3 Pills - $US 350.00

[xsedrinam]

My mother-n-law is 78. She has an infection, the result of minor surgery last week, so the nurse from the doctor's office called to advise her that they called in a prescription for an antibiotic at Walgreens this afternoon. She went to pick it up. 3 pills. $US 350.00. She walked out and said she'd take her chances. I don't blame her. What can be done about:

(1) Pharmaceutical Industry Lobbyist presence in Washington and the need to erase this administration and their attached-at-the-hip leeches from the D.C. area come November?
(2) immorality - aren't avarice and gouging included in the top 10 list of cardinal sins (or whatever they're referred to)?
(3) oppression of the widow, the aged and poverty level populace who cannot afford medical care?

I know this is old/news/new/news, but had to vent in livid color. If there are no responses, I understand. Yawn here, and carry on.

[swiftaw]

Yeah, some pills are expensive, did she ask if there was a generic version, those are always much cheaper if available.

The pharmaceutical industry owns the government.

[xsedrinam]

Yeah, some pills are expensive, did she ask if there was a generic version, those are always much cheaper if available.

The pharmaceutical industry owns the government.
Yes. The generic was $US300.00

[swiftaw]

Yes. The generic was $US300.00

Wow

[obeygiant]

Which antibiotic was it?

Because there are probably hundreds of antibiotics out there she could have used. Sometimes I think these doctors go golfing with their drug reps and get convinced to prescribe a certain drug. I would ask him to prescribe something cheaper.

[LethalWolfe]

Part of the problem is some (most?) of the pharmacies keep the prices of drugs artificially high so they make the same amount of profit whether someone gets the name brand or the generic. I know someone who used to work for a drug company and they said the big pharmacy chains would typically pocket the price cut when generics would come out instead of passing it along to the consumer.


Lethal

[it5five]

The pharmaceutical industry is a joke. Other countries around the world pay far far far far less for the same drugs we pay hundreds for here. Time to get lobbying groups out of our government.

On another note, I'm surprised Swarmlord hasn't come in here saying that she deserves to pay those high prices.

[yg17]

The pharmaceutical industry is a joke. Other countries around the world pay far far far far less for the same drugs we pay hundreds for here. Time to get lobbying groups out of our government.

On another note, I'm surprised Swarmlord hasn't come in here saying that she deserves to pay those high prices.

Why of course she deserves to pay those high prices, it was her fault for getting the infection :rolleyes:

Whenever I pick up my prescriptions each month, I feel happy that I'm only paying $20 for both of them (generics FTW) especially since Walgreens prints on the sheet how much insurance saved you...so I'm thinking "Oh wow, insurance saved me 50 bucks!"

And then I realize how much cheaper this would be in other countries and feel like I was just screwed out of 20 bucks that would have been better spent on something else....like beer :D

[iBlue]

Which antibiotic was it?

Because there are probably hundreds of antibiotics out there she could have used. Sometimes I think these doctors go golfing with their drug reps and get convinced to prescribe a certain drug. I would ask him to prescribe something cheaper.
Precisely what I was going to say/ask.



That's ridiculous. There are very few infections that can't be treated with an antibiotic that runs around the $20 range.

BTW, Walgreens seems to be notoriously bad for marking up prices, in my experience. Not that they could mark something up THAT much but I'm just sayin'.

[.Andy]

My mother-n-law is 78. She has an infection, the result of minor surgery last week, so the nurse from the doctor's office called to advise her that they called in a prescription for an antibiotic at Walgreens this afternoon. She went to pick it up. 3 pills. $US 350.00. She walked out and said she'd take her chances. I don't blame her.
Although it's easy claim it's a medical conspiracy to make money I'd really suggest that she gets those antibiotics or at least seeks a second opinion. If she'd picked up an infection just going about her daily business then a cheap penicillin (or like) would have done the trick no problems. However when one gets an infection in hospital following surgery chances are things are going to much worse. Commonly bacteria that colonise hospitals are far more resistant to common antibiotics and are also usually far different varieties than one comes into contact in their day to day activities. Hence you need to use a more specialised antibiotic which unfortunately means more expensive.

At 78 I'd really advice against taking her chances. She'd already be relatively immunosuppressed at her age, and without knowing what surgery she had or bacteria she's been infected with, the complications could be very severe or fatal.

Edit: xsedrinam if you can get ahold of the microbiology results and the antibiotic sensitivity tests of your mother in law it would be interesting. I might even be able to run them past my infectious diseases registrar tomorrow to see what she recommends if you like (and if she's got time).

That's ridiculous. There are very few infections that can't be treated with an antibiotic that runs around the $20 range.
Infections that are community acquired yes. Infections picked up following surgery or whilst admitted in hospital unfortunately, usually no. Hospitals are filthy places for insane bacteria, as are elderly women (and men) who are in and out regularly.

[yg17]

BTW, Walgreens seems to be notoriously bad for marking up prices, in my experience. Not that they could mark something up THAT much but I'm just sayin'.



I've never noticed that at Walgreens, then again, I have pretty small copays so I wouldn't notice. One thing that annoys me a bit is that one of my prescriptions is 4 bucks at Wal-Mart (they have that cheap generic program) but Walgreens doesn't have it. I still spend the extra 6 bucks to not go to wally world, but I wish Walgreens had something like that.

[iBlue]

...

Infections that are community acquired yes. Infections picked up following surgery or whilst admitted in hospital unfortunately, usually no.
Yes, but that's a part of the "very few" I mentioned.
If it isn't a community acquired infection, I would think that the hospital themselves may be liable for one of their superbad infections. (?)

