If only both houses of congress weren't beholding to the highest bidders...
10
"It failed 52 to 46 after 13 Democrats voted against it.."
Well, the Democrats - champions of the people - champion the people only when it does not hurt their pocketbooks.
Really, the are the same as GOP; they only have a different set of lobbyists and interest groups.
12
As they have shown this year, not that the past is so very much different, but money, donors will always win out. Its looking more and more as if our form of government has become so corrupt, so out of usefulness for the people we need something else. Congress is as Trump is in collusion with Russia and its oligarchs, in with pharmaceutical companies. And also any other industries with big pockets. What would be the answer? Personal stories of hardship, too expensive medicines, public outcry hasn't gotten even a measure of what is needed in this country. Im really tired of make America great again. For who? The ones who proclaim patriotism, and wave the flags are the ones that are not suffering under the government of today. Either that or they are naive to think things are going to get better. Do not look to representatives, senators ,governors, administration they have brought it out into the open more and more this year. Powerless to change anything. We are to deal with all the corporate greed one by one. After years of billions and billions in profits after taxes, its like Trump saying "what Russian thing?" We see your greed, we know you!
Well, it is self-evident that not everyone wants to reduce drug prices. There must be some who don't or it would happen for the greater good of the most number of citizens. I wonder who they could be. I guess whoever they are, they must have a great deal of influence. They seem to be able to get the laws crafted to better serve their own interests. Who could they be, I wonder?
1
Pharma gouges sick people.
They're the biggest obstacle to a single-payer system.
Why do Americans pay more for medicine than anyone else?
Because we won't crack down on pharma abuses.
The Epi-Pen is just the tippy-top of the iceberg.
5
Drug costs are soaring at twenty percent a year. That's to help cover the drug companies' $60 billion profit. It is no wonder health insurance premiums are increasing like mad. But the Republicans are glad for it -- that way they can blame the premium increases on the "failing" ACA. And then, if they get their way and repeal Obamacare, congress still won't address drug prices. Because pharma bankrolls the whole lot of them.
6
What to do about drug prices: 1. Allow Medicare to negotiate drug prices. 2. Allow importation of drugs from countries who do a good job testing their drug supply. Many of our drugs are already made in China. How safe is that? 3. Increase transparency of pricing. 4. Reform patent law. Make pay-to-delay generic payments illegal. 5. Require higher govt earned royalties for drugs/devices/tests that come from govt-financed research. 6. No tax deductions for charitable donations made by companies who donate to help people afford their own meds. 7. Break monopolies!!! Two competing drugs/devices/IUDs should not be made by the same company. Must sell one off. 8. Plain limit profits by putting caps on percent a price can increase. Isn't it illegal to gouge people during a disaster? Why is it acceptable to gouge people when they are sick? 9. Demand head to head studies on drugs and devices. 10. Require clinical guidelines to be developed by specialty organizations that include the prices of alternative treatments and whether they are worth the different costs. 11. Keep contraception free - saves $4 for each $1 invested. 12. Never ever approve the TPP as long as the investor-state settlement dispute is in it which will cement pharma's profits forever.
3
Tropic of Carricorn is right, the US is getting ripped off by the rest of the world. The good news is, the answer is easy: Congress only has to legislate most-favored-nation global pricing for all pharmaceuticals. That would profoundly disrupt global drug pricing and lead to the EU and ROW paying more for drugs, but in the end the cost burden would be equally shared and the US would pay on the order of half the current bill. Easy. Now, bad news is that you cannot blame drug prices for the cost of healthcare ... while they seem to be a lightning rod, the reality is that inpatient costs are far higher and there is as much greed and nest-lining among doctors and hospital administrators as among drug executives for sure. So lets fix the drug pricing issue tomorrow and then more on to the less politically attractive issue of greedy physicians and even greedier hospital systems.
5
Why would anyone try to regulate pharma when they are the goose that laid the golden egg, especially with a Washington that is so corrupt even beyond what corruption is in 3rd world countries, because here we are hypocrites, phony do-good'ers and way to ignorant to see past the wool over our eyes. Pharma, the insurance companies, processed food industry, the government.... see the circle, see the loop? All keeping each other safe and rich at the expense of our citizens, of all ages. Of all three industries mentioned, have you known any of them not paying dividends? and the Government, have you know our Representatives not being "For Sale"?.
5
If they allow the importing of legit drugs from Canada, then that would benefit
the public immensely, though it's probably never going to be allowed officially, but why not.
Single payer, of course, and just paying retail for Canadian legal drug prices should be Bernie's agenda, which could get him the presidency in 2020.
I think I know the boring, responsible, conservative arguments against.
But as I cynically think how Trump won despite the "establishment" opposition.
There are enough voters to elect Bernie on such a radical platform.
Trump proves it, I concede, and to heck with establishment Hillary type voters.
It's past time for the Democrats to win again, there shall be 4 years of cleaning DJT's enraging messes.
And--to me--single payer and safe legal drugs from Canada or Canadian drug prices are the ways to get the Trump voters and many more red state voters.
The heck with the establishment that luvs to advertise expensive legal drugs.
The people are fed up with the outrageous prices we have to pay.
9
Why do I feel so helpless and hopeless in this "free" country? Perhaps because the IRS told me my identity was stolen; my credit cards are somehow hacked fairly regularly despite my best efforts; Equifax collects all my data without any right or permission and not only sells it without paying me a nickel but wants to charge me to protect it; I need drugs and have no option but to pay the inflated prices because none of our elected representatives will stand up for my rights to affordable drugs--or at least drugs that are not sold at absurdly inflated prices "because they can". And while the price of some basic foods, such as basic cold cereal, have just about doubled in the last few years, the cost of living is deemed not to have risen sufficiently to require Social Security payments to keep anywhere near pace with the real cost. What a total and absolute disgrace. Of course, with a billionaire now in the White House--several in fact--why would any of this change? It won't until those in the Senate and House receive the same benefits as the rest of us, and not for life either.
12
In planning health care, the 1st questions should be:
1. What do the people need?
2. What resources to we have to meet those needs?
Instead the priority is: What business opportunities can be maximized?
The starting point in pricing (pharmaceuticals, or health care in general) is the actual cost to provide products and services, not letting private for-profit companies set arbitrary prices for public services, in which the public does not negotiate and has no say. All of the middle men and their smoke-screen pricing mechanisms do not concern themselves with the public welfare. This all brings us to where we are: The public is there to be milked by parasites, in medicine as with credit bureau data harvesting and monetizing. Market economics does not function in the interests of the public in providing essential services.
Services regarded as essential for the public need to be government run or strictly regulated as non-profits. As long as corporations wield the money and Washington influence as is now the case, there is no incentive to look out for the interests of the public. This past year the swamp in Washington has gotten a lot deeper and vermin infested. If politics are capable of righting the trajectory of government in the service of public well being, these next two Washington elections have serious work to do.
5
From each according to his ability...
to each according to his needs.
1
Citizens United. Corporations are considered people. Thus the great buy offs by all corporations which of course includes Big Pharma. Until this Supreme Court ruling is overturned, there will be little motivation for any changes. And we continue to subject medicine and medical care to the free market view--with patients as consumers. Especially when their lives depend upon it. It is a moral and ethical failure.
1
Every night, advertising on commercial TV is dominated by car and pharmaceutical companies. If you are not in the market for a new car, watching ten thousand car commercials is not going convince you to go out and buy one and if you are not afflicted by one of the boutique diseases touted by the drug companies, no amount of advertising is going to change the situation. Since the amount of ad dollars is so astronomical and the responsive audience so minimal, the ROI on a single customer must be incalculably huge.
2
It pains me to see the red herring of high drug prices in this country dangled again and again, simply because the payers of health insurance - primarily, employers - prefer the 12-16% of the national health expenses which are prescription drugs, carry out-of-pocket costs in a way that is conspicuous and plain offensive to the patients. Prescription medicines compared to any other portion of the nation's health bill - hospital charges, doctor's salaries, costs of diagnostic and surgical procedures - for the payer (insurance company) frequently cost less than in other advanced countries' health care systems. Plus, if we really after it, we can just stop approving new medicines... in about 15 years when everything now on the market goes generic, the national drug bill will drop by 60 or 80%... why nobody is supporting this?
While it is frequently claimed on these pages (and especially in the comments) that all or most of drug innovation happens thanks to NIH work, results of this work are available to any researcher worldwide - but only in the U.S. pharma and biotech startups are able to get capital needed to pursue drug development; more than 80% of innovative medicines approved by FDA are coming from this work. And venture capitalist needs truly the "golden" potential returns to invest in a 10-year quest for the new medicine (with maybe 5% likelihood of success) rather than in a 1 year needed to develop an app. So, if we want innovation we have to pay for it...
2
I wish the old, proud comment that American consumers pay for that benefits everyone on the planet were actually true. Not exactly. Most drug research is spent on "me-too" drugs and minor changes to existing drugs in order to maintain patent protection--and monopoly profits. Most "improved" drugs are improved only in the technical sense--the actual improvement is often negligible.
Most ground-breaking research is done in Universities using taxpayer funding to a greater or lesser extent, with the drug companies buying the patents (and profits).
The cost of testing is far higher than it needs to be because of the chaotic state of medical record-keeping. This was at least addressed in the ACA, but still needs work.
Huge amounts of money are spent by drug companies lobbying and advertising to the public on television and elsewhere, and to doctors by sponsoring what are essentially all expenses paid vacations with a talk.
Saving lives is unimportant compared to increasing revenue. Generating a cure is far less valuable to a drug company than finding some pill that can be sold at high cost for life to an unfortunate patient.
Because none of the decision makers have any interest in either actual cures or in reducing costs, the normal automatic economic controls capitalism can provide do not work. The key requirement of Informed purchase by the payer is also absent.
2
When it comes to research in medicine its safe to say that most people would agree that it is important, however why do all the research if regular people are not able to afford it. It is the same thing as saying yes we have cure for cancer however only the top 1% can cure cancer and the rest oh well too bad.... I have seen people who have been diagnosed with cancer stop their treatment due to lack of resources and lack of insurance coverage, who end up coming back with stage 4 cancer and there is no saving, no hope for their life...
The problem here is that the pharmaceutical industry is global. All those other countries with low-cost drugs and price controls? They're living off the US consumer, who is essentially paying 100% of the R&D costs for new drugs for the entire world.
Spread out those costs globally and medications will be much less expensive in the US, and a little more expensive everywhere else.
NYT, how about a FULL list of Big Pharma donations to PARTICULAR politicians AND a SPECIFIC list of how the pols voted on relevant legislation. Then we will KNOW which of them needs to get booted out of office.
5
Elections should be paid for partially by the state, contributions should be limited to individuals, and no person should be allowed more than a contribution over $100.00. Terms of office should be no more than two.
The quickest way to lower drug prices would be for the east and west coasts agree to be annexed by Canada.
Unfortunately drug prices here will only go higher with our corrupt Congress, our clueless President and his corrupt Cabinet. Take Tom Price, our Secretary of Health, who as a former Congressman introduced a bill to increase the value of his medical device investments. Senator Manchin, father of Mylan's CEO, introduced a bill mandating that Epipens be bought by every school in the country.
We need a Government for and by the people, not one that is beholden to corporations. We need to elect a President like Teddy Roosevelt who was the first to recommend single-payer.
The NYTimes should publish the names of our representatives and how much money they accepted from drug and insurance companies. Maybe then we would have an informed electorate. And let's not forget to educate our children so when they go to the polls we will not have the embarrassing fiasco we saw last November.
6
There is no mightier swamp creature than the Pharmaceutical Lobby.
6
Put some of the Big Pharma executives in Prison, for conspiracy to defraud the public?
Short of that, term limits are NOT a workable solution, that just puts the revolving Staff/Lobbyist complex in charge of things. Be engaged, write your legislators (At least Monthly?), work to vote out (As in GOTV canvasing) those who are too aligned with the "Free Market" ideologues, ie, ever last one of the GOP (reptilian) faction.
2
The best way to avoid sky high drug prices, is move to a country with single payer healthcare.Patients countries with single payer healthcare, have no idea what anything cost, including drugs.
Here is a telling vignette from my clinic this week.
Deflazacort is a corticosteroid which, in studies done at the Hospital for Sick Children in Toronto (a world-leading pediatric institution) has been shown to substantially increase the lifespan of boys born with Duchennes muscular dystrophy. Numerous other benefits, amonsgst them, dramatic reduction in need for spinal fusions for progressive scoliosis.
For years, Deflazacort was not approved in the US. The alternative drug for these kids was prednisone. The side effects of prednisone in this population are substantial and much worse than deflazacort. Many families opted not to put their kids on the medication - shorter life, but higher quality.
Deflazacort has recently been FDA approved and is marketed by Marathon pharmaceuticals as Emflaza. This company had no role in developing this drug. They likely expended money in getting it approved, however, this medication has been used for years with a good track record in other countries.
My patient’s family up until now has been getting their medication from the UK. The cost of Deflazacort for them was $800 per year. That option is no longer available because the medication is now available in the US.
It costs $40,000 per year now.
Compare to $800.
So the insurance company is saying “just take prednisone which is cheaper”, and Marathon is saying they will cover the cost this year. Just like selling drugs on the corner - first one is free...
7
The United States needs a courageous, honest, entirely rational and ethical entity to make it illegal for drug, medical - anything to do with medicine and health - companies and industries to make campaign donations or to lobby. Unfortunately, citizens suffer because they are and have been divided - at whim - by the capitalists in charge of everything.
2
"The drug lobby has spent $28 million so far this year to air six ads depicting heroic researchers about 4,600 times on national TV, according to iSpot.tv, an ad tracker."
I'm a (not heroic, just small fry) researcher in Big Pharma. Even with a PhD, my salary is at the bottom of the totem pole. The real issue here is the millions spent on marketing, lobbying, and yes, television commercials.
1
There is a very simple way to legislate lower drug prices. The US is the largest drug market so we should have lots of leverage. New law: drug companies can charge anything they want as long as the price is not sold for less money anywhere else in the world. There's no reason why Americans should pay for the R&D of drugs for the rest of the world.
5
The NIH, the NSF, governments across the planet, and biotech startups fund the research. Scientists, mostly at universities and startups, do the research. Big rich drug companies buy the promising results of the research, run clinical trials, and market the drugs. If the FDA set drug prices and banned the advertisement of drugs or if Medicare and Medicaid negotiated drug prices, the rate of new discoveries would not decline.
2
Or we can do like the French do, and go out in the streets and protest, but alas, Americans don't have the belly for it. Absent that, there's no hope, because even if our politicians wanted to, they don't have the courage to take on their campaign donors - too concerned for their own jobs to advocate for the public.
2
How much is US pharmaceutical price policy costing us?
I have a Canadian wife, was living in Canada when I met her, and still have a vacation home in Canada. I always get my prescriptions filled in Canada because I consistently save 60% to 75% off the costs in the US.
If that savings were applied to the US pharmaceutical expenditures, $425 billion in 2016 (from a recent Bloomberg article), Americans could save around $250 billion a year, or $2.5 trillion over the next ten years.
That is a crude analysis from my experience. I'd like to see a more authoritative analysis of what current policy is costing us vis a vis the Canadians or Germans or Japanese. But I think it must be a huge number.
I'd like to see someone focus on answering my opening question; how much is this drug policy costing us? How many of our problems with sky rocketing health care costs could be solved by just fixing the pharmaceutical pricing issue? How much of our problems, regarding the cost of insuring all Americans, could be solved by fixing our runaway drug prices.
Just for the sake of argument, if there are 25,000,000 uninsured in this country and we spend $9,000 per year per person in the US (from the OECD report on health care costs of member nations), then we could pay for the health care of nearly all uninsured just from fixing drug pricing In the US.
If this is close to true I think it should be articulated in articles like the one above, to expose the cost of of this policy debacle.
4
Some commenters are suggesting that the US is somehow subsidizing the rest of the world on drug prices, with European countries being particularly denigrated as free-riders on US drug innovation -- as if it was a sin for buyer to negotiate with vendor.
a) The US government says there's no link between America's costly pharmaceuticals and medical innovation: "Higher prescription drug spending in the United States does not disproportionately privilege domestic innovation, and many countries with drug price regulation [such as the UK and Switzerland] were significant contributors to pharmaceutical innovation.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/
b) Of the world's ten biggest pharma companies, half are European – and based in four countries [the UK, Switzerland, France and Germany] with a combined population far below America’s.
c) Drug pricing is only one aspect of US medical profiteering. A few years ago the NYT found that an MRI scan cost $1,121 in the US and $319 in Holland, a hip replacement was $40K in the US and $7.7K in Spain, an angiogram was $900 in the US and $35 in Canada, and a A colonoscopy was $1,185 in the US and $655 in staggeringly expensive Switzerland.
http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-le...
US health care is a rip-off. Drugs are merely part of that. $20 aspirin anyone?
2
One of the biggest things that utterly changed the landscape for pharmaceutical drugs was making it legal to advertise.
I don't remember the exact year, but this was about 30 years ago I think. When I grew up in the 60s and 70s, advertising drugs on TV would have been unheard of us and shocking. (They also did not advertise law firms or lawsuits on TV, or solicit legal business! nor could DOCTORS advertise!)
Being able to advertise on TV, meant expensive new budgets for advertising -- and that's a big reason to charge $$$ for drugs, so the pharma company can afford a huge advertising budget. Those commercials for Viagra don't film themselves!
Ditto for politics, btw. The cost of TV advertising a HUGE part of the reasons that politicians MUST raise private dark money and a lot of it. Many politicians of recent memory LOST elections, because frankly they just plain ran out of money for commercials in the last weeks of the campaign.
Frankly, I think advertising DRUGS is despicable, unfair and immoral. No patient is qualified to decide he/she needs certain cancer drugs, anti-depressants, weight loss drugs or erectile dysfunction drugs. If you have a problem, you should be seeing a doctor -- period -- and the DOCTOR should decide which drug is best for you.
The real underlying problem here is NOT prices, though they clearly too high and exploitive. The real problem is this unholy circle of high prices, to pay for costly advertising -- and who benefits from all of this?
2
As long as the pharmaceutical industry pays for Congress, reform is as likely as a snowstorm in Scottsdale in July. The last "reform" was when the industry drafted the Part D prescription drug benefit program. After years of resisting any attempt to bring drugs into Medicare, the industry became a strong proponent after they were able to remove the ability for the government to negotiate drug prices instead of allowing Medicare to to develop a single buyer model similar to Canada's or the Veteran's Administration (both have MUCH lower prices).
The House vote itself set a new low in Congressional "sausage making". Read more here: https://mlyon01.wordpress.com/2007/04/04/under-the-influence-drug-lobbyi...
Many of the congressional staffers who shepherded the bill through went on to lucrative careers in the pharmaceutical industry, including its lobbying arm, PHRMA, led for many years by... Bill Tauzin, the Republican whip in charge of its passage.
The collusion between congress and the industry is unlikely to end - The industry employs nearly three times as many lobbyists as there are senators and congressmen...
Compared to the profits coming in, buying the politicians is really cheap.
And the politicians do listen, especially to threats to turn off the cash fire hose off, Just ask GOP Sen. Cory Gardner who said as much at the recent GOP retreat.
https://www.nytimes.com/2017/09/22/us/politics/republican-donors-obamaca...
The returns on politician buying are amazing. Just ask the Koch brothers.
3
I think where this article gets it wrong is the title: NOT everyone wants to reduce drug prices. Certainly, pharmaceutical companies, politicians, and others who stand to profit do not and they lobby hard against it.
About a decade ago, I studied shifts in medication types and prices as elderly people moved from their homes into nursing home care. I learned that because the VA system negotiates as a bloc, i.e. for millions of veterans, they are often able to obtain medications at 50% or less of what other pay for it, with or without insurance.
If we moved to a national healthcare system, we could negotiate as a bloc of a 323 million people. This is what other countries do.
Currently, as a stopgap measure, I've suggested Blink Health for some patients. This is a group that negotiates as a bloc and thus gets discounted prices. It's open to anyone. Check it out. (I have no connection to the company.)
Let me emphasize the heart of Mickey D's comments about drug pricing.
