Healthcare going forward

[Benvolio]

Gilead (the same company that produces Truvada, the PrEP medication) said in interviews that it randomly chose $1,000 per pill, in effect, to see if insurers would pay it. Most insurers would because a) it was an FDA-approved treatment and b) because the drug results in cure in about 90% of the cases, the 12 weeks of treatment at $84,000 still ended up being less than the cost of a lifetime of managing the disease process of Hep C.

It wasn't until later that the cost of $1,400 for the 12 week supply was disclosed in an interview with one of the physicians involved in the development of the drug. That physician now works for the VA, so Gilead's retail price of the drug shocked him since he knew how much the drug actually cost to make.

Gilead plays another game that is increasingly common in the market: they provide "discount cards" that help cover copays or in some cases, result in a lowered price for some patients. They also provide the initial doses of the medication free to physicians so that the patient can get the first couple of days free before they discover the actual cost of the full 12 week treatment. This is the same strategy that they're using with PrEP which costs about $1300 per month and is partially covered by insurance.

The words "cost to make" on their face do not include research development.

 

[gsdx]

The words "cost to make" on their face do not include research development.

We've already established many times over that R&D are minimal, and a fraction of the cost of advertising. You simply cannot justify the $84,000 cost when the actual cost manufacturing cost is only $1,400. R&D doesn't justify it. Advertising doesn't justify it. The only thing that justifies it is the predatory greed. People need the medicine and they will bloody-well buy it if they want to live. How many people have $84,000 in their bank accounts?

Face it, mate. You simply cannot justify it.

 

[Benvolio]

We've already established many times over that R&D are minimal, and a fraction of the cost of advertising. You simply cannot justify the $84,000 cost when the actual cost manufacturing cost is only $1,400. R&D doesn't justify it. Advertising doesn't justify it. The only thing that justifies it is the predatory greed. People need the medicine and they will bloody-well buy it if they want to live. How many people have $84,000 in their bank accounts?

Face it, mate. You simply cannot justify it.

Your assertions are not "established". It often costs hundreds of millions of dollars to research, develop and obtain regulatory approval for a drug which must be recovered in a limited amount of time. Advertising to advise of availability and side effects is unavoidable expense.

 

[Kulindahr]

That is obviously false. Even with the smattering of basic economics you are so proud of having, you should be able to see from the advertisements that they spend half their time telling the public some of the horrible side effects which may result from the drug. If they were playing on the emotions, they would not be doing so in such a negative way. I am sure even you, watching some of the adds, have wondered why anyone would take the risk of such a drug. The drug companies hope to sell more during the limited patent window by informing the public that a new drug is available if their doctor advises it, AND, the companies hope to avoid punitive damages by informing the public of the side effects.

Come on -- what they're doing is not "informing", it's snake-oil remedy propaganda. They want people to think, "Oh, I think I suffer from that!" and go beg their doctors to give them a drug they may not need.

Big Pharma doesn't care if people get appropriate medications, they only care that medications get sold. That's what capitalism does: it turns people into "consumers", and manipulates them into consuming, whether there is any benefit to the consumption at all. When it comes to caring for people's health, that is unconscionable.

I see those commercials. They're very nicely crafted in a way that will make most people forget the side effects and only remember the emotional hype.

 

[Kulindahr]

That is not 'free enterprise'. That is price gouging, and they have the people who need the medication 'by the balls' so to speak. That cannot be justified by a minimal amount of R&D and a more-than-minimal amount of advertising.

No justification. None. Zip. Zilcho. (Except for pure greed.)

5900% is plundering, not buying and selling.

 

[rareboy]

 

[Benvolio]

5900% is plundering, not buying and selling.

Remember, not every idea works out. Often new drugs are researched and tested, they don't work and the expense is lost. That expense nevertheless has to be recouped for the company to stay viable. Further, some drugs are priced high to allow others to be sold lower. Drugs like viagra and cialis, for instance have gone up enormously in price to allow other to be sold at a lower price.

