goldberry Posted September 22, 2015 Share Posted September 22, 2015 Drug Goes From $13.50 a Tablet to $750, Overnight http://www.nytimes.com/2015/09/21/business/a-huge-overnight-increase-in-a-drugs-price-raises-protests.html?WT.mc_id=2015-SEPTEMBER-AOL-BUSINESS_AUD_DEV-0901-0930&WT.mc_ev=click&ad-keywords=AUDDEVREMARK&_r=0 Insanity. 3 Quote Link to comment Share on other sites More sharing options...
Camelfeet Posted September 22, 2015 Share Posted September 22, 2015 Disgusting. 3 Quote Link to comment Share on other sites More sharing options...
Tsuga Posted September 22, 2015 Share Posted September 22, 2015 He is a psychopath. Nobody in their right mind would be able to sleep doing that. He doesn't care. Narcissistic psychopath. But yes, the reality of for-profit anything is that those who are willing to kill and harm have an advantage of those who do not, when the rule of law does not intervene. Disgusting, indeed. 7 Quote Link to comment Share on other sites More sharing options...
ChocolateReignRemix Posted September 22, 2015 Share Posted September 22, 2015 A prime example of why the prices of vital goods with inelastic demand curves shouldn't be subject to the whims of the market. 20 Quote Link to comment Share on other sites More sharing options...
Farrar Posted September 22, 2015 Share Posted September 22, 2015 I read another story about this happening for another drug today - that one for drug resistant TB, though in that case it looks like the deal is being reversed. Apparently it's part of a trend. :( 2 Quote Link to comment Share on other sites More sharing options...
Bluegoat Posted September 22, 2015 Share Posted September 22, 2015 Gross. We really need to get a proper pharmacare program here in Canada. Unfortunately none of the three major parties have it on their election platform. The Greens do, and depending on the election results, they may be able to push it in Parliament if there is a minority government. Why its been overlooked I don't know, its generally considered that it is cheaper. Quote Link to comment Share on other sites More sharing options...
FO4UR Posted September 22, 2015 Share Posted September 22, 2015 It's a perfect storm of for-profit AND the fact that the pharm company has a certain guarantee that it will have customers no matter how high they price the pills. When people are mandated to be insured, and when insurance companies are mandated to do certain things, and when Dr.s are nudged into following a protocol based upon the previously mentioned mandates, there is a guarantee that the drug will be prescribed with a certain frequency regardless of price. If for some crazy reason your town said that everyone has to eat pizza on Friday nights or pay a huge fine, the pizza joints in town are going to raise their prices on Friday nights. They would no longer have to play by the basic human laws of supply and demand. We will likely someday have a law that caps the profit that can be made off of pharmaceuticals to prevent this atrocity. I'm not convinced that it will have the long-term benefits we need as a society. There is something lost for the researchers and innovators when the reward of their work is capped. (And, I'm aware that this drug is 62 years old...the price jump does NOT reward the maker of a new drug!) Meanwhile, b/c it is such a huge profit opportunity, we will likely see a bunch of nonsense over drugs and medical procedures so long as the medical sector is mandated by law from every angle. I've already been a victim of being treated as par a protocol rather than what was actually needed and nearly lost a baby. We need to look at all angles of the $$$ stream, not just who sells the product. 7 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted September 22, 2015 Share Posted September 22, 2015 Well, yes and no... It's a perfect storm of for-profit AND the fact that the pharm company has a certain guarantee that it will have customers no matter how high they price the pills. When people are mandated to be insured, and when insurance companies are mandated to do certain things, and when Dr.s are nudged into following a protocol based upon the previously mentioned mandates, there is a guarantee that the drug will be prescribed with a certain frequency regardless of price. While the dual mandates of mandated insurance coverage and insurance company mandates to cover sick people may at the margin increase what economists call "inelastic demand" -- that a product will be purchased irrespective of how high the price goes -- the much, much bigger fundamental factor is that sick people actually need treatment. That, not mandates, is the underlying "fundamental" in the sector. (The first eye-popping, politically controversial drug charges that led to the evolution of pharma-bashing as a sport, back in the bad old Act Up days, was AIDS treatment. At that point there were no insurance mandates. People still had to pay whatever the cost or they'd die, full stop.) We will likely someday have a law that caps the profit that can be made off of pharmaceuticals to prevent this atrocity. I'm not convinced that it will have the long-term benefits we need as a society. There is something lost for the researchers and innovators when the reward of their work is capped. (And, I'm aware that this drug is 62 years old...the price jump does NOT reward the maker of a new drug!) Meanwhile, b/c it is such a huge profit opportunity, we will likely see a bunch of nonsense over drugs and medical procedures so long as the medical sector is mandated by law from every angle. I've already been a victim of being treated as par a protocol rather than what was actually needed and nearly lost a baby. We need to look at all angles of the $$$ stream, not just who sells the product. I agree that profit caps is exactly the corner we are painting ourselves into. Yesterday in response to this story Hillary Clinton made a (I think rather offhand) remark that if she were elected she would seek to limit pharma price gouging. The stock market for pharma TANKED within minutes for just the reasons you outline here (and also because pharma companies have to invest heavily for very long/expensive lead times in 10 drugs for every 1 that gets approved and becomes profitable and yada, yada...) It's complicated for sure, but I'm having a hard time believing we're headed in a sensible or ethical direction. 8 Quote Link to comment Share on other sites More sharing options...