Americans are often being charged _twice_ for the same drug -- first by funding drug development through NIH and other grants to universities and research groups, and then again through the marketing of that drug back to the American taxpayer.
If we already have supported the development of that drug, shouldn't we at least get a return on our investment when that drug is "commercialized" and put out on the market?
3
Why should we allow the “old liberal idea” of letting other countries negotiate discounts when we can do the same? Our nation lost its way when we abandoned FDR’s contempt for colonial and corporate empires, corporate empires that are bribing Congress in remarkably bipartisan ways and fleecing America. My company helps translate medical material for clinical trials, and I meet many medical researchers who decry how their companies take Americans to the cleaners. Drug companies spend more on marketing than research, and it's time Americans ban consumer marketing that has taken over TV since the early 1985 and took off when the FDA allowed in 1997 “condensed” information of side effects in public advertising. Medicare Part D that pays for prescription drugs is essential for the health of seniors, but the provision Medicare cannot negotiate discounts for large purchases is another way drug companies fleece Americans. Imagine holding a patent on a drug many seniors take, and your largest client says you can charge them whatever you want. Lovely, isn't it?
1
Who are the 13 Democrats who voted against it?
You mentioned the Drug lobby is paying heavily (bribes) to defeat all these plans. In Tennessee we had a plan called Tenncare that was a type of Medicare for low income citizens. The plan failed because of runaway prescription drug costs. At the time, a majority of TN state legislators were accepting money from drug companies.
We know the Republicans are routinely bribed. Who are the 13 Democrats, and what ties do they have to drug companies?
1
Too many congress people are enslaved by the Lobbysit of the Drug industry and thus are afraid to force price reductions in medications. Even Generics prices are getting very expensive. We need some elected official who have the "gut" to rein in the pharmaceutical industry. If they can control it in Europe, surely we can control it in the US.
Have any of you read: An American Sickness, how healthcare became big business and how you can take it back, by Elisabeth Rosenthal? You should. Answers are there. Oodles of them. Rosenthal was a former senior health reporter at NYT and now is editor-in-chief at Kaiser Health News.
The reader who wrote that Canada doesn’t want our business, talking nonsense about the empty plane seat is a plant. Fake news. Canada gets lower prices because prices are way lower from India, for example.
I am the woman who opens Chapter Four of the book. The chapter title is: The Age of Pharmaceuticals. Generic mesalamine is an older gut drug that I’ve been buying from pharmstore.com in Canada via India. Sun Pharma makes the drug that costs about $75.00 per month. The folks in Canada, and India, have their act together. We sure don’t.
Most recently, and not in the book, is the fact that mesalamine is now also a generic in the USA. The cost is about $1,300 per month.
Same generic is $1,300, thirteen hundred in the USA. Cost from India, $75.00, seventy-five US dollars.
Now you tell me.
Check out Amazon for the book.
1
Part (but, of course, not all) of the problem here is that medications outside the US are heavily cost controlled, so Americans are footing most of the R&D bill.
My concern is that lowered US drug prices will lead to a massive reduction in investment in development of new drugs. One only has to look at what happened in the hypertension marketplace when all of the branded drugs went generic--pharmaceutical companies stopped developing new antihypertensives because there was no possible way they'd ever recoup their investment.
The end result? In 30 or 40 years, when I develop high blood pressure, I'll be taking the same poorly effective, side effect-laden medications my grandparents are taking now to lower their blood pressure.
No, I don't know what the answer is to this.
1
Now that I have disposed of my full airsickness bag, I would like to present the conservative math, so that we are all aware of how much money is being unnecessarily stolen from the American people each year by the pharmaceutical industry. We spend about 3.2 trillion dollars per year on health care as a whole. This is everyone all in: Medicare. Medicaid, American citizens, managed care insurance companies, and self pay. 10% of our health care spend is on PRESCRIPTION drugs. That is 320 billion dollars per year. Conservatively, our cost is 50% more than in the rest of the world. The data is extremely clear, and it is worse than I am stating. So by simply placing our drug costs at everyone else's level, we would save 160 billion dollars PER YEAR. This does not include doctor office and hospital infused drugs, such as many chemotherapy agents and other drugs, which could easily bring the total annual savings to 200 billion per year. What could we do with 200 billion per year? Um- have a national for the people drug company? Stabilize Medicaid, buy a couple of new aircraft carriers a year? A few ice breaker ships for the antarctic? restore the F-22 raptor program? Pay down a bit of the national debt, balance the budget? How about all of the above? Every year for ever. Why do we sit & let drug company lobbying and manipulation at multiple levels of the government fleece us like this? For profit? The rest of the world's drug supply is not dangerous. Drug companies will make money.
7
Bad math because it is based on faulty assumptions. The rest of the world can pay lower drug costs because we pay full retail. If prices were equalized, everyone would pay a rate maybe 80-90% of our current costs because we are major consumers of medications. Think if it like college tuition. If in pursuit of diversity, one quarter of entrants to an Ivy League school are charged a discounted rate of say $20,000, that doesn't translate into the entire class being entitled to that rate. A substantial number of students have to pay the full $60,000 charge to make that possible.
2
Disagree. The rest of the world negotiates based on a budget. Drug companies can walk but they don't. And they aren't selling at a loss. Drug companies will not have any mechanism and no ability to raise prices on anyone. They will threaten, stomp their feet, argue, or try little trick arguments like yours. Let us not be fooled or distracted. Unless we take care of this industry, our health care costs in the US will always be much higher, no matter if we have a single payer option or system. The light needs to shine on this drug cost issue continuously and repetitively so we as a nation can begin to take care of our future responsibly for our children. We can no longer afford to look the other way and ignore this. It is way too much money we don't have every year year after year. We need to do what we need to do to point out the oversized elephant in the room; Cost of drugs - 200 billion thrown away each year minimum for nothing. We get nothing. Not a thing. Zippo in return. We cannot afford this travesty. And even if your math was right - why should US citizens have to be the $60,000 students? Most of these companies aren't even American companies.
"Everyone Wants to Reduce Drug Prices. So Why Can’t We Do It?"
We, America, could easily do a reduction in our cost of prescription drugs, except for one thing: republicans being lavishly courted, lobbied, treated to jet plane rides, all expense paid trips to "drug company conferences" in the very best, expensive resorts in countries our congress people want to vacation in.
All it would take is a new, simple, law that would open up competition for buying prescription drugs on the world market where the other nations, like Canada, buy their drugs. But republicans just can not bring themselves to cutting off the attention they get from drug companies who want to keep getting those multi Billion dollar profits on their products.
2
Global corporations own the Congress, the White House and the Supreme Court, and couldn't give one hoot for the welfare of the American people. The role of government is to ensure the profitable unfettered operation of their businesses. Consumer protection is merely a quaint concept.
2
Quit whining about drug prices! If we want to fix that and myriad other issues, the people need to start demanding laws that overrule the Citizens United decision by the Supreme Court. Without that, complaints about drug prices are like spitting into the wind. Pointless; Congress will never lift a finger until their blood supply in political contributions from big pharma are cut off.
5
Don't forget the American values some hold so dear, free market, competition, reward the risk takers etc. socialism is evil except for Medicare, social security and the VA.
Drug ads were forbidden until about 10 years ago when congress agreed to permit them.
Then there is the billion dollar health food/supplement business that congress allows.I read a lot of that is made in Utah.
2
Who said Medicare, SS and the VA aren't evil? What percentage of the US economy do they take out of circulation in pursuit of a leftist agenda?
Drug companies are already importing drugs from India and selling them here as my latest prescription from Walmart attests to. They are offshoring their business like good little capitalists.
2
The drug companies always cite their high costs of R&D.
But they actually spend more on sales and marketing than R&D:
https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-pharmaceutica...
4
The article you quote says that the drug industry spent $3 billion on marketing to the public and an estimated $24 billion marketing to healthcare professionals. Well the $3 billion marketing to the public could easily be eliminated, but according to the article that represents only 12% of their total marketing cost. How do you suppose they spend that estimated $24 billion marketing to healthcare professionals? Don't you think we should ask?
2
Money!
The predatory costs to 'We the People' has little leverage compared with donations and trips to lawmakers, physicians, and health care executives.
1
Well, health care in general is a market where producers have significant power to set price because of willingness to pay and consumer ignorance. This is further helped along by excessive patent protection and industry concentration. Single Payer would have the government negotiate prices for drugs an other services thus removing a great portion of monopoly profits. Other attempts to regulate will likely be less comprehensive and less effective.
Are all drugs sold in the US manufactured in th US?
Why are other counties not bearing a portion of R&D costs?
Are other developed countries poisoning their citizens with poor quality drugs?
I think we all know the answers.
1
Interesting that there's not a lot of discussion here about the revolving door between the lobbyists on K Street and the Congress. Exhibit A is Billy Tauzin, R-Louisiana, who left his Congressional seat to go to work the very next day leading the Big Pharma lobby. It wasn’t because of his specific scientific qualifications (none), but his multimillion dollar salary must have been well worth the price.
It's a sad commentary on politics in Washington that a member of Congress who pushed through a major piece of legislation benefiting the drug industry, gets the job leading that industry.
— Public Citizen President Joan Claybrook 2004
3
My company helps translate medical material for clinical trials, and I meet many medical researchers who decry how their companies are fleecing Americans. Drug companies spend more on marketing than research, and it's time Americans ban consumer marketing that's taken over TV since the early 1985 and took off when the FDA eased regulations on side-effects in 1997. Medicare Part D that pays for prescription drugs is essential for the health of seniors, but the provision Medicare cannot negotiate discounts for large purchases is another way drug companies fleece Americans. Imagine holding a patent on a drug many seniors take, and your largest client says you can charge them whatever you want. Lovely, isn't it?.
2
Capitalism has no answers to modern questions like this. It's an out of date system that should've been replaced following the financial collapse of the 1920's. This is a symptom of late stage capitalism, and neoliberal economics.
2
The idea of patent prevention for drugs that are simply reformulations is really interesting - and could make a big difference in cost. But sadly this issue is much more complex than simply "drugs cost too much." There are amazing breakthroughs in science right now that could potentially revolutionize the way some hideous diseases are treated. We need these breakthroughs and lead the world in creating them. Doing the work to find them costs a huge amount - and has to be paid for. On the other hand, "investors" who buy up patented drugs like the epi-pen and raise the price ten fold should be punished.
The original version of epi-pen was approved by the FDA in 1987, and has therefore been off patent for many years. The original epi-pen worked very well, and any company who was inclined could make the original epi-pen today. So the price increase had nothing to do with the patent. The only reason the price could be jacked up on the later version of epi-pen is that only one company was making it. The same thing would happen today for toasters if their was only one company in the business. Whose fault is that?
Actually, drug companies spend more on sales and marketing than they do on R&D:
https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-pharmaceutica...
trump promised he would reduce drug costs - Instead he wants to take away health care from millions and do nothing about out of control drug prides. It is obvious who trump is working for, and he could really care less if the rest suffer.
1
I took a relative to an orthopedist, in whose waiting room there was a TV. The TV had an ad for an anti-inflammatory drug, and the ad showed an elderly man waltzing with a young child and then dancing vigorously with his wife. One guy in the waiting room said, "Look at that!" and most of the others in the waiting room, each with a cane or a brace, said "Yeah, right" or "Talk about lying ads" or things I can't quote in a family-newspaper comment section.
At the end of the ad, it said "Ask your doctor" about Medication X. Like the doctor has never heard of a medication advertised on national TV until some patient asks "Why don't you give me that?" and the doctor needs to explain why that won't help in her case.
The fact that drug companies spend more on advertising than on research gives the lie to the statement that they are meeting real needs. Yes, we do need a miracle drug that will make the lame walk and the blind see and the deaf hear. But the lame, blind, and deaf will not find that drug in a TV ad.
1
Here is one thing I think everyone should bear in mind about the pharmaceutical industry in our country: they regularly make the argument that they have to charge high prices because the development of new drugs is expensive, and their success is uncertain. The counter argument is that the pharma has been one of the most successful sectors of our economy every year since at least the first Clinton administration. If you win big every year, where's the risk?
1
If the profit margin of a company should reflect the value to the public of the products they produce, exactly what kind of company would you suggest should therefore have the highest profit margin? Nabisco, Disney, State Farm - remember that every company listed on a stock exchange is in a daily competition for the publics investment dollar.
Want to stop corporate and lobby influence over our democracy?
Prohibit direct donations to state and federal campaigns.
Tax all entities (corporations, PACs, large-amount donors) that have contributed large-amounts (pick a threshold) over the last decade. Tax them at thier average yearly contributions; no deductions. Then, distributed evenly among the candidates in the General Election.
2
I'm from Brazil and have been living in the US for 15 years. Love this country, but still can't understand why the richest country on earth can't simply provide free healthcare for his citizens or at least press pharma companies into reducing their prices.
Back in the 90's, we in Brazil used to have TV ads about medications and cigarettes all the time, and a law was passed then to ban any ads for prescribed drugs (OTC products are ok) and cigarettes. A 3rd world country did something that the major power on earth wouldn't even think about doing it.
Also back in the 90's pharma companies in Brazil were price gouging and after some unfruitful negotiations between them and the government, the latter came down with laws to force prices to be reduced, by revoking patents from some medications to common illnesses (high blood pressure, malaria, high cholesterol), so that state-run laboratories and generic manufactures could provide medications at low or no cost.
It's high time for a country known for leadership to really take action items to improve the health of its citizens.
5
Our country, for the most part, worships at the alter of money and power. People will tell you that they voted for this president because he is rich and powerful. It doesn't matter that he stiffed people for years. It doesn't matter that he spoke of sexually assaulting women or that he bragged about shooting someone and it not making a bit of difference. Why can he act like this and still be considered a worthwhile human being? Because fame, power and wealth are considered more important than decency, fairness, and being ethical or compassionate. This is the same reason a smirking pharmaceutical executive calls himself a robber baron as he screws over millions. It doesn't matter...he's rich and powerful. The real problem lies with us, the American public, who bow down to these disgusting pigs and secretly wish they could be as rich and powerful.
7
The fact is that wealth is capitalism's scorecard and rightly so.
Barack Obama's Obamacare gift to Big Pharma was to require Americans to buy health care insurance without any drug price controls.
2
Some years ago my e-mail account was hacked, "contacts" was plundered, and all were treated to adverts for Viagra. (I told my friends it was because of my rep as a stickman, but that was just a joke.
I thought there must be a hefty markup on pills of this sort if guys are going to these lengths to push them. At the corner drugstore, I learned that a single tab of Cialis would cost me about $26, Wow!
So, naturally I scanned the Net to price generic Cialis. I found it, tadalafil, for about $2/tab, from India. I bought a couple hundred and took to vending them around the village for $4 or $5 a piece. They were a hit.
I relate this tale to illustrate the markups applied to a cartel market. Look around, you can beat the cartel to death.
There are rumors that foreign producers are dirty, sloppy, slack and all that.
Balderdash!...such an egregious piece of chauvinism!
An Indian producer has more to lose from a "bad batch" than a domestic, because the bad PR would be shouted from the mountaintops by professional holler-boys.
3
We all know the answer: negotiate pricing the same way the veterans administration does. The same as my Fair Canada does.
As usual extreme profit matters more than citizens.
Stupid is as stupid does.
3
Isn't it odd how exactly the same prescriptions, made by the same companies are far cheaper in Europe and other parts of the world? I guess those companies just see the U.S. as a treasure trove of suckers. We're a country of idiots with the world's worst health care system.
6
I have not had to examine the circumstances exstensively but I have found I can get drugs by calling phone numbers. Gee, is this illegal? No. I am not dealing nor doing anything against the , what do they call it? what does the "H" represent?
Should I need a major organ transpant I would just go somewhere and get it. There are [people who consider getting health care to be subversive..
I cannot compel them with a knife because that would be criminal. Yet they can refuse because they may not be paid. I believe that is a deadly sin excluding them from Heaven.
1
Here's a thought: why not have a single-provider for pharmaceuticals?
The government could use its Medicare/Medicaid structure to negotiate fair prices for drugs. This takes the doctors out of the loop. A structure like this could argue for developing drugs, like antibiotics, that have limited appeal with pharma by ensuring a fair price. Although this is a leap of faith for big pharma it is a worthy experiment for those who claim to be the standard bearers of good health.
2
If only one entity (the government) can buy drugs at wholesale and sell them at retail, calling it negotiation is a lie.
hey baby boomers, thought you could take it with you ? it's redistribution of the wealth time. welcome to the MEDICAL INDUSTRIAL COMPLEX. insurance, doctors, pharmacies hospitals, rehabilitation centers, nursing homes, funeral parlors............lawyers. not one of them wants a single payer health system.
1
Many among us know that the entire Congress, specifically the GOP, is marching to the tunes of the drug and healthcare industry, and yet we keep electing the same mafia perpetuating the protection racket.
3
Congress has become a freaky puppet show with corporate lobbyists yanking its strings and mega-donors scripting its spiteful, viscous activities. Demand an end to gerrymandering! Deny private jet travel on the public dole! Take away their privileged health plan! No more redecorating on the public dole! Make them eat the same gruel they're slinging at us! Term limits! Vote the bums out of office and closedown the puppet show.
5
It's a horrible indictment of our Congress and our elected "representatives" who don't represent us at all because they have been purchased by interests with more money than ourselves. Aided and abetted by five hacks and charlatans in black robes who purport to uphold our constitution while they do the bidding of the rich and powerful.
5
I've purchased medications from Canada at reasonable prices.. These medications have come from Israel and India. When CEO's receive million dollar bonuses, that cost goes to consumers. "Shareholders" receive hefty dividends. I call this criminal behavior. The "market" is rigged.
1
Based on data from open secrets.org, 5 of the top lobbying groups are health/phara associated. Where's the mystery?
6
One person's experience with prescription drugs in the past 3 weeks- Vagifem in Stockholm is over-the-counter at 1/2 the price. Anti-inflammatory cream in France is over-the -counter at 1/4 the price. Anti-itch cream in France 1/10th price. All these prescriptions were covered by insurance! What a rip off!
4
Everyone wants to reduce prices except the law makers who are paid off!
Outrageous they will even gamble our very lives against their $$$. This is the greatest scandle of all and uniquely American.
Money talks, actually it screams.
1
Some day, some year, the forces will all line up in the right places and the thieving, exploitive US drug industry will get the stuffing kicked out of it, and no longer being in the position to empty the pockets of Americans, mercilessly, with inhuman greed and a lock on bought-and-paid-for senators and representatives.
Punish Big Pharma!
2
Another marker of American "exceptionalism"!
Along with infant mortality rates, incarceration rates, police killings, etc.
3
Isn't this all we need to know to answer the question of why Congress won't bother with controlling drug prices. "Drug makers gave $4.5 million to congressional campaigns" Oh, and you could just sell your drug patent to an American Indian Tribe to prevent generics.
https://www.nytimes.com/2017/09/08/health/allergan-patent-tribe.html?mcu...
2
Here is the problem: "...hired the former F.B.I. director Louis Freeh to study the impact of importation." That is only a part of the $145 million big pharma spent in the first half of 2017. Follow the money. Drain the swamp. Please. Thank you very much. You do not need to be an attorney, a PhD in chemistry or economics to see the problem. For the love of God, please make this country a better place to live, follow your heart and not the money. Do the right thing. Break the back of every "Robber Barron"; arrest, convict and imprison.
3
The entire pharmaceutical health care model is a scam and needs rethinking.
- Our health care is ranked at the bottom of the industrialized world, below Costa Rica, but costs twice as much as top-ranked France.
- 75% of health care cost is from non-communicable disease - chronic disease - heart disease, cancer, alzheimer's, diabetes.
- Doctors are entirely clueless about chronic disease. Note that 50% of men and 41% of women will die of cancer and there has been zero progress since Nixon's 1971 war on cancer, despite billions paid.
- According to research at Harvard's Safra Institute, 90% of drugs are ineffective - but they all have bad side effects. Doctors, with an average income of $300,000, massively prescribe these ineffective drugs.
- Doctors and their drugs (correctly prescribed) kill over 100,000 people every year, making them the number four cause of death.
