Prescription Drug Prices - FaunaClassifieds
FaunaClassifieds  
  Tired of those Google and InfoLink ads? Upgrade Your Membership!
  Inside FaunaClassifieds » Photo Gallery  
 

Go Back   FaunaClassifieds > General Interest Forums > SOUND OFF!!!

Notices

SOUND OFF!!! Ever have something REALLY bugging you and nowhere to vent about it? Well, this is the place. It does not have to be fauna oriented at all! Get it off your chest right here.

Reply
 
Thread Tools Display Modes
Old 01-27-2022, 01:16 PM   #1
Insomniac101
Prescription Drug Prices

So, I read this article the other day, and it made me even more angry than I was before. I knew that drug prices in the U.S. were higher than anywhere else in the world, but wasn't aware of exactly why.

The reason that this is such a sore spot at the moment, is because my husband's job was eliminated in a corporate buy-out, and we lost our group health insurance. COBRA cost per month was almost $2k. Thankfully, he found another job, and we moved back to Michigan. However, our new benefits don't start for 90 days, so we're stuck paying out of pocket for prescriptions and whatever may happen (knock on wood).

The thing is, I'm diabetic, and my medication is $625 per month (Januvia). I need it, but it really infuriates to hand over my credit card at Costco, knowing that anyone outside of the U.S. is enjoying affordable meds, thanks to people like us.

The article is quite lengthy, but very eye-opening about how badly we're getting screwed in this country.

https://www.medpagetoday.com/opinion...ail-definition

Why Are Physicians Silent About Outrageous Drug Prices?
— Milton Packer wonders why physicians are struggling to get their priorities straight
by Milton Packer MD
January 12, 2022

One of the bizarre aspects of drug pricing in the U.S. is that the government is not permitted by law to negotiate the prices of drugs with pharmaceutical manufacturers. In most of the world markets, the national health authority in each country engages in long (and often difficult) discussions with drug sponsors about what the government is willing to pay for a newly approved drug. These negotiations dramatically reduce the cost of prescription drug prices throughout most of the world.

But not in the U.S. In the U.S., pharmaceutical companies can essentially dictate prices for their drug products, and Medicare and Medicaid are not allowed to challenge or disagree with the offer. If a company wants to charge $80,000 a year for a new drug, it can. If a company wants to increase the price of an old drug by 10%, 50%, or 500% each year, it can easily make the price increase a reality.

In employment-based insurance, negotiations typically take place between pharmaceutical companies and pharmacy benefits managers (or 340B contract pharmacies), who play a middle-man role. But the process is not transparent, and all too often, much of any achieved price reductions are retained by the intermediary entities as profits. Any discounting of a drug's price by a pharmaceutical company is not necessarily translated into a lower cost for the employer or the patient.

As a result of these policies and forces, drug prices are much higher in the U.S. than in the rest of the world. According to the RAND corporation, U.S. prices are 2.56 times higher than in 32 other countries. Of all OECD (Organisation for Economic Co-operation and Development) nations, total drug spending was $795 billion. The U.S. accounted for 58% of the sales, but just 24% of the volume. Other studies suggest Americans pay four times more than residents in other wealthy nations for the same drugs.

Accordingly, the profits of most multinational pharmaceutical companies are driven by sales in the U.S. If the CEO of a company desires to increase profits by 20% in any given year, he or she can most easily accomplish that goal in the U.S. Because U.S. profits are so generous, the company can charge much lower prices in Europe, Asia, or Latin America, or can sell drugs essentially at cost in lower-income countries.

In essence, U.S. residents are effectively subsidizing the cost of drugs for patients in the rest of the world -- without realizing they are doing so.
Some might argue that wealthy countries (like the U.S.) should subsidize the costs of healthcare for economically disadvantaged countries. But many of the countries that benefit from the enormous U.S. subsidy are rich industrial giants. In a recent study of 65 cancer drugs, prices rose faster than the rate of inflation for 74% of the drugs in the U.S., with a median monthly treatment cost increase from $5,790 in 2009-2010 to $14,580 in 2018-2019. In contrast, only 13% of the drugs in Switzerland, 2% of the drugs in England, and 0% of the drugs in Germany experienced price increases that rose faster than inflation.