goldberry Posted September 22, 2015 Author Share Posted September 22, 2015 It's a perfect storm of for-profit AND the fact that the pharm company has a certain guarantee that it will have customers no matter how high they price the pills. When people are mandated to be insured, and when insurance companies are mandated to do certain things, and when Dr.s are nudged into following a protocol based upon the previously mentioned mandates, there is a guarantee that the drug will be prescribed with a certain frequency regardless of price. I'm not sure how you are relating this to mandatory insurance or coverage, or to laws. (Although I do agree with you about doctors nudged into following protocols, but it is usually the pharma companies doing the nudging. There are numerous confirmed cases of pharma buying out doctors to influence prescription procedures.) People need medication in most cases because they are sick and need it, not because they are mandated to buy it. The article mentioned this is one of the only drugs available for toxoplasmosis, for example, and that pharma companies do everything they can to prevent generics being developed to compete with them. How is a drug that cures a sickness comparable to something optional that can be regulated by a "supply and demand" principle? Especially when there is so much money there that the "supply" side is being controlled and limited? I'm asking your opinion honestly because I have never understood this argument. 7 Quote Link to comment Share on other sites More sharing options...
Pawz4me Posted September 22, 2015 Share Posted September 22, 2015 I'm not sure this can be reduced to a pharma, insurance or supply and demand issue. It seems to me the main problem is a greedy hedge fund manager trying to line his investors' pockets. 7 Quote Link to comment Share on other sites More sharing options...
Serenade Posted September 22, 2015 Share Posted September 22, 2015 I don't understand the price increase for generics…. Is it true that Doxy has risen from $20 a bottle to $1849. I haven't used any in a while but that doesn't sound right. I hope I am misreading something. Sounds to me like manufacturers don't want to bother with generics because there is not enough profit. I do think drug pricing policy will have to change. There are enough people on both sides of the aisle that are ready to make changes to make drugs more affordable for the masses. When a drug sells for a cheap price in Canada, and costs a lot more in the US, Americans are basically subsidizing drug prices in other countries. Manufacturers know they can charge high prices in the US, so they use those high prices to subsidize the costs in other countries. I want to stomp my foot and say, "Not fair!" Americans must be allowed to buy drugs from other countries via the free market. Drugs should be the same cost for all, with the possible exception of third world countries. 1 Quote Link to comment Share on other sites More sharing options...
FO4UR Posted September 22, 2015 Share Posted September 22, 2015 Well, yes and no... While the dual mandates of mandated insurance coverage and insurance company mandates to cover sick people may at the margin increase what economists call "inelastic demand" -- that a product will be purchased irrespective of how high the price goes -- the much, much bigger fundamental factor is that sick people actually need treatment. That, not mandates, is the underlying "fundamental" in the sector. (The first eye-popping, politically controversial drug charges that led to the evolution of pharma-bashing as a sport, back in the bad old Act Up days, was AIDS treatment. At that point there were no insurance mandates. People still had to pay whatever the cost or they'd die, full stop.) I agree that profit caps is exactly the corner we are painting ourselves into. Yesterday in response to this story Hillary Clinton made a (I think rather offhand) remark that if she were elected she would seek to limit pharma price gouging. The stock market for pharma TANKED within minutes for just the reasons you outline here (and also because pharma companies have to invest heavily for very long/expensive lead times in 10 drugs for every 1 that gets approved and becomes profitable and yada, yada...) It's complicated for sure, but I'm having a hard time believing we're headed in a sensible or ethical direction. Risk of death is certainly the end-all, be-all. Agreed. Painting ourselves into corners with no sensible or ethical outcome...agreed. Dr.s must be free to make medical decisions based on the needs of the patient, not by which drugs are covered by their state. (My asthma kid had to switch meds when we moved for this very reason. I was told it was like the difference between "Dr. Pepper and Cherry Coke"... :confused1: ...no...it's like the difference between breathing and not, between terrible side effects and manageable side effects, between $25/mo and $250/mo. I can't even fault the Dr. as asinine as his comment was. He has to factor in the cost of the drugs, what is covered by insurance and what is not, and what the patient will actually be able to afford long term. His heart is in the right place, but he's working within crazy confines, definitely not free to treat the patient as HE sees BEST.) 3 Quote Link to comment Share on other sites More sharing options...
goldberry Posted September 22, 2015 Author Share Posted September 22, 2015 I'm not sure this can be reduced to a pharma, insurance or supply and demand issue. It seems to me the main problem is a greedy hedge fund manager trying to line his investors' pockets. But it's not isolated. Apparently, it has been happening and continues to happen. I think it goes to the argument about why healthcare should not be a for-profit industry. When you are dealing with people's health and well being, what happens when the desire for profit overrides the best interest of the people? If a private company controlled the water supply in a certain area, and just decided to start jacking up prices so they could make more profit to the point where some could not afford water, we would never accept that. Why do we accept it with healthcare? 15 Quote Link to comment Share on other sites More sharing options...