- Health care treatments and procedures kill 783,000/year.
- Only 15% of all procedures used in medical practice have been shown to be efficacious by controlled trial.
- 89 million people are hospitalized unnecessarily each year and 17 million iatrogenic "events" will occur among this number.
- Marketing is Big Pharma's most expensive line item (not R&D).
The alternatives to the scam of Big Medicine are inexpensive, effective, safe, and easily found. Get sequenced for $100 and then see Dr. Google.
Take responsibility. An hour with Dr. Google will save your life.
1
Much of Congress is in the pocket of Big Pharm. They propagate safety myths. Canadian drugs, for example, are as safe as American ones. They are simply enormously less expensive. In fact, they are the same drugs sold here in the good old USA. This all will change when the public demands it at the ballot box.
4
Because this is a BUSINESS FIRST country. Profit is King. Large U.S. corporations really are the one writing the laws because politicians are bought, the best money can buy as Bob Brinker likes to say. Is an open secret.
3
A long as there is money to be made, especially large sums of money, people are going to do anything to keep it. Remember this- Nothing is for free! Any semblance of a "discount" will be reimbursed through a back door policy or clever little loophole- It's Smoke and Mirrors 101 and the American taxpayers are dupes.
Don't believe one thing this President says and while we're at it- none of our elected Representatives fair any better. For 50 years we have been "trying" to improve things: Taxes, Healthcare, Education, Housing, Poverty, Military Spending, Balanced Budgets, Deficits, Trade, Jobs .. bla bla bla the list goes on .. and the only thing I see and hear are the SAME politicians in both parties reappearing term after term- year after year- telling us why they aren't responsible for making our lives miserable and unmanageable and that it's always somebody else's fault for making our lives miserable and unmanageable! So what do we do? We continue to re-elect them! It's Smoke and Mirrors 101 and the American taxpayers are dupes.
What kind of expertise did exFBI director Freeh bring to his opinion that drugs manufactured overseas are less safe than those manufactured here, that we should believe him?
Rid ourselves of that abomination called Citizens United and provide for public financing of elections and this problem too shall go away. Greed is standing in the way.
1
The answer to the question in the headline is found in the article: bought and paid for members of Congress, and an executive branch that thinks every rich person or entity is by definition smarter and more worthy of accommodation to their demands.
Time to rid the nation of Citizens United, which allows often massive contributions to re-election campaigns by Big Pharma. (Translation: bribes) How can the same drug be sold in Canada for a factor of, say, 5, times less than the price it sells in the US? Often, US taxpayers paid to develop those drugs. This is capitalism run amok.
The way drugs are being priced is not a bug in the free enterprise system, but rather a feature, and within free enterprise the solution is to buy the stocks of drug companies. In attracting consumer dollars, they have a natural advantage and they are exploiting it to the hilt. Defenders of free enterprise and government noninvolvement in details of the economy will want to get on board and get a piece of this success.
We have the world’s highest priced, most profitable drug prices, and health care, and elections. EU nations have much lower costs on all 3. That tells you all 3 are related.
The European union bans direct to consumer drug ads on TV, that here swamp our media 24/7 manipulating us and driving up prices with huge ad budgets.
Other nations negotiate/ regulate costs for citizens. They don’t have our powerful medical-industrial complex that finances elections. What exotic cultures they are.
Here, it took a rebel like Bernie Sanders to take a busload of Americans to Canada for the cancer drugs they couldn’t afford here.
Reuters: “U.S. doctor group calls for ban on drug advertising to consumers”. The U.S. and New Zealand are the only two countries that allow direct-to-consumer advertising of prescription drugs....AMA said drugmakers’ ad spending shot up 30% to $4.5 billion.
But US courts say drug ads are a form of constitutionally protected commercial speech so can’t be banned. Same for corporate megadonations poured into our campaigns. Profits galore.
Europeans resist this. Reuters: “ Allowing drug ads is a dangerous move towards American-style mass TV ads of "wonder-drugs pushed by a hard sell into people’s homes.”
EU voters aren’t bombarded with election campaign ads. Candidates get free media time for their platforms, they use public funding and limit private donations. Thus they have health care for all at lower cost that we have to fight a long battle for.
33
Where in the Constitution is commercial speech protected?
The solution is to realize that many of the drugs pushed upon us are impotent, dangerous or simply unnecessary. We have been led down a road of deceit by these unscrupulous abusers of public trust for nearly 100 years. The most common diseases are preventable and reversible by diet and lifestyle. The unnecessary pills pushing upon every age group is reprehensible. I have seen it particularity with the aged..pushing countless pills at a time upon them in nursing homes where they are helpless and can not protest etc...aside from the lack of training of those administering drugs..the deleterious interactions of drugs is unknowable. The system is beyond broken! It is dangerous and it is immoral! Our kitchen cabinet contains the most powerful and healing agents on the planet.
It is time (I hope) to have a compromise. That is, to have Medicare and Medicaid Negociate as a provider of 120 million or so patients with the drug companies, aiming for prices of the same drugs that France or Canada or others, pay. It will work.
1
It's not enough of a problem for our elected officials and the money they receive from the pharmaceutical companies is enough to offset any interest they may have in regulating price increases or modifying the patent laws. The real losers are Americans who require certain drugs to live: insulin dependent diabetics, people with HIV, anyone of modest means or who is unemployed and requires medication for high blood pressure, cancer, etc.
It's not just drug prices that are the problem. The pharmaceutical companies take advantage of our ignorance on how they conduct their research. As someone who has worked in the pharmaceutical industry I know that far more money is spent on market research than on drug research. Pharmaceutical companies, like the auto manufacturers, are not always honest about what can go wrong when taking their drugs. Their real interests lie in making money, not being charitable, and certainly not in pricing drugs so that they are affordable. In fact, their claim, echoed by susceptible politicians, about the lack of quality in drugs manufactured abroad is a lie too. Plenty of drugs we take are made in other countries. We're paying full price for brand name drugs that are not being made here. The real concern is when we mail order the drugs and get the wrong thing, or worse.
Our politicians are not doing their jobs: creating a health care system that works for all Americans regardless of where we live or how much we earn.
2
The GOP ACA repeal is about ending Medicaid and opening up funds for tax cuts. Pharmaceutical companies waste vast amounts of money on advertising. Innovations for diseases like TB and malaria are no where because the people who need them are mostly extremely poor. The looming antibiotic apocalypse is certainly not being addressed nearly as much as necessary. The pharmaceutical companies have completely bought off the congress.
1
If we allow unrestricted drug imports from Canada then Big Pharma will just squeeze of the supply to Canada to just what is needed for Canadians.
Pay for play on both sides of the aisle, that is why I am a Libertarian.
Once again a sense of the surreal while reading this article! Kaiser Heakth News? Hmmmmm!
"allowing the government to negotiate the price of Medicare-covered drugs?" One throw-away clause! The "government" specifically forbade the Centers for Medicare and Medicaid Services to use its buying power to negotiate the price of drugs. The VA had that power (perhaps it still does.) When the Medicare Drug bill was debated in the House, it barely squeaked through, and then only after the vote had been kept open for over six hours; when the C-SPAN cameras had been fixed so as not to show the goings-on the the GOP side of the House with the Sec'y HHS negotiating on the floor (the Legislative branch being invaded by the Executive! Tommy Thompson!); and after much arm-twisting and back-scratching the vote was taken in the wee hours. When the bill was signed into law, Billy Tauzin, the GOP member who had shepherded it through the House, left for a lucrative job with Big Pharma. There was more skull-duggery (Search the names Thomas A. Scully and Richard S. Foster for information on lies about the costs of the bill.) And BTW, Tom Delay was censured by a House Committee for his actions during this debacle. Blame the GOP in Congress for a large part of the problem of drug prices.
3
What is the drug prescription plan for members of Congress ?
Perhaps if we eliminate it they will share our "Pain".
4
It's too bad Hillary Clinton wasn't elected, she would totally have stood up to these people just like Obama and the rest of the Democrats. NOT.
Robert: These people? Which people? The decision to prevent CMS from negotiating drug prices was made by Congress.
So, they hired Louis Freeh?
And they paid him.
And he came to the conclusion that importing drugs would lead to nefarious individuals poisoning our drug supply?
What was that quotation about how difficult it is for someone to understand a problem, when their remuneration is based on their NOT understanding it?
Why can't we reduce drug prices? Because lower prices would not financially benefit pharmaceutical companies, many doctors, many politicians, or the media. Nine out of 10 pharmaceutical companies spend more on advertising than on R&D. Most advertising--and lots of financial bennies--are aimed at doctors, but billions are also spent each year on direct-to-consumer ads--something only New Zealand and the USA (among developed countries) allow. The AMA came out against direct-to-consumer advertising in 2015--both for reasons of cost and because consumers are being persuaded to ask their doctors for drugs that may not be in their best interest. Hear much about the financial and health costs of Big Pharma advertising in the media? In Congress? At the White House? If the New York Times is serious, write about drug advertising.
1
Any note on how many Americans go without medication do to the cost?
3
Still watching TV? Do you actually ask your doctor to prescribe the costly medications Big Pharma is cramming down your throats every 10-minutes?
Big Pharma controls programming. Turn the TV off, go for a walk and stay healthy. Read a book, write a poem, anything but sitting there like Big Pharma's zombie. Only positive side effects can occur from turning the blasted thing off.
1
Answering the question ask congress dont they get paid off to keep the prices high, If Price can fly on charter flights why not padding to his accounts
because this country is run by the military industrial complex and is the corporate welfare state.
1
Why is not considered Bribery?
"The offering, giving, receiving, or soliciting of something of value for the purpose of influencing the action of an official in the discharge of his or her public or legal duties."
They are all corrupt crooks.
Lock them up. Lock them up. Lock them up!
2
Big Pharma's motto: "Your money or your life!" (Borrowed from the English highwaymen of days gone by.)
2
National politics in this country is pay to play, enshrined in law thanks to the Supreme Court. There are over 1,300 registered pharmaceutical lobbyists. Study the misbegotten career of Billy Tauzin if you want a poster boy for how this works.
1
Senior citizens are the biggest consumers of medications - prescription and non-prescription. Yet, how many of these same seniors have pharmaceutical stocks in their portfolios - from which they expect significant dividends? Go figure. Stockholders demand profit, and the CEO's know that if they don't deliver, they are out. How much of the cost of medications is the result of paying for advertising and lobbyists and detail sales-babes? Sales-babes, you ask? Big pharma hires attractive young women in short skirts and high-heels to go from doctor's office to doctor's office to pitch their wares. It works. Doctors who were once too busy to listen to a sales pitch from a detail "man" now find time for the detail-dollies. Bet you didn't know about that! So much of the cost of medication is the result of such "fluff - fluff that contributes nothing to patient care. Lobbyists have influence only if they are allowed access, which is also true of detail salesmen. (In our Emergency Room, we had a flat rule against detail-persons). The ban on TV advertising could be reinstated, were it not for the influence of big-pharma in foggy-bottom. Doctors are forced to waste time explaining to their patients why the latest snake-oil pitched in a TV ad is not appropriate. Such nonsense! We deserve better.
... but do they? DoCorey Booker and colleagues who voted against importing cheaper drugs from Canada want cheaper drugs? How about all those republicans who forbade government from negotiating cheaper drugs thru Medicaid? How about democrats and republicans who accept campaign donations from big pharma ... do they really want cheaper drugs?
The answer is pretty clearly NO! So, that takes of just about EVERYBODY except the American people who are routinely ignored in our political decision making processes. Now, we've accounted for everybody over and out
1
Are we so brainwashed as to not realize that almost all basic science is conducted in Universities. All the hard work, the wrong paths are eliminated and then the best possibilities are handed over for private exploitation. Pleez
One data point from personal experience:
--30g tube of Econazole cream 1% in the US: $150
--30g tube of Econazole cream 1% in France: $3
Can there possibly be any reasonable explanation for this ?
2
Yes - an unregulated profit driven system. Decades of politicians catering to the business interests to the exclusion of our welfare.
Greed
1
let us buy drugs from other countries, i.e., canada, thereby increasing competition.
Let our Government negotiate for lower prices like they do! Remove the restriction on Medicare negotiating pharmaceutical prices - imposed by Republicans. This is Proven to lower drug prices in Canada and Europe.
1
This article underscores the corruption of the Democratic party and the expansion of the neoliberal agenda led by the likes of HRC and the DNC. There is nothing new about these people - they used to be called Republicans - and there is certainly nothing liberal about them. What a disgrace.
1
Who were the 13 Democrats?
Not a surprise.
Pharma has BOTH parties in their back pocket.
2
Oh. My. GOD I just love this line.....
The top 10 publicly traded United States drug companies made $67.8 billion after taxes last year, regulatory filings show.
What a convincing argument. Who would have thought that big companies "make money"
How has this happened. Surely it means something is wrong
What would happen to their profits if we all emigrated?
1
Your illness = their profit. Come ON folks - get sick. The robber barons need your cash - and remember: the sicker you are, the more they'll make! Exciting to be part of, isn't it?
Step One: PROHIBIT drug ads on TV and any media not direct to prescribers. Huge instant savings AND doctor/big pharm accountability.
Price controls have a nefarious history which ought not be ignored. When the government makes an industry unprofitable through regulations investments dry up. We don't want to live in a world without antibiotics to treat evolving bacteria or without research to find new cancer cures. We need to be careful what we wish for.
Vote in a Congress that is willing to regulate and negotiate on behalf of the welfare of the people; Voters, reject false free market ideology! - a mixed model of government and business is the proven model that made us great post WWII. Finally, borrow from other successful Western healthcare models.
1
It's high time the subject of pharmaceuticals - and healthcare in its many guises - is regulated in order to reduce costs and so make any health plan affordable to al. Here in France, as everyone knows, the government sets prices and negotiates with the pharmaceutical industry in order to prevent the scandalous (criminal?) conditions the American public has to put up with. And before anyone jumps down my throat by using the terms "socialized medecine" , let's consider that other western countries all have single payer systems that work just fine thank you very much!
2
We can't do it because, clearly, not everyone wants to reduce Rx prices.
This is the logical consequence of dollars as "free" speech - further tilting the playing field to accommodate those who aleady have the greatest advantages for economic and political success, confirming their collective narcissistic belief that they deserve their noxious largesse. The next step of this institutionalized malfeasance would appear to be the re-codification of the Divine Right of Succession.
1
Good Question! Better question - how does Canada do it?
Question: why?
Answer: this is the same as the military industrial complex.
Eisenhower is correct again.
1
This is an excellent article that we don't get as often as we'd like of manximum national importance. I wish the NYT would have many more like these instead of going in circles with all the anti-Trump hate mongering. Keeping Trump straight on his promises and monitoring the swamp, both on the Republican and Democratic parts, should be pursued.
"Everyone Wants to Reduce Drug Prices. So Why Can’t We Do It?"
What an absurd title, what an absurd thought. Replace "Reduce Drug Prices" with any of the myriad of things that people want:
Be Rich
Not Get Old
Not Pay Taxes
Be Beautiful
Fly
"Why can't we"? Isn't it obvious? STOP electing politicians who serve strictly their corporate donors, in this case, the lobbyists from the healthcare industry and start electing people who will do something about it! Republicans and democrats who continue to accept money from the healthcare industry will NEVER do anything!
Deus oh two;
With Gerrymandering, That is pretty hard to do.
We would need to have a democracy for that to work.
In America nothing is more important than money. Period. Not health, happiness, family, or human life itself.
2
"thanks to lobbying and campaign contributions, the GOP controlled Congress just won’t act."
In the GOP, money talks loud and clear and their right-wing pawns obey.
If U.S. drug companies don't want us to import drugs from Canada, maybe they should keep their prices competitive.
Why not research how many members of Congress own stock in pharmaceutical companies, and how many have relative who run these companies? The Democratic senator from West Virginia comes to mind, as does the Secretary of HHS. Call out the denizens of the swamp by name!
Echoing some of the other comments, it boggles my mind how an article about high drug prices makes absolutely no mention of the cost - and collateral influences - of drug advertising, which appears to be one of the largest - if not THE largest -- sources of commercial TV ad income and can't help but be a big factor in drug prices.
Unless there is FAIRNESS of access, pricing and delivery of healthcare services in general, there will be no reduction of drug prices alone.
What does fairness mean?
Fairness is defined in the what, where, when, how, with (within):
1) the prices & access to generic drugs, imaging services, primary care, urgent / emergency care, outpatient specialty OB / medical / pediatric / surgical / mental health services & procedures & allied health services (e.g., physical therapy), home / palliative care)
2) urban and rural environments roughly equal to more affluent environs
4) settings that degrade the doctor - patient interaction such as ones that distort that interaction through the imposition of unfair documentation rules and regulations
5) adversarial OUTPATIENT care settings created by the setting PLUS reimbursement mechanism OR because doctor-patient interaction outcomes are dissatisfactory in spite of reasonable patient & physician expectations
6) the "off hours"
7) continuity of care plus non-continuity of care and multi-conflicting regulation containing settings.
8) non-intelligent and burdensome selection opportunities
Ask Bernie Sanders.
America is one of only two countries in the world that allows direct advertising of prescription drugs to the general public.
drug companies, lobbyists, supporters in Congress are criminals. Plain and simple. All of their points to jusitfy their greed are the words of criminals. Don't expect criminals to act in a moral or even reasonable manner.
Vote out the criminal co-conspirators in Congress: jail the rest, and then jail the Congresssmembers, too.
Or, go to their houses with large, info based protests and cause a media event. Out them everywhere. They will never change if we don't.
When an article begins with a patiently false premise:
"Everyone Wants to Reduce Drug Prices..."
I don't bother to read the article because the article is not worth reading.
"...So Why Can’t We Do It?"
Because the people who make money selling drugs do not want to make less money. They are addicted to their greed.
See.
No need to read past the title, Mr. Hancock.
Remove the power of money in politics - make your politicians less corrupt. Is quiet simple.
The problem isn't the currently jailed Shkreli. It's the several dozen far smarter, richer and rapacious CEOs of Big Pharma, determined to extract every penny from working people. The cost of their life-saving drugs drains the economy and the spirit of the American people and our political leaders are too ideological, stupid and venal to do anything about it.
Dan Kravitz
This was Elisabeth Rosenthal's favorite example in her series on health care in the NYT. The NYT had a nice graphic showing how many inhalers you could buy in different countries for the price of one inhaler in the US.
The EPA banned one of the common hydrofluorocarbons, which was used in refrigerators and air conditioners.
Some industries and manufacturers got exemptions to the bans, because they used a small amount for critical applications, like aircraft fire extinguishers.
The pharmaceutical industry could have easily gotten an exemption for inhalers. But they didn't apply, because they knew that if the price went up, they would make more money. (And it protected them from foreign competitors.)
You could fly to Italy, have a nice vacation, buy a year's supply of inhalers, fly back, and come out ahead.
1
The US has the world’s highest priced, most profitable drug prices. Same for health care system. Same for elections. EU nations have much lower costs on all 3. What does that tell you? These are all strongly related.
The European union bans direct to consumer drug ads on TV. Here these ads swamp our media all day, manipulating us and driving up prices with huge ad budgets.
Other nations negotiate/ regulate costs for citizens. They don’t have our powerful medical-industrial complex that finances elections. What exotic cultures they are.
Here, it took a rebel like Bernie Sanders to take a busload of Americans to Canada for the cancer drugs they couldn’t afford here.
See Reuters: “U.S. doctor group calls for ban on drug advertising to consumers”. The U.S. and New Zealand are the only two countries that allow direct-to-consumer advertising of prescription drugs.”
AMA said drugmakers’ ad spending shot up 30% to $4.5 billion.
US courts say drug ads are a form of constitutionally protected commercial speech so can’t be banned. Same for corporate megadonations poured into our campaigns.
Europeans can resist this. Reuters: “ Allowing drug ads is a dangerous move towards American-style mass TV ads of "wonder-drugs pushed by a hard sell into people’s homes.”
EU voters aren’t bombarded with campaign ads. All candidates get free media time. They use public funds & limit private money. Thus ---health care for all at lower cost that we have to fight a long battle for.