U.S. residents suffer horribly from this policy. Because of the outrageous pricing of drugs, access to drugs is restricted for many people in the U.S. For many, insurance plans will not cover scores of innovative medications. And even when coverage is provided, patients are required to pay high out-of-pocket expenses every month (which can exceed $30,000 per year), a level of hardship that has been termed "financial (drug) toxicity." A substantial proportion of patients cannot afford these costs, and thus, never fill prescriptions or elect to stop a therapeutically important medication simply because they need to pay for food or housing. Many physicians do not even try to complete the preauthorization forms typically required for expensive drugs. In contrast, drug costs seem never to be an impediment to drug access in other economically wealthy countries (e.g., Germany).

As a result, many patients -- especially those with chronic diseases requiring therapy for many years -- are not receiving drugs that have been newly developed in the past 10 to 20 years. Newer drugs for diabetes have been shown to prevent heart attacks, strokes, heart failure, and kidney failure -- beyond their effects on blood glucose -- but they are being used by a small fraction of diabetic patients. Sadly, most patients with type 2 diabetes or with heart failure are currently being treated with drug regimens that have not changed since the 1980s or early 1990s.

Attempts to allow drug price negotiations and enhance drug pricing transparency have been blocked in Congress by special interests. Some modest proposals for improvement have been included in H.R. 5376. But the legislation is puny; the bill would apply to only a tiny fraction of drugs and only 9 to 13 years after approval. Yet, even these modest proposals are being met with stiff resistance. Pharmaceutical companies and pharmacy benefits managers are important contributors to the campaign war chests for House Representatives and Senators who are interested in re-election. The Pharmaceutical Research and Manufacturers of America (PhRMA) has advertised to the public that passage of H.R. 5376 would restrict access to innovation, a claim that has been deemed false by the Annenberg Public Policy Center.

In truth, the profit margins of pharmaceutical companies are almost three times the average of the S&P 500. And it has been estimated that brand-name pharmaceutical companies could lose $100 billion a year in sales and still remain the most profitable industry in the U.S. With these resources at their disposal, pharmaceutical companies will not lessen their drive to develop innovative drugs, because it is in their financial interest to develop new drugs.

Physicians fully recognize the enormous problems for patient care that have been created by the exorbitant cost of drugs in the U.S. They complain that many patients cannot access a substantial proportion of the advances in medical care that have taken place over the past 10 to 20 years. But what have physicians said about this?

Almost nothing.

The American Medical Association (AMA) hotly debated the issue in November 2021. Quite shockingly, many delegates strongly opposed any AMA advocacy for price negotiations. Why? The AMA delegates were concerned that if they supported "price controls" then such a policy would be applied to physicians. Even more amazingly, some delegates refused to support H.R. 5376 until they would be assured that any cost savings would be passed down to physicians!

In December 2021, the Association for Clinical Oncology, the American College of Rheumatology, and the American Academy of Neurology issued a joint statement of support for H.R. 5376, but with a catch. They wanted to make sure that payments to physicians for prescribing very expensive drugs would not be reduced; they wanted only payments to pharmaceutical companies to be affected.

The only large physician-based organization to voice support for the principles of price negotiations included in H.R. 5376 has been the American College of Physicians, which issued a letter on this issue in July 2021. But most medical societies have been silent, intentionally so. And as far as I know, none have engaged in any strong or meaningful advocacy.

What have individual physicians said?

Most practitioners bemoan the cost of drug prices, but few have taken a public stance. The silence applies not only to those who are on the frontlines of healthcare, but also those who are leaders in clinical research. When I have raised the issue with my colleagues who spearhead large-scale clinical trials, their reticence to become involved is palpable.

What do they say? (This is not verbatim): "I want to continue to do large-scale trials with new and exciting drugs. Therefore, it is my interest for pharmaceutical companies to be replete with the funds that are necessary to promote my work. So it is best to say nothing right now."

But, as Ian Tannock, MD, PhD, and Anthony Joshua, MBBS, PhD, note, the pricing of drugs bears no relationship to costs of development and manufacture, the drug's effectiveness, or the extent to which public funds were used in its development. Price is set to maximize profit, based on what the market will bear.

There are a few notable exceptions to the silence of physicians. Mathew Maurer, MD, of Columbia University, was the principal investigator of the landmark clinical trial of tafamidis (Vyndamax) in the treatment of cardiac amyloidosis. The trial was published in the New England Journal of Medicine and directly led to FDA approval of the drug. Pfizer sponsored the entire cost of the drug's development (including the clinical trial led by Maurer), and Maurer earned consulting fees for his work on the study. But when Pfizer decided to price tafamidis at $225,000 per year, Maurer was outraged, publicly called the price exorbitant, and demanded that Pfizer lower the cost. Together with Jerry Gurwitz, MD, he expressed his strong disapproval both in the medical literature and to the press, joking that his overt anger might lead the pharmaceutical industry to retaliate and cost him a job. Fortunately, that concern never materialized. (Disclosure: Maurer was one of my heart failure fellows, and I recruited him to the faculty of my division when I was at Columbia. He is one of the finest physicians I know.)