Either way, I think she should go either to another doctor or ring back this one and ask for a reasonably priced antibiotic. I don't think she should take her chances, especially when there are other antibiotics out there.

[.Andy]

Yes, but that's a part of the "very few" I mentioned.
If it isn't a community acquired infection, I would think that the hospital themselves may be liable for one of their superbad infections. (?)
Not really. Like I said those whom are elderly who are in and out of hospital are often colonised with MRSA (etc) themselves so it's impossible to determine that the infection actually came from the hospital. Also infections following surgery can't be avoided at all - it's a roll of the dice (although you do everything possible to avoid complications such as regular clean dressings, prophylactic antibiotics, isolation etc). It's just one of those things. The hospital would only be liable if they were somehow demonstrably negligent in their pre and post-operative care.

[xsedrinam]

Edit: xsedrinam if you can get ahold of the microbiology results and the antibiotic sensitivity tests of your mother in law it would be interesting. I might even be able to run them past my infectious diseases registrar tomorrow to see what she recommends if you like (and if she's got time).
"What kind of antibiotic was it?" was the first question I asked her. She couldn't remember or just didn't know. She thinks she's allergic to penicillin, though that must be in recent months since we don't recall that in her history. I'll see what I can find out. With HIPAA firmly entrenched in the U.S., they're reluctant to give out medical info to a son in law who doesn't have POA. I'll see if my wife can get some solid information from them, tomorrow.

[takao]

350 _with_ prescription ? that is outragous

[Osarkon]

That's unbelievable, if the medicine costs that much maybe she should be in hospital for treatment seeing as the cost is that high!

One good thing about Wales, we get free prescriptions.

[edesignuk]

That's just awful. Exactly the sort of thing mentioned in "Sicko", I had no idea of the situation with regard to the price of medication over there until I saw that.

<praises NHS for &#163;6.75 fixed cost for any medication by prescription*>



*even though NHS definitely have their faults too.

[bartelby]

That's just awful. Exactly the sort of thing mentioned in "Sicko", I had no idea of the situation with regard to the price of medication over there until I saw that.

<praises NHS for £6.75 fixed cost for any medication by prescription*>



*even though NHS definitely have their faults too.

Praises Wales' free prescriptions! :D

[edesignuk]

Praises Wales' free prescriptions! :DTwunting Wales, grrrrrrrrr! :p

[MacRumorUser]

Precisely what I was going to say/ask.



That's ridiculous. There are very few infections that can't be treated with an antibiotic that runs around the $20 range.

BTW, Walgreens seems to be notoriously bad for marking up prices, in my experience. Not that they could mark something up THAT much but I'm just sayin'.


If she is like me - she could be allergic or immune to many of them. But $300 is still insane.

Even with my recurring infections - the most I've ever had to pay for a weeks antibiotic course was €89 / $119

What I also don't understand is 3 pills ? That's a very strange course of antibiotics altogether. Usually it's a week or 10 day course ? How does 3 work out ? strange..

[takao]

it's not free here either but it's 3.60 euros which is still gazillion times less

[solvs]

On another note, I'm surprised Swarmlord hasn't come in here saying that she deserves to pay those high prices.

Ditto. I once had a medication that was around $800 for a 30 day supply. I'm sure some people are perfectly fine with that, but it really shouldn't be that bad. And we all have horror stories proving it is.

[Swarmlord]

Which antibiotic was it?

Because there are probably hundreds of antibiotics out there she could have used. Sometimes I think these doctors go golfing with their drug reps and get convinced to prescribe a certain drug. I would ask him to prescribe something cheaper.

It's easier to whine about it and blame Bush.

[Swarmlord]

The pharmaceutical industry is a joke. Other countries around the world pay far far far far less for the same drugs we pay hundreds for here. Time to get lobbying groups out of our government.

On another note, I'm surprised Swarmlord hasn't come in here saying that she deserves to pay those high prices.

I'm all for forcing our pharma companies to charge the same for their drugs whether they are sold in the states here or overseas.

[bartelby]

I'm all for forcing our pharma companies to charge the same for their drugs whether they are sold in the states here or overseas.

They probably do. But in other countries the governments/health care systems absorbe a large amount of the costs instead of companies hiking the price to make a buck or two from the sick.

[Swarmlord]

They probably do. But in other countries the governments/health care systems absorbe a large amount of the costs instead of companies hiking the price to make a buck or two from the sick.

Not true. I've purchased many perscription drugs with my own money (not through any state benefits plan) in both Europe and the Middle East and I was charged in some cases an order of magnatude less than I would in the states.

When I checked with some people in the medical community about this I was told that we in the US subsidize the cost of all development and approval of drugs, but they are priced only on the cost of production and distribution to other countries.

[bartelby]

When I checked with some people in the medical community about this I was told that we in the US subsidize the cost of all development and approval of drugs, but they are priced only on the cost of production and distribution to other countries.

Development and approval within the US.
I very much doubt the US subsidises development and approval of drugs in other countries.

So who pays for drugs to be developed and approved in the UK and European countries?

[Peterkro]

When I checked with some people in the medical community about this I was told that we in the US subsidize the cost of all development and approval of drugs, but they are priced only on the cost of production and distribution to other countries.