There is one thing we know when it comes to managing prescription drug spending: competition works. Specifically, the average cost of generic medications has *dropped* over time while the average cost branded products has risen. This happens because there are multiple manufacturers of generic medications, all of them competing on price. Payers that have employed programs that advantage generic alternatives over branded products have done very well in managing their overall drug spend.
Specialty medications (typically large molecule biologic drugs) are different because FDA regulations and federal law make it much more difficult for "biosimilars" (the biologic equivalent of generics) to be approved. This reduces the amount of competition substantially and therefore provides cover for drug manufacturers to keep prices for specialty medications high.
If we want to manage the cost of prescription medications, we need to revisit the legal pathway for the production of biosimilars. There is no good economic or clinical reason argument against this making this change.
As many others have said, not only have we financed their research without return, the big Pharmaceutical groups have bought up the GOP, and many Dems, too. This is evidenced in the Congressional hearings, as well.
One would think that at least they should refund the research grants, paid for with our taxes, plus a formula of an additional amount commensurate with their annual profits. However, they are so greedy that some have said they cannot research without our grants.
I see the very same US brand of my prescription drug selling over the counter in Asia for $10/pill while it costs $60/pill here in the US. I doubt if the pharmaceutical company is exporting at a loss.
6
Here's an idea. How about instead of allowing the Pharmaceutical Research and Manufacturers of America to spend obscene amounts of money on lobbying, the money that is given to them by the pharmaceutical companies to protect their price gouging is instead withheld and used to lower drug prices. It's one thing to allow free speech, but quite another to allow our political system to be sold to the highest bidder, in this case, the pharmaceutical companies, so they can maintain their inflated price structures. This is not speech, it is corruption.
3
Ever since the Kefauver hearings in 1960, the drug industry's argument has been that high prices are needed to recoup their R&D costs. But where does that leave Shkreli and his ilk, who conduct no R&D at all, acquire decades-old drugs and jack up the prices astronomically?
When patents grow close to expiration, big pharma companies can tweak one atom on a drug molecule or change some physical feature like pill shape and create something "new and improved" — at least with respect to profitability and patentability; clinically the improvement is often dubious.
Also, price controls on drugs in other countries leave multinational pharma companies in need of a place to make up what they can't get there — which means the U.S.
I recall that the last time there was discussion of allowing imports from Canada, the Canadians very quickly announced they will not allow it. Why? Because they know they are the "empty airplane seat", that the only reason they get low prices is they are a tiny, marginal market.
They know that if all of a sudden a lot of drugs are being exported to the US -- after having been imported from the US -- the drug companies will have the pricing power to raise prices on the Canadians. So, predictably, the Canadians will not allow this to happen.
1
Drug pricing is yet another example of the dysfunction of our government. It has utterly ceased to be responsive to the needs of the public it “serves”. Campaign contributions are a de-facto form of graft where the quid pro quo is sufficiently indirect to avoid prosecution.
Congress happily aids formation of monopolies that defy public good. We now have “Soviet style” customer service in air travel due to the regional monopolies they abetted. Similar problems exist, in telecommunications and healthcare.
I loathe Trump, but I share his electorate’s cry to “drain the swamp”.
1
An easy way to lower drug prices would be get rid of monopoly patent rights. It is usually the case that the company that is first to launch an effective drug into the market receives most of the profits.
How about "most-favored nation" status for US consumers? No US drug company should be allowed to a US distributor at a higher price than it charges any distributor in the developed world. That would be much less wasteful than re-importation, which is just dumb.
The cost of developing new drugs is astronomical, but it must be shared by consumers in all prosperous nations that use them. Putting so much of the development costs on US consumers and selling at much lower prices to foreign users is bad policy, and it should be made illegal.
"everybody" knows why drug prices are in another stratosphere here compared to other western democracies.....money, money and more money. Our capitalism has become so severe, broken, corrupt and completely unresponsive to its citizens because we are an Oligarchy...not a Democracy. It's all about corporations and the super wealthy no matter the industry because they have effectively purchased every lever of government.
2
"Everyone Wants to Reduce Drug Prices. So Why Can’t We Do It?" Well, as the article indicates, everyone but Big Pharma wants it, and ever since Citizens United, money rules. Six-figure donations to the Speaker and the committee chairs is all it takes. Welcome to the United States of America, Inc., the best ex-democracy that money can buy.
I used to think that statements like the above were hyperbolic rants. Now I think they are literally true. Up to 80% of Democrats AND Republicans oppose Citizens United, and 75% of those polled think that corruption is widespread in Government. But it's too late — our elected officials now represent corporations and the 0.1%, and that's who they listen to. What citizens want doesn't matter any more. If money = speech, then the rich own the megaphones and the rest of us are just background noise.
5
It's simple. Ban drug advertising. Eliminating advertising expenses would reduce overall drug costs by about 1/3, reduce the incentive to produce "Block buster" drugs with little value and refocus drug companies on producing drugs that cure illness. It worked in the past. Let's try it again.
1
Going back to disallowing commercials for prescription drugs would go a long way towards reducing costs.
The new Republican Health care plan if it passes has a potential to reduce drug prices. Each state will have the bargaining ability which Obamacare failed to reduce drug prices. Giving states the responsibility of how to spend federal dollars will give opportunities to Americans to choose the state they want to live in. If a state does not satisfy the health needs , there are 49 other states to move to. When Massachusetts managed its heath program under Gov. Romney, from what I heard people of that state were quite happy. So let the states manage health care to the best of their abilities. I don't understand what problem Senators Paul, McCain, Collins have with states managing health care for their own states. I also don't understands why all the democrats are so stuck up on Obamacare when the top democrat Bill Clinton calls it the worst system in the world? Do they not care about the rising premiums and deductibles of Obamacare and fewer provider choices?
1
There is no doubt drug prices are now absurd. They are increasing month by month like stock prices. There is no easy fix.
Probably the single most important contributor to pricing is health insurance coverage. When you say I only paid $5 for my prescription that was not the full price. That was your cost -- not the price. Insurance subsidizes the costs of drugs creating a non-competitive system.
If drugs were not covered by insurance then market forces would more likely prevail because no one would buy at full price. How else do you explain $40,000 experimental cancer drugs?
Generic drugs are seemingly part of the answer and are mandated in many states. But this is flawed. Generics are not as well standardized. They do not need to pass the same set of rigorous requirements as the original proprietary drugs. There is a difference.
There is no easy fix. This is one more crisis like rentals, housing and student loans
So it's not only conservatives who think that magic bullets will solve their problems...
The root of the drug pricing issue is pretty simple: drug companies have innovative products that only they have and that are very useful to the population in general.
The vast majority of solutions offered here and in the comments section will have the desired effect in the short term only. You can lower prices through importation, government pricing ceilings, etc in the short term and still see innovation for a couple years as pharma companies continue to develop drugs that are already in their pipeline. But longer term - say 5-10 years - you'd be naive to think Pharma companies will spend billions of dollars developing low-margin drugs. I've heard the argument "well, they'll have no choice". True - pharma companies won't have a choice but investors will: sell low-return pharma stock, buy higher-return tech stock
This would eventually lead to more consolidation of a few pharma producing only sure-bet drugs. Which means as a society we'd be deciding that rarer cancers, patients for whom current rheumatoid arthritis drugs don't work, etc will go untreated.
That may be a legítimate choice we make as a society - treat the biggest populations only and defer the rest - but it's never acknowledged in the debate. Again - long term, there's no magic bullet.
A generic pharmaceutical manufactor increased the price of duloxetine (pain + antidepressant) for my patients by 8-fold last month. This is absolutely criminal. There was no novelty in clinical effect, same old drug, new price. Without 1 monitor (i.e. 1 payer system) to be able to have a leveraged position in negotiating prices, pharma will continue to steal from US patients.
One of the problems is the legislators are in bed with big Pharma. They don't care because they have the insurance and money to pay the exorbitant prices of drugs.
We keep asking the same question and never get an honest answer: Why do Americans pay more than any other country in the world for Rx drugs?
Big Pharma are the real drug dealers.
1
Restricting ads for medications simply won't work. The drug industry will find a way to get around the restrictions. Television advertisements for pharmaceuticals have to be totally banned on social media. I believe that there are only two countries that allow t.v. ads for drugs and the U.S. is obviously one. These ads are geared toward the potential patient who, in general, has no idea on how to evaluate the advertisement. imagine the cost of these advertisements?
1
Shareholder value....the same as it ever was. Capitalism is little more than the rights to civilized predation toward parties with unequal bargaining power or position.
For all intents and purposes, American consumers are footing the entire cost of new drug development. The rest of the world free rides on this. Tariffs should be imposed on foreign buyers of drugs developed in the US. These tariffs should then be used to defray the cost of drugs sold to Americans.
2
Well, here's an idea: In the United States' unregulated market, drug companies price the third, fourth, sixth generation of a drug (e.g., SSRI's for depression, statins for elevated cholesterol) at the same price (or more) than the first such drug on the market. Yet these successor drugs are invariably never tested head-to-head against their predecessors, but instead need only show superiority over placebo in order to gain FDA approval. Even if we aren't willing to go "all the way" to drug price controls, we could require that drugs that are essentially copycats of prior drugs be priced some percentage less (e.g., 25%) than the original drug absent evidence of true superiority in a majority of patients. The pharma industry's cry will be, "Oh, but every patient is different, so every new drug has potential superiority in any given patient." To which I reply: baloney (mostly).
1
I am sick of all kinds of illness being pushed in my face every time I try to watch tv? No wonder so many are cutting the cable cord and thank heavens for the mute button.
I can't prescribe drugs for myself, so why are these ugly symptoms (diarrhea, incontinence, liver malfunction, etc.) pushed in my face every time I watch tv--especially as the negative side effects usually take more time to describe than the benefits? Why not take this money and turn it toward lower pricing? Why not take the millions or more dollars spent on lobbying and turn it toward lower pricing? What purpose do these lobbyists serve anyway? Is it a zero sum game with money that could go to lowering drug prices going to lobbyists and advertising? I don't know.
Where are our supposed "representatives" whom we elected to solve these problems? What is taking so long?
I have a friend to drives regularly to Mexico to fill prescriptions, get dental and other treatments and new glasses. Most of us can't do that. But millions of sick people can't afford their drugs while this unchecked gouging goes on. This is just plain WRONG especially when we the people are forbidden to import less expensive versions of our own drugs and if caught treated like naughty children.
I will vote for ANYONE who proves to me they are seriously trying to change this horrendous status quo.
And yes; I am one of the really angry seniors who votes!!
1
I'd suggest getting together with the Med. Professionals in countries that have universal health care.
Put together a plan that incorporates the best. Get the middlemen,(Ins Co) who have ruined affordable health care, out of the loop.
Our Gov. (We) should pay a reasonable price to Eminent Domain any drug that is essential and that is being used by vulture capitalists to price gouge.
"Your Money or Your life" is not a health care system. It is extortion.
Nothing pleases the Oligarch's, like Trump, more than stealing nice homes, on the cheap, from those who lost them due to health care vultures and those who live off their mobster mentality.
A few years ago, my nasal spray (Flonase) was taken from my carry-on briefcase by the airport security people. A one-month supply was $80 in Menlo Park, CA. In Budapest a few days later, I visited the "Apoteka", which my high-school Latin class informed me meant "Drugstore." I asked at the counter for a bottle of Flonase. "Sure," the sales lady told me. "How much?" I asked. The answer: 3,000 Forint—about $12.00 US.
1
Like many Medicare patients, I pay nearly $50 a month for Part D prescription coverage, even tho I have no prescriptions, because the penalty for not doing so is to risk financial peril because of the accumulated penalties for not doing so.
Nevertheless, like all Medicare patients, I still remain exposed to the danger of Medicare's drug pricing system, because of the arbitrariness of Medicare's drug approval procedures and price limitations. Like all Medicare patients, I understand that in the event I need a prescription drug, I might not even be able to use my Part D insurance because Medicare's negotiated prices are higher than prices available through pharmacies and coupon programs.
Congress created a government-supported price-gouging program that benefits drug companies here. And they called it "insurance" in spite of the fact that the concept of shared risk has been completely eliminated.
Why can't we do it? Well, start with the fact that drug companies aren't regulated utilities. There is no legal apparatus to control prices. They are set by the market, just as the prices for houses, cars, etc. are.
In a free market, there is no way to "control" prices, only ways to shape the market in which they are set: patent reform, competition.
There is a good reason why Medicare isn't allowed to negotiate better prices. Medicare is a politically motivated monopsonist, able to use its market power to bludgeon drug companies into a crippled state. If you don't think this likely, look no further than the Medicaid program. In states like California and New Jersey, the Medicaid reimbursement rates for doctors and hospitals are so low, many will not take Medicaid patients. Everyone knows the problem. Everyone can see it. Yet it is never fixed because it costs money. Exactly the same thing would happen with drugs, for exactly the same reason.
1
Everyone does not what lower prices, the drug companies and their owners probably don't. Now a fair compromise would be that US consumers get the lowest price in the developed world. That would mean others would have to pay more or do without the latest drugs. Currently US consumers pay most of the development costs, which is not fair.
Drugs are not bought and sold in anything even remotely resembling a free market.
Drugs are bought and sold in a monopoly market.
All monopoly markets are, or should be, treated as utilities. If the drug makers and sellers want to be able to set prices themselves, then they should agree to do business in a totally and truly free market, which allows competition, commoditization, free trade.
Otherwise, and under the current reality, drug prices should be subject to strict regulation, just as are water, electricity, etc.
23
RHE: "Drugs are not bought and sold in anything even remotely resembling a free market."
That's a good point, but you need to be more specific about two constraints on reform:
1. The US Constitution gives Congress the power to provide patent protection to inventors,* so you need to explain how patent law should be changed.
2. The FDA regulates drugs for safety and efficiency,** so you need to explain how the FDA's regulatory authority should be changed.
* Article I, Section 8:
"To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries;"
** Google '"What We Do" site:fda.gov'
Both valid issues. But keep in mind that a lot of Federal Government supported research and funding goes into patented pharmaceuticals. Why are not the government and taxpayers rewarded as are any other investors?
I have an idea. Shorten the time of patents to be held. Consider the cost of each pill with the active and inactive ingredients. Multiply by 1000 for the sale price. Fair enough?
There are so many problems with our patent system one doesn't know where to begin. It is not just drug costs that our broken patent system but all areas of our economy. This broken system keeps costs high and discourages and even prevents innovation. It is time to dump this broken system.
4
NO and NO. If you shorten the time patents are for then new drugs just won't be created, happy about that?
It's actually assurance that offsets the cost or doesn't. My meds were $7.50 per refill in Boston covered under MassHealth Common Health, a sliding scale Medicaid for the disabled. Brand Keppra $898 Medicare Plan D carrier Philadelphia; was a $15 copay Aetna and Unitedhealthcare. I now take generic $91 for 90 day supply. Same efficacy, lower dosage as prescribed by leading epilepsy specialists. Best MDs can prescribe correct generic.
2
If such exist, there is no generic insulin in a pen.
1
"Everyone Wants to Reduce Drug Prices. So Why Can’t We Do It?"
Well, Jay, not "everyone" wants to reduce drug prices. If the pharmaceutical companies wanted to reduce their prices it would happen. If you think that the federal government should dictate the prices for drugs, why stop there? Why not let our all-knowing and all-caring government dictate wages as well? Maybe some faceless bureaucrat would decide that you make too much money and you should have your pay reduced - what would be your response, Jay?
The bottom line is this - government should get out of pricing things. They have no clue as to actual cost of anything, not even a loaf of bread. Whenever the government sticks its nose into the pricing system it always messes things up. Companies price things based on what the market can afford. If there are not enough customers buying at the higher price, the market (and not a government agency) will find equilibrium.
3
It appears you have no problem paying astronomical prices for prescription meds. This is not the case for a vast majority of us. Folks depend on meds to improve and/or save lives. This is definitely an area where Govt. should step in and negotiate drug prices for us as the VA does and as many Countries around the world do.
The people you're thinking about to deny "everyone" wants cheaper medicines is the famous 1%, the pharmaceutical CEO's, physicians profiting from prescribing medicines from deals with these companies' sellers and more jungle.
So, you're in line with current conventional American thinking, which is normally wrong, either liberal, conservative or else. A realistic person can talk about "everyone" with much less than 1%.
And no hm, the free market doesn't get the best prices because the world is too complex. Wherever there's big money conflict of interest (=corruption) will happen. Anyone involved in any sort of profit will be willing to become corrupted to protect its money.
Americans claim everyone is unique, which is wrong, as said earlier. The average always rules. Our medicines are designed based on statistics, never in our uniqueness, and so insurance, all sort of laws, etc.
Government is sure messy and is the best we, deeply flawed humans, can come up for fair arbitration, sorry libertarians and the like. We live in an imperfect world. Your pharmaceutical businesses will still make good business with government regulation as they do in the rest of the world.
Your free market will also make these businesses to deny making medicines for unusual diseases plaguing the poor, and actually does happen. Only government funded research makes a difference.
What you don't seem to know is that much of the "cost" of developing drugs is in fact borne by the taxpayer and philanthropists to university medical research centers. Drug companies piggy-back off this fundamental research once others have done the much harder work of determining the mechanisms that underlie many diseases. The pharma companies typically carry the football from the Red Zone into the end zone; the first 80 yards was the result of work paid for by others, with a final handoff to the pharma industry.
How about the needless, incessant advertising? Ads are an overhead expense. It is infuriating to be subjected to ads for serious illness as if it is normal. Big pharma obviously sees a handsome return from this barrage of ads claiming to make tolerable serious medical conditions. But it is not necessary to the provision of good medical care, nor is the advertising informative to those suffering from cancer or other serious disease. The commodification of drugs and treatments exemplifies predatory, greed-based capitalism. Stop it.
29
Prescription drugs should not be advertised to consumers. It’s gotten way out of hand. No consumer should go into a doctor requesting a specific drug name & brand. A doctor should examine, diagnose, and prescribe treatment. If there are multiple treatment options, including pharmaceuticals, give the patient their options and educate them on those options.
How may people walk into a doctor’s office saying, “I think I have XX and need XXX drug” without even an official diagnosis?
1
Here's an old idea that needs to be reinstitute - ban direct to consumer drug advertising, on which US pharmaceutical companies spent over $5 BILLION in 2016 alone. Some firms spent more on their ads than on research, and I don't believe I'm really better informed as a patient by seeing half a dozen ads for ED meds during an evening or magazine filled with pages of fine print about side effects for drugs treating odd ball diseases.
26
I agree! I remember when drug companies did NOT advertise on TV, newspapers, or anywhere. No idea why that began, but sure raised the cost of our prescriptions.
1
that is probably not constitutional, but you could make them not tax deductible.
It would be instructive to research how much drug prices have risen since the adoption of consumer Rx advertising compared with the years before.
Also worth noting is that, the last I remember hearing, this is one of only two countries in which Rx drugs are pitched to consumers, the other being New Zealand.
Meaningful action by Congress to rein in big pharma would be probably the clearest sign they could give that they represent the people rather than those interests that line their pockets, and it's desperately needed in our dysfunctional times.
I'm not holding my breath.
13
We spend 5% more of GDP on health care than first world nations with no better results. They cover everyone, we do not. A large portion (16% according to another letter here) of that expense is drugs. I am surprised that the GOP, champions of eliminating waste, fraud, and abuse (uh-huh) will not follow best practices of other nations, cover everyone, and free up 5% of GDP. That would be quite a raise for most people...
13
And you think that spending (we pay the best) is the only factor in results??? If so I have several bridges in NYC you might buy.
Drug prices are one of many blots on our system. Easily fixed if the political will is there.
9
I suspect that at least a few members of the House and Senate hope to get a high paying lobbying job with Big Pharma when they leave Congress. Billy Tauzin helped write the disgraceful Medicare Part D law when he was a House member. Shortly thereafter, he went to work for Big Pharma with a big increase in compensation. There is no political will to do what's best for the public at large.
Despite all the shouting and finger pointing by both sides, supply and demand is apply.
Yes. Supply and demand. Your money (your house, your life savings) or your life. Same basic principle as buying and selling loaves of bread.