As I have described in an earlier column, I have also argued with pharmaceutical executives to lower the price of an expensive drug that I helped develop. But my discussions focused on a drug that was less than 2% of the list price of tafamidis. And I failed miserably in trying to convince the company to lower the price.

Here is the irony. Most clinical trials do not show that a drug is safe and effective for its intended use. But in the few instances when a trial is successful and leads to drug approval, the most important goal of a clinical investigator should be to ensure that all patients who can benefit from the new drug actually have an opportunity to receive it without incurring financial hardship. Otherwise, what is the point?

We need to be clear: Physicians can no longer stay silent about outrageous drug prices. Those who think that allowing negotiations for drug pricing in the U.S. will hurt our professional and personal interests need to get their priorities straight.

Milton Packer, MD, is currently distinguished scholar in cardiovascular science at Baylor University Medical Center at Dallas and visiting professor at Imperial College in London. Packer is an internationally recognized clinical investigator who has made many seminal contributions to the field of heart failure, both in understanding its mechanisms and defining its rational management. His work has spanned more than 40 years and has established the cornerstone of the current modern treatments for heart failure, including ACE inhibitors, beta-blockers, angiotensin neprilysin inhibitors, and SGLT2 inhibitors. He has authored nearly 600 peer-reviewed publications and has been the overall principal investigator for 20 large-scale international trials of novel interventions in heart failure.
 
Old 01-27-2022, 03:02 PM   #2
WebSlave
Yeah, I have always thought that doctors MUST be getting a cut of the proceeds for any prescription they write. They seem to push drugs, vaccines, and whatnot SO hard these days. I am going to be seeing a new GP doctor next month (my old one retired), and I am certain I am going to have to go all through the battle again telling them that I do NOT want that arsenal of vaccines and crap shoved into my veins. If they get adamant, I walk out, and tell them where shove those needles.

So the pharmaceutical companies have congress in their pocket with the profits they can put into political contributions. They have the doctors in their pocket because they can use part of those high profits to funnel back to the doctors as kickbacks who are successful in getting patients to agree to buy them. Sounds like a very effective business plan to me.

Oh, as for the patients? Screw them (apparently how they think). They are just cash cattle for their merchandise. The more necessary the treatments are to treat (not CURE, mind you) some malady, the better. "Curing" something is not a very smart long term business model for them.

Heck, I would wager that an effective cure for at least most cancers has already been developed but is locked away somewhere because of the financial damages such a thing would do to the medical industry.

This COVID crap just opened my eyes even wider about just how malevolent the medical industry really is. They are sweeping effective *cheap* therapeutics under the rug and nailing it down, even doing their best to make them illegal, or at least EXTREMELY difficult, for a private individual to obtain. So that our ONLY choice will be what they want to sell us at the prices they DEMAND we pay for them. The truly sick aspect of this is that they would obviously allow people to DIE rather than see their profits suffer any.

Honestly, I believe it is a rare person any more who wants to go into the medical field to actually and truly help people. Most, if they were honest, would admit that this is where the money is and that is what they are after. Any that survive to remain in the field long enough to get into management, well, they likely lost much of their humanity along the way.

Sorry if this seems so negative. But that is just how I feel about it after watching this COVID fiasco so closely for the past 2 years.
 
Old 02-04-2022, 07:00 AM   #3
bcr229
Quote:
Originally Posted by Insomniac101 View Post
The thing is, I'm diabetic, and my medication is $625 per month (Januvia). I need it, but it really infuriates to hand over my credit card at Costco, knowing that anyone outside of the U.S. is enjoying affordable meds, thanks to people like us.
I think Costco accepts GoodRx coupons, so you might save a bit if you sign up with them. Not as good as having insurance but better than nothing.
 
Old 02-04-2022, 02:22 PM   #4
Socratic Monologue
"Honestly, I believe it is a rare person any more who wants to go into the medical field to actually and truly help people. Most, if they were honest, would admit that this is where the money is and that is what they are after. Any that survive to remain in the field long enough to get into management, well, they likely lost much of their humanity along the way."