To be blunt that's bollocks for instance:


The drug industry’s top priority increasingly is advertising and marketing, more than R&D. Increases in drug industry advertising budgets have averaged almost 40 percent a year since the government relaxed rules on direct-to-consumer advertising in 1997. Moreover, the Fortune 500 drug companies dedicated 30 percent of their revenues to marketing and administration in the year 2000, and just 12 percent to R&D. (See Section X)
http://www.citizen.org/publications/release.cfm?ID=7065

The figures on that site are somewhat out of date but the principal holds true (the pharma industry is none to forthcoming with figures and it pays government highly to add that ). It's a short page but a reading of it will help dispel the fog of misinformation coming from the pharma industry.

[Peterkro]

Development and approval within the US.
I very much doubt the US subsidises development and approval of drugs in other countries.

So who pays for drugs to be developed and approved in the UK and European countries?

R&D is paid for by taxpayers in Europe mainly as indeed it is in the US although unless you look hard at the US industry you'd mistakenly think private companies invested all the money.

[bartelby]

R&D is paid for by taxpayers in Europe mainly as indeed it is in the US although unless you look hard at the US industry you'd mistakenly think private companies invested all the money.

Yeah, I knew that. I was asking Swarmlord as he seemed to be implying that we pay less because the US pays for everything...

[Peterkro]

I don't think Swarmlord lives in the same world frankly.

[Swarmlord]

Development and approval within the US.
I very much doubt the US subsidises development and approval of drugs in other countries.

So who pays for drugs to be developed and approved in the UK and European countries?

You're missing the point. The drugs are already developed and gone through trials and approval here before they are sold overseas. They may have to go through some hoops to get approval for use elsewhere, but the hard work is already done by then.

[bartelby]

You're missing the point. The drugs are already developed and gone through trials and approval here before they are sold overseas. They may have to go through some hoops to get approval for use elsewhere, but the hard work is already done by then.

Even drugs that are developed outside the US?

Or is it only the US who manufacture drugs?

The approval system for drugs in the UK is the same, if not more stringent, than in the US. It's not just a case of agreeing with the Manufacturers claims...

[Swarmlord]

To be blunt that's bollocks for instance:


The drug industry’s top priority increasingly is advertising and marketing, more than R&D. Increases in drug industry advertising budgets have averaged almost 40 percent a year since the government relaxed rules on direct-to-consumer advertising in 1997. Moreover, the Fortune 500 drug companies dedicated 30 percent of their revenues to marketing and administration in the year 2000, and just 12 percent to R&D. (See Section X)
http://www.citizen.org/publications/release.cfm?ID=7065

The figures on that site are somewhat out of date but the principal holds true (the pharma industry is none to forthcoming with figures and it pays government highly to add that ). It's a short page but a reading of it will help dispel the fog of misinformation coming from the pharma industry.

I never said that advertising also wasn't a source of the high cost.

I guess you're implying that the cost of advertising outside the US is much less expensive or that they don't advertise as much there.

[Cybergypsy]

the most I paid was 100 bucks for 5 day(5pills) treatment.

[takao]

I guess you're implying that the cost of advertising outside the US is much less expensive or that they don't advertise as much there.

because in many countries it's illegal to advertise for prescription-only drugs

[beatzfreak]

I never said that advertising also wasn't a source of the high cost.

I guess you're implying that the cost of advertising outside the US is much less expensive or that they don't advertise as much there.

The US and New Zealand (who are considering banning it) are the only western countries that allow direct to consumer advertising for prescription drugs.

Gee, I wonder how much Pfizer paid to license Elvis' "Viva Las Vegas" for their current campaign "Viva Viagra".:rolleyes:

[atszyman]

Even drugs that are developed outside the US?

Or is it only the US who manufacture drugs?

The approval system for drugs in the UK is the same, if not more stringent, than in the US. It's not just a case of agreeing with the Manufacturers claims...

I don't see why "where" a drug is developed has anything to do with who pays for it. If a drug company can develop and test it's drugs more cheaply or with fewer regulations in another country and then proceed to get approval and charge an exorbitant price in the US then I don't see why they wouldn't pursue that course. Where you develop/manufacture something has very little to do with the market you can make the most profit in. Otherwise we wouldn't be importing lead infested toys from China.

Now the pharmaceutical industry in general has a massive problem with working for profits. How much money has been sunk into Viagra-like drugs and advertising of those drugs? Wouldn't it be more moral to spend that money researching cures for terminal diseases, and finding drugs that save lives more than drugs that simply make lives more pleasurable? Or is the $ more important?

I know someone is going to chime in and say that profits made from "pleasure" drugs go towards development of the life saving drugs, I will give you that, but the scientists working on the "pleasure" but they are also spending time and knowledge working on those drugs that could/should be spent on life-saving drugs.

[bartelby]

I don't see why "where" a drug is developed has anything to do with who pays for it. If a drug company can develop and test it's drugs more cheaply or with fewer regulations in another country and then proceed to get approval and charge an exorbitant price in the US then I don't see why they wouldn't pursue that course. Where you develop/manufacture something has very little to do with the market you can make the most profit in. Otherwise we wouldn't be importing lead infested toys from China.

It was swarmlord who suggested it has everything to do with the cost of drugs, not me. I was countering the idea.

[leekohler]

because in many countries it's illegal to advertise for prescription-only drugs

You're looking pretty bad here Swarmy. You should get your facts straight. ;)

[Ugg]

Even drugs that are developed outside the US?

Or is it only the US who manufacture drugs?

The approval system for drugs in the UK is the same, if not more stringent, than in the US. It's not just a case of agreeing with the Manufacturers claims...

Exactly what I was going to say, swarmy seems to think the US is the only country that manufactures drugs.

R&D gets short shrift in the US, I think R&D budgets are less than the advertising budgets.

