an expensive new drug. Let's say the cost of the drug is $200. It makes more sense for the drug company to cover your $40 copay so that they can charge $200 to the other patients whose insurance will pay it.

The second thing they did was setup sliding scale payments for drugs like Truvada. You sign up for a discount program, you give them all your personal information; from the prescription, they also know that you might be open to marketing for other HIV-related products and services. They discount the drug for you but they still continue to charge the $1300 per month to everyone else- especially those who have insurance that covers the cost.

Yeah, that's a dent that needs to be hammered out. I believe that big pharma had a huge seat at the table when ACA was written. Oh yeah. Thanks for the link, too.

You're right. Steven Brill's book Bitter Pill has a whole section about the Obama administration's negotiations with former Congressman Billy Tauzin who became President and CEO of PhRMA after he left Congress.
Rep. Tauzin is the one who helped get the Medicare D legislation through Congress (the same bill that prevented Medicare from negotiating prices). He then left Congress in time to negotiate a similar deal for Obamacare and in exchange for Phrma's backing the ACA's passage through Congress.

 

[gsdx]

^ Thanks for that. All in the name of profits, even when it looks like they're taking a loss or doing the 'humanitarian' thing.

 

[ballcaphair]

^ Thanks for that. All in the name of profits, even when it looks like they're taking a loss or doing the 'humanitarian' thing.

That is a huge marketing, tax abating, and profit motive. You are right. It has nothing to do with healthcare. It is about money. Now even healthcare is drug based.

 

[Benvolio]

Of course he does. He says that our system is failing and the drug companies are going belly-up because of it. We can't seem to convince him that both have been going strong for over a half century even with pharmaceutical advertising being banned. We get enough of them on American programmes.

Why can't you understand that your companies advertise and sell into the much larger US market, free from price controls.

 

[ballcaphair]

"price controls" are void because monopoly controls. I understand the business ethic, but our clients often cannot afford medication and I understand profit margins. I'm conflicted because I see the results first hand. Please don't drag out the old horse and beat it yet again. I'm entitled to be conflicted and just wanted to vent. In advance, forgive me.

 

[Benvolio]

"price controls" are void because monopoly controls. I understand the business ethic, but our clients often cannot afford medication and I understand profit margins. I'm conflicted because I see the results first hand. Please don't drag out the old horse and beat it yet again. I'm entitled to be conflicted and just wanted to vent. In advance, forgive me.

Remember that if a company spends huge amounts to develop a new drug, which an individual cannot afford, he has not been injured by the company. The individual is where he would be if the company had done nothing.how many new drugs did the soviet era communists make available? Or ordinary philosophers and liberals? It takes hard work, strong incentive and huge sums of money from past drug sales to get the job done. It is so easy to sit back and say; you other guys should develop new drugs and sell them cheap and accept a tiny profit.

 

[gsdx]

Why can't you understand that your companies advertise and sell into the much larger US market, free from price controls.

Where is the proof for that? It's the first time you've mentioned it. I Googled it and found nothing except ways for Americans to buy the drugs from Canada.

And why can't you understand that, even with our cheaper prices, our drug companies are STILL making a profit? It's a sad day when you place profits above people's lives.

 

[Benvolio]

Where is the proof for that? It's the first time you've mentioned it. I Googled it and found nothing except ways for Americans to buy the drugs from Canada.

And why can't you understand that, even with our cheaper prices, our drug companies are STILL making a profit? It's a sad day when you place profits above people's lives.

This is form an article "Why are drug prices lower in Canada.
" Trouble is, drug companies are willing to sell for less in Canada and elsewhere only because they can sell for more in the United States. They are engaging in what economists call "price discrimination"--that is, charging different prices to different buyers of the same product. Price discrimination works in the drug industry because drugs are very expensive to develop, but fairly cheap to manufacture. As long as companies can recoup their research and development costs by charging high prices in the United States, they can make a profit in Canada and elsewhere by merely covering the cost of making the pill (or tube of ointment or whatever). Similar price discrimination occurs within the United States, with HMOs and other large buyers able to negotiate lower prices while the uninsured pay top dollar."

 

[Benvolio]

Her is the citation to the article. :http://www.slate.com/articles/news_...2000/05/why_do_drugs_cost_less_in_canada.html

 

[Kulindahr]

A lot of that increase is because these companies are really pushing biologics which have a high profit margin and are the dream drug because they don't cure the disease, they instead ameliorate symptoms and must be administered weekly or monthly for life (which creates a constant revenue stream).

Watch CNN for a few hours and count the ads for Keytruda, Harvoni, Humira, Neupogen, Enbrel, Remicade, Stelara and Simponi. Even Cyndi Lauper has gotten into the game, appearing in an ad for psoriasis drug Cosentyx.

In the case of AstraZeneca, they had a big writeoff because they had several drugs in development and in testing, they discovered that the drugs didn't improve outcome. Tralokinumab, a drug for asthma, failed in a late trial. Another drug which was a combination of durvalumab and tremelimumab, was discovered to not be superior to chemotherapy in cancer treatment.

When a drug trial fails, the R&D costs are usually written off. On the other hand, if a drug is approved, the company can write off the costs (depreciation) over the lifetime of the drug's patent.

So they're getting tax write-offs whether they succeed or fail... which means the taxpayer is de facto subsidizing their research.

Which means they don't need the substantial profits.....

 

[Kulindahr]

The big question is whether the US with Obamacare or its replacement or amendment will impose price controls or "negotiation"? Without the vast US economy, without drug price controls, the amount of money spent here and abroad will be dramatically reduced.

Forbidding negotiation is against the free market.

 

[Kulindahr]

The problem is that Medicare and Obamacare will control such a large part of the market that the bureaucrats who negotiate will have all the bargaining power. A decade ago, the government negotiated the price of vaccines so low that most American companies got out of the vaccine business. The liberals on this forum are hostile to drug companies and begrudge their advertising and profits etc, as was Obama.. It illustrates a mind set which could be very damaging to future drug development here and in other countries.

No one is "begrudg[ing]... their advertising and profits", they are challenging whether making a profit off human suffering is moral.