FO4UR Posted September 22, 2015 Share Posted September 22, 2015 How is a drug that cures a sickness comparable to something optional that can be regulated by a "supply and demand" principle? Especially when there is so much money there that the "supply" side is being controlled and limited? I'm asking your opinion honestly because I have never understood this argument. You are right in that a drug to cure an illness is not always optional, and the pizza comparison falls apart at that point. However, usually there are choices between drugs and those choices are made Top-Down by which drug the ins.co. covers more fully. The Dr's feel for the patient's overall care, and their ability to pay for drugs and food so Dr's will prescribe the drug more fully covered by ins. The ins co. therefore creates a guarantee that certain drugs WILL be prescribed over others. The drugs can then be price-gauged. Even the most well-meaning legislation can upset the delicate balance needed. It will probably never be fair or right, but it would help if there were some sort of law protecting the freedom of Dr's and patients choices. It is analogous to the education system, I believe. Many of us homeschool b/c the NCLB and CC mandates the classroom as much as healthcare law mandates the Dr's office. Quote Link to comment Share on other sites More sharing options...
goldberry Posted September 22, 2015 Author Share Posted September 22, 2015 However, usually there are choices between drugs and those choices are made Top-Down by which drug the ins.co. covers more fully. Many of us homeschool b/c the NCLB and CC mandates the classroom as much as healthcare law mandates the Dr's office. But it seems you are mixing two different issues here, insurance company control and "healthcare law". What you are describing where the insurance company dictates to the doctor what drugs it will cover, making others unaffordable, is part of the problem with the for-profit system - not healthcare law. The insurance companies are motivated strictly by cost, not well-being, and are highly manipulated by the pharma industry. In fact, as you mentioned, a decent healthcare law should STOP what you are describing. (I have been down the same road as you have, changing medication because of which one was actually affordable, not which one was best. Yep, sucks.) 5 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted September 22, 2015 Share Posted September 22, 2015 Risk of death is certainly the end-all, be-all. Agreed. Painting ourselves into corners with no sensible or ethical outcome...agreed. Dr.s must be free to make medical decisions based on the needs of the patient, not by which drugs are covered by their state. (My asthma kid had to switch meds when we moved for this very reason. I was told it was like the difference between "Dr. Pepper and Cherry Coke"... :confused1: ...no...it's like the difference between breathing and not, between terrible side effects and manageable side effects, between $25/mo and $250/mo. I can't even fault the Dr. as asinine as his comment was. He has to factor in the cost of the drugs, what is covered by insurance and what is not, and what the patient will actually be able to afford long term. His heart is in the right place, but he's working within crazy confines, definitely not free to treat the patient as HE sees BEST.) I don't want to "like" this because of the part about your child not being able to breathe. :grouphug: Gah. That is terrible. I really am afraid we are painting ourselves into a corner. Pharmaceuticals really is a complicated sector. It takes years to develop a drug; there (rightly) are rigorous clinical trial requirements that are not just time-consuming but also very expensive to do; not just the drug but also the end-to-end factory processes for its manufacture have (rightly) to be approved as safe. And most drugs that pharma companies start out developing turn out, in clinical trials, not to work well enough, or to have too many side effects, to be allowed. So the companies have to make Very Expensive bets on 10 drugs for each one that turns out to make any money. So although the cost-of-goods-sold for actually manufacturing each pill might be just a few cents, the companies can only be profitable ( /remain in business / invest in developing the next decade's drugs) if the whole system somehow balances... (kind of like the oil and gas industries, which have to invest enormously in exploration efforts that don't end up panning out, and upfront infrastructure before they can extract-- you can't compare their current cost-of-good-sold for a one-off gallon of gas either). There's no perfect answer to such Very Snarly issues; even countries that have universal payer systems still have to somehow work out the problems of financing investment costs, and the trade-offs associated with very expensive drugs for very low-incidence diseases, etc. But I'm afraid that for all the disproportionate $$$ we are as a nation sinking into healthcare, we're not getting any closer to a stable solution. 8 Quote Link to comment Share on other sites More sharing options...
go_go_gadget Posted September 22, 2015 Share Posted September 22, 2015 I really am afraid we are painting ourselves into a corner. Pharmaceuticals really is a complicated sector. It takes years to develop a drug; there (rightly) are rigorous clinical trial requirements that are not just time-consuming but also very expensive to do; not just the drug but also the end-to-end factory processes for its manufacture have (rightly) to be approved as safe. And most drugs that pharma companies start out developing turn out, in clinical trials, not to work well enough, or to have too many side effects, to be allowed. So the companies have to make Very Expensive bets on 10 drugs for each one that turns out to make any money. I've never understood this. Most non-medical (and non-tech, I guess) science manages just fine as non-profit. Why is medicine different? Why isn't it treated the same as NASA, the National Labs, etc.? I've heard the argument that in the absence of market competition there'll be no incentive to innovate, but that's nonsense in the context of scientific research as a whole. 7 Quote Link to comment Share on other sites More sharing options...
Mergath Posted September 22, 2015 Share Posted September 22, 2015 I'm not sure this can be reduced to a pharma, insurance or supply and demand issue. It seems to me the main problem is a greedy hedge fund manager trying to line his investors' pockets. The fact that our system even allows for something like this to happen is unconscionable. 5 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted September 22, 2015 Share Posted September 22, 2015 I've never understood this. Most non-medical (and non-tech, I guess) science manages just fine as non-profit. Why is medicine different? Why isn't it treated the same as NASA, the National Labs, etc.? I've heard the argument that in the absence of market competition there'll be no incentive to innovate, but that's nonsense in the context of scientific research as a whole. I don't know that it is so different; other countries do manage to fund pharmaceutical development through significant publicly funded research supplemented by the non-profit sector. Theoretically I would imagine we could too. But I don't think we could somehow splice out R&D and clinical testing from the industry set-up as a whole. We've evolved our overall system -- a patchwork of for-profit drug companies, for-profit insurance companies, and private doctors / other health care providers, all subject to various and increasingly complex regulations to protect against various problems that economists call "market failures" -- presumably because of our cultural preference for market solutions. And now that we have the more-or-less-for-profit system that we do have, it would quite hard to replace it wholesale with the kind of single payer / government-intensive system that (more or less; no system is perfect) work in other parts of the world. I can't see that happening for, oh, 1,345,931 reasons. Maybe a few more.... 2 Quote Link to comment Share on other sites More sharing options...