Bribing politicians for captive markets is the real path to riches in the US.
18
High drug prices and the ability of pharma companies to gouge consumers is due to the fact that our politicians are being bought and paid for by the drug giants.Its becoming more than obvious that the needs citizens and consumers are completely discounted and disregarded by both the politicians and the pharmaceutical companies who lay together in a bed of our money.
17
Yes, I would like my pharmaceutical expenses to be lower--who doesn't. However, I'm not sure the majority of people realize that the development of a significant drug, for example, for the treatment of cancer, takes years and an expenditure of hundreds of millions of dollars. There is a multi-step process to obtain final FDA approval, usually at the end of years-long research and development. Drug companies, like all businesses, are there to earn a profit.
If the drug manufacturing companies were clearly over-pricing their products to produce windfall profits, wouldn't it be a simple thing to purchase stocks in publicly-traded pharmaceutical companies, and become rich overnight? Obviously, it's not that easy. It's a complicated issue.
Having said that, the prices of specific drugs should not increase 20-fold or 100-fold overnight for patients who depend on those very drugs to fend off disease and possibly an early death. Outright profiteering at the expense of people's misery is clearly intolerable. So, some regulation is in order. And, yeah, the amount of money funneled into pharmaceutical industry lobbying and accepted by our legislators is shameful.
6
The pharmaceutical industry has been enriching itself by gouging people in this country for years with the tacit endorsement of many of those we elect to "represent our best interests." It's high time Congress takes a sledge hammer to the pharmaceutical industry and slashes drug prices across the board - especially 'speciality' drug prices. The time for 'reducing' drug prices is long past. It's time to pull out the sledge hammer.
7
My doctor recently gave me a sample of a new drug Vimovo, a combination of naproxen and esomeprazole magnesium to treat a very painful hip bursitis. I was having stomach issues taking naproxen. It worked very well. It's a new drug, not covered by most health insurance. It costs $2400.00 for 60 pills. That is not a typo. Further investigation led me to a NIH trial that had addressed the problem of stomach upsets with naproxen. The results were, this combination that I was able to take for 3 days. So we the taxpayer paid for the research, both ingredients were tested by NIH and the company put it together 500mg,naproxen and 20 mg esomeprazole at the cost of $60. a pill, both ingredients are generic.. Made by Horizon Pharma. That should not be allowed.
12
No reason you can't take both ingredients individually and get the same clinical result, since they are cheap generics when sold that way.
1
Everyone does not want to reduce drug prices. How about: no one wants to reduce drug prices.
Not even customers.
What Americans want is "their" drugs to be free, but are fairly sanguine if "others" are paying predatory prices. And if the "others" include people who are outside the current definition of the "ethno" state - so much the better.
This relates to the larger question of healthcare too. If republicans could vote for a universal healthcare system that benefited only whites, they would vote for one tomorrow. It is that it would help everyone, including people whom they deem unworthy and sub-human, that bothers them to the extent that they will deny it to everyone.
Cheers.
Kalidan
1
The big pharmacy world in America is an example of the reason I left the USA 14 years ago to attempt to live a life of retirement that was more sane than my 55 years before of enduring the greedy capitalist insanity I was born into.
The cost of prescription drugs in France is laughingly low compared to America and I still laugh and cry at the same time after every trip to the pharmacy in Provence.
Until and if the US finally has a revolution in its economic philosophy, nothing will change in any area of the American economy. This last election with Trump as victor is a major setback for the hopefulness in America that the war mongering mentality and supreme department of defense economy will ever change.
13
I don't know if we can find a way to prevent massive amounts of greed, I just really don't think we can, unfortunately. And until we as a society can reign in greed it will continue unfettered. In the end, greed is going to kill us all.
3
The republicans enjoy the rising costs due to their vulture Capitalists, and encouraged them.
The wink and nod went hand in hand with driving up premiums.
"We'll blame it on Obama care"
3
Obviously, "we can't do it" because our executive. legislative, and possibly the judicial, branches are overrun with drug company bribe money. Health care, in the U.S. is FOR PROFIT, not intended to actually help people, but rather to take advantage of our inevitable health misfortunes. Purely disgusting, along with our governmental individual's response to it. I'm referring to YOUR own Senators and representatives. You get what you vote for.
7
Th idea that importing drugs poses a danger to American citizens flies in the face of how drugs are manufactured.
When NATO countries started supplying parts to make their own weapons systems, it was recognized that there had to be a way of positively identifying each step of the manufacture process, even to the point of specifying the way the specifying system itself was to be defined and verified, so that potential errors could be tracked down even by 'consumers' of parts, the better to be uncovered and fixed.
This evolved into the ISO 9002 system, which is now applied to many industries who typically buy components of their products from other companies whose quality must be assured and documented. The same sort of system in the US is the Good Manufacturing Practices (GMP) system of quality assurance.
The important thing to note is that both ISO 9002 and GMP permits purchasing companies to do on-site verification of their suppliers product lines practices, record-keeping and so on. The result is a win-win relationship between supplier and manufacturer, as the verification of quality improves control over the manufacturing process while assuring better products.
This takes the wind out of assertions that buying drugs from abroad, particularly from Canada, is somehow dangerous. In fact it is simply a way of squeezing greater amounts of money from the American public.
3
Pretty simple. Just follow almost any other civilized countries' plan.
They have figured it out.
This is not rocket science.
8
Everyone in a postion to influence lower drug prices is on the take except Sanders and a few of his allies. The Pharma execs belong in prison , not shopping in Tiffanys' spending their loot.
3
If you want to gain control of this tangled web called health care, which may involve every facet of our economy, the solution is simple. Force Congress and all Federal employees to healthcare.gov. All members should buy their own coverage on the open market, perhaps, only active military shall receive care through the government. Tell me, what might spur reform faster ?
3
Change that silly title ("Everyone Wants to Reduce Drug Prices...")! Drug companies want to INCREASE drug prices. Most Republicans in Congress are on the Drug Companies tit so they want drug prices to INCREASE too. President Trump has condemned drug price increases. Therefore, based on past experience, he probably wants the prices to INCREASE a lot.
1
Of course it is easy to vilify the pharma companies but the search for treatments and cures for diseases is kind of a noble goal. Of course there may abuses but tarring an entire industry that is seeking new therapies for diseases is extremely ignorant.
1
There are lots of practices that the pharmaceutical companies engage in that should be stopped or at least curtailed. Something that is less often discussed is that these same drug companies that are selling meds here for thousands of dollars are selling the same meds for hundreds or thousands of dollars less in Europe, Canada, and other countries where prices are regulated. They're obviously not doing that out of the goodness of their hearts. They're obviously making a profit even when the prices are regulated.
There's no reason that can't be done here.
SMK
2
Medications are cheaper in the rest of the first world for a very simple reason: the rest of the first world negotiates on price, we do not - Medicare part D was FORBIDDEN so do to. Drugs developed originally at US universities, approved through the US FDA making approval abroad very substantially cheaper - both for the manufacturers and the government - are sold cheaper in the rest of the first world because they negotiate and we don't. In this way, our representatives - largely Republican representatives - guarantee the freedom of the US public to subsidize medications in the rest of the world, because the manufacturers can negotiate lower prices with those countries and still make a profit. Subsidizing India, no problem at the moment. Canada and Britain, I am not so sure about. (Corrupt) democracy at work.
Millions on paying lobbyists and supporting congressional campaigns to protect billions in ill gotten profits by blocking any legislation that would save money-- you do the math-- our bloated healthcare system in a nutshell. All the recent and pending legislation just pushes dollars around, mainly, that by the Republicans, from the poor to the rich. Everyone cites our overpriced, inefficient healthcare system in comparison to the Canadians and the Europeans but no proposals to actually save on healthcare costs. Not only the drug lobby, but also the insurance lobby, the trial lawyers and all the well paid pressure groups continue to do their dirty work and to buy congressional silence. Voters wake up!
4
A huge reason to extend Medicare for everybody, no exceptions. It will be cheaper, better health care and eliminate the insurance companies ripoffs. Oh yes, mandate that the single payer medical insurance also covers drugs and can negotiate prices.
1
Why is it never mentioned in these articles, much less in Washington deliberations, that every other industrialized consumer nation has restrictions on drug prices? We don't need to go to Canada for our medicines, we need to regulate the prices of medicines like every other consumer country does. Americans pay for the world's drugs and drug research. Americans ALONE. Once the drug companies are put on notice that this travesty is at an end, prices will have to be reset around the world. Yes, drug prices should rise modestly in these other countries--believe me, they will not go along with steep increases--and stabilize so that drug companies can make a decent profit (not a rapacious one) and have money to invest in research. And please, outlaw those horrible, incessant drug commercials. They are very costly and inappropriate as doctors should be selecting drugs, not consumers. I say this as someone who was involved in the pharmaceutical advertising business for nearly 25 years.
1
Good article. The only quibble I have is when it says Congress won't act.
Congress has in fact acted many times... but when it does it does so to encourage, enshrine, and protect high prices not lower them. One of the most egregious examples was the GOP implementation of Medicare Part D preventing the government from being able to negotiate medication prices. And so on...
1
Go back to the not so distant past when it was illegal to advertise prescription drugs to consumers (still is illegal in many countries.) That will save tons of money and reduce the level of medication prescribed unnecessarily just because a demanding patient was brainwashed to "ask your doctor."
The inability to approach exorbitant drug prices is just one of a great many examples of how a corporate-run Congress does its donors desires. Other examples are rife: infrastructure, environment, affordable housing, rehabilitation, child & elder care, real education (not job-training for temporary work) ... The pharmaceutical industry is just one of many instances of how Congress has become the willing lackey of corporate control.
2
Nothing will happen on drug prices as long as Republicans control congress. Democrats should draft bills that would deal with some of these issues and circulate them to show the American people the contrast. That's assuming, of course, that there is a difference.
1
DRUG PRICES Remain inflated for a number of reasons: #1 The Supreme Court found that paid political ads are free speech and corporations are people. No, you're not reading an updated version of Alice in Wonderland, the Mad Hatter's Tea Party or the court of the Queen of Hearts. Here in the US, as Greg Palast wrote, we've got the best politics money can buy. Even more dangerous than inflated prices is the fact that drug companies limit their research and production to drugs taken for a lifetime, not vaccines that are used periodically--hence result in fewer profits. Worst of all, the GOPpers and Trump have slashed $6 billion from research funds for the National Institutes of Health. Meaning that Trump is effectively committing crimes against humanity. Because if even one of the numerous bacteria or viruses that no longer respond to antibiotics or antivirals turn into epidemics, millions of people will die. In the flu epidemic of 1917, many millions died since there was no vaccine available. So if Trump signs a budget that intentionally produces severe threats to national security due to untreatable epidemics, he will concretely have committeed crimes against humanity. If he signs such a budget now, he, the politicians, lobbyists, legislators and Supreme Court justices will all have been engaged in criminal conspiracies due to medical neglect that will foreseeably cause many millions of people in the US to sicken and/or die.
A clear case of 'government capture" by special interests. It is one of many. As long as American citizens are passive and/or wilfully ignorant, they will continue to be fleeced.Unfortunately the poorest and least educated get hurt the most.
1
the only thing that actually works is:banning pharmaceutical companies to have lobbyists (making this a national security issue as we can not be secure if we are sick)
Not everyone wants to reduce drug prices. Certainly not the drug companies and their lackies in Congress.
It seems that the feeling of being gouged by Big Pharma is universal, and no valid excuse can be found. Generic drugs can be released sooner but are delayed on purpose. Although true that the cost of producing new drugs is high, but why increase it by factors under their control, like the shameful direct propaganda to consumers about Brand Names (not allowed in Europe), and the 'licentious' lobbying going on? There seems an almost religious zeal in adoring its god, Greed, while the purpose of Pharmaceuticals is supposed to be to serve the public, and not be just an afterthought.
Want to bring good drug prices down? Shorten the time that new drugs have patent protection thereby allowing generics to sooner come to market and compete.
1
I know liberals and NYT can have or portray a very simplistic view on drug pricing.
As a pharmacist, especially for uninsured patients, drug prices are high because the pharmacist just gives a "cash" price, which is almost always, exorbitantly high but not the actual real price for pharmacies to acquire the drug. I've seen others do this simply cause they're busy. In reality, you "could" override the drug price to close to your acquisition price, make a $1 or $2 profit on a $40-50 drug but very few do that.
Competition is another issue. Digoxin, Epipens (as I'm sure you all heard) rocketed up cause lack of competition among manufacturers. AuviQ went out, Epipens had a monopoly on an indication, Mylan jacked the price. Skhreli did the same.
Most commonly used medications for blood pressure, diabetes, cholesterol, lifestyle diseases, are very affordable for pharmacies to buy and copays generally low. But sometimes, insurance charges a higher copay, depending on your formulary, even if the drug is cheap or forces mail order. 1 drug I take, costs $40 at the pharmacy for a month, $12 at mail order, and less than $2 to actually buy from wholesaler. So it's not always drugs are high, but what insurance does. I see this in patients too
Best way to lower drug prices is to simplify drug pricing. Replace insurance with Medicare for all and reduce plan complexity. Get rid of Aetna, Horizon, United, Humana. Why do we need so many middle-men? It just adds billions more.
Big Pharma OUT of Wall Street .
Health insurance companies OUT of Wall Street .
It's IMMORAL to profit from illnesses .
When the health industry czars will be out , prices will come down .
1
Americans should take better care of themselves, question EVERY drug that the doctors say we need and try alternative therapies. We don't need all these drugs. Of course, those with certain diseases will need Big Pharma, but we should each get off our couch, exercise, keep the pounds off and you know what, you may not need all these expensive drugs that Big Pharma seems to think we want and need. I am in my mid 50's and take only Motrin every few weeks. Say NO TO DRUGS and BIG PHARMA.
"We" (thru elected reps.) can't "reduce drug prices" for one overarching reason: our insane system of private financing of campaigns for public office.
The SAME DAY a member of Congress votes on a bill affecting drug prices a drug company can write him/her (or an opponent!) a check for $10 million dollars! That's it .. heart of the problem.
Ask yourself about how many highly effective trials and new drugs might be suppressed in research because they would render a currently sold profitable drug redundant. Simple to do. Just don't fund them. I know of one such cancer drug that is in that predicament. Sure it could still fail but what if it was a stunning success? All those pink ribbons and no questioning of final drug costs and possible development suppression. Pink washing needs to grow a spine.
As long as we have an incredibly unhealthy population that relentlessly demands disease care and NO incentive to prevent illness and control disease care consumption, doctors and "providers" incentivized by five minute medicine focused on tests, pharmaceutical and surgical treatments, and a government that supports all of this through programs like Medicare and Medicaid, high pharmaceutical prices are inevitable. That is why neither Obamacare nor single payer will make "health care" more affordable and better quality.
Seems that all the corporate entities do well in an oligarchy. The biggest flaw in capitalism has always been corruption. It caused many an empire before us to fall. Electing Trump was a primal scream from the American electorate. The people want honest change that rein-franchises the people.
Until the people have a real impact on government, and the corporations are regulated into good behavior, expect more of the same. It't the corporate wild west out there where the richest gunslinger is the fastest and the most ruthless... and public be dammed.
"Everyone wants no reduce drug prices?" Incorrect. Not everyone wants to. The pharmaceutical industry doesn't want to. And it gets it way. Why? Their submissive politicians, "our" leaders don't want to either, despite what they may say for public consumption, because what they really want first and foremost is to get reelected, and they want BigPharma's campaign contributions to help them do it.
Nah, Big Pharma's part of the Big Five: BigOil, BigPharma, the MIC, Wall Street and Silicon Valley. They all eat first, and they eat what they want. Think I'm wrong?
Ban lobbying. Until such time as the senate and congress are not "owned" by special interests nothing will happen. They will jump up and down and scream about high prices or something being unfair but that is for the photo-op. As soon as the cameras are off, they are putting money in their pockets from they very groups they speak against in public.
All western countries except for the U.S. establish price limits for prescriptions drugs to enable their citizens to access them at affordable prices. These countries negotiate for ‘best prices’ (similar to how the U.S. Veterans Health Administration does in the U.S.). The ‘open market’ in the U.S. for Rx drug pricing has resulted in predatory pricing for many single-source brand drugs, and now includes generic drugs. Congress can improve upon this by simply legislating that the F&DA require pharmacoeconomic data at the time each drug is reviewed for approval. If new drugs do demonstrate evidence of superiority vs. existing drugs for their indication, they should only be approved if their price does not exceed existing drugs. Since PBMs negotiate deep discounts for most multi-source generic drugs, then charge their clients for the ‘wholesale acquisition cost’ of the generic drugs, this allows the PBMs to pocket all of the savings. The patient then pays a co-pay to the PBM that in many cases exceeds the generic drug’s actual cost (i.e., the patient could pay cash at Costco for less than the PBM’s co-pay). If more people knew how pricing games are played between drug company rebates, PBMs hiding the actual cost of the drugs, and the amount that patients pay for these drugs, many people would be up in arms. That there is no transparency in Rx drug pricing explains why those who pay for Rx drugs are taken advantage of.
Drug costs are just one of a myriad of problems confronting the United States. There are solutions, but none of them will be implemented as long as the Citizens United decision is in place. The Koch, Mercer, etc. money controls the Congress. To paraphrase a popular expression "money talks, people die"
The Republicans voted to ban government bargaining for drug prices.
That kills free trade and commerce and makes governrnent and citizens the pawns of Big Pharm. That's the way of monopoly not the common good.
The rejection of economic forces in drug prices makes for economic tyranny over the whole system. These 'fiscal conservatives' are actually agents for robber barons to rip off every citizens and all the government alike.
As we know cheaper drugs from Canada are banned in this country, so that the drug robber barons can strangle everyone and the whole system.
Madness and exploitation reign.
“There is a very aggressive lobby that is finding any and all means to thwart any reform to a system that has produced very lucrative profits." Translation: Congress has been successfully bribed.
My doctor received $8,000 in kick backs for prescribing opioids. This should never be allowed. Doesnt the doctors make enough? My chiropractor gets
$500 kick back for every MRI.
When corporate donations and lobbying have no limits, neither will corruption in Washington. When corporate America is at odds with the People, we have this mess, in which Pharma grows richer and America grows sicker and poorer.
It ALWAYS comes down to money. Take money out of politics and a lot of this gets solved. Of course that will never happen because the politicians are the ones getting the money.
And where are the Democrats on this? Oh right, they're concentrating on a medicare for all bill that doesn't have a prayer of passing in the current climate instead of doing things to actually help people with their medical bills. Ah well, maybe there was nothing they could do anyway with their numbers.
Most of us want to live forever - that too is unlikely to occur.
And most of us are too financially inept to understand how costing and pricing actually works - so that too is unlikely to resolve itself.
You want cheap drugs - get a PhD in BioChem - be truly brilliant and create one and offer it to the market for free - Community College grads need not apply.
Why can't we do it? Because so many lawmakers are being paid off by lobbyists for big pharma.
1
It's pretty clear the US has one of the most corrupt political systems on the planet. When Congress passed a drug bill in 2003, Rep. Billy Tauzin, its sponsor and prostitute for the drug industry, included a provision precluding Medicare from being able to negotiate drug prices. Shortly thereafter, he took a $2 million/year job with Pharma, the drug industry's lobbying group. This should be a criminal offense, but Tauzin is just one of many former congressmen to use time served in Congress as just a stepping stone to the big money on K Street.
A political solution to drug prices would be helpful. As a practical matter, however, virtually every elected official has a vested interest in the current health system through lobbyists, food companies and the medical system that make vast amounts of money available to maintain the status quo, including drug prices. Tragically, our addiction to the health-crushing standard American diet (SAD) creates an infinite demand on this corrupt system.
The real solution is to take matters into our own hands and stop buying so many drugs. This approach would sound foolish, except that it's as easy as switching to a simpler whole food plant-based (WFPB) lifestyle. Most of the rest of the world follows this approach to a significant degree and avoids our ubiquitous chronic diseases, along with the drugs that mask the symptoms, that afflict the developed world.
Eating in this simple way would crush the drug companies. It would also eliminate many of the food processors and factory animal farms that kill millions of people and act to facilitate the drug dealers.
