Why Do Prescription Drugs Cost SO Much?
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- Опубликовано: 13 сен 2024
- In 2020 the expected global expenditure on prescription drugs was somewhere around 1.3 TRILLION dollars, with around $350 BILLION of that spending being done in the United States. The US seems to have a particular issue in this area, with citizens paying much more than their counterparts in similar countries. But why do prescription drugs cost so much? And why do some cost so much more than others?
Special thanks to the NIHCM for supporting this special series on the costs of prescription drugs.
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One reform I'd like to see is a return to 7-year patents with no extensions.
Because I am a realist and understand that medicines/medical products take longer to bring to market due to approval processes, I would accept completely pausing the patent calendar from the day they file for approval to the day approval is granted. Takes four years to go through approval trials? Those four years don't count.That way _safety_ doesn't get in the way of profits, so they're less likely to shortcut safety.
"They're less likely to shortcut safety" *if they're acting in good faith and in society's interest*. I do not trust that they do the former, and their legal obligations to their shareholders take priority over an ideal.
I doubt the Sacklers were acting in good faith when they actively hid information about the addiction risks for oxycontin.
I doubt that Danaher was acting in the interest of society all the time they were selling TB diagnostic cartridges at an exorbitant markup. TB shouldn't still be killing people but it is.
Money is a token used to facilitate the movement of goods and services through an economy. I'd like it if I didn't live in a world where people so casually accept using that tool to put price tags on human lives for the benefit of some random shareholders
I'm going to guess it rhymes with "for profit healthcare and price gouging for inelastic demand goods."
Legally protected monopolies (patents) and customers that don’t have the luxury to say “I don’t need that right now”. Crony capitalism. Decrease company protections on their products. Don’t even let them give a medication a “brand name”. Only allow one name for a medication and the company name beside it. The company that develops the medication will obviously be the first to market, so they don’t need a patent protection any more than a year (they aren’t underdogs,and will still make plenty profits regardless).
I couldn't believe it when I moved overseas and saw the bill for my three medications (for blood pressure, diuretic & cholesterol) cost me about $12 for a three month supply.
Canada?
@@johnransom1146I hope they answer if only because it could be a lot of places. A Fluticasone inhaler costs over 400 USD if I try to get it at my pharmacy using the GoodRx discount. So I went through a Canadian pharmacy because ordering 3 of that same inhaler from their distributor in New Zealand was about 220 USD (including shipping cost). It was literally cheaper for me to have three inhalers shipped from Middle Earth than to walk two blocks from my door to buy one from the pharmacy.
@@johnransom1146 hahaha. yes, the lesser known Canada thats *overseas* in Europe.
@@johnransom1146 Southeast Asia.
I am essentially down to three medications as well: one psychiatric one, one as a preventative medicine (lifestyle related), and the last one for overall wellness.
I have had the luxury of not paying out-of-pocket for any of the above meds. At the same time, the reality that the system here is exploitative by design is not lost on me.
Liberty is out there, if we choose to reclaim it. The work is tough, but, we're tougher, if and when we are united. 🎺◾️▫️
R&D is publicly funded with grants, and tax deductible. We subsidize them twice.
We can't talk about policy reform without talking about the incentive structure that led us here. How can we achieve policy reform when there is so much money behind the status quo? Any attempt at policy reform is going to be squashed by the billions of lobbying dollars going to politicians who favor the status quo and to targeted advertising to sway people into voting against their own interests. I don't see policy reform happening any time soon, especially with respect to secondary patent abuse. If anything, the USPTO will just get less funding.
Exactly - like so many other issues, it comes down to money in politics corrupting our lawmakers' incentives.
If you bankroll someone's election campaign, they're almost always going to act in your favor when it comes to policy.
That's the reason this problem was allowed to get so bad in the first place. Until we fix that, no solution is going to stick.
@@BrianMartensOfficial we change policy the same way us plebs always have. Organize as a glass to force the system to put our right to life over our economic overlords endless lust for profit.
Wow….this is TRUTH if I’ve ever seen it. Experienced it. Been there. Done that. The only change we can hope to make starts with ourselves. Keep up the Courage! Don’t let the Man beat you down! Woman, slaves, minorities, they have all been in this position metaphorically for millennia! You will not survive or thrive unless you keep your head up and make change with every dollar you spend, every person you choose to walk alongside and care for, every moment you breath, BE the change you wish to see in the world. If all of US (the people) did that?? Imagine ……The Change….❤❤❤
@@MamaMija333 You can't individual action your way out of systemic problems.