Lady Florida. Posted September 22, 2015 Share Posted September 22, 2015 While I'm in no way defending the price increase, here's a blog entry that gives a bit more detail. People who truly need the drug are protected from the increase, plus there are more effective inexpensive drugs that are more commonly prescribed. http://www.skepticalraptor.com/skepticalraptorblog.php/skyrocketing-prices-of-an-anti-parasitic-drug-the-facts/ Some might not like this site because they call out anti-vaccine types, but I urge you to read at least this entry. And the author does not at all condone what Turing Pharmaceuticals has done. From the final section titled The Bottom Line The pricing behavior of Turing is unsupportable, that’s clear. The effect on needy patients, however, is small. Turing is guilty on most points. But it might not matter all that much. I still think that their behavior is disgusting. 2 Quote Link to comment Share on other sites More sharing options...
Lady Florida. Posted September 22, 2015 Share Posted September 22, 2015 While I'm in no way defending the price increase, here's a blog entry that gives a bit more detail. People who truly need the drug are protected from the increase, plus there are more effective inexpensive drugs that are more commonly prescribed. http://www.skepticalraptor.com/skepticalraptorblog.php/skyrocketing-prices-of-an-anti-parasitic-drug-the-facts/ Some might not like this site because they call out anti-vaccine types, but I urge you to read at least this entry. And the author does not at all condone what Turing Pharmaceuticals has done. From the final section titled The Bottom Line The pricing behavior of Turing is unsupportable, that’s clear. The effect on needy patients, however, is small. Turing is guilty on most points. But it might not matter all that much. I still think that their behavior is disgusting. Quote Link to comment Share on other sites More sharing options...
Mergath Posted September 22, 2015 Share Posted September 22, 2015 While I'm in no way defending the price increase, here's a blog entry that gives a bit more detail. People who truly need the drug are protected from the increase, plus there are more effective inexpensive drugs that are more commonly prescribed. http://www.skepticalraptor.com/skepticalraptorblog.php/skyrocketing-prices-of-an-anti-parasitic-drug-the-facts/ Some might not like this site because they call out anti-vaccine types, but I urge you to read at least this entry. And the author does not at all condone what Turing Pharmaceuticals has done. From the final section titled The Bottom Line The pricing behavior of Turing is unsupportable, that’s clear. The effect on needy patients, however, is small. Turing is guilty on most points. But it might not matter all that much. I still think that their behavior is disgusting. All of the drug companies supposedly have programs in place to provide medication to poor patients. But in my experience from way back when dh was unemployed, they make it almost impossible to actually get the free/cheap medication. And I'm guessing there are a lot of people in the middle class who don't qualify for the programs, have no or crappy insurance, and couldn't even begin to afford that much money for one pill. 13 Quote Link to comment Share on other sites More sharing options...
Posted September 22, 2015 Share Posted September 22, 2015 It takes years to develop a drug; there (rightly) are rigorous clinical trial requirements that are not just time-consuming but also very expensive to do; not just the drug but also the end-to-end factory processes for its manufacture have (rightly) to be approved as safe. And most drugs that pharma companies start out developing turn out, in clinical trials, not to work well enough, or to have too many side effects, to be allowed. So the companies have to make Very Expensive bets on 10 drugs for each one that turns out to make any money. The drug in question was approved by the FDA in 1953, and until recently cost just $1 / pill. The company that now owns the rights to this drug does no drug research or development of their own -- they are run by a former hedge fund manager whose m.o. is to buy up the rights to old drugs like this, then jack up the prices. 6 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted September 22, 2015 Share Posted September 22, 2015 The drug in question was approved by the FDA in 1953, and until recently cost just $1 / pill. The company that now owns the rights to this drug does no drug research or development of their own -- they are run by a former hedge fund manager whose m.o. is to buy up the rights to old drugs like this, then jack up the prices. Believe me, I am not defending Turing here. At.all. This is an example of what market failure looks like; this is why regulation is essential in the health care sector (if we're going to run it on a for-profit basis). 4 Quote Link to comment Share on other sites More sharing options...
zoobie Posted September 22, 2015 Share Posted September 22, 2015 But it's not isolated. Apparently, it has been happening and continues to happen. I think it goes to the argument about why healthcare should not be a for-profit industry. When you are dealing with people's health and well being, what happens when the desire for profit overrides the best interest of the people? If a private company controlled the water supply in a certain area, and just decided to start jacking up prices so they could make more profit to the point where some could not afford water, we would never accept that. Why do we accept it with healthcare? We kind of do this now when we let private companies pollute the water supply. 3 Quote Link to comment Share on other sites More sharing options...