Next time you want to cry about drug prices, pick up a book about WFPB (China Study, How Not to Die, etc) and learn how to stop these monsters in their tracks. One bite at a time.
The amount of money that the pharmaceutical cartel spends on lobbying, bribbing of politicians, advertizing, paying off physicians and hospitals, manipulating the patent laws and other legal fees, and helping paid researchers to publish junk science, must be astronomical when added all up. According to reports I have seen in the NY Times the pharmaceutical companies import 40-80% of meds sold here, so what is the real reason that US consumers can not? It has been known for some time that the majority of "new" meds are reformulated older drugs or combinations of existing drugs. R&D is the result of work principally in the public domaine or done outside the US. They get away with high prices because corrupted politicians let them. Follow the money. The simplest solution is that the prices should be the same as in Europe. Controlling drug prices is another one of Trump's empty promises.
Im going the alternative route. I no longer subscribe to western medicine. No drugs for me. Theyve made us think everyone needs some kind of drug to live. Is there any doctor trying to get people off their meds? When you go on these meds has a doctor told you how long you will be on them? They never do because its forever. Crazy!
The fact that nothing is being done to reign in outrageous drug prices shows that our Congress represents campaign contributors and not voters. This is a disgrace.
The big lie: Canadian drugs can be inferior.
In majority of cases the same major companies provide the drugs to Canada as they do to the U.S. A few years ago I payed for Eliquis, a blood thinner, over 900 dollars through my Medical Advantage drug company. That same drug and dosage was 600+ in Canada. Bristol Meyer Squibb was the manufacturer.
Truth: our politicians want the cash of the filthy rich drug companies, and don't mind letting the common man pay for it through exorbitant prices.
Will we have, in our lifetime, any leaders who will put Americans first, and tackle this disgrace?
We can begin by allowing Medicare to negotiate drug prices and put a ceiling on those prices at the average paid in UK, Canada, Germany & Australia. The US already funds graduate research for ....everything...why don't they get their cut of the profits and use that to fund universal health?
The story should be about what politicians have been bought by drug companies/pharmacies/advertisers with "campaign contributions" which, as we know, end up in part in the politicians' pocket and/or lifestyle.
The answer is really simple: do like Europe does, single payer negotiated prices. But that would make a lot of overpaid people less overpaid. Perhaps that's not very American. Money first, public last. That's our motto. Keep the pols and druggies rich.
What this article is telling us is that Americans pay twice as much for prescription drugs because of Congressional corruption. The answer to this type of bribery based corruption has always been public outrage. As the American public becomes more and more outraged over scandalous healthcare costs they are going to look for targets and the drug industry is a ripe target. I charge the New York Times with the responsibility to beat this drum over and over, helping to rouse the American public. It's not just the Times. American media,that purports to care about the welfare of the American people have a greater responsibility than just reporting whatever is new in the news each day. If the Times, the Post, Politico, CNN and the thousands of other newspapers and TV channels are just going to be observers then they are going to be failed institutions.
2
Socialized medicine is the answer. Vigilance is the price of liberty. We must keep fighting the good fight at every turn. Yes it is tiring but there is no alternative. The wealthy will not stop fighting their fight to maintain their power and lucre.
2
Consider if the pharmaceutical industry was government owned; any profits could go towards healthcare. Appropriately salaried scientists would help relieve problems with skewed research. There are some industries/institutions that shouldn't be for-profit. Any ideas on how to get there?
2
Or, rather than government owned, not for profit as a model? Self-sustaining over time.
This article is on the (pardon me) money. High, and in many cases downright extortionate, drug prices have become one of the leading causes of extraordinarily expensive medical care in the US; these costs result in medical insurance that many cannot afford, with or without Obamacare.
It is very expensive to develop new drugs, and the pharmaceutical firms that actual do the research to bring new drugs to market should be able to recoup their costs. But that's not what's happening. Firms that do little or no research have become adept at manipulating our laws and regulations such that they enjoy monopolies on drugs long off patent, and can charge exorbitant prices.
The FDA is essential to protect our safety. But their regulations need reform. Presently, FDA rules often go too far, and prevent competing versions of proven products from entering the market.
US drug companies often sell drugs abroad for far less than Americans pay. This nation can no longer afford to subsidize drug costs abroad to the extent we do today.
In a lawsuit in Los Angeles, a drug firm was just lost a case for almost half a billion dollars to a single plaintiff, who claimed her ovarian cancer was caused by talc in baby powder. This unfortunate woman had a fatal disease, but there is essentially no scientific evidence it was caused by baby powder. We will all be paying the costs of verdicts like this in the form of high drug prices. We very much need tort reform.
6
When a smirking chief executive says "I liken myself to the robber barons", I must say all the pharmaceutical companies are scum, at least in this country...
"... Mr. Trump’s characterization in January of drug companies as “getting away with murder.”'...I, finally, agree with something Mr. Trump said.
10
We should lobby to cap their multimillion dollar bonuses just as they cap paying out on benefits.
1
'“When we’re talking about garden-variety, generic drugs that can be easily imported from another country that has regulatory procedures that make them safe?” Senator Lee said in an interview. “I don’t see why not.”'
I've been a consumer of such medication; Indian pharmaceuticals. I've always found the medication effective. Perhaps instead of a broad replacement for domestic manufactures, a percentage of the medication available under Medicare and Medicaid, should have to be such an alternative. For instance, if a patient needs a prescribed amount of medication, once he or she has reached the domestic limit -- in dollars, the remainder will be imports. Or, the program could be front loaded -- imports first, to ensure cost savings.
3
Generics are manufactured differently. I had a massive allergic reaction last year. Stevens- Johnson Syndrome can be fatal. Same medication, different generic manufacturer I've been stable 12 months plus.
There is no question drug prices need to be justified.There is also no question that appropriate use of drugs reduces costs elsewhere in the system, for example hospitalizations,ER visits etc.Here is the puzzle ; account for around 15% of healthcare costs.Drugs are ordered by physicians, the same people who order investigations, procedures and other therapies ,together accountable for the other 85%.Those same physicians are usually incentivized and remunerated to overuse the vast majority of activities in the 85%.Requiring a vast time wasting bureaucracy funded by premiums to try and challenge such excess use but passing any ensuing savings to shareholders and executives.And yet, we want to focus on drug costs?? Come on.
1
I never understand the logic where a man or a company not given a ridiculous amount of money will decide not to work. For most people less money makes us work harder. If drug companies need to work harder to make their profits (rather than arbitrarily raising prices) perhaps it will encourage them to bring out more new drugs or drugs for underserved uses. They might have to become more productive.
6
The way things work now is not to spend the money to create a new drug, that is expensive and risky. The easiest way to make more money is to increase prices.
This is Wall Street trying to run businesses with the only goal is to make a profit. Nothing will improve until Wall Street is pushed back into a much smaller role in the business.
There are many reasons that pharmaceuticals have become ruinously expensive, but the primary one is that Congress allows it. They are awash in drug lobby money, and lack the political will and moral courage to control prices in the way that most developed nations have been doing for many years.
15
The important thing to remember is that when finally passing the Part C Medicare Prescription laws these Republicans, who claim to believe that "free enterprise" solves all commercial and economic issues, forbade Medicare from bargaining with drug companies. Simply eliminating that provision of Part c would probably yield a drastic drop in drug prices.
Shame just does not seem to a factor in Republican policy making.
18
Then why didn't the Democrats include drug pricing regulations as a part of Obamacare when they had a majority in the House and Senate? Big Pharma owns both sides of the aisle not just the GOP. That is pretty clear.
There is a name for telling the consumer to either pay the price demanded for the medication or suffer and perhaps die: blackmail. And the politicians are complicit. They bow to the pharmaceutical companies, they refuse to protect the consumer, and they even go so far as to get insider tips on stock investing in exchange for protecting pharmaceutical companies ( see Price and Collins). Another reason for a single payer system: doctors would only have one formulary to use to determine what medication would be covered by insurance. And then the shoe would be on the other foot for drug companies. Play ball with the Medicare for all system or lose out to your competitors. Pay back is coming.
10
Why can't we lower drug prices? It isn't all that complicated.
Drug prices are protected by patents, which companies tweak in either packaging or formula to extend. Normal competition is limited for many drugs by low but inelastic demand (only a few want a drug for a specific cancer, but they want it a lot.) Otherwise price negotiation is left to insurers. The government cannot negotiate. Insurers who do drop a drug are vilified by insurees who want it.
Companies who have drug - think Epi-pens - will extract "what the market will bear" when we all know that the market for a drug that can revive your child at school will be highly valued even if the cost is near zero. Companies will take a drug that has been around since 1970 like cyclosporine, package it as an eye drop for $300 an month, repackage it as the patent runs down, and sell the product to an Indian tribe to protect it from a patent challenge.
Inelastic demand, monopolies, the desire to extract wealth rather than create it, a total lack of scruples or social conscience, poor to minimal regulation and entrenched profiteering are all drivers.
Why can't we reduce drug costs? Because we don't want to rock the drug and advertising lobbies, or the investments of our good buddies to do so.
8
Maybe the current patent system, which simply protects the monopoly for a number of years, should be fundamentally changed. How about patent protection divorced from time, replaced by a formula based on other factors, among them (a) profits that are a generous but reasonable multiple of research costs, (b) the corporation's efforts to develop drugs for orphan illnesses, (c) the ratio between CEO compensation and rank-and-file salaries.
But if you want to stick to those market forces so beloved of Republicans, just start by directing Medicare to negotiate drug prices.
3
With politicians in the pocket of the pharma industry, there is no hope of lowering prices for drugs. In addition, politicians are not interested in understanding the key factors that drives up cost of healthcare and take action accordingly through sane policies.
The GOP is only interested in saving their face in 2018 election by peddling short term plans to repeal ACT versus thinking long term that can serve this county well.
Given that the pharma industry is contributing 6 figures to Paul Ryan, his actions shows that the contribution is working.
13
Market-based healthcare systems do not control cost because people will spend whatever they can to buy reasonably good health. If you have a chronic ailment hurting the quality of your life you will of course be more susceptible to commercials that promise the moon for drugs that are no better than the old generic. You will want to give companies 'flexibility' to bring drugs to market with little testing under systems that are prone to corruption. You'll spend your last dime and worry about eating tomorrow.
4
Drug discovery is a high risk and expensive process. It's true that the US market "pays for" more of that R&D than other markets like Europe. However, what problem are we trying to solve here? Is it rampant overcharging on drugs by a few bad apples? In my experience, most Pharma employees in R&D are committed to the idea of saving and improving people's lives: they are not part of the problem. Shkreli is an aberration, not the norm ... he is a former ethically-challenged banker who decided to try to make money in Pharma. He didn't last long, and shame on those actors who let him in. Still, we can "regulate" drug prices via the ACA, and giving medicare more leverage to barter for the right price.
Lobbying by the Healthcare industry? This is a much harder problem. Big money in politics is the very root of the tree of problems in the USA, the source of the antidemocratic influence that makes Americans corporate victims.
However, can we seriously blame corporations for acting in their best interests? They are designed to make money for their shareholders. The best ones have more generous and deeper identities than this, but if we let them influence our politics, than of course they will. So it's not about blaming corporations.
It's about laws and policy, and good governance. Put smarter and wiser people in office, and you will have your solution.
4
Put the power of the American government behind vigorous bargaining and you will have a solution.
Actually, the pharmaceutical industry is engaged in an extortion conspiracy - individuals and hospitals must pay up or the pipeline that produces new drugs will dry up.
The investors, chemists, biologists, and clinical researchers will, I guess, abandon the industry if they can no longer make the profits they've grown accustom to. Nope. They'd better start changing their tune "voluntarily" or the regulations will come, and they won't be pretty.
Personally, I view the sector's attitudes as terroristic threats worthy of public shaming and heavy regulation.
5
The truth is the American people subsidize the pharmaceutical industry for the rest of the world, and this is mostly because the companies take advantage of opacity in pricing and that "other peoples' money" is paying for them through insurance. Even the pharmacists have little idea how much a drug will cost a patient until they "run it through." This isn't a free market. It is worse than Wall Street at its worst. They all know it could come to an end soon, so they are raking it in now, just like any greedy people without consciences would, rather than lowering prices on their own to prevent government interference, like any decent people would.
12
Not quite everyone... Big Pharma execs do everything they can to keep profits high. They claim they need the big profits to support high development costs, but evidence on this isn't there. They spend hundreds of millions on "ask your doctor about..." advertising, and even more enticements to the medical professionals, all to get the prescriptions that then must be paid by insurers and, ultimately, us either in taxes or premiums. For all the cost, we don't find new cures any faster than other countries that pay far less for often the same identical medications from the same manufacturer. Big Pharma has done everything it can to head off regulation and competition, exploiting patents and spending millions on lobbying and "campaign contributions" in this country, and paying well-concealed bribes where that's more a normal way of doing business. The end result is that the government, one of the largest purchasers of drugs, is prevented from leveraging its volume to get lower prices... they can't negotiate. In other countries, where this isn't the case, prices are substantially lower. In effect, high US drug prices subsidize the rest of the world. Big Pharm backed laws even prevent individuals from buying overseas, though that's proven difficult to enforce with the internet working against the restriction. There is lots of room for improvements: ban RX meds advertising to consumers; restrict it to MDs; limit patent terms where public money supported development at any stage.
5
I've never really understood how the government can lower the prices of drugs by negotiating through Medicare. First, I don't understand how would that lower the prices of drugs for people who aren't on Medicare. Second, it seems to me that it would be possible to negotiate the price of a drug only when there is an equally effective alternative drug, and I don't know how often that is the case.
Government does not negotiate drug prices through Medicare. Each state negotiates prices through Medicaid.
We should all benefit from the Medicaid methods for drug pricing.
How is it that every other advanced country negotiates over drug prices and pays far less than America? Are we just too stupid to learn from dozens of other countries?
No, not everyone. Not the pharmaceutical firms, not their stock holders, not the lobbyists for the pharmaceutical firms, not out Congressional representative bought by the lobbyists. The piece of information that I have yet to find during any discussion about the price for drugs is any accountability of the pharmaceutical firms to reveal the amount of profit they reinvest into research and development of new, badly needed drugs. Numbers and percentages are thrown up into the air but I have yet to see any firm provide the basis for those numbers. It is important. Money is needed to develop drugs. The bottom line profit, though, is indecent when it is scraped off the backs of those who depend on the drugs. We, as a nation, found our way to the moon. And no one can find a fair and equitable way to solve this problem? Political will, folks, political will intertwined with decency. Please let your representatives, at every level, know what their responsibility is. Thank you.
2
Research is often done in university labs with NIH funding (that's our tax dollar). Only when a drug starts to look promising does a drug company step in to buy the rights from the research institute. The claim of arduous research is disingenuous as the riskiest part of the research is not being done by big Pharma. The pricey new cancer drug Ibrance ($10,000 for 28 capsules) was developed at UCLA, a publicly funded university. Pfizer is now raking in the bucks. I'd love to know how much public money went in to the development. Oh yes, and in Canada the drug costs 40% less than in the US.
It just seems that we in the U.S. pay the highest prices in the advanced economies of the world. Much higher prices for the same drugs. The drug companies are profitable, if not highly profitable. So, it just seems that the American consumer is subsidizing the rest of the world for those profits to the drug companies. The enabler of this must be the U.S. government?
1
As long as big corporations like big pharma are blinded by greed they will continue to ask themselves this question: what can our country do for them; not what can they do for our country; for the common good, like reasonable drug prices. Thus, until there's a transformation of heart, or forced change due to increased competition, everything will remain the same. And that's the down side of capitalism. That's also the down side of a Scrooge-like attitude about money our culture has cultivated and is exercised by the wealthy and powerful which focuses on getting more and more even if unneeded for a good life.
1
Why won't we do it?
Simple short answer: we prefer to spend our tax money on endless, pointless Pentagon wars, gratuitous subsidies for prosperous businesses, and endless tax breaks for the 1%.
Until we elect representatives who want to change these priorities, nothing will change.
2
The best explanation I ever read about drug prices was quite simple." Drug manufactures raise prices or charge what they want, because they can". Their battle cry is they need recover their cost to develop a blockbuster drug. Next of course patent protection for several years guarantee's price elasticity. The total healthcare pie as a a % of GDP is enormous and growing. Drug companies , the AMA, For profit hospital corporations, and major Insurance companies all get their piece of the pie.The big big question of course is if we ever adopted single payer could the swamp manage such a task?
Direct to consumers advertising of the latest expensive, marginally effective and side-effect laden pharmaceuticals is rampant, demographically targeted and extremely misleading. Other countries ban this and we should as well.
13
This article would be strengthened by naming names and dollars. While it points out the vigorous lobbying efforts, until individual legislators are named and the money they take before and after their votes astre itemized , you have not communicated the real real answer to your question: Why drug prices are not lowered? In some cases these numbers are readily available from organizations like FollowtheMoney.org. Often these campaign contributions are the best investments , i.e. most bang for the buck, drug companies ever make.
3
Using numbers that the author gave us, $67B in after-tax profit (rather than revenue) for the ten largest pharmaceutical firms, one can say this more of a molehill than a mountain.
Drug companies would have to make some profit - so cut theirs in half and save $33B.
Now compare that to the $3.3 trillion spent on healthcare in 2016 - averages about $10,000 per person.
You would save $100 a person per year.
1
Everyone wants to reduce drug prices, except maybe for the pharmaceutical industry. This is America. The pharmaceutical industry, like All other corporate entities are first and foremost concerned with the financial health of their respective stockholders. General healthcare including advances in medications is but a byproduct of the financial machinations of the corporate players.
First and foremost, provide a return on investment. If cutting costs doesn't provide a healthy "return", nothing and no one else matters. Very American.
Trusting the pharmaceutical industry to have a moral conscience is akin to waiting for the fox to start guarding the hen house. Expecting a for profit hospital to provide you with any treatment you can't financially afford is not what American healthcare is about.
American healthcare is about providing as little service or medication as possible with profit margins being protected as much as possible. So, "everyone " may want to reduce drug prices in fantasy mode, but in the real world, don't expect your current crop of politicians on the Right to help you anytime soon.
3
High drug prices reflect the high cost of innovation. Then what reflects the $67.8 billion in profits?
5
Speaking about drug prices, the Times recently published a story about canakinumab, an anti-inflammatory drug, preventing heart attacks. The risk reduction was stated as 15%. But,the data showed that 156 people would have to be treated for a year to prevent one cardiovascular event. At a cited price of $200,000 a year, it would cost $31,200,000 to prevent one event. Number needed to treat is a more useful expression of a drug's effectiveness than risk reduction.
7
"Proposals include allowing cheaper imports from other developed countries; allowing the government to negotiate the price of Medicare-covered drugs; speeding approval of cheaper generics; requiring notification by drug companies before they raise prices; and restricting drug ads aimed at consumers."
What do all of these proposals have in common? All are sensible, rational means of saving healthcare costs and none have any prospect of being included in legislation.
10
Wait - you mean to tell me that a "market-based" healthcare system doesn't adequately control costs? Heresy!
Seriously, though, the issue of drug prices is an old and thorny one. The link below is to an excellent 2015 NYT Upshot article that describes the issues involved. But one thing seems clear, actually two things - first, as the linked article describes, US patent law, perhaps unintentionally, creates a perverse disincentive for drug companies to bring promising drugs to market when they are deemed not patentable, and secondly, patents appear to be misused to protect monopoly pricing power on the part of drug manufacturers long after they have recouped development costs and earned a fair, incentive-creating return. Add to that a system in which the ultimate "buyer", the patient, is rendered powerless in the marketplace relative to suppliers, and medical care pricing is a license to get rich, most definitely including drugs. Regardless, as other commenters have said, as long as our political system allows the degree of lobbying and political contributions we see today, little is likely to change. And we will continue to pay through the nose.
https://www.nytimes.com/2015/09/29/upshot/how-patent-law-can-block-even-...