Also, bushco has prevented Medicare from negotiating price cuts for volume purchases. What's that if not a corporate handout? I've never seen a more anti competitive president.

[atszyman]

It was swarmlord who suggested it has everything to do with the cost of drugs, not me. I was countering the idea.

I was just pointing out that where you recoup your development costs has little to do with where you do your development. If Swarmlord's point had been that US regulations interfere with the development of drugs and the extra cost is due to that government regulation, then yes, where development occurred would be an issue. But if you're talking about generic development and qualification those costs have to be recouped regardless of where the drug was developed.

Yes, drugs are developed overseas, but that has little to do with recouping costs in whatever market will tolerate the higher prices. The point of where the development occurs does not have anything to do with the US being the marked used to recoup the development costs.

[Swarmlord]

The US and New Zealand (who are considering banning it) are the only western countries that allow direct to consumer advertising for prescription drugs.

Gee, I wonder how much Pfizer paid to license Elvis' "Viva Las Vegas" for their current campaign "Viva Viagra".:rolleyes:

I think that commercial is rediculous. I hestiate to agree completely with the "cost of advertising" argument though since only sex, allergy and sleep drugs seem to get any advertising. I haven't seen ads for expensive antibiotics.

[Swarmlord]

Exactly what I was going to say, swarmy seems to think the US is the only country that manufactures drugs.

<snip>

Wow, are you wrong there or what? Post a link where I stated that no one makes drugs outside the US or put a sock in it.

It's almost impossible to make a point in this forum anymore without a handful of your going into fugue state or having looseness of association.

[Black&Tan]

To the OP, please check with other local pharmacies to find out what their prices are. I was surprised to note vast differences in prices, depending on which chain store you visit.

[Swarmlord]

To the OP, please check with other local pharmacies to find out what their prices are. I was surprised to note vast differences in prices, depending on which chain store you visit.

They can also tell you all the alternative equivilent drugs to consider too and can contact your doctor to change your prescription to one of them.

[Peterkro]

Part of the problem in the US is the slight modification of drugs just before the patent runs out then with the help of a medical profession mainly bought off by pharma these are prescribed at high cost even though they offer no real advantage over the drug which has just gone generic.

[obeygiant]

Part of the problem in the US is the slight modification of drugs just before the patent runs out then with the help of a medical profession mainly bought off by pharma these are prescribed at high cost even though they offer no real advantage over the drug which has just gone generic.

Part of having a patent is that you have to change it every seven years. They might change the color or alter the chemistry or process, but essentialy the drug is the same.

[Aea]

Another rant to the list...

My mother had some issues with digestive system, nothing too bad, but definitely an inconvenience. She was prescribed Nexium when she walked out of the office, without any sort of tests being conducted. She went to go see a specialist who actually ran some tests, prescribed PrevPak (which also costs quite a bit), and all the problems went away without spending hundreds on a drug which ultimately was unnecessary.

This kind of **** has really got to stop :mad:

[.Andy]

Another rant to the list...

My mother had some issues with digestive system, nothing too bad, but definitely an inconvenience. She was prescribed Nexium when she walked out of the office, without any sort of tests being conducted. She went to go see a specialist who actually ran some tests, prescribed PrevPak (which also costs quite a bit), and all the problems went away without spending hundreds on a drug which ultimately was unnecessary.

This kind of **** has really got to stop :mad:
Are you angry at the treatment your mother received or the price of the medications? I'm not sure I understand your 'rant' :confused:.

[imac/cheese]

I think that commercial is rediculous. I hestiate to agree completely with the "cost of advertising" argument though since only sex, allergy and sleep drugs seem to get any advertising. I haven't seen ads for expensive antibiotics.

Actually a large portion of the advertising dollars is not for the "if XYZ sounds right for you, contact your doctor" type of ads. Most advertising dollars are spent on advertising to those who actually write the prescriptions. Doctors and hospitals are inundated with drug advertising every day.

[.Andy]

Actually a large portion of the advertising dollars is not for the "if XYZ sounds right for you, contact your doctor" type of ads. Most advertising dollars are spent on advertising to those who actually write the prescriptions. Doctors and hospitals are inundated with drug advertising every day.
And in dollar terms the largest promotional cost to pharmaceutical companies is actually spent on giving drugs away free. Free samples given to doctors (which are handed on to patients for free) are what drives sales the most. If enough patient's report back that X drug they were given worked wonderfully or was easy to take or had lower side effects is the most persuasive advertising possible.

The trend in pharmaceuticals promotion is telling in what works, and there was just a large paper published in the NEJM (http://content.nejm.org/cgi/content/abstract/357/7/673) on this very topic. Since 1996 to 2005 advertising to doctors has fallen (5.4% to 4.4% of total promotional $) whereas direct advertising to the public (1.2 to 2.6% of total promotional $) and the provision of free samples has increased (7.6% to 11.2% of total promotional $). So the trend for the last decade is that direct to public advertising is by far the biggest mover, if it still only accounts a fraction of total expenditure.

[Roger1]

Part of the problem in the US is the slight modification of drugs just before the patent runs out then with the help of a medical profession mainly bought off by pharma these are prescribed at high cost even though they offer no real advantage over the drug which has just gone generic.

Don't forget, the companies that hold those patents also spent millions (billions?) developing the drug that it protects. A person really can't blame them if the company wants to maintain the patent for as long as possible, before another company comes out with a generic (a company that didn't contribute a dime to the development, testing, marketing, etc, of the name brand).

[solvs]

I don't think Swarmlord lives in the same world frankly.
I've often thought the same thing, since it seems to be the only logical conclusion.