Azalea Posted September 22, 2015 Share Posted September 22, 2015 I've never understood this. Most non-medical (and non-tech, I guess) science manages just fine as non-profit. Why is medicine different? Why isn't it treated the same as NASA, the National Labs, etc.? I've heard the argument that in the absence of market competition there'll be no incentive to innovate, but that's nonsense in the context of scientific research as a whole. Liking this wasn't enough. There are plenty of people more than willing to serve science, society, and themselves without earning millions. Folks being paid out of government grants are not earning what they could earn in private industry, but they are still willing to do it. Give scientists a small income and they will do drug research because they actually want to help people. 5 Quote Link to comment Share on other sites More sharing options...
MistyMountain Posted September 22, 2015 Share Posted September 22, 2015 While I'm in no way defending the price increase, here's a blog entry that gives a bit more detail. People who truly need the drug are protected from the increase, plus there are more effective inexpensive drugs that are more commonly prescribed. http://www.skepticalraptor.com/skepticalraptorblog.php/skyrocketing-prices-of-an-anti-parasitic-drug-the-facts/ Some might not like this site because they call out anti-vaccine types, but I urge you to read at least this entry. And the author does not at all condone what Turing Pharmaceuticals has done. From the final section titled The Bottom Line The pricing behavior of Turing is unsupportable, that’s clear. The effect on needy patients, however, is small. Turing is guilty on most points. But it might not matter all that much. I still think that their behavior is disgusting. The problem is the people who do not qualify for Medicaid but who can not afford the drug. Lots of people fall into this catagory. A lot of people do not have great insurance. Even having great insurance that covers the cost of medication the costs will be passed on with an increase in price. It does not matter that The condition it treats for is nowhere near as common as heart problems so less people need it. 5 Quote Link to comment Share on other sites More sharing options...
kiana Posted September 22, 2015 Share Posted September 22, 2015 Liking this wasn't enough. There are plenty of people more than willing to serve science, society, and themselves without earning millions. Folks being paid out of government grants are not earning what they could earn in private industry, but they are still willing to do it. Give scientists a small income and they will do drug research because they actually want to help people. They might even be able to do more bloody research if they don't have to spend all their time chasing grants from various agencies to make a profit. 1 Quote Link to comment Share on other sites More sharing options...
Lady Florida. Posted September 22, 2015 Share Posted September 22, 2015 All of the drug companies supposedly have programs in place to provide medication to poor patients. But in my experience from way back when dh was unemployed, they make it almost impossible to actually get the free/cheap medication. And I'm guessing there are a lot of people in the middle class who don't qualify for the programs, have no or crappy insurance, and couldn't even begin to afford that much money for one pill. The problem is the people who do not qualify for Medicaid but who can not afford the drug. Lots of people fall into this catagory. A lot of people do not have great insurance. Even having great insurance that covers the cost of medication the costs will be passed on with an increase in price. It does not matter that AIDs is nowhere near as common as heart problems so less people need it. True, and like I said I'm not defending it in any way. In fact, we would likely be in that group that has to pay the ridiculous price. But that blog entry (I hesitate to call it an article because it isn't) just adds some perspective. 1 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted September 22, 2015 Share Posted September 22, 2015 re: private companies running public utilities such as water / not being "allowed" to charge exorbitant rates: We kind of do this now when we let private companies pollute the water supply. Yes and yes -- first, utilities such as water and electricity are regulated (or alternatively provided by public companies), precisely because they are essential ("inelastic demand")... and second, economists do consider pollution to be a cost that private companies push off onto the world rather than incorporating the costs of cleanup into their true cost of production ("externality"). Both issues are considered "market failures" -- examples of places where an unbridled free market doesn't get us to the right answer. re: feasibility of R&D and clinical testing being done a different way: ... There are plenty of people more than willing to serve science, society, and themselves without earning millions. Folks being paid out of government grants are not earning what they could earn in private industry, but they are still willing to do it. Give scientists a small income and they will do drug research because they actually want to help people. They might even be able to do more bloody research if they don't have to spend all their time chasing grants from various agencies to make a profit. There certainly are great numbers of scientists, doctors, and public health officials who genuinely wish to serve; and there certainly is scope for drug development to take place outside Big Pharma. In some domains it already does... Partners in Health, the Gates Foundation, and Doctors Without Borders have all led global development efforts to tackle intractable health problems -- resistant TB, malaria, ebola -- that no pharma company wanted to take on (the diseases were most prevalent in populations that couldn't afford to pay -- yet another type of market failure). Slogging through international aid and UN agencies to get the drugs approved in each country that will trial them (and rightly so), slogging through each place they're being manufactured to ensure it meets quality standards (and rightly so), begging for UN, WHO, bilateral and charitable funds (thank you, Canada, for underwriting the development of the ebola vaccine with Doctors Without Borders!). They are heroes, all. God bless them every one. But their focus is on public health -- big incidence or highly contagious diseases. They will not (and IMO should not) turn their attention to rare diseases ("orphans," another market failure...), or try to Build a Better Mousetrap for diseases with reasonably-OK-but-could-be-a-lot-better existing treatments, or pure research that might, one shot in ten million, cure CF or a rare form of cancer-causing mutation. That's not what they exist to do, and God knows they have enough on their plate. Yet such research needs to happen, and I wouldn't want to leave it to the political willingness to fund things like NASA to see it happen... Outside the private sector, the biggest centers for pharma- and biotech-related research in the US right now is the university system. Which is itself funded very differently in the US than in most other countries. It's hard to take out one little piece of an interlocking system and "fix" just that one piece. Things are connected. 3 Quote Link to comment Share on other sites More sharing options...