I would speculate that you don't actually know any physicians?

Backing up a ways: Here's a neat rhetorical trick (I taught a college course in informal logic; I remember a bunch of cool tricks). Tell (print) a story -- true, of course -- "Three doctors under investigation for overprescribing drugs after accepting pharmaceutical company gifts" and a while later another one "Drug distributor fined $13 million for illegal kickbacks" and a couple more of the same sort. Then print the (true) statistic that "In 2015, 48% of physicians accepted some sort of payment or gift from the drug or medical equipment industry."

The inferential part of our lizard brain takes this all to mean that half of doctors overprescribe drugs to me and get paid extra for it. When a person is primed to accept some conclusion, they'll accept it without formal reasoning intervening (because it doesn't look like an incorrect inference). (Good book on this subject: Kahneman's 'Thinking Fast and Slow'.)

People are also primed to unconsciously infer some conclusion in virtue of their overall interpretive paradigm. When some guy gets busted and the cops find a bunch of half dead snakes in his basement, I see an outlier; PETA sees confirmation of what they already knew. This works both ways, so to speak; NPR doesn't have to convince me of much in the same way that Fox doesn't haven't to convince their viewers of much.

But the inference isn't true of course; all sort of kickbacks are illegal and are prosecuted -- anything involving Medicare and Medicaid, and they make an easy path for malpractice lawsuits (which, by the way, is one main driver of high testing and prescribing rates; docs cover their butts by doing everything medically possible even if a long shot). Most (88%) of these gifts are for lunch, which doctors can afford to buy on their own, and are in exchange for listening to a sales pitch. The average yearly amount per doctor is $200 -- chump change.

So, back to the point. My wife is an MD, clinical and admin. We've been together since before med school. We hang out with MDs (and PAs and NPs); our families spend holidays together, and go up north together, and help each other move, those sort of things.

As for the quoted claim, it doesn't square with reality. At all. Not one bit. All the MDs I know -- ER docs mostly, but GPs and surgeons too -- are much more caring and concerned and compassionate and thoughtful in one day than I am all month. Based on what they see sometimes, they should have PTSD, but they just make the best of it and keep helping. And though I only have N=1 on this, the move to admin work can be made out of a goal to make a bigger positive difference to patients than one can make just doing clinical work.

Physicians have a high risk of suicide (40% above the general population for men, 130% more for women). This is not because the money isn't what they expected. It isn't because they got a crummy lunch from a drug rep. It is because they are deeply caring people doing an often impossible job under pressure from all sides, including from meritless commentary on their motivations.

Anyone sick of "this COVID fiasco" should (1) get fully vaccinated, (2) wear a mask properly at all times in public, (3) stand six feet apart when in public, and (4) get out of the way and let those people who are trying to help, help.
 
Old 02-04-2022, 08:05 PM   #5
WebSlave
Since this conversation took a turn in a direction that I would prefer to keep in the more "dark web side" of this site, I have taken my response to the above post here -> https://www.faunaclassifieds.com/for...92#post2289492

The reason for this is because there seems to be quite a few sites and persons who have been censored and deplatformed by Google and other sections of their tentacles by not towing the company line concerning certain topics. Not saying I think this could happen to this site, as this is pretty small potatoes, but I sure as heck can't rule it out. Maybe paranoia, or maybe just exercising good common sense to be cautious. Freedom of speech ain't what it used to be, it seems. You can act accordingly to what you think is true.
 
Old 02-04-2022, 10:22 PM   #6
Lucille
Kathleen, I'm sorry you are in such a bind. I have heard that many of the large pharmaceutical companies have programs that help with the cost. Perhaps if you contact Merck that can help with the Januvia during the 90 day waiting period. Thinking of you, and hoping you find a program that can help. Congratulations to y'all on your husband's new job.
 
Old 02-05-2022, 09:14 AM   #7
Insomniac101
Quote:
Originally Posted by WebSlave View Post
Yeah, I have always thought that doctors MUST be getting a cut of the proceeds for any prescription they write. They seem to push drugs, vaccines, and whatnot SO hard these days. I am going to be seeing a new GP doctor next month (my old one retired), and I am certain I am going to have to go all through the battle again telling them that I do NOT want that arsenal of vaccines and crap shoved into my veins. If they get adamant, I walk out, and tell them where shove those needles.