3
The perverse disincentive to develop a drug which is non-patentable is valid. Clinical trials require a very large investment of capital, and if the drug was non-patentable it would automatically become a generic drug as soon as it was approved; a guarantee that the company would never recover its investment. As to the use of a patent to protect monopoly pricing even after the investment and a profit is recovered, this is also true; but you need to take into account that only one in seven drugs that start clinical trials are ever approved and those loses also have to be covered. Further if a drug is highly successful there is a near guarantee that the patent, however deserving, will be repeatedly challenged by outside forces trying to chip of a piece of the profit - the vultures descend.
2
Greed, maybe? Big Pharma gets Big Grants for R&D from Big Government. That's corporate welfare, not capitalism.
18
Jeff Bezos had mentioned months ago that the selling of pharmaceuticals through Amazon.com is on the horizon. Knowing Amazon, we all understand that selling at the lowest prices and delivery convenience are hard to beat, yet this is exactly what Amazon does.
How Ironic that the congress will never regulate the "For huge profit" pharmaceutical cartels whereas Amazon probably and eventually will.
4
The pharma company should be asked to itemize the costs of bringing a drug to the market. Then it can determine how much profit it wants. If the profit seems excessive to government regulators, rather than force the company to reduce the price, the regulators can allow the drug to be imported thus providing an alternative to those patients who are willing to take the risk of imported drugs.
The hospitals charge an exorbitant amount for many tests without giving any breakdown on the actual costs of performing the test. It is simply what the market will bear.
We must challenge this free market principle when it is applied to health care prices. Let the price gougers have free reign in expensive restaurants, hotels, boutiques but not in something so basic to our society as healthcare.
4
Drug companies treat lobbying and advertising costs as investments, and they expect a return just like money spent on plant and equipment. And they certainly get their money's worth with the pharma industry always near the top of the ROI columns. Lowering drug prices is actually pretty easy as the plethora of bills show, but not as long as Congress is on the industry payroll. If only we had a government of, by and for the people.
7
Where to start? "Nine out of 10 of the biggest pharmaceutical companies actually spend more on advertising than on R&D" (reported by CBS news in 2016 based on Washington Post reporting). We should return to the sane era when prescription drugs were not allowed to be advertised on television. Information needed by patients is available on the Internet; the constant hawking of drugs is unnecessary and raises drug prices substantially. Congress can start by prohibiting such advertising. Of course, that won't happen because both big Pharma and the TV networks have a major interest in maintaining the status quo. At the root of the problem is the vast sums of money buying political influence.
51
The explanation to inaction on controlling drug prices is Citizens United and Trump appointees who industry insiders
"The pharmaceutical and health products industries spent $145 million on lobbying for the first half of 2017" "Drug makers gave $4.5 million to congressional campaigns in that period, including six-figure donations to House Speaker Paul Ryan; Representative Greg Walden, a Republican of Oregon who heads the House Energy and Commerce Committee; and Senator Orrin Hatch, Republican of Utah and chairman of the Senate Finance Committee"
" Trump administration official, Scott Gottlieb, the F.D.A. commissioner ...
has served on the boards of several pharmaceutical companies and earned large consulting fees from the industry"
10
Oh, stop with the hate Trump. Yes, his appointees are as terrible as he is, but the drug cost drag has been weighing on the public through many political administrations. The problem is far deeper than the bias of the fools the Fool-In-Chief appoints.
To Anonymot: So, pointing out that Trump said he would address excessive drug prices then appointed a drug industry man as commissioner of the FDA equates to hating Trump?
As the article says, many government policies could be implemented to reduce drug prices but the Administration is not pursuing those It said "Efforts to restrain prices have also made little progress in the executive branch. The White House has long been expected to issue an executive order on drug costs. But leaked documents show that deliberations have focused on things the industry wants, like extending overseas patents and changing a drug-discount program for hospitals, and not so much on lowering prices."
It's not about hate, it's about the fact of what Trump is not doing and what he is doing regarding drug policy.
Another, simpler, solution to the pricing issue would be to draft legislation that requires pharmaceutical companies to match their best worldwide price for US customers. Let other countries do the negotiating for us. It would prevent the same medication from being $3 per pill in England or Canada and $56 per pill in the US.
43
Long ago electricity was declared a "life sustaining utility". To protect the consumer, rates are approved by regulators.
Simple question; If an electric company cannot raise rates without PSC approval, how come big pharma can set any price they want?
Existing laws make preventing allergic reactions or curing diseases less important than electricity!
123
That was a fluke. Business has a much better grasp on our politicians now.
You can speak to some lobbyist or one soon to be lobbyist aka your local representative and he or she can explain it to you.
For it to happen now. it would take a real life revolution.
Why is electricity regulated while pharmaceuticals are not? Because it was a different time and a different place. The Fourth Estate exposed double-talk. Being recognized as statesmen rather than greasy politicians appealed to those in power. Today, the Fourth Estate is weak and politicians aren't concerned with how they look in public: they count on gerrymandering to keep their seats.
Bill:
Yours is a fair comment, and one that others have raised before. As medicine has evolved in most developed countries around the world, it has taken on characteristics of a public utility. These include clean running water (we hope), electricity and/or gas, and sewer service. The idea that basic medical care should not be part of the package is a stunning feature of the basic tenets of congressional Republicans.
There are a few big things to be done to reduce our out-sized health care costs: cut administrative overhead, control extraordinary costs of drugs/tests/procedures, and stop the over-sale of almost every element of "health care." Mr. Hancock's essay outlines the problems with getting a handle on medication costs. There are very wealthy donors threatening to withhold hundreds of millions of dollars in campaign contributions if the GOP cannot overturn Obamacare--with luck those attempts will fail (but I suspect a fair amount will still be donated to campaigns).
It is stunning to what lengths current congressional Republicans will go to create some odd-ball narrative as to why we need to upend a sixth of the economy--but it is perhaps a given considering the amount of money they are being offered to do so. Those representatives tout all source of nonsense, including "consumer choice": https://www.washingtonpost.com/news/wonk/wp/2016/03/03/why-savvy-shopper... .
I liked it in "the olden days" when prescription drugs were not advertised on TV or in magazines. Advertising inflates demand by convincing potential patients that they are sick and "need" specific, high-cost drugs so they pressure their doctors to prescribe the latest and greatest (most expensive). Drug advertising is turning the US into a nation of over-medicated hypochondriacs.
Anecdotally, though, I am grateful for the very expensive drug that kept my family member with multiple myeloma alive for an additional seven years of relatively healthy life after a stem cell transplant.
27
Juanita:
Once the initial FDA approvals have occurred, then the marketing arms of the big pharmaceutical firms are going to be in charge--barring some major medication problem that surfaces post-release. Those marketing forces will charge what the market will bear, the most extreme recent example being the case with the antics of Martin Shkreli: http://www.newsweek.com/martin-shkreli-daraprim-drug-prices-374922 .
There is little reason for "either...or." Those remarkable medications you mention should be available at more reasonable prices. The companies often argue that they need the money for research and development, but that appears not to be the case: http://www.npr.org/sections/health-shots/2017/09/11/550135932/r-d-costs-... .
We are the only developed nation subject to such extreme costs. And the USA and New Zealand are the only ones who allow direct-to-consumer advertising of medications: http://www.who.int/bulletin/volumes/87/8/09-040809/en/ . We have not, so far, been able to make a dent in this very lucrative practice.
9
There are many things that could be done to bring drug prices down at the expense of pharmaceutical firms' profits, but it shouldn't be done under the illusion that it will have no effect on development of new drugs, for it is precisely the lure of obscene profits that drives drug discovery. Drug discovery could be relegated to nonprofit entities, and indeed there are drug discovery groups at universities around the country working tirelessly to develop new compounds, yet the vast majority of truly innovative drugs continue to come from big pharmaceutical firms and startups driven by the profit motive. They and their venture-capitalist patrons invest billions with the expectation that the pricing power they enjoy in the US market will continue. Anything done to reduce that pricing power, like allowing generics to enter the market more quickly or allowing importation from Canada - essentially asking the Canadian government and its health system to negotiate with drug companies in our stead - might be worth it, but it should be done with the full knowledge that one effect will be to slow the pace of drug development significantly.
7
The lure of obscene profits leads to research to discover obscenely profitable drugs, while drugs that do not have a large profit potential do not get much research funding. Antibiotics, for example, have a low profit potential because they are taken for a short time rather than every day for the rest of one's life. Research will look for ways to copy an existing profitable drug without violating its patent protection, or a way to tweak a drug so that its patent protection is extended.
Most research aims at advancing the frontiers of moneymaking rather than the frontiers of medicine, so in terms of advancing the frontiers of medicine, much of the vaunted research spending is wasted. And other sorts of spending, such as money for marketing or patent-protecting lawsuits, do nothing to advance the cause of human health. Doctors are flooded with information designed to sell a particular drug rather than help them choose the best drug, and objective comparisons of drugs, including their bad features, is hard to find and gets much less funding than the propaganda.
51
where is the evidence that drug companies actually do research to develop NEW drugs rather than new variations on old drugs.
2
"Antibiotics, for example, have a low profit potential because they are taken for a short time rather than every day for the rest of one's life."...... While this is partly true it is not the main reason drug companies are not widely engaged in the research for new antibiotics. The main reason is that if they discovered and developed a new antibiotic that successfully treated resistant bacteria, the medical profession would immediately assign the new antibiotic to reserve status to be used only as last resort. While this would be the correct thing for the medical community to do, it would also guarantee that the drug would not ever be widely used, and discovery and development cost could never be recovered.
3
Americans are being ripped off and they need to wake up. I live in a "middle income" African country and pay a fraction for medication here that is exactly comparable to what I would be prescribed in the US. 4 years ago, my US prescription for a topical medication for an auto-immune condition cost $800 for 6 oz. Insurance wouldn't cover it. The exact same thing here cost $80, and my insurance paid for more than half of that. These meds are manufactured in Germany, the Netherlands, India or South Africa and are regulated. My insurance here is also half of what it cost me in the US, with no real deductible, plus generous coverage including vision and dental. I just had an MRI (in a Siemans machine) for neck pain. Insurance covered most of it. If local specialists can't treat a condition, I can be flown to South Africa for treatment. I'm lucky to be able to afford private health insurance, but even the poor in this country have access to a public health scheme. And there are mobile clinics twice a month to rural areas.
I was just in Europe and purchased a medication OTC that in the US is still prescription and absurdly expensive even though it has been generic for many years. Wake up Americans. You live in one of the richest countries in the world. Demand more.
224
The fact that we Americans live in one of the richest countries in the world is precisely the reason we have the highest prices for pharmaceuticals. Health care in general is obscenely high in the U.S. because there are lots of people or entities ready, willing and able to pay those prices.
6
No one likes getting ripped off, wealthy or not. But until recently most Americans have had little awareness that our system is so much more expensive yet covers fewer people and is not higher quality than systems in other developed countries.
I blame the media for this ignorance. Those bills that recently introduced lower drug prices have gotten almost no attention in the media, unlike the attempts to repeal Obamacare which have stirred public protests. Had they gotten similar attention the public would be more engaged in the issue. Trump's attacks on the NFL, while not unimportant, get a lot more attention than drug prices which adversely affect the lives of millions and help bust our budget.
If only the media would make it clear that we Americans are subsidizing those cheaper prices that other countries pay, the public would be outraged. If companies really cannot afford R&D if Americans get lower prices then they should raise the prices on people from other countries to bring a more equitable balance.
1
A part of the reason Americans pay higher prices for patented drugs is that people in the rest of the developed world have imposed price controls at the country level to avoid contributing toward R & D. And those price controls shift essentially all of the R & D costs to Americans, even for drugs invented in foreign countries. We are one of the richest countries in the world, and the other rich companies are freeloading. It is excusable for third world countries to free-load, but no excusable for people like you, who can afford to pay a fair price, to expect Americans to subsidize you. We're paying $800 so that you can pay $80 for a drugs that should be costing everyone $250.
For patented drugs that have not reached the end of their period of exclusivity, the world's alternative to Americans being overcharged is a significant slowdown in development.
Demand that you pay your fair share.
I've said this before. And I'm sure. I am not the only one. But separate identities. Those of patent holders. And those of researchers. Must be promoted, for the success of scientific research. A lottery and library. Documenting world wide research. With each completed schedule becoming eligible. For entry to sweepstakes. And proceeds being forwarded to researchers. Based on their work on completed schedules. The patent owned by the company. Thereby becomes underpinned only by those responsible. For breaking ground in the research fields. As after a schedule in progress is completed. Researchers, can file there discoveries for chances at prizes supplied by the library. Yet it would still take a court. To favor researcher over patent holder. But it will open either side to public lobby.
For every thousand drugs that receive patents, five or six make it to market, and one or two are high profit. The academics who "invent" drugs sell them to drug companies who do the ten to fifteen years of heavy lifting high-cost drug approvals, which typically leaves them with three to five years of market exclusivity to recoup their costs. The problem in US drug costs is not the hugely expensive drugs that are new to the market. Seventy to eighty percent of prescription drugs consumed by Americans are generics. The price of drugs in the US has increased 24% since Obamacare while the CPI increased 10%.
The FDA needs to speed approvals of generics so it doesn't take $5-25 million and three to five years for an established drug company to get a generic approval from the FDA.
Congress needs to pass a law making it illegal for a patent holder to settle their challenge of a generic drug company's attempt to sell a substitute for a branded product by paying off the potential competitor.
For drugs provided by hospitals to patients, the hospitals should not be permitted to mark up the price they paid for the drug by more than 100%. [The hospitals should also not be permitted to form purchasing consortia which are driving producers out of business and then not even pass along the savings to consumers.]
The US public pays for research that gets privatized through Congress.
The CDC reports that the Percentage of national health expenditures for prescription drugs is only 10.1% (2015). And the vast majority of prescriptions are for generics.
While the Pharma industry suffers from some bad actors and bad behavior, the fact is that the USA is the most innovative, advanced and productive when it comes to new drug development- a slow, expensive and high risk process that can go south at any time.
People tend to attack the Pharma industry until their or a loved one's life is hanging in the balance and it's only through drug interventions that life is maintained. Only then are we very grateful.
7
To Robert Kadar: Try telling people whose cost for desperately needed medication suddenly rises by 100% to 1000% that they should be "very grateful" that "it's only through drug interventions that life is maintained." Drugs they suddenly can't begin to afford and that their insurance won't pay for.
68
Reply to Chadwick: you make an important point but so does Kadar. There are pharmaceutical companies that invest in expensive and risky research to discover treatments for significant human health problems, and there are the get-rich-quick your money or your life schemes that you describe so well.
It is outrageous ( but understandable given it is controlled by the Republican Party) that the Congress has not acted immediately to address the very easy problem of dealing with the Shreklis.
That the pharmaceutical industry lobbying group protects all, including the very worst actors, has destroyed its credibility.
As for reimportation from Canada, there are legitimate supply chain safety concerns (which also are confronted with drugs manufactured overseas) but reimportation is a solution to a symptom, not the underlying problem of high prices.
High prices are protected because the Republicans wrote into law that Medicare could not negotiate for lower drug prices (and then the Republican author of that law immediately left Congress to run the pharmaceutical lobbying group PhRMA)
10
Check your stats...your 10.1% is for retail purchases - excludes use by healthcare providers. And a 2016 study by US health insurance providers cited the cost of prescription drugs in US as highest worldwide and a key component of escalating health care costs.
5
There are certainly issues in having such a large market as the U.S. set prices through regulation, which would be subject to the same types of political pressures outlined in the article. But that is no reason for us to continue subsidizing the rest of the world by letting drug companies and medical device companies extort all their profits from the U.S., and then just accept whatever other countries feel like paying them as an add-on. I would propose a kind of reverse of the standard trade doctrine of 'most favored nation' - the U.S. should require drug companies to give government funded programs a price no higher than the highest price availabe in any other country i.e., the U.S. would get a price equivalent to the 'least favored nation' to which the company sells its products. Companies would then have to consider what their world wide pricing strategy should be, rather than just soaking the U.S. Most private insurance companies would likely follow the government prices in setting reimbursement rates. Couple this with a prohibition on drug advertsing (not allowed anywhere else in the world) and licensing of imports from manufacturers with proven safety records in other advanced countries, and we could make a serious dent in this problem without having the government set drug prices artificially.
12
Pharma would just buy a little, tiny country with no real population and make its drug prices really, really high. Call it Phizerland.
The question isn’t a hard one to answer. Many Americans acknowledge that drug companies charge Americans exorbitantly for their products, particularly recently as some have increased the cost of some drugs many times in an obvious profit-play; but they’re also concerned with our ability to craft a balanced response.
Once you regulate the cost of drugs, two things likely will happen. The first is that the regulation would descend to a tool of demagogues seeking to manipulate electoral preference by demonizing business under color of law, defining what is an appropriate profit, and effectively enslaving it to populist desires irrespective of the rights of property; and the second is that an elite starts imposing its own judgment and not the marketplace’s on what something is worth.
Is there abuse in the U.S. drug market beyond the need to fund most of the world’s drug innovation while turning a reasonable profit? Undoubtedly. But it’s a complex matter that involves the subsidy our companies grant European and other countries owing to restrictions on what U.S. companies can charge there, as well as the traditional American hesitancy in allowing government too much power to define what a product is worth.
Regulating drug pricing, which is the true objective of some, is a slippery slope to a Europeanized framework of governance. Until you can convince enough Americans that we SHOULD become Europeanized in such a matter, expect such regulation to continue to be difficult.
2
In competing for the consumer dollar, drugs have obvious advantages because they involve life and the well-being necessary to enjoy the results of other sorts of expenditures. This means that in a free enterprise system, drugs can be immensely profitable and it is in the interest of drug makers to preserve this profitability by competing in some ways and not in others.
Part of the essence of free enterprise is that businesses make more money colluding to compete against customers, workers, or vendors than they do competing with each other, which is to the benefit of customers, workers, or vendors (and is the standard picture used to sell free enterprise). If talking about this collusion is demonizing business and trying to prevent it is picking on business, oligarchy has won.
15
One of the things that's especially interesting about McGilchrist's work is that he hypothesizes that one of the causes of the rise in autism is the overemphasis on "left hemisphere" selective attention.
The whole idea of libertarians being above emotion, being rooted in "reason" is a rather remarkable reflection of this increase in autistic thinking. When you talk to a libertarian, and try to point out the forest, and they go on - in a quite unsettling, disconnected manner, almost as though you're talking to someone with a thought disorder of some kind - as if there is and cannot be such a thing as a forest, you see this.
So you have someone who believes they're being logical, talking about business and pricing, and someone like sdavidc9, who has an intact, integrated brain, is concerned about people dying, and there's really no way to communicate, because you're not just talking a different language, you're functioning with completely different operating systems.
1
just to follow up - I remember the first time I realized I was talking to someone with a severe thought disorder. I was leading a group therapy session at Bellevue, and a man had come to the group who had just previously been living in a cardboard box on Houston Street.
He would speak in a way that, for a sentence or two, seemed to make sense. Then at some point - the most vertiginous aspect of this experience was you could never quite pinpoint where it happened - you realized he had veered off somewhere and by the time you realized where he had gone, he was somewhere else.
it's much the same experience reading a comment like this, in which each sentence seems to have a normal syntactical structure but overall, it's like it was written by a committee who had never met.
1
This how it can be done.
First, open up Medicare to anyone who wants to buy into it.
Second, allow Medicare to negotiate the price of drugs.
It really is that simple, but since the insurance companies and pharmaceutical companies buy our elected politicians it can't get done. Even if a politician wants to get something changed, they leave rules in place that would allow another politician to block or amend a bill. Until the flow of money into government is checked, the chances having the will of the people done will remain remote.
180
I totally agree and wonder why the VA can and does negotiate it's drug prices with the pharmaceutical industry, a government run agency, nevertheless, why can't Medicare, Medicaid and the rest of us?
1
I had assumed that US Medicare could negotiate prices for drugs, somewhat like the UK's NHS. Why on earth can't they? With obvious economies of scale from the huge US population, it would seem an obvious first step towards pushing down drug prices.
Spot on Mark.
I bought an albuterol/ventolin asthma inhaler in Italy last year. It was about six dollars, and the pharmacist (who can prescribe such things) dispensed it. My CO-PAY in Pennsylvania for the same medication and number of doses is $20. I was told it was because they changed the propellant.