It's almost impossible to make a point in this forum anymore without a handful of your going into fugue state or having looseness of association.

Well when you say things like this:

It's easier to whine about it and blame Bush.

... in response to some very real concerns, what do you expect?

[Peterkro]

Don't forget, the companies that hold those patents also spent millions (billions?) developing the drug that it protects. A person really can't blame them if the company wants to maintain the patent for as long as possible, before another company comes out with a generic (a company that didn't contribute a dime to the development, testing, marketing, etc, of the name brand).


Drug industry R&D does not appear to be as risky as companies claim. In every year since 1982, the drug industry has been the most profitable in the United States, according to Fortune magazine’s rankings. During this time, the drug industry’s returns on revenue (profit as a percent of sales) have averaged about three times the average for all other industries represented in the Fortune 500. It defies logic that R&D investments are highly risky if the industry is consistently so profitable and returns on investments are so high. (See Section V)

http://www.citizen.org/publications/release.cfm?ID=7065

The pharma industry is a mess the profits are ridiculous ,tax breaks are high,a lot of core research is paid for by taxpayers,a lot of top drugs are discovered by small research companies which are bought out by the big players,and so on and so on.

[Swarmlord]

I've often thought the same thing, since it seems to be the only logical conclusion.



Well when you say things like this:



... in response to some very real concerns, what do you expect?

Those are some deep thoughts from someone that admittedly lives in LaLaLand.

[xsedrinam]

Well, we've been able to find out her infection. H. (Helicobacter) pylori which calls for a 10 day antibiotic like clarithromycin or amoxicillin, along with a proton-pump inhibitor such as omeprazole (Prilosec). We can give her Nexium which we get in Ecuador for half the U.S. price.

We've asked her to call her doctor and ask for a less expensive prescription.

[Aea]

Well, we've been able to find out her infection. H. (Helicobacter) pylori which calls for a 10 day antibiotic like clarithromycin or amoxicillin, along with a proton-pump inhibitor such as omeprazole (Prilosec). We can give her Nexium which we get in Ecuador for half the U.S. price.

We've asked her to call her doctor and ask for a less expensive prescription.

H. Pylori is commonly treated by PrevPak, I don't know how she contracted it, but H. Pylori exists in the stomach and is present in a large majority of the older population. If properly treated you won't need Nexium for too long.

[xsedrinam]

H. Pylori is commonly treated by PrevPak, I don't know how she contracted it, but H. Pylori exists in the stomach and is present in a large majority of the older population. If properly treated you won't need Nexium for too long.
Lots of options. I still wish I knew what the $350/3 pill prescription is.

[pseudobrit]

I just got a boxload of precscription meds from Canada. Without going through insurance (just paying cash), a six month supply cost me $60.

My cost for the same six months buying within the US healthcare system from my pharmacy would have been close to $200.

Now, where are all those morons who used to talk **** about Canadians running over the border to get decent healthcare?

[obeygiant]

I just got a boxload of precscription meds from Canada. Without going through insurance (just paying cash), a six month supply cost me $60.

My cost for the same six months buying within the US healthcare system from my pharmacy would have been close to $200.

What did you pay in shipping? Your savings would be $140 less shipping. not bad. BTW, is that legal?

[Sobe]

My father is/was (he no longer does the lab work) a synthetic organic chemist who was the inventor of one drug brought to market that has made billions (don't ask, he didn't get a cut).

He made several other drugs that could have been marketed and were not.

I would suggest that 99 people out of 100 do not have the slighest idea what goes into making a drug.

And I'm not just talking about understanding the chemistry necessary to perform the synthesis, but rather the top to bottom staffing and equipping and support that is required to do medicinal chemistry.

It is a massively expensive and risky endeavor.

Anyone who would suggest how they would price pharmaceuticals should pick up an organic chemistry textbook, rent some lab equipment and see how easy it is to make life saving drugs.

[Sobe]

Well, we've been able to find out her infection. H. (Helicobacter) pylori which calls for a 10 day antibiotic like clarithromycin or amoxicillin, along with a proton-pump inhibitor such as omeprazole (Prilosec). We can give her Nexium which we get in Ecuador for half the U.S. price.

We've asked her to call her doctor and ask for a less expensive prescription.

H. pylori is not your normal bug.

there's a reason the doc is giving her kick butt antibiotics.

[AP_piano295]

Hey guys dont forget no matter how bad it sucks here it's waaaay worse in Canada. :rolleyes:

[Sobe]

Hey guys dont forget no matter how bad it sucks here it's waaaay worse in Canada. :rolleyes:

well yeah for starters there's all those Canadians...

[adk]

I've just sort of grazed over this thread, but I wanted to comment on a few things.

The main reason drug prices are so high is due is the exorbitant costs associated with the liability insurance the drug companies must carry. The litigious nature of the United States is the main reason for the price differential between American and Canadian Drugs. The liability insurance companies have decided that Canadians are statistically less likely to sue the drug company, thus the lower costs of insurance are passed onto the Canadian customer.


New drug R&D is extremely risky. Take Pargluva, a diabetes drug being developed by Merck and Bristol Myers-Squibb. In 2006, a few weeks before the drug was scheduled to be put on the market, The FDA requested that more tests be performed before the drug was launched. The companies, having already invested billions in the project, decided that the research would be too costly to continue and shelved the drug without making any money back on their investment.


Doctors are not treated to laving vacations on the Drug companies' dimes. The maximum perk doctors may receive is a "modestly priced meal" (this term was coined by the government) that totals less than $100 per person.

[xsedrinam]

I have no qualms in general with those who practice medicine.