 

[KaraBulut]

Medicare and Medicaid recently released some analysis about how much it is spending on specific drugs. The interesting thing that came out of the analysis is that many established drugs are increasing in significantly in price as companies begin to corner the market or investors buy companies that produce them.

Medicare reports that 11 drugs more than doubled in price compared with 2014, while Medicaid saw 20 covered drugs more than double in per-unit cost. Valeant’s anxiety med Ativan posted the largest price increase in 2015, growing 1,264% over the previous year, according to a Centers for Medicare & Medicaid Services (CMS) dashboard that analyzes drug spending. Turing’s now-notorious Daraprim followed with an 874% average per-unit price hike.

...Gilead’s megablockbuster hep C med Harvoni topped total 2015 spending for both Medicare and Medicaid. The agencies shelled out a bit more than $7 billion and $2.2 billion, respectively, for the pricey drug last year. Sanofi's basal insulin Lantus, often among the industry's goliath meds, came in second for Medicare, third for Medicaid, with double-digit price increases in both programs, as most of the top-spending drugs did.

Time recently did a series on how pharmaceutical companies are profiting from the opioid epidemic that they helped create (which is referred to as the "drug cascade"). For example, there are now commercials running during prime time (including during the Super Bowl) promoting a drug for "OIC" - aka Opioid Induced Constipation" - a condition that the pharmaceutical industry created so that they could market a drug that counteracts the effects of other drugs like Opana and oxycodone on the intestine.

Even more shocking, the price of naloxone- a drug that reverses opioid overdose- has risen as drug companies promote its use by the public. Naloxone has been available since the 1970s and has long been generic.

...a small Virginia company called Kaleo is joining their ranks. It makes an injector device that is suddenly in demand because of the nation’s epidemic use of opioids, a class of drugs that includes heavy painkillers and heroin.

Called Evzio, it is used to deliver naloxone, a life-saving antidote to overdoses of opioids. More than 33,000 people are believed to have died from such overdoses in 2015. And as demand for Kaleo’s product has grown, the privately held firm has raised its twin-pack price to $4,500, from $690 in 2014.

On a lighter note, some fun analysis of the BCRA:

 

[gsdx]

Your assertions are not "established". It often costs hundreds of millions of dollars to research, develop and obtain regulatory approval for a drug which must be recovered in a limited amount of time. Advertising to advise of availability and side effects is unavoidable expense.

Which we have shown you several times about. Yes, they spend millions and millions on R&D. We have no problem with that. But they also spent multiples of that number on advertising is not necessary or even ethical in many cases. And then they charge multiples of those combined on price. They are raking in billions of dollars in profits. That. Is. Greed.

Now, please stop flapping your gums and offer up some proof of your claims. We've offered more than enough to back up OUR claims.

 

[thewiz]

Come on -- what they're doing is not "informing", it's snake-oil remedy propaganda. They want people to think, "Oh, I think I suffer from that!" and go beg their doctors to give them a drug they may not need.

Big Pharma doesn't care if people get appropriate medications, they only care that medications get sold. That's what capitalism does: it turns people into "consumers", and manipulates them into consuming, whether there is any benefit to the consumption at all. When it comes to caring for people's health, that is unconscionable.

I see those commercials. They're very nicely crafted in a way that will make most people forget the side effects and only remember the emotional hype.

The commercials are chump change to what the pharmaceutical and insurance companies spend on individual doctors and hospitals. As a hospital board president -- we were regularly sent "samples" of all the new medications in an effort to get us to prescribe them -- particularly in the emergency room. Doctors, individually, are provided boxes of new meds along with trips, other perks, and "personal attention" from the companies. Two benefits of being president were to attend hospital conferences -- two that were top of the line and only presented in Arizona and Hawaii. And guess who underwrote pretty much every cost for the event along with dinners, drinks, etc.? It wasn't our hospital.