So the pharmaceutical companies have congress in their pocket with the profits they can put into political contributions. They have the doctors in their pocket because they can use part of those high profits to funnel back to the doctors as kickbacks who are successful in getting patients to agree to buy them. Sounds like a very effective business plan to me.

Oh, as for the patients? Screw them (apparently how they think). They are just cash cattle for their merchandise. The more necessary the treatments are to treat (not CURE, mind you) some malady, the better. "Curing" something is not a very smart long term business model for them.

Heck, I would wager that an effective cure for at least most cancers has already been developed but is locked away somewhere because of the financial damages such a thing would do to the medical industry.

This COVID crap just opened my eyes even wider about just how malevolent the medical industry really is. They are sweeping effective *cheap* therapeutics under the rug and nailing it down, even doing their best to make them illegal, or at least EXTREMELY difficult, for a private individual to obtain. So that our ONLY choice will be what they want to sell us at the prices they DEMAND we pay for them. The truly sick aspect of this is that they would obviously allow people to DIE rather than see their profits suffer any.

Honestly, I believe it is a rare person any more who wants to go into the medical field to actually and truly help people. Most, if they were honest, would admit that this is where the money is and that is what they are after. Any that survive to remain in the field long enough to get into management, well, they likely lost much of their humanity along the way.
Funny you mention this - my long-time doctor retired about four years ago. I was with him since he got back from Vietnam, and set up a private practice. This new generation of docs is very different than what I was used to.

I agree that there are some who go into it for the paycheck, but I think they're in the minority. I have a few medical people in my family; my mom was a nurse, sister is an RN, sis-in-law is a PA, and cousin is a DO. Heck, I even went to nursing school for a year! All of these family members went into medicine to help people, and absolutely love their jobs.

But my issue is pharmaceutical pricing. There seems to be little intervention on behalf of patients. If you don't have insurance, or deep pockets, you're pretty much screwed.
 
Old 02-05-2022, 09:30 AM   #8
Insomniac101
Quote:
Originally Posted by bcr229 View Post
I think Costco accepts GoodRx coupons, so you might save a bit if you sign up with them. Not as good as having insurance but better than nothing.
Thanks Melinda; I did check it out. Still about $550 for 30-day supply, but better than nothing.

Check this out though; Merck (Januvia mfgr.) has a coupon on their website, but it's for insured patients only! I understand that some people may still need help with co-pays, but what about people who have no coverage?! I guess they can do without.
 
Old 02-05-2022, 09:47 AM   #9
Insomniac101
Quote:
Originally Posted by Lucille View Post
Kathleen, I'm sorry you are in such a bind. I have heard that many of the large pharmaceutical companies have programs that help with the cost. Perhaps if you contact Merck that can help with the Januvia during the 90 day waiting period. Thinking of you, and hoping you find a program that can help. Congratulations to y'all on your husband's new job.
Thanks Lucille, I appreciate that!

See my response to Melinda; I must be missing something, if Merck is offering help only for insured patients.
Attached Images
 
 
Old 02-05-2022, 12:01 PM   #10
Lucille
If I had to guess, I would guess that Merck has made some sort of deal with insurance companies for them to help underwrite the cost of the coupon. Really I would contact them and ask, the most they can say is no but they might say yes.
Also you might ask your doc if there is another medication you can use for now. My diabetes is currently well controlled with just Metformin, a medication which has been around for a long time and which is extremely cheap.
 

Join now to reply to this thread or open new ones for your questions & comments! FaunaClassifieds.com is the largest online community about Reptile & Amphibians, Snakes, Lizards and number one classifieds service with thousands of ads to look for. Registration is open to everyone and FREE. Click Here to Register!

 
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Similar Threads
Thread Thread Starter Forum Replies Last Post
$93,000 cancer drug: How much is a life worth? SamanthaJane13 General BS forum 0 09-26-2010 02:39 PM
coccidia....drug help jaysun Veterinarian Practice & General Health Issues 15 02-09-2010 04:15 PM
Frontline/Merial Drug Company and my vet chondrogal SOUND OFF!!! 3 04-08-2006 12:52 AM
-The Shocking Truth About Drug Prices jenn_jeffery SOUND OFF!!! 3 11-22-2003 08:28 PM


All times are GMT -4. The time now is 08:41 AM.







Fauna Top Sites


Powered by vBulletin® Version
Copyright ©2000 - 2024, Jelsoft Enterprises Ltd.
Page generated in 0.08992791 seconds with 11 queries
Content copyrighted ©2002-2022, FaunaClassifieds, LLC