@@Praisethesunson You can collective action your way out of them though - join advocacy organizations and fight alongside them!
I was in Sweden for a month recently and it's like a paradise... they say they have problems too sure but I never once felt threatened or unsure of someone in public. Their healthcare is awesome. They also focus heavily on exercise and healthy meals.
To paraphrase Goodfellas~ "Because FU, pay me!"
Corporations are the Mafia with permission from the state to do their stealing.
Part of the reason drugs are cheaper in other countries is the immense bargaining power big drug purchasers have when tied to state healthcare systems. In the UK there is pretty much one buyer for prescription medicines and they will negotiate hard with drug companies, and are quite prepared to reject a drug if it's considered poor value for money, which can be controversial (though there are exceptions for orphan drugs). But that's the trade-off for cheaper medicines, you might not always get the latest and greatest if it's only a marginal improvement on existing treatments.
That's a really interesting insight! Doesn't sound like a terrible system tbh. Do you know how long these contracts tend to last?
Honestly, I'd take that over what we have. One fluticasone inhaler here with the GoodRx discount is over $400. I can order three from New Zealand for $220. It's literally cheaper to get the things shipped from Middle Earth.
We didn’t even mention PBMs…. That’s a huge relatively new cost, and a large reason prices are increasing
@@connorkendrick9317 they are just another made up middleman. Nonsense to force complexity into the system as a paper thin pretense to justify jacking up prices.
"Top answers on the board. Name the reason prescription drugs cost so much."
BRRR
"Uh, Greed."
DING
"Greed 100"
@@sshuggi but billionaires pay millionaires to tell me that America has the best healthcare in the world. As an American I wouldn't know, since I can't afford to access any of it.
Shocked Canadian here. Insulin was invented here and was given to the world free from patents. Banting and Best, the creators, wanted as many people to get it as possible so shared the way to make it free of charge. How does it cost so much in the USA if it’s not patented? Greed and corruption are the only answer.
How does this channel not have wayy more views ?
becaue of greed
strange how the companies with the biggest government protections are coincidentally always the greediest 🤔.
@@sofia.eris.bauhaus 100% that's its so important to ban lobbyists and stop their influence on government
A wise man once said, "Expecting morality out of corporation is like expecting a racoon to not steal your pizza. It's not the racoon's fault, it's your fault for letting them do it." Abolish all lobbying.
When other countries do it, we call it corruption. But when it's done here in the US, it's called "lobbying" and politicians act all indignant when you suggest otherwise. We have the best government money can buy.
No. Patents should not be allowed to grant exclusivity. Instead they should allow for a mandatory fee on profit on goods sold / related services offered, capped up to a maximum percentage. This enables innovation and also grants value to the inventor.
Like a 'compulsory licensing' thing where anyone can manufacture but they have to give the patent holder a fixed cut?
That's a cool idea!
@@ArgzeroYT but how is that supposed to extract ever greater short term profits from people with no other choice? Won't somebody PLEASE Think of the shareholders?!?!?!
And for pharmaceutical companies, and anyone else, governmental fines need to be 1.N (with N scaling to the severity of the violation and the previous frequency of violations from said offender) times the amount of money that they would have made committing the violation. When the FTC fines AT&T for illegally selling our personal information against the law and their own policy, and the fine is 0.1% of their yearly profit, it's just a cost of doing business.
And there a long history of all sorts of white collar crime like this, so estimating the financial benefits of those violations should be pretty easy...
I feel the problem with patents is they start when a compound is identified instead of when approved by FDA for marketing. If patent term begins at marketing at a shorter term could be used to allow companies to recoup their expenses. Additional patents should be eliminated.
Also manufactures should be required to sell the drugs at the same price they charge in foreign countries. Further more do away with advertising like they have done in other countries ie Australia, and do away with lobbying.
I'm wondering if a good solution would be to reduce the term of patents, but also have it vary by investment. A drug that costs more to develop gets a longer period of exclusivity. I'd also propose that federal dollars can still apply to this to not brunt the government's ability to direct research, but maybe government dollars increase the patent length by a third per dollar, or something similar.
Or alternatively we could remove most of the exclusivity period completely, and change to a royalty system.
Lack of competition.
Dont they also just spend the most of their money on extending their patents instead of actually coming up with new drugs, i.e. coming with new ways to administer the drugs.
I haven't seen a Cross Punisher in years; great avatar, Trigun rocks! Yeah, the pharma companies do that all the time with stuff like "oh now it's timed release, oh now it's a prodrug that metabolizes into what you want" etc. They've carved out so many loopholes and extensions it's ridiculous. Health care should not be like this, people should get what they need without getting shaken down.