Serenade Posted September 23, 2015 Share Posted September 23, 2015 The drug in question was approved by the FDA in 1953, and until recently cost just $1 / pill. The company that now owns the rights to this drug does no drug research or development of their own -- they are run by a former hedge fund manager whose m.o. is to buy up the rights to old drugs like this, then jack up the prices. This is what I have a huge problem with. An old drug, that was inexpensive (generic?), now being jacked up in price like a newly released wonder drug. That's wrong. I would have more sympathy for a company who spent a lot of time and effort developing a drug, and that drug is new to the market -- of course that company needs to make a healthy profit. But that is why there are limits as to how long a drug can be on the market before the generics can compete. I know the drug companies frequently get extensions, but I thought that even had reasonable limits. I'm not really understanding how this hedge fund manager can buy up the rights to a drug whose patent should long be expired. I do know that sometimes companies stop making generics because there is not enough profit in them, but this is ridiculous! 3 Quote Link to comment Share on other sites More sharing options...
Serenade Posted September 23, 2015 Share Posted September 23, 2015 Believe me, I am not defending Turing here. At.all. This is an example of what market failure looks like; this is why regulation is essential in the health care sector (if we're going to run it on a for-profit basis). It seems like if there were truly a free market for pharmaceuticals, the prices would naturally come down. However, there is no free market to set the rates, as many governments (not ours) set the price, and then we here in the US are forbidden from buying overseas. Although I've heard it's easy to do so now, and the official policy is not to go after anyone who is buying for personal needs. Not sure if that is true, but it's my understanding. 1 Quote Link to comment Share on other sites More sharing options...
TechWife Posted September 23, 2015 Share Posted September 23, 2015 Nobody in their right mind would be able to sleep doing that. He doesn't care. I saw an interview with him yesterday. I agree with you - he doesn't care. 2 Quote Link to comment Share on other sites More sharing options...
ktgrok Posted September 23, 2015 Share Posted September 23, 2015 All of the drug companies supposedly have programs in place to provide medication to poor patients. But in my experience from way back when dh was unemployed, they make it almost impossible to actually get the free/cheap medication. And I'm guessing there are a lot of people in the middle class who don't qualify for the programs, have no or crappy insurance, and couldn't even begin to afford that much money for one pill. Yup. I was prescribed an eye medication and got to the pharmacy to find out that AFTER insurance it was about $200 dollars for a tiny bottle. I told them just to hold onto it, and went home and googled. Found the website for the company that makes it, found their special pricing program, enrolled, and printed the "savings card", then took that to the pharmacy and got the medicine for about $35. But..I had the time and money and reliable transporation for two trips to the pharmacy, access to the internet, access to a printer, AND the knowledge that most expensive drugs have these kinds of programs. Most people do NOT know this, and man many many low income people would NOT have the time and ability to do what I did. So the poorer ones end up being the ones paying the whole $200. Disgraceful. 5 Quote Link to comment Share on other sites More sharing options...
ktgrok Posted September 23, 2015 Share Posted September 23, 2015 It seems like if there were truly a free market for pharmaceuticals, the prices would naturally come down. However, there is no free market to set the rates, as many governments (not ours) set the price, and then we here in the US are forbidden from buying overseas. Although I've heard it's easy to do so now, and the official policy is not to go after anyone who is buying for personal needs. Not sure if that is true, but it's my understanding. No, because often there is only one drug that will fill the need. So there is no competition. 1 Quote Link to comment Share on other sites More sharing options...
Serenade Posted September 23, 2015 Share Posted September 23, 2015 No, because often there is only one drug that will fill the need. So there is no competition. I'd be curious to know what that same drug costs in Germany or Canada. Or if it's even available in those countries. 1 Quote Link to comment Share on other sites More sharing options...
Posted September 23, 2015 Share Posted September 23, 2015 I'd be curious to know what that same drug costs in Germany or Canada. Or if it's even available in those countries. Couldn't find German prices, but it is available in Canada and the UK for about $1.50 a pill. 1 Quote Link to comment Share on other sites More sharing options...
goldberry Posted September 23, 2015 Author Share Posted September 23, 2015 Although I've heard it's easy to do so now, and the official policy is not to go after anyone who is buying for personal needs. Not sure if that is true, but it's my understanding. This is true somewhat, but I'm wondering how much longer. I get a medication from Canada. A few months ago I was told that my pharmacy and any other pharmacy that is CIPA certified (the Canadian International Pharmacy Association) were going to stop taking credit cards. They will slowly be switching over to customers having to mail a check, which will extend the already long delivery times. The big pharma companies are making deals with credit card companies to not process or offer accounts to international pharmacies, even those who meet required safety standards. Here is one article about it http://pharmacycheckerblog.com/visa-policies-curtail-consumer-access-to-safe-medicines-online-reminiscent-of-china-or-north-korea 1 Quote Link to comment Share on other sites More sharing options...
Amy in NH Posted September 24, 2015 Share Posted September 24, 2015 It's ALL a big scam. The government pays a majority of pharma R&D, pharma gets rich, the poor and elderly suffer. 5 Quote Link to comment Share on other sites More sharing options...
BlsdMama Posted September 24, 2015 Share Posted September 24, 2015 I was smack dab caught in the Makena mess. http://www.litigationandtrial.com/2011/03/articles/attorney/medical-malpractice-1/17p-makena-exploiting-premature-birth-for-billions-in-profit/ I have a love hate relationship with Big Pharma. 1 Quote Link to comment Share on other sites More sharing options...
