Trump Calls for Lower Prescription Drug Prices

Discussion in 'Politics, Religion, Social Issues' started by dannyyankou, Oct 25, 2018.

  1. dannyyankou macrumors G3

    dannyyankou

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    #1
  2. NT1440 macrumors G5

    NT1440

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    In before the lobbyists drown the notion in a bathtub of campaign contributions....
     
  3. RootBeerMan macrumors 65816

    RootBeerMan

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    Just another BS vote grabbing scam from the idiot in chief. His "plan", (whatever that is) only applies to Medicare. It will have no effect on the rest of us, and may just drive up prices for us as the drug companies will have to make up the difference somewhere. Just more meddling in the markets by a buffoon. Drug prices are already warped by government, this will not improve things.

    https://www.cnbc.com/2018/10/25/tru...te-lower-drug-costs-to-end-rigged-system.html
     
  4. NT1440 macrumors G5

    NT1440

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    Medicare legally can't negotiate drug prices.

    Think about that, the single largest drug purchaser on the planet is legally forbidden from using it's market leverage to get a better price. Why is the largest purchaser barred from participating in such a market?

    Drug companies spend more on advertising than they do on development (most of the work is done by our tax payer funded universities before a treatment is handed over to be commercialized).

    If you truly believe in free markets (I don't, personally) why exclude the biggest player from being able to participate? Sounds awfully anti-free market to me....
     
  5. Rhonindk macrumors 68040

    Rhonindk

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    Been a while since I visited this thread, well anyone has. In an update I ran into this article in Time that tried to do a job of explaining some of the complexity surrounding drug prices.
    http://time.com/5564547/drug-prices-medicine/

    *snip*
    But as it exists today, the system isn’t designed to prioritize savings for patients. A big reason for this is that PBMs are not incentivized to negotiate for lower list prices as much as they are for higher rebates, since the share of those refunds they keep is a part of how they make their money. Manufacturers, competing to secure high formulary tiers, know PBMs want juicy rebates. And so they have two options: offer a larger discount and make less money on the drug, or offer a larger discount while also raising the list price of the drug, therefore keeping the net price level. If you’re a manufacturer, you’re going to pick the latter option. Little of this is evident to the average consumer.

    That does help explain why Pharma has been talking about rebates more so than actual price.

    Either way, this is looking less and less like an easy fix even with bi-partisan support.
     
  6. VulchR macrumors 68020

    VulchR

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    No. Drugs prices are high because companies are charging what the market can bear, and that price is high becuase there is no nationalized health system bring to bear the bargaining power of an entire nation. Profiteering, not government regulation, leads to high drug prices.

    But you're right, no half-a$$ed solution will save the US health system. Trying to restrain corporations from fleecing the sick simply isn't possible in a private system.
     
  7. Rhonindk macrumors 68040

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    Yes and No. Profiteering for whom?
    Keep in mind I am going by what I was reading in Time. It appears to be far more complex, and secretive that a simple "what the market will bear".
     
  8. stylinexpat macrumors 65816

    stylinexpat

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    I would be curious as to whom the lower price drugs applies to in the end. Lower prices would be a welcome to those in need of prescription medication. In the US medication can be 3 to 15 more compared to other countries. Cost is the same for manufacturers so there is no reason to gouge end users in need of medicine.
     
  9. jkcerda macrumors 6502a

    jkcerda

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  10. stylinexpat macrumors 65816

    stylinexpat

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    For that part only but he made the people pay a lot more then Obama ever did. Who has been paying for all the higher tariffs at the borders for all the goods coming in from China? Who has been paying higher taxes? Who has been paying higher fuel taxes? The list goes on..;)
     
  11. A.Goldberg macrumors 68020

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    Easier said than done. I guess short of a complete take over of the Pharma industry, which is very unlikely under either party, the real question is how. I’d reccomend the easiest way (and by that it’s still an uphill battle) would be at least limit direct to consumer marketing.

    When you factor in manufacturer rebates it’s difficult to know how much insurers are actually paying.

    The blame gets put on the pharmaceutical companies, to an extent they are responsible. At the same time, no one talks about the PBM’s (pharmacy benefit managers- ExpressScripts, CareMark, Optum, etc) who are the middlemen between you prescriptions and your health insurance. These companies make billions while allegedly saving insurers money, but said savings don’t always seem to be passed onto consumers.
     
  12. Rhonindk macrumors 68040

    Rhonindk

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    Is it the Pharma companies, the PBM's, the insurance companies, the ... This right now is as clear as a Haboob.
     
  13. A.Goldberg, Apr 13, 2019
    Last edited: Apr 13, 2019

    A.Goldberg macrumors 68020

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    It’s also your friendly neighborhood CVS, Walgreens, Rite-Aid, etc. They charge insane prices for patients without insurance or whose insurance does not cover the medication. Some independent pharmacies do this as well, but are less likely to do so or will make adjustments for hardships. Unfortunately giant chain pharmacists don’t have access to wholesale pricing, only what the computer spits out which is either their “minimum charge” (explained below) or the “AWP” (aquired wholesale cost)- which is a misnomer. It’s more like an MSRP or list price, a fictitious price set by the manufacturer. In fact, many CVS, WAG, RiteAid, etc pharmacists are indoctrinated while in school and have no conception of actual drug prices because of this.

    For example, a person on Medicare walks into a chain pharmacy. They’re having an MRI and have a prescription for qty 1 alprazolam (Xanax) for anxiety associated with the MRI. The cost to the pharmacy for the drug is $0.02 per tablet. Medicare doesn’t cover the Benzodiazepine class of medications. Therefore the patient is charged their minimum Rx charge of $14 or whatever it is these days.