But specifically the pharmaceutical industry, which is documented in '03 with having 1,274 registered pharmaceutical lobbyists in Washington D.C., (that's more than two for every one member of Congress), spent $U.S. 143,000,000 on lobbying activities (http://www.medicalnewstoday.com/articles/23518.php), and has been strange bedpersons with this administration; that's my qualm before the storm. And I'm hoping there will be a storm of protest at the polls. Though small, I shall cast what voting voice I have in the direction of those who are not brainwashed in to thinking gouging is justified because of elitist qualification and effort. They gouge because they can.

And patronizing the rest of the planet with text booked staleness and genealogical ties to justify such is really quite pathetic. Perhaps someone is impressed with that approach. Not I.

[Ugg]

The main reason drug prices are so high is due is the exorbitant costs associated with the liability insurance the drug companies must carry. The litigious nature of the United States is the main reason for the price differential between American and Canadian Drugs. The liability insurance companies have decided that Canadians are statistically less likely to sue the drug company, thus the lower costs of insurance are passed onto the Canadian customer.


New drug R&D is extremely risky. Take Pargluva, a diabetes drug being developed by Merck and Bristol Myers-Squibb. In 2006, a few weeks before the drug was scheduled to be put on the market, The FDA requested that more tests be performed before the drug was launched. The companies, having already invested billions in the project, decided that the research would be too costly to continue and shelved the drug without making any money back on their investment.


Doctors are not treated to laving vacations on the Drug companies' dimes. The maximum perk doctors may receive is a "modestly priced meal" (this term was coined by the government) that totals less than $100 per person.

Would you care to provide some numbers so we can see how much those "exorbitant liability costs" are?

I wonder why the FDA decided to take a second look at that drug. It wouldn't happen to have been because they found shoddy research or an attempt to cover up possible "mistakes" would it?

Doctors for a long time got lots of free vacations from the drug companies. Now they simply give them kickbacks based on how much they prescribe.

If the drug companies would stick to their business instead of using propaganda, they would be a lot better off.

[takao]

It is a massively expensive and risky endeavor.

Anyone who would suggest how they would price pharmaceuticals should pick up an organic chemistry textbook, rent some lab equipment and see how easy it is to make life saving drugs.

well the same can be said about about every complex product
take silicium and cooper and a computer architecture book and try making a CPU who then sells for less than 1 of those 100$ pills ;)

[synth3tik]

Pharmaceuticals don't cure you or remove the problem, they just mask them. You have a headache you take Aspirin, it does not fix the problem, it just masks the issue. The only thing Pharmaceuticals are know to do is cause more issues. Just make sure she is eating good old fashioned raw vegetables and that should help her immune system fight off infection.

[solvs]

Those are some deep thoughts from someone that admittedly lives in LaLaLand.
I'm surrounded by people oblivious to reality, so I can tell when I see it elsewhere.

Anyone who thinks the healthcare system in the country is fine the way it is must be living in a fantasyland or alternate universe.

BTW, is that legal?
Probably not, but for those without insurance it's much more affordable even with shipping.

Pharmaceuticals don't cure you or remove the problem, they just mask them. You have a headache you take Aspirin, it does not fix the problem, it just masks the issue. The only thing Pharmaceuticals are know to do is cause more issues. Just make sure she is eating good old fashioned raw vegetables and that should help her immune system fight off infection.
I'll be sure and tell that to my Stepfather currently taking 6 different meds as he recovers from cancer that had metastasized.

[atszyman]

Pharmaceuticals don't cure you or remove the problem, they just mask them. You have a headache you take Aspirin, it does not fix the problem, it just masks the issue. The only thing Pharmaceuticals are know to do is cause more issues. Just make sure she is eating good old fashioned raw vegetables and that should help her immune system fight off infection.

This is only true for some drugs. Yes pain killers and many over the cold/flu medicines only mask the problem. I avoid taking over the counter medications as much as possible, but sometimes you need a good night's sleep and congestion/headache/stomach discomfort is preventing that, which only makes you feel worse tomorrow.

Antibiotics on the other-hand actually go in and kill the organism that is making you ill. They aren't masking the problem, they are curing it...

[Sobe]

well the same can be said about about every complex product
take silicium and cooper and a computer architecture book and try making a CPU who then sells for less than 1 of those 100$ pills ;)

Well sure, but you won't see me telling intel how to price their chips.

[iBlue]

Well, we've been able to find out her infection. H. (Helicobacter) pylori which calls for a 10 day antibiotic like clarithromycin or amoxicillin, along with a proton-pump inhibitor such as omeprazole (Prilosec). We can give her Nexium which we get in Ecuador for half the U.S. price.

We've asked her to call her doctor and ask for a less expensive prescription.
Anything back from the doctors? Metronidazole and Clarithromycin would take care of the infection (and they're safe for penicillin allergies) and I don't believe they are super expensive either. As luck would have it I've known someone who needed treatment for this very thing.

[Aea]

Pharmaceuticals don't cure you or remove the problem, they just mask them. You have a headache you take Aspirin, it does not fix the problem, it just masks the issue. The only thing Pharmaceuticals are know to do is cause more issues. Just make sure she is eating good old fashioned raw vegetables and that should help her immune system fight off infection.

H Pylori is a bacteria that THRIVES in Hydrochloric Acid, it is the only Bacteria that can survive in the human stomach, a large majority of the elderly have it, many for decades, do you really think that veggies will help her immune system beat it? It's just not going to happen, and all the time she'll be suffering from one of the many nasty effects of it. I know PrevPak is used (with extremely high success) to treat it, it costs about $300 for a 2-week supply.