Serenade Posted September 24, 2015 Share Posted September 24, 2015 This is true somewhat, but I'm wondering how much longer. I get a medication from Canada. A few months ago I was told that my pharmacy and any other pharmacy that is CIPA certified (the Canadian International Pharmacy Association) were going to stop taking credit cards. They will slowly be switching over to customers having to mail a check, which will extend the already long delivery times. The big pharma companies are making deals with credit card companies to not process or offer accounts to international pharmacies, even those who meet required safety standards. Here is one article about it http://pharmacycheckerblog.com/visa-policies-curtail-consumer-access-to-safe-medicines-online-reminiscent-of-china-or-north-korea Well, that's really lousy. I guess the pharma companies don't want to lose their cash cow, even if it takes unethical means to do so. Thanks for sharing the link. Quote Link to comment Share on other sites More sharing options...
goldberry Posted September 24, 2015 Author Share Posted September 24, 2015 I was smack dab caught in the Makena mess. http://www.litigationandtrial.com/2011/03/articles/attorney/medical-malpractice-1/17p-makena-exploiting-premature-birth-for-billions-in-profit/ I have a love hate relationship with Big Pharma. That's awful. And really shows this is not an isolated incident. Regarding the other article...No one wants government to regulate pharmacy, but pharmacy still gets taxpayer funded research funds as well as additional tax credits. But government and/or taxpayers are not allowed to negotiate for better deals because pharma turns right around and uses those funds to buy out politicians and pay for lobbyists. Yeah, makes sense. :glare: I know politics as well as most big business is corrupt. I get it. But when it comes to people's health and possibly even lives, it takes on a whole other level of immorality. Listening to people talk about "Hey, we can charge whatever we want because these pregnant women are still going to pay!" is disgusting. 1 Quote Link to comment Share on other sites More sharing options...
Bluegoat Posted September 24, 2015 Share Posted September 24, 2015 This is true somewhat, but I'm wondering how much longer. I get a medication from Canada. A few months ago I was told that my pharmacy and any other pharmacy that is CIPA certified (the Canadian International Pharmacy Association) were going to stop taking credit cards. They will slowly be switching over to customers having to mail a check, which will extend the already long delivery times. The big pharma companies are making deals with credit card companies to not process or offer accounts to international pharmacies, even those who meet required safety standards. Here is one article about it http://pharmacycheckerblog.com/visa-policies-curtail-consumer-access-to-safe-medicines-online-reminiscent-of-china-or-north-korea FWIW, it isn't great for Canada to have people from the US buying Canadian drugs. i don't think anyone begrudges them to individuals, but on a large scale it can have an effect on our system - we have drugs available for our population, which is a lot smaller than that of the US. Quote Link to comment Share on other sites More sharing options...
BlsdMama Posted September 24, 2015 Share Posted September 24, 2015 FWIW, it isn't great for Canada to have people from the US buying Canadian drugs. i don't think anyone begrudges them to individuals, but on a large scale it can have an effect on our system - we have drugs available for our population, which is a lot smaller than that of the US. Except wouldn't your economy benefit? Capitalism here would mean more sales, stronger company, more production, more hiring, more jobs, more folks spending money. Wouldn't an increase in sales lead to an increase in profits and lead to positive effects? It isn't as though there is a limit on production, just that they would need to ramp up production? There is a lot I don't know and understand about the Canadian economy so I would truly like it if you correct my thinking? Quote Link to comment Share on other sites More sharing options...
Laura Corin Posted September 24, 2015 Share Posted September 24, 2015 Except wouldn't your economy benefit? Capitalism here would mean more sales, stronger company, more production, more hiring, more jobs, more folks spending money. Wouldn't an increase in sales lead to an increase in profits and lead to positive effects? It isn't as though there is a limit on production, just that they would need to ramp up production? There is a lot I don't know and understand about the Canadian economy so I would truly like it if you correct my thinking? It would depend on why the drugs are cheap in the first place. Are they subsidised (in which case Canadian tax payers are benefitting US consumers)? If not, the pharmaceutical companies are likely to change their terms if the grey market gets too large - companies like to keep control of pricing in different markets. If that causes Canadian prices to equalise with US prices, then Canadian consumers would lose out. 2 Quote Link to comment Share on other sites More sharing options...
Pam in CT Posted September 24, 2015 Share Posted September 24, 2015 It would depend on why the drugs are cheap in the first place. Are they subsidised (in which case Canadian tax payers are benefitting US consumers)? If not, the pharmaceutical companies are likely to change their terms if the grey market gets too large - companies like to keep control of pricing in different markets. If that causes Canadian prices to equalise with US prices, then Canadian consumers would lose out. Right. There is no country in which pharmaceuticals are in anything anywhere close to a "free market" -- there are far too many structural reasons why that sector has far too many "market failures" for that to work. Several of them have already been discussed in this thread -- very high start up costs both to develop the drugs themselves, as well as to build out the very specific manufacturing facilities (economists call these sorts of things "barriers to entry). The reality of having to try-a-bazillion-and-only-a-few-will-hit also adds to the startup costs ("barriers to entry"), because many must be pursued but only a few will profit. As well, all countries also have extensive drug approval procedures as well, because society -- having had an earlier era with snake oil touted as "remedies" -- has come to concur that it's rather important that drugs actually work; and similarly all countries have some sort of certification procedures for the manufacturing facilities because the risk of contamination. These add "certification costs" to the already high "barriers to entry." As well, medicine is necessary in a very specific and non-negotiable way that, say, potatoes are not: people can die if they are not treated (economists call this "inelastic demand"). So at least for certain drugs, suppliers can charge Very High prices and people will still be forced to pay -- that's what launched this thread. There are other specific market failure problems associated with development of treatments for very rare diseases ("orphan diseases") and development of treatment approaches that do not have profitability potential (i.e., specific diets). But that's enough to be getting on with (!). The point is, this isn't a free market anywhere, including Canada. All governments are involved in the management / regulation / subsidy of different points of a complex and interlocking system. It's not in Canada's interest to subsidize their industry R&D and then have a sizeable hunk of that (taxpayer paid) benefit siphoning off to Americans. (I'm not defending the current system, BTW. It's a MESS. Sadly there are no quick simple fixes.) 3 Quote Link to comment Share on other sites More sharing options...