Don't forget all the money spent on marketing to both patients and doctors.
They don't have to be! Because the USA isn't as free as you think it is!! Congress is actively working to keep this system because they're profiting off of it!
Have you ever discussed the prices of orphan drugs? My meds are $50k/month (thank goodness for government assistance for rare diseases)
Stop giving tax dollars to companies who raise prices faster than inflation.
Greed.
When will we cure blindness caused by retinal vein occlusion?
Because congress gets government healthcare and is lobbied to keep the healthcare system as profitable as inhumanely as possible.
Then there's pharma-bro…
The more I learn about USA, the more insane it gets…
It gets even worse if you live here
It's corporate greed. Saved ya 7 minutes
Greed and corruption. Doesn't EVERYBODY know that?
corporate greed doing capitalism things.
While I don’t believe capitalism is the solution, I also believe healthy competition is an important factor in this conversation. YES, ever greening of insulin products makes it unaffordable, but ALSO there is no competing cheap alternative. Insulin should be a non-issue, cheap versions exist and can be immediately widely available. Why aren’t they though? No competition allowed. That’s what needs to be solved first. We have a monopoly situation in effect, where humble products-not the super great stuff, just the basic stuff-are not being allowed on the market so that people HAVE to pay for the expensive stuff. Like if the power company shut off everybody’s power until they agreed to hike their rates by 1000%. Wouldn’t be tolerated, shouldn’t be tolerated. If cheap alternatives exist, they should be given consideration. If people can’t make drugs expensive because the market wouldn’t tolerate it, they shouldn’t be gaming the market like a bunch of communist drug czars.
Research and development of drugs should be completely separate from the manufacture of the drug itself. Scientists and universities can do all the work to solve all the most compelling problems and then sell the rights to make it to drug companies.
hmm.. all those cost reason are BS, since they sell WAY cheaper in other countries. They have the same cost, minus manufacturing locally.
The simple and biggest reason is GREED. because they can!
@@moestietabarnak the shareholders second yacht isn't going to pay for itself. your grandma's fixed income is supposed to pay for it.
About half of all drugs that increased prices increased above inflation is an odd thing to say. This means the median increase is at the rate of inflation. It also seems like if you take into account the drugs that decreased in price the median should dip below inflation. It was just an odd statistic to use and an odd way to phrase it.
While I agree the political dimension is vital to reform, I don't think transparency is the issue. The Sunshine Act requires extremely detailed disclosures of anything of value that goes to government or related entities. And by the way, as a result of the extraordinary bookkeeping costs of that bill, small research-stage pharmaceutical companies have cut whole research divisions, mainly in infectious disease.
The US should not have to continue to subsidize the rest of the world's drugs. It is not fair for Canada (or any other country) to be able to negotiate lower prices for drugs than Medicare can just because the companies have better lobbyists here in the US than they do in other countries. Finally allowing Medicare to negotiate prices is a good first step Maybe another part of the reform could be to allow US consumers and pharmacies to purchase/import and/or re-import medicines that are approved for sale in the US.
@@connecticutaggie America only subsidizes certain client states. America has NEVER subsidized the world's drugs. American paywalls access to drugs and sanctions nations that dare to produce life saving medicine without generating profit for wealthy westerners.
I mean. It's pretty cheap at the point of access. Laughs in non American
Greed. 7 minutes 19 seconds wasted.
@@Martial-Mat sponsors are way harder get if you dare challenge the financial interests of our corporate overlords.
@@Praisethesunson Exactly. That's why I respect channels that are self sufficient or depend purely upon patrons/members.
If you didn't want to pay high prices, stay healthy.
If i start a company and create a drug using my knowledge and my money, i can charge whatever i want. It may save your life, but it's not my responsibility to provide to you. If we want cheap drugs, have the government create them and sell them at cost.
"stay healthy"
tell that to people with type I diabetes, cancer, disabilities, or who develop illness as a result of old age. this "fuck you, got mine" libertarian mentality is part of why we're in this mess to begin with. it's incredibly destructive and antithetical to a healthy society, and just because you "own" a business shouldn't give you the right to make filthy profits off of an inflexible market.
You are going to be such a delight when you get an unexpected cancer diagnosis in your late 50's.
You don't have capital so your hypothetical is totally irrelevant to reality.
The government DOES pay to create them with grant and R&d deduction.
We already do pay for most of them.