[Sobe]

H Pylori is a bacteria that THRIVES in Hydrochloric Acid, it is the only Bacteria that can survive in the human stomach, a large majority of the elderly have it, many for decades, do you really think that veggies will help her immune system beat it? It's just not going to happen, and all the time she'll be suffering from one of the many nasty effects of it. I know PrevPak is used (with extremely high success) to treat it, it costs about $300 for a 2-week supply.

While you're not wrong about H. pylori, strictly speaking it does not thrive in HCl.

It thrives by secreting protective pH raising fluids that allow it to thrive in low pH environments like the stomach.

Ripped shamelessly from here (http://sciencelinks.jp/j-east/article/200202/000020020201A1043866.php)

H.pylori proliferates in mucin layers of gastric mucosa cell surfaces which are weakly acidic, and where cytolyses are prevailing. When mucin layers are upheaved, move to surface, and change milieu interieur into strong acidic side, H.pyroli uptakes urea, activates urease, and produces ammonia to neutralize its surrounding microenvironments. Then, it initiates again to proliferate after returning to mucosa surface layer by urease-dependent urea chemotaxis.

[xsedrinam]

Okay. She met with the doctor. Said she would not buy what was prescribed. He gave her 14 day PrevPak Samples. No charge.

[solvs]

Well sure, but you won't see me telling intel how to price their chips.

But you don't need Intel chips to live.

[pseudobrit]

It is a massively expensive and risky endeavor.

And that's why our tax dollars pay for so much of R&D.

[Sobe]

But you don't need Intel chips to live.

There's lots of things necessary for life.

I'm not an advocate of instituting price controls on any of them.

[solvs]

There's lots of things necessary for life.

I'm not an advocate of instituting price controls on any of them.
So only the people who can afford it should be able to live so a company can make more money, even if the tax payers helped subsidize it?

[Sobe]

So only the people who can afford it should be able to live so a company can make more money, even if the tax payers helped subsidize it?

That would depend entirely on the degree of public support.

If the NIH wants to develop drug X and hand it out free of charge, sure that's taxpayer money at work.

Generally when a grant is given, the institution controls the rights to the fruits of the research.

The exception to this would be, say, if you were a contractor for the Department of Defense and they gave you money. That would be different and the rights would stay with the DoD.

The very premise of your question obfuscates the issue though.

Would it be nice if people just gave things out cheaply or for free?

Yes, however, it is also nice to have people who want to sink their money into risky investments to try to make therapies that will cure people. You start restricting what people can charge for their breakthroughs and a lot of people simply will not bother.

Fairness is all fine and good, but fairness isn't going to cure cancer or AIDS.

Ultimately, though, it is a false choice you are suggesting.

The choice isn't between Grandma getting a drug for $350 for 3 pills or Grandma getting them more cheaply.

The alternative is not getting them at all because they wouldn't exist.

[solvs]

I doubt drug companies would just stop making drugs if the gov were to start negotiating for lower prices.

The issue is when the drug companies make obscene profits while asking for gov handouts and paying lobbyists to make sure this system stays as is. It would be nice to at least start with negotiating for lower prices via Medicare/Medicaid. There should at least be some gov regulation, or else they will continue being able to charge whatever they want, especially if they're the only supplier in some cases.

And yes, some people are getting sick, even dying, because they don't have access to and/or can't afford the medication they need, which is the point I was trying to make that for some reason some people don't have a problem with.

[Sobe]

I doubt drug companies would just stop making drugs if the gov were to start negotiating for lower prices.

The issue is when the drug companies make obscene profits while asking for gov handouts and paying lobbyists to make sure this system stays as is. It would be nice to at least start with negotiating for lower prices via Medicare/Medicaid. There should at least be some gov regulation, or else they will continue being able to charge whatever they want, especially if they're the only supplier in some cases.

And yes, some people are getting sick, even dying, because they don't have access to and/or can't afford the medication they need, which is the point I was trying to make that for some reason some people don't have a problem with.

Who shall define that your need for the fruits of my labor exceeds the need for me to be compensated for those efforts accordingly to how I value them?

Shall we base it on need?

Shall you be arbiter? How about your neighbor?

And do you really need that computer? Surely, the money you spent on it could be better spent putting food in the mouths of the hungry. Do you really need to paid as much as you are for your job?

Surely there are others as deserving or more.

Tis a very slippery slope once you start attempting to divine who needs what and how much someone is entitled to based on need.

[xsedrinam]

Who shall define that your need for the fruits of my labor exceeds the need for me to be compensated for those efforts accordingly to how I value them?

Shall we base it on need?

Shall you be arbiter? How about your neighbor?

And do you really need that computer? Surely, the money you spent on it could be better spent putting food in the mouths of the hungry. Do you really need to paid as much as you are for your job?

Surely there are others as deserving or more.

Tis a very slippery slope once you start attempting to divine who needs what and how much someone is entitled to based on need.
You're tipping your hand as these aren't even the right questions, and serve to demonstrate the boxed in paradigm which is that of the pharmaceutical industry and their lobbyist regime. Do you seriously think the poor and marginalized of the U.S. have any influence in what's presently charged, regulated and controlled by the pharmaceutical machine in the U.S?

[Sobe]

You're tipping your hand as these aren't even the right questions, and serve to demonstrate the boxed in paradigm which is that of the pharmaceutical industry and their lobbyist regime. Do you seriously think the poor and marginalized of the U.S. have any influence in what's presently charged, regulated and controlled by the pharmaceutical machine in the U.S?