goldberry Posted September 24, 2015 Author Share Posted September 24, 2015 It would depend on why the drugs are cheap in the first place. Are they subsidised (in which case Canadian tax payers are benefitting US consumers)? If not, the pharmaceutical companies are likely to change their terms if the grey market gets too large - companies like to keep control of pricing in different markets. If that causes Canadian prices to equalise with US prices, then Canadian consumers would lose out. The pharmacy is in Canada, the drugs come from England, Singapore, other places. I would guess Canada does not have the same rules as the US about purchasing drugs sourced in other countries? And as for Canadian taxpayers benefiting US consumers... It's really the other way around. The drug companies located HERE are benefiting from our government subsidies for research and new drug development. They charge exorbitant prices here which allows them to sell cheaper in other markets. If you research it, the drug companies *claim* (not that it's true) that the exorbitant US prices are what allow it to continue developing and also selling cheaper to other markets. So no, I don't feel like getting my prescription from Canada is hurting your market. 2 Quote Link to comment Share on other sites More sharing options...
Laura Corin Posted September 24, 2015 Share Posted September 24, 2015 So no, I don't feel like getting my prescription from Canada is hurting your market. I'm not Canadian, by the way. I was just musing on possible replies to the pp's question. 1 Quote Link to comment Share on other sites More sharing options...
Entropymama Posted September 25, 2015 Share Posted September 25, 2015 I'm not sure how you are relating this to mandatory insurance or coverage, or to laws. (Although I do agree with you about doctors nudged into following protocols, but it is usually the pharma companies doing the nudging. There are numerous confirmed cases of pharma buying out doctors to influence prescription procedures.) People need medication in most cases because they are sick and need it, not because they are mandated to buy it. The article mentioned this is one of the only drugs available for toxoplasmosis, for example, and that pharma companies do everything they can to prevent generics being developed to compete with them. How is a drug that cures a sickness comparable to something optional that can be regulated by a "supply and demand" principle? Especially when there is so much money there that the "supply" side is being controlled and limited? I'm asking your opinion honestly because I have never understood this argument. Here's my thought on how high prices are related to an insurance mandate - If I'm paying out-of-pocket for a drug that's hugely expensive, I may balk at the price, complain, get online and make a fuss or ask for alternatives. If my insurance company is covering it, I'll probably just go with it, thanking my lucky stars that it's covered. The insurance company covers it by jacking up premiums, which have historically been covered in large part by employers (though this is changing). Everyone is passing the buck and no one feels it the same way an individual does when he has to pay. So drug companies can overcharge without direct consequence. I found this to be true when one of my sons was hospitalized and on his line item bill we found out things like a dose of Tylenol cost $15. That was outrageous, but I only found out because we were paying much of it out of pocket. If my insurance had covered it we wouldn't have even looked at the line item. All of the drug companies supposedly have programs in place to provide medication to poor patients. But in my experience from way back when dh was unemployed, they make it almost impossible to actually get the free/cheap medication. And I'm guessing there are a lot of people in the middle class who don't qualify for the programs, have no or crappy insurance, and couldn't even begin to afford that much money for one pill. My mother pays $1200 per month for her prescription (yes, that's singular). Her insurance only kicks in when she meets the $7,500 deductible. She basically works (at 65) to pay for her prescription. Thankfully her husband still works full time and can support them, but retirement is literally never going to happen. Quote Link to comment Share on other sites More sharing options...
Laura Corin Posted September 25, 2015 Share Posted September 25, 2015 Here's my thought on how high prices are related to an insurance mandate - If I'm paying out-of-pocket for a drug that's hugely expensive, I may balk at the price, complain, get online and make a fuss or ask for alternatives. If my insurance company is covering it, I'll probably just go with it, thanking my lucky stars that it's covered. Just for an input of how it works in a single payer system: if a drug company wants to sell anything to the 60 million residents of Britain, it needs to sell to the NHS. If it does, it has both a guaranteed market and a behemoth that can match it in bargaining power. So the prices are lower, but the deal benefits both sides - the company gets the purchase guarantees. There isn't true central purchasing (it's more complicated than that in ways that I don't understand) but the system works pretty well overall. The UK pays through taxes less as a percentage of GDP to cover everyone in the country than the US does just to cover those entitled to Medicare and Medicaid: http://data.worldbank.org/indicator/SH.XPD.PUBL.ZS Before someone tells me that a system like that would stifle innovation: one in five of the world's biggest selling drugs were developed in the UK, and the UK is home to the fifth and sixth biggest pharm. companies in the world - not bad for a small population on a tiny series of islands. 8 Quote Link to comment Share on other sites More sharing options...
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