    When I was early in pharmacy school I had a horrible summer internship with one of these large chain pharmacies in Connecticut. CT has a lot of migrant farm workers from Mexico. These guys would come in with a script for an $4 antibiotic and be charged $60 or a $15 inhaler and be charged $80. These people often could not afford the cost and would forgo it. These people already make little money, send as much as possible back to their families, and are often sadly exploited by their employers. I wanted no part in this blantant price gouging when it came to underprivileged peoples health who depended on their health for their livelihood in ways most people don’t have to.

    I should also mention CVS (Largest and most profitable pharmacy chain) and Caremark (2nd largest PBM in the US) are the same company. There couldn’t possibly be any problems with that setup... :rolleyes:

    Also keep in mind vertically integrated PBMs/Pharmacies ie CVS/CareMark can set whatever reimbursement rates they want for their competition. That’s the primary reason mom and pop pharmacies are few and far between.
     
  14. Rhonindk macrumors 68040

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    Damn!! The deeper I am starting to look into this the more whacked out it is getting. :confused:o_O
     
  15. VulchR macrumors 68020

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    I think the main complexity is that is costly to get drugs to market. A drug that fails in the final stages of clinical trials can bankrupt a company. However, in spite of these risks, drug companies have been very profitable on the whole and there have been examples of drugs increasing enormously in price when a company is taken over by new owners. I am not suggesting that the government nationalizes drug companies, but simply that a socialized health care system allows a nation considered as a whole to have the best leverage for negotiating drug prices. Honestly, I wonder whether drug companies can only make modest profits from countries with socialized medicine, like Canada and most of Europe, so they stick it to people in the US because that's they only place where they can go for maximum profit.
     
  16. BoxerGT2.5 macrumors 68000

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    If both sides can't work together on this one to make it happen then I submit we are all truly ****ed.
     
  17. jkcerda macrumors 6502a

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    they work together to keep the drug prices high, BOTH sides are in the pockets of big pharma :(
     
  18. Rhonindk macrumors 68040

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    I do agree on some of these, Cost to bring to market & Takeover finances, however the more I dig into the sale aspect; PBM, pharmacy, chain stores, etc ... the crazier this process is looking. @A.Goldberg has shared some great info.
    This is not going to be any kind of an easy fix.

    Step one IMO; get rid of rebates.
     
  19. BoxerGT2.5 macrumors 68000

    BoxerGT2.5

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    Here's what I would do, I'd get a staffer, maybe the Deputy COS (if he has one), compile a list of all the members of congress who have taken money from Pharma starting with the largest sum and work down. Contact every one of their offices and arrange for the COS from the top 10 to come to the White House. Have an informal sit down with them all at the same time, explain to them that if the WH hears their boss come out against this proposal publicly or does anything to torpedo the effort that list will get plastered all over the news and they can explain away why it's bad while defending being in Pharma's pocket.
     
  20. Rhonindk macrumors 68040

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    Why not all Congress Critters who involved themselves with lobbyists from anywhere in the Rx supply chain?
    I am rapidly learning that focusing on "Pharma" is a lose situation as you miss a significant, maybe the biggest piece, of this spaghetti bowl (or ramen). They are not innocent, however if you exclude the big "What the market will bear gouger's", you still have most of the Rx supply chain left to deal with. Those IMO are a bigger impact.
     
  21. VulchR macrumors 68020

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    On that we definitely agree. The US system is out of control and it seems to me to be a market failure.

    Maybe for not much longer. It seems to me that enough people on both sides have experienced what happens when a loved one suffers a major illness. Once that happens, the propaganda BS from the health care lobbies becomes something that nobody can swallow. I think the voters might just give legislators who get in the way of reform (whatever it turns out to be) a good swift kick out the door. Socialized medicine is one answer, but maybe there are others that would be as good or better. Hopefully a nation of 300 million reasonably educated an resourceful people can figure it out. I think it is going to take a national effort the likes of the New Deal or WWII. The starting point has to be the acknowledgment that the current system is simply unsustainable for most Americans as the population ages. In my family two generations (father, grandfather) were bankrupted by it in spite of being upper-middle-class, and it's even worse now.
     
  22. Chew Toy McCoy macrumors regular

    Chew Toy McCoy

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    I’ve thought for a long time that whenever a politician is defending something on TV there should be a graphic showing any donors that are related to what they are promoting.
     
  23. MacAndMic macrumors 6502

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    Be careful of what you wish for. If there was gov’t intervention to lower prices, where does that money get reduced from? Do you think shareholders or top execs are going to give up that money? Heck no. The money will be taken from R&D, production, facilities and the middle class employees. The next thing you know, no new drugs are being discovered and mistakes will be made in manufacturing and distribution. Mistakes similar to food recalls and could cost people their lives.
     
  24. Rhonindk macrumors 68040

    Rhonindk

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    One thing I would add, maybe split out... (see bold text in your quote)
    I am not seeing this at all from the "major illness" aspect. That is the exception and it does have its issues. These tend to be most of the major headlines.
    I'm looking more, and the cost as far higher, for the day to day prescription costs that the average person has to endure. Diabetes, blood pressure, arterial plaque, anxiety, etc ... These are the drugs the more and more via deductible, lack of choice (major vs. generic or alternatives), forced choice, not covered, etc... that are killing the finances and forcing many to choose what to get vs. what they need.
    --- Post Merged, Apr 15, 2019 ---
    I read your post and gave it some thought. and again.
    I think if you said "Corporate Donors" that would likely work. Personal donations? Not so much.
     
  25. Chew Toy McCoy macrumors regular

    Chew Toy McCoy

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    Yeah, I meant corporate donors should be displayed, not individuals. Hell, if the corporate news media isn't going to do it then some genius on YouTube should. Just repost the previous day's news with the pertinent donor info displayed. I'm sure it would be quite popular.
     

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55 October 25, 2018