Indeed?

What are the right questions then?

[xsedrinam]

Indeed?

What are the right questions then?

Just some random starters….

How can philosophical ethics contribute to the moral development of health professionals and the making available of medical care?

What are physicians who are in favor of a national health care program saying?

Why are other countries’ drug prices lower than ours? Is there merit to the monopsy buying power of a consolidated health care program?

How can our fragmented health care system, which contributes to uncoordinated care, waste, and inefficiency, become more consolidated?

Shouldn’t competition among medical care providers be about competing for patients, not about how much they can charge and get by with it?

How can medical care providers make quality medical attention available to everyone, regardless of their financial status?

Consider an example of the nation’s health insurance program for the poor, versus the National Naval Medical Center in Bethesda, MD, that serves members of Congress. Access to care for the poor is deteriorating because Medicaid is a grossly underfunded health care program. Because it doesn’t serve the wealthy, the payment rates are low and many physicians refuse to see Medicaid patients. Calls to improve Medicaid fall on deaf ears because the beneficiaries are not considered to be politically important. On the other hand, members of Congress have completely free access to care at National Naval, where the quality of care couldn’t be better. Of the nearly 45 million Americans without health insurance, nearly one-quarter or more than 10 million are children.

[Sobe]

Just some random starters….

How can philosophical ethics contribute to the moral development of health professionals and the making available of medical care?

What are physicians who are in favor of a national health care program saying?

Why are other countries’ drug prices lower than ours? Is there merit to the monopsy buying power of a consolidated health care program?

How can our fragmented health care system, which contributes to uncoordinated care, waste, and inefficiency, become more consolidated?

Shouldn’t competition among medical care providers be about competing for patients, not about how much they can charge and get by with it?

How can medical care providers make quality medical attention available to everyone, regardless of their financial status?

Consider an example of the nation’s health insurance program for the poor, versus the National Naval Medical Center in Bethesda, MD, that serves members of Congress. Access to care for the poor is deteriorating because Medicaid is a grossly underfunded health care program. Because it doesn’t serve the wealthy, the payment rates are low and many physicians refuse to see Medicaid patients. Calls to improve Medicaid fall on deaf ears because the beneficiaries are not considered to be politically important. On the other hand, members of Congress have completely free access to care at National Naval, where the quality of care couldn’t be better. Of the nearly 45 million Americans without health insurance, nearly one-quarter or more than 10 million are children.

That's fine and those are interesting questions to debate, but those questions don't address why person X should be able to tell person Y what to charge for the fruits of his labor.

I would suggest that the answer is always going to be "need."

[solvs]

Tis a very slippery slope once you start attempting to divine who needs what and how much someone is entitled to based on need.

We already do that, ie keeping monopolies in check. It's a slippery slope to suggest companies should be able do as they wish, especially those in such industries. All I'm advocating is some gov oversight to make sure we aren't getting screwed, which we are right now, because regulation is lax. It's not about want, in this case it's need.

I don't know, it just bothers me when people get sick and die because they can't afford the care while the healthcare industry makes money hand over fist.

[pseudobrit]

Who shall define that your need for the fruits of my labor exceeds the need for me to be compensated for those efforts accordingly to how I value them?
...
Tis a very slippery slope once you start attempting to divine who needs what and how much someone is entitled to based on need.

Is it so? I thought it was a pretty simple formula: will the person come to harm without it?

Perhaps the Hippocratic oath should be amended thus: first, do something.

Or we could just use the corporal works of mercy:
Feed the hungry
Give drink to the thirsty
Clothe the naked
Shelter the homeless
Visit the imprisoned
Visit the sick
Bury the dead

[xsedrinam]

That's fine and those are interesting questions to debate, but those questions don't address why person X should be able to tell person Y what to charge for the fruits of his labor.

I would suggest that the answer is always going to be "need."

Granted, but one must throw in the possibility of greed and who is left in charge of determining "need" and "needy". It's at that point the triage gets pretty subjective. And with the present 1,500 plus health care agencies in the U.S. vying for their competitive self preservation and keeping themselves and their offspring in the life to which they've become accustomed, I wonder if the consideration of "need" hasn't been relegated to rhetorical levels of ineffective and fragmented health care.

[Sobe]

Is it so? I thought it was a pretty simple formula: will the person come to harm without it?

Perhaps the Hippocratic oath should be amended thus: first, do something.

Or we could just use the corporal works of mercy:
Feed the hungry
Give drink to the thirsty
Clothe the naked
Shelter the homeless
Visit the imprisoned
Visit the sick
Bury the dead

So basically a mandatory good samaritan law?

Granted, but one must throw in the possibility of greed and who is left in charge of determining "need" and "needy". It's at that point the triage gets pretty subjective. And with the present 1,500 plus health care agencies in the U.S. vying for their competitive self preservation and keeping themselves and their offspring in the life to which they've become accustomed, I wonder if the consideration of "need" hasn't been relegated to rhetorical levels of ineffective and fragmented health care.

I don't doubt that many are greedy and many have legitimate needs. What concerns me is the method by which we determine, acquire, and require.

[solvs]

So basically a mandatory good samaritan law?
Isn't that what gov is for, to do what the people themselves cannot for themselves?

I don't doubt that many are greedy and many have legitimate needs. What concerns me is the method by which we determine, acquire, and require.
Again this is what gov is supposed to do, determine the who, why, and how.

[pseudobrit]

So basically a mandatory good samaritan law?

The cornerstone of civilization.

[solvs]

The cornerstone of civilization.

Not our civilization apparently.