Much of the R & D costs for new medications are paid for by the federal government to address specific diseases; in some cases all of the costs. In addition, we, the people, pay through our government to universities, research facilities, and others to create "cures" for what ails us. The companies rarely pick up the costs and enjoy exclusive monopolies for years; monopolies other countries do not honor and bargain for actual prices.

 

[Benvolio]

Which we have shown you several times about. Yes, they spend millions and millions on R&D. We have no problem with that. But they also spent multiples of that number on advertising is not necessary or even ethical in many cases. And then they charge multiples of those combined on price. They are raking in billions of dollars in profits. That. Is. Greed.

Now, please stop flapping your gums and offer up some proof of your claims. We've offered more than enough to back up OUR claims.

The effect of the liability law, holding companies liable for punitive damages for failing to advise of possible side effects, makes advertising necessary.

 

[ballcaphair]

The commercials are chump change to what the pharmaceutical and insurance companies spend on individual doctors and hospitals. As a hospital board president -- we were regularly sent "samples" of all the new medications in an effort to get us to prescribe them -- particularly in the emergency room. Doctors, individually, are provided boxes of new meds along with trips, other perks, and "personal attention" from the companies. Two benefits of being president were to attend hospital conferences -- two that were top of the line and only presented in Arizona and Hawaii. And guess who underwrote pretty much every cost for the event along with dinners, drinks, etc.? It wasn't our hospital.

Much of the R & D costs for new medications are paid for by the federal government to address specific diseases; in some cases all of the costs. In addition, we, the people, pay through our government to universities, research facilities, and others to create "cures" for what ails us. The companies rarely pick up the costs and enjoy exclusive monopolies for years; monopolies other countries do not honor and bargain for actual prices.

Also, auto manufactures do R + D to provide safer and brilliantly higher mileage with a price point that is very competitive in a global economy.

 

[Benvolio]

The government does not pay the cost of clinical trials which often cost hundreds of millions and which often fail to obtain regulatory approval. And remember that research, development, trials and advertising are paid from the dread profits from prior medicines sold that liberals hate so much. American companies pay the highest income tax rates among major countries plus state income taxes as well.

 

[thewiz]

The government does not pay the cost of clinical trials which often cost hundreds of millions and which often fail to obtain regulatory approval. And remember that research, development, trials and advertising are paid from the dread profits from prior medicines sold that liberals hate so much. American companies pay the highest income tax rates among major countries plus state income taxes as well.

Please, please, please don't spout the Republican drivel on "highest tax rates of major countries." The tax system is skewed so that major companies pay little, and sometimes no income tax because of loopholes in the existing system. GE, despite making $33 billion, got a rebate from the federal government. https://www.sanders.senate.gov/top-10-corporate-tax-avoiders

The line that companies pay all of these taxes is, plain and simple, bullshit. My small company does not pay 35 percent, either; we are an LLC and my effective tax rate last year was 19%. If company has any brains and an accountant, it never pays the stated rate -- hell our president received rebates and paid no taxes for more than a decade.

Most state income taxes have also been slashed by Republican legislatures with the burdens transferred to local governments that have little or no options to dump any lower. Michigan, for one, as well as New York have slashed rates more than two dozen times in the last two decades. I am also very familiar that business taxes have been virtually eliminated in Michigan along with sales on personal property used in business.

 

[gsdx]

The effect of the liability law, holding companies liable for punitive damages for failing to advise of possible side effects, makes advertising necessary.

Bullshit. Only because of advertising do they have to list all of the side effect. Otherwise, they learn about them when the doctor prescribes them, and that's what pharmacists are for. And they keep coming up with new names for common ailments to shove those new drugs down our throats. And they don't list all of the side effects. If they did, there wouldn't be new lawsuits almost every day. They pay millions for advertising, but they certainly don't spend much on testing. Their 'clinical studies' sound more like those idiotic studies done for Lipozene. And I'm guessing they pay millions to the FDA to approve their products so they can earn enough money to pay off the lawsuits.