My health insurance premium is only about $800 now. Four years to Medicare.
45
Good to see this issue remains alive, and that there is a "catalog" of ideas for addressing it (from Sloan Kettering Institute). Short of price controls, I'm for any solution that preserves financial incentive to develop effective new drugs, and keeps existing, proven drugs available and accessible. I suspect what needs to happen is, other nations must pay more for drugs as a way to shoulder more of the R&D cost, while we negotiate (or whatever) to bring US prices down below the stratosphere.
6
Or perhaps the drug companies could spend less on marketing and advertising. In February 2015 the Washington Post printed an article entitled "Big pharmaceutical companies are spending far more on marketing than research". STAT, a website reporting news having to do with health care, medicine, and science reported in 2016 that spending on advertising--print media and television--was soaring. Not included in their figures was digital and social media advertising or marketing to doctors. Don't forget that the U.S. and New Zealand are the only two countries that allow advertising of prescription medications to the public.
31
Left out of this discussion is the fact that we are talking about an industry that is subsidized by taxpayers, to a large extent. About 75% of the most innovative new drugs were developed through funding via the National Institute of Health. The industry restricts itself to the "me-too" drugs - finding new uses/applications for existing drugs. Whether it is the NIH, DARPA, government grants, or the public university system, this is socialism for the rich, while taxpayers get to pay not once, but twice. And the second payment is brutal.
Also left out of this discussion is the fact that between diet and environment (such as poisonous products in the home, like cleaning supplies and cosmetics), we could dramatically reduce most illnesses and diseases, and thus the need for these pills which often carry damaging side effects.
78
"About 75% of the most innovative new drugs were developed through funding via the National Institute of Health.".....Can you provide a source? On its face the claim does not sound remotely reasonable.
6
NIH and the rest of the academic (ie University) research system provides the basic research and in many cases the actual drug discovery. The development and clinical testing needed before a drug can be manufactured and marketed is done by or in concert with private companies. That's how the system works and has for a long time.
32
I noticed that Congress pushed back against the Administration's proposed heavy cuts to the NIH. Naively I had thought this was an act of wisdom and principle. But it was obviously dictated by Big Pharma, which didn't want its funding cut.
4
This is the same root problem that rescinding healthcare is about. Overly wealthy Republican donors want ACA repeal for the same reason they want high drug costs, it makes them richer. In the case of the ACA they want to use the savings to cut their taxes even more. Drug companies just want profit, there is no concern for the patient's ability to afford their overpriced drug. Until we see healthcare as a right, not just a privilege of the wealthy, this will continue. Citizen's United has allowed Congress to be purchased by the highest bidder. It must be overturned.
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Citizens United is a nightmare for Americans but is a GOP dream. The double talking Scalia who spun words trying to look intellectual was just doing the work the GOP wanted him to do. He died in one of the GOP donors grand ranch/resort. Scalia claimed to be a catholic yet he decreed a corporation is a person and can donate whatever they want without being identified. A corporation is not a person, a person has a soul according to the usccb and corporations do not;a corporation is an ENTITY and it must be INCORPORATED under the laws of a state, usually Delaware, because of their minimal taxes. Scalia twisted words to help the 1% because he was a fanatic right wing nut and he did not care for people who were not elite like him and his GOP cronies. This case should be thrown out and when Gorsuch tries his Scalia-like double talk, every word he says must be analyzed and dissected;no more double talking judges;recall it was Scalia who gave the 2000 election to Bush for no damn reason, just his arbitrary need to serve conservatives and GOP.
You may be right, but are you sure it is only one party getting the "donations"?
"Overly wealthy Republican donors want ACA repeal for the same reason they want high drug costs, it makes them richer."
You think it's just Republican donors who want high drug costs? Did you miss this part?
"It failed 52 to 46 after 13 Democrats voted against it, with some citing safety concerns about foreign-sourced medicine — an idea promoted by American drug makers."
"That same day, a dozen Republican senators, including Ted Cruz of Texas, John McCain of Arizona and Mike Lee of Utah, voted for the old liberal idea of letting Americans buy cheaper drugs from Canada." Rand Paul too.
What Mr. Hancock neglected to mention was that was Bernie Sanders' bill, and the Dems who voted against it included the likes Cory Booker and Patty Murray - have a look at their donor lists if you're bored sometime.
The CBO recently said that Sanders' bill would save Americans $6.8 billion over 10 years.
https://www.circa.com/story/2017/08/01/politics/bernie-sanders-prescript...
So many of the problems in the U.S. today are the result of unbridled capitalism. Health insurance companies, for example. No other developed country allows insurance companies to be for profit. Our Congress members are bought by big donors, who they seem to work for, rather than working for us. This has worsened since the Citizens United decision. Congress should be making laws that make our economy and tax system fairer, not that make the rich richer. No essential service - police, fire, education, health care, for examples - should be left to the whims of the market. It will never work. We need a touch of social democracy. People and planet must come before profit, or we will soon destroy the world as we know it.
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Not true. Here in Switzerland the health insrance companies compete heavily for our mandatory health insurance payments. The government does cap the maximums they can charge, the deductables they can impose, and the co-pays (10% to a maximum of CHF700 per adult per year). The government also prohibits "pre-existing condition waivers" and sets out what must be covered by law.
Still, the pharmaceutical and insurance industries still make a profit.
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True and useful information.You should also mention that drugs in Switzerland cost between two and three times the price in neighbouring France.( Even when those drugs have been made and marketed by Swiss pharmaceutical companies.
We pay for Dr. prescribed drugs without knowing or realizing benefits. Some day we will demand benefits from doctors and the health care industry.
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So be an 'advocate' for your health. Eat and rest and exercise. If you still get sick and need docs and their meds demand to know what the effects are etc.
Lobbyists own government. When do we take the money out of campaigning and use public funds for all elected leaders? Campaign finance reform is the best thing we can do.
As it is now, congress works not for the people, but for the money. if we don't fix it, we will continue our demise.
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No, the lobbyists' clients own the government. The lobbyists, often ex-congresspeople, just help them do it, and get their cut.
And we should have the health care Congress has;this is a sick arrangement that the GOP congress can give Americans crumbs but get the whole health insurance pie for themselves; vote the corrupt GOP congress out
Just like greedy Big Health insurance corporations, BigPharma has the inherent tendency to invent new needs, disregard all boundaries and turn everything into an object for sale and big profit. To fix this problem, we might nationalize the pharmaceutical industry and mandate that drug companies be converted to non-profit public service corporations that serve the public interest rather than being used by a tiny number of one percenters for unlimited profit.
Another option is to establish a single-payer system of health insurance that allows a single purchaser — the government — to directly haggle with drug manufacturers over drug prices. This would bring U.S. drug prices in line with those of other high-income countries, which pay substantially less than we do for the same medications.
Additionally, we need comprehensive reform in the way we produce new drugs — inclusive of a public path for drug development and clinical trials that would produce new medications that remain forever in the public domain. Drugs need to function as real social service goods, not profit-producing commodities.
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And when drugs are priced high, increasingly insurance companies won't cover them. I used to take a biologic drug that worked like a miracle. For the past two years the insurance I've had has not covered it. As a result I've been in pain for awhile.
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Because the fix is in.
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And of course Trump told careless lies about the price-reducing actions he would take on behalf of the common folk, and then forgot he had even told the lies! As usual!
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"Everyone" does not want to reduce drug prices. Donors don't want to reduce the money they take. Politicians who say one thing take money for the other thing, because that is where the money is.
As Hillary explained about her Wall Street speaking fees, they take it because that is what is offered.
Drug prices? How big is the check. Mere chicken feed can buy any one politicians, on the scale of health care looting of our economy.
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I wish journalists were more precise. Patients want lower out of pocket costs - and these can be very low for extremely expensive products due to insurance coverage. Payers should want extremely valuable medications. These could be outrageously expensive if the conditions or treatment costs that are avoided are also extremely high. Lowering wholesale acquisition cost in the United States may be part of those two important goals. For example, a relatively inexpensive medication should be similarly inexpensive to the patient. However the pharmacy is also free to mark up products in many states, especially to cash paying patients.
I price pharmaceuticals professionally. And we have to be more clear about what we want first before we can accomplish the goal. Also, even if we eliminated ALL spending on pharmaceuticals branded and generic, we’d only save 16% of our healthcare spending. It’s the most visceral because patients pay the bills directly in the pharmacy. But drug cover is 1/6th if premiums. Thinking about ways to clean up billing for medical procedures, getting better at end of life care, & rationalizing hospital and LTC expense will do a lot more to make healthcare affordable perhaps.
Completely agree on the points about TV, lobbying, and the lack of political will. It this article could be a lot stronger with more precision in the language and associated thinking.
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I as a patient want more than just low out-of-pocket. I understand full well that if I pay $10 and the insurance company pays $1000, everybody's insurance rates go way up. It's rubbish to basically claim that low copays are the magic solution for the consumers' problems. It's also absurd to simply point at the other guys as a way of deflecting blame for the outrageous cost of health care in this country. Pharma is huge part of the problem.
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Yes all of those ways to control health care costs would be great. But wouldn't it be refreshing to see just one drug company executive do the right and moral thing? Buy a cheap generic and keep it cheap? -may already be cheap to manufacture. Cut the annoying meaningless ads that waste money. Develop a new drug that would improve things and not be exorbitantly priced? Martin Shirkelli could just be the poster boy for bad Pharma CEO's, but where is one good one doing the right thing for a patient's good because they can. It really takes a good example.
I was under the impression that there was a book used by pharmacies that listed both the wholesale and suggested retail price for most Rx items. The rule of thumb, I always believed was retail = double the wholesale price plus a fee to cover cost of filling the prescription.
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"The pharmaceutical industry’s recent publicity nightmare included 1,000 percent price increases and a smirking chief executive who said, “I liken myself to the robber barons.”.....The first thing that is important in any discussion of drug pricing is to understand the difference between new drugs, which are on patent, and generic drugs. They need to be identified and cost issues addressed separately. The big drug companies whose names are familiar; Merck, Pfizer, and etc., almost never deal in generic drugs. New drugs require a huge expense to discover and develop and they have patent protection, exclusive rights which last for 20 years. (I should add here that most clinical trials will take 6 to 8 years or more and no sane company would invest the kind of money required if they did not already have patent protection before clinical trials started). The information required to make and sell generic drugs is already in the public domain and is available to anyone who is inclined to pursue their production. The problems and costs of the two kinds of drugs are totally different.
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WA Spitzer: I appreciate your insight into your own industry. Frankly most Americans are bewildered why SOME drugs cost so much. My husband takes a few generic drugs (a statin, a BP pill) that are ridiculously cheap -- about $1.99 a month each -- but I know about EpiPens that cost $600 for delivering a dime's worth of an old, generic drug. WHY? how do we stop that exploitation? How can that go on, with nobody speaking out and intervening?
It is abuses like EpiPen that have people up in arms. And frankly, it is stupid -- the industry is ASKING to be slapped down here, and very hard.
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That's an interesting theory. Unfortunately, reality is different. When patients go to fill their prescription at the drug store, they find that the prices of generics are also going up. That's reality.
Here's an article in the NYT about the price increases of dicyclomine, terbutaline, and fluphenazine -- and of course digoxin, all manufactured by Lannett.
https://www.nytimes.com/2017/04/14/business/lannett-drug-price-hike-bedr...
Defiant, Generic Drug Maker Continues to Raise Prices
By GRETCHEN MORGENSON
APRIL 14, 2017
Milton Friedman said that if one manufacturer prices his product too high, other manufacturers will come in and compete with him in the free market by lowering their prices.
Milton Friedman was wrong.
What do you mean, "we"?
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I spent the better part of my career producing communications materials for agencies whose clients were drug companies. I used to buy into the "'research and innovation argument" but soon realized how much waste went into marketing, and even into clinical decisionmaking that favored quick-hit profits from developing "me too" drugs over finding novel compounds.
I just finished Ross Douthat's piece on the problems facing America other than healthcare, and let me just repeat what said there, which is: MONEY is our biggest problem. Money in politics, bought and paid for politicians, Citizens United, lobbyists who write legislation to free up politicos for--what else?--fundraising.
Drugs cost a bundle because they pay an army of industry flacks to preserve the status quo, fight price regulations, ensure politicians get rewarded for votes, and make America subsidize the lower prices the rest of the industrialized world demands to add a product to their government-run formularies.
“If there ever was a time to strike while it’s hot, it’s now," said "Dr. Sarpatwari.
No, I have a better time: when we as a nation decide to roll back Citizens United and enact term limits.
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"clinical decisionmaking that favored quick-hit profits from developing "me too" drugs over finding novel compounds."....You are arguing against yourself. When a drug company makes a "me too drug" they are necessarily introducing competition into the market place. More competition means a lower drug price. Less competition means a higher drug price. You argue that higher drug prices are caused by the development of "me too drugs" which introduce competition. It makes no sense.
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@W.A.Spitzer: that's simply not true. When a drug maker does a quickie "me too" product it comes to market quicker and because it can claim it has some "unique" property (in the case of antidepressants, this can be true, proton pump inhibitors not so much) allowing it to compete with the other branded products on formulary. Plus it gets patent protection for (I think, unless it's changed) 12 years.
So, instead of lowering prices through competition, all branded drugs in a class rise to the highest price drug. Once the drug is in generic form, the other drugs begin losing money, unless they can convince the clinician a patient only tolerates the branded drug. In my career, I never ever saw lower prices through competition, only a rising tide that lifted all branded products. Ironically, the generics also tend to rise in price over time as well. Most big pharma companies maintain an in-house generic production unit, but in the end, contracting tends to keep generics far lower.
And remember "brand me too" has saved development costs but still, because of the clinical trial process, gets the patent protection.
It's really a vicious cycle: in Europe and other continents, governments establish the price points for an entire formulary class. Not so here, where the first to market with a novel brand cashes in, until the other companies enter the same market. But again, branded, and ideally unique benefit products can pretty much dictate their own starting price.
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W.A. Spitzer: I don't think that is what ChristineMcM said. She said too much money goes into "me-too" drugs instead of true innovation. That doesn't mean there should be no competition; it's about the choice of how to allocate resources.
You also overlooked the huge expenses of legalized advertising, which used to be a no-no until the drug companies got the rules changed.
I suspect the big companies, in addition, prefer to spend much more money on expensive variations on known drugs than possibly much less money on completely new ones, such as from plants known by some native peoples to have health benefits.
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“There is a very aggressive lobby that is finding any and all means to thwart any reform to a system that has produced very lucrative profits,”
Gee, now there's a shocking statement. I knew there had to be some reason our government has allowed our health care costs to rise to double the average spent by other wealthy countries while achieving worse results them many of them.
Maybe the reason we have about 6 times the incarceration rates as the average nation in the rest of the modern world is the result of a similar problem? Do you think?
How about our for profit student loan system? What about defense contracts?
Boy, it is a good thing that the wealth of this country is unlimited, or these things could be markers of our decline as a world power- perhaps an Argentenian collapse.
Seriously, our political corruption is like a perpetual motion machine. A sizable slice of obscene profits at the expense of the taxpayers are put back into the system to control our government. We have to find a way to reverse the increasing influence of money in our political system that has been rising precipitously since the 1980's.
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"We have to find a way to reverse the increasing influence of money in our political system that has been rising precipitously since the 1980's."
Money has been influencing our politics since our founding. It is more pervasive because of all the power that resides in Washington.
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hm1342, it is more pervasive because of the increasing wealth accumulated by the interested parties, i.e., big companies and billionaires. It should be easy to document this; look at the value of the dollar vs. the value of the biggest companies and the number of such companies (and billionaires).
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And Citizens United, which is a bit more recent than 1776.
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American consumers pay for the pharmaceutical drug research that benefits the everyone on this planet. The drug companies are willing to accept price regulation in every other nation because they know that they have free reign to raise prices in the USA. The only way to control drug prices here is to adopt the policies used in other nations.
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"American consumers pay for the pharmaceutical drug research that benefits the everyone on this planet."
No. Just no.
First off, the amount of money spent on genuine, meaningful research by Big Pharma is surprisingly small. They spend far more on marketing (especially if you omit money spent to research analogue drugs that don't offer any new benefits, other than higher prices and new patents).
Most biomedical advances come about either wholly, or heavily, thanks to government-funded research that takes place all over the world. As usual, the corporate drug companies are largely piggybacking off of government-funded work. It is your classic socialism for the rich, rugged individualism for the poor, privatising profits and socialising costs model that the corporate world runs on.
We keep being told that "American consumers pay for the pharmaceutical drug research that benefits everyone on this planet." But that claim is never accompanied by the fact that it is only the United States and New Zealand that allow advertising to the public of prescription drugs. And the amount of money spent on advertising is huge. STAT, a website that reports on news in the fields of health, medicine, and science reported in March 2016 that "Even as politicians and physicians press for strict limits on prescription drug ads, the pharmaceutical industry is pouring billions into new TV and print campaigns. Ad spending soared more than 60 percent in the last four years, hitting $5.2 billion last year." That's advertising dollars for print and television and doesn't include money spent on digital ads, social media, and marketing to doctors. That final item is estimated to be an even bigger expenditure than advertising to the public. The Washington Post reported as recently as February 2015 that of the ten largest pharmaceutical companies, nine spent more on marketing and advertising than on R&D (https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-pharmaceutica...
Wow, Brad, you have figured it all out. Problem solved.
But seriously, Germany, England, et al., do not have a First Amendment, so they can scrap “free speech” rights—and their governments do. We would need a constitutional amendment to undo the Citizens United decision.
And by the way, a lot of lawyers think the Citizens United decision was correctly decided because it’s holding is based on the reasoning that American citizens have the collective ability to engage in “political speech”—the most protected form of speech in America—via a corporation formed for that purpose.
Sometimes Congressmen need to just do the right thing. Negotiating is the American way. Also, Americans must grow up and ultimately accept that maintaining their bodies correctly is important, that death is part of life, and that there is no free government lunch.
I have been priced out of a medication supposed to alleviate my mild COPD. Oh well, I will die of something. Greed wins.
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The greed disease rages out of control. It's metastasized throughout elected and appointed federal, stare, county, and municipal government officials. Their greed will destroy us.
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I have been working in this area, drug pricing and patenting, for almost my entire professional life. All that time the Bayh Dole act has contained a price limiting section. The majority of big drugs are developed with some federal funding for all or part of their inventions. No administration, Republican or Democratic, has ever had the nerve to assert these rights against expensive drugs and their manufacturers. Instead, government agencies, especially the NIH which usually grants these funds, throws up its hands and says they have no expertise in setting fair prices. Well the statute says they have that responsibility and all they have to set up is what all agencies have similarly done, whether they deal in transportation, agriculture, safety, or even emergencies. They hire some economists and get to work.
But the pharmaceutical companies have clearly bought them all off with lobbying and promises of funding for new prestige enhancing articles.
My prediction, after forty years at this, is that nothing is going to happen. My personal failure, including congressional testimony, media interviews, op ed pieces, published letters to the Times, and the like, is nothing compared to our social failure which condemns us to decades and more of suffering because big money has stolen our democracy and our access to reasonably priced pharmaceuticals.
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"The majority of big drugs are developed with some federal funding for all or part of their inventions."....This is a claim that is often repeated and almost always misleading. Most federal funding is directed toward basic research. Discovery and development of a drug requires applied research. Basic and applied research are complimentary but they are very different. Both are essential, but you can't substitute one for the other. While basic research funded by The Federal Government is critical, the actual discovery and development of a drug is something they are simply not capable of doing. The parts and pieces that are necessary are not there, and one should not imagine that applied research is not every bit as difficult and challenging as basic research.
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W.A. Spitzer, they are not "complimentary", they are "complementary". A more serious objection to your claim is that applied research depends on basic research. The line between the two is not a line but a broad region, and much of what drug companies depend on federal financing for is in that broad region.
As for "the actual discovery ... of a drug", that is false. If you had limited your statement to development you would have a better case.
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"The majority of big drugs are developed with some federal funding for all or part of their inventions."
Then it's time for the government to stop subsidizing the R&D for these companies, right?
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