And you have yet to justify the exorbitant prices charged by drug companies. You have yet to justify a 5,600% price increase. You have yet to justify ANYthing, including why American drug companies charge incredibly-bloated prices when other countries charge and fraction of those prices And Still Make A Profit.

We've asked for proof of your statements. You have yet to provide any, because there isn't any.

As I said before, 'flapping gums'.

 

[rareboy]

The word 'women' apparently does not appear once in the 142 page GOP bill.

https://qz.com/1013409/the-senate-h...-to-talk-about-abortion-or-work-requirements/

 

[DantheManFL]

So, the CBO (Congressional Budget Office) has released their review of Trump Care today.

22 Million will be uninsured by 2026, with 15 million by next year.

The measure would dramatically scale back federal funding for Medicaid and financial assistance low- and middle-income people receive to make private health insurance affordable. The hundreds of billions of dollars saved would mostly be transferred to wealthy people and health care companies in the form of tax cuts.

The budget office report said it believes the Senate bill "would increase the number of uninsured people substantially. The increase would be disproportionately larger among older people with lower income" - especially those between 50 and 64 and with incomes below 200 percent of the poverty level, or around $30,300 for a single person.

Those ages are just shy of when people begin qualifying for Medicare coverage.

Insurers can charge older consumers up to 5 times what they charge younger people, leading to higher costs for older people and lower costs for younger policy holders.

http://www.huffingtonpost.com/entry/senate-health-care-bill-cbo_us_59512a7de4b0da2c731d398e?ncid=inblnkushpmg00000009

http://www.wesh.com/article/cbo-22-million-more-uninsured-by-2026-under-senate-health-bill-released-last-week/10224434

Yea Donald, that is a Mean bill.

 

[Benvolio]

So, the CBO (Congressional Budget Office) has released their review of Trump Care today.

22 Million will be uninsured by 2026, with 15 million by next year.







http://www.huffingtonpost.com/entry/senate-health-care-bill-cbo_us_59512a7de4b0da2c731d398e?ncid=inblnkushpmg00000009

http://www.wesh.com/article/cbo-22-million-more-uninsured-by-2026-under-senate-health-bill-released-last-week/10224434

Yea Donald, that is a Mean bill.

Money will not be fransfered to the wealth;less will be confiscated from them.

 

[frankfrank]

Money will not be fransfered to the wealth;less will be confiscated from them.

No, the money will be CONFISCATED [STOLEN] from those who can barely afford another burden. The wealthy will simply be allowed to leisurely coast as they become richer and richer. Is this the most massive Robin-Hood-In-Reverse in the history of the world?

Your utter hypocrisy is showing. You have NO issue with confiscating what wealth the less fortunate have, but LEAVE THE RICH ALONE!

You are blatantly promoting out-and-out class WARFARE.

Let sick Americans DIE, if it means preserving the sanctity of more and more tax cuts for people who don't even need the damned tax cuts, and cannot even possibly spend all the money that they already have, while tens of millions of Americans aren't sure if they'll be able to eat tomorrow.

When will somebody come out with a study of how much ACTUARIAL LIFE SPANS WILL PLUMMET in this country, if this shit is passed?

Though I know NOTHING about the basis-in-fact for what I've heard discussed here in western Illinois, I've heard some suggestions that this town could lose its hospital if Republicans get their way. I just don't know, but even the slightest hearsay of losing the hospital here...well, this town would die. And people in this town would start to die. I mean, it could kill ME.

Also just wait until they get their grubby mitts on AMTRAK and get rid of that...which is really the only transportation in and out of here, and very heavily depended on by so many University students who are here from Chicago, etc. Republicans have been trying to get rid of AMTRAK for decades.

I've heard talk about "medical savings accounts" again. Who the fuck can afford those?

 

[Benvolio]

Tax cuts do not transfer money to the taxpayers, it is their money and tax cuts take less away.