USA vs Europe: The DEADLY DIFFERENCE of Prescription Drug Pricing | 2023 Comparison
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- Опубликовано: 30 июл 2024
- Do Americans REALLY subsidize the cost of prescription drugs in Europe by paying sky high prices for medications? Why is Big Pharma suing the American Government for enacting European-style drug regulations? How exactly does Europe bargain for their prescription medications? In this video, I dissect the complex factors influencing the prices of prescription drugs, comparing the US and Europe. 🔍
🔸 Key Takeaways:
Overview of the healthcare systems in the US and Europe.
The role of patents and generic drugs in price determination.
How government regulations impact drug prices.
Insights into the pharmaceutical industry's pricing strategies.
💊 Why this Matters: With soaring drug prices affecting millions of patients, it's crucial to understand the core reasons behind these price disparities. Whether you're a concerned patient, a healthcare professional, or just curious, this video offers an eye-opening analysis.
🔗 Related Links:
@Vox The true story of America’s sky-high prescription drug prices
• Why drugs cost more in...
Infographic: Drug Prices Comparison
kffhealthnews.org/news/tag/dr...
Podcast: Interviews with Pharmaceutical Experts
@TheProblemWithJonStewart
www.theproblem.com/episode-9-...
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Episode 121
Jump to Your Favorite Topic 🙌 :
00:00 Intro
02:11 How Europe Negotiates Drug Prices
06:57 How America Negotiates Drug Prices
10:57 Public Utility vs. Private Equity
14:17 Innovation via Venture Capital
18:20 A Thought Experiment 
Развлечения
There's one thing that did not come right out of this video - it almost sounded, like all the pharmaceutical develpoment comes from the US. But in relaity, the drugs are developed all over the world, mostly paid from government grants to scientific research. When in promising stage, large companies typically step in and buy the rights, pay for testing and distribution. And it happens that many of those financially pumped comapnies are from the US, so it may seem like the US is the origin of the drug, which by far is not that common case. So in fact European and many other nations pay for the research in all those cases, not the pharmaceutical companies themselves.
The US is actually pretty bad in inventions in that sector, because they don't spend that much money in it. Now, they are demanding that others, doing the work, have to give them lower prices or getting fined. That's basically 100% gangster, and how many people will support that? Nobody. You are also wrong, that governments in the rest of the world support pharaceutical research. It is just done by themselves, while the government lives opon the collected taxes of these companies. So, less income of those, result in tax increases in Germany and Germans. The prices of drugs in that companies from different states and different owners, vary not only in the production price, but also if they further limit the price for their primary users (e.g. Germans). So it is the opposite. The more state interference you have, the more the prices rise for the domestic producers and so for the users.
Absolutely correct! There are huge EU and national Research and Development programs. And btw the “Pfizer” Covid drug was developed by Biontec in Germany by a Turkish immigrant couple…
Plus that many of the big pharmaceutical companies are European anyway.
@@urlauburlaub2222In 2001 the US government forced Bayer to deliver its anthrax drug Ciprobay for half the price - so much for that! But when it came to release the Aids drugs patents for Africa: "🤣 Of course that's not possible, where are we going to get to!?" 🤔
In the US a company can patent all food subgroups or spinoff. The rest of the world thinks it's a community property instead of a company property.
I was visiting Texas from the UK and needed to see a doctor about a wound that wasn't healing. He prescribed an antibiotic and an antibacterial cream. The cream cost my travel insurers $102. When I got home I discovered I could buy exactly the same cream - same manufacturer, same packaging - in any British pharmacy for just over £9, a tenth of the US price, without seeing a doctor.
To add to this, there can also be situations where a doctor gives you a prescription for medication that is also available without one. In those situations, at least in Finland, it is often cheaper to NOT use the prescription but rather buy the same product without one at a cheaper price.
In Belgium, they can no longer do this. Doctors can only prescribe active ingredients and not even brands.
Then the pharmacy is obligated to propose the cheapest generic to you.
@@sanderd17 Even though doctors prescribe products here, it is very common these days for the person behind the counter at the pharmacy to either suggest a cheaper alternative or tell you if it is cheaper to buy the product without using the prescription at all.
@@ZnakerFIN Aren't some US pharmacists prohibited from telling you about a cheaper option? Not any more it seems.
*No More Secrets: Congress Bans Pharmacist ‘Gag Orders’ On Drug Prices*
But there’s a catch: Under the new legislation, pharmacists will not be *required* to tell patients about the lower cost option. If they don’t, it’s up to the customer to ask.
@@NoSpam1891 I have no clue how stuff in US work. I'm in Finland.
As a German/American living in America rn I can say it is so bad here. My partner has cancer and can’t even afford treatments here. The cost of it should be a crime. We have to fly to another country to get what he needs. The healthcare system here in US is truly disgusting. Thankfully and impatiently I am moving us to Germany next year✨ Love your content ✨
Good luck on your travel kiss your partner today is a good day.
All the best to your husband ❤
Its terrible taxiers from other countries has to pay for that. ♥♥🤍🤍💙💙
Meine Gebete sind bei dir und deinem Partner. Alles Gute❤
@@jensholm5759 As one of those taxpayers from another country...glad to help.
Do cheaper drug prices really mean less money for research? Or rather less exorbitant profits for a few people who are already rich?
It do, but 90-99% of the higher prices goes to marketing and profit, so it would be rather cheap (but possible complex) to compensate.
@@cynic7049 Problem here is that you understand "marketing" as pure promotion, but it's significantly more than that. Often, external researchers will ask for support with a specific topic regarding a drug they'd like to investigate, and if that research aligns with the interests of the company, they may either supply the drug and/or provide funding for the study. That's not done by R&D, but by the local structures in the various countries, which on paper are marketing and sales structures, but which also have a medical affairs function supporting investigator-sponsored trials among many other functions.
Also look hard into some of the drugs mentioned and you will find it was public institutions that did the development, sofosbuvir as an example. This is the key ingredient in Harvoni mentioned as one of the examples.
I was thinking this myself, if the prices werent so high then insurance companies wouldnt have to charge so much.
Logically follows that if insurance companies were able to get better deals they would have financial leeway to invest a % into R&D of new drug development programs.
Besides, it's not as though drug development and research isn't funded by governments across the world in the first place.
The Pfizer vaccine being funded partially by the german gov is a perfect example of this.
Most of the research is not done by the pharmacy-companies that sell the drugs - and those companies are often subsidised for that anyways.
The money they make is not going to research, but to the adverticement department and the shareholders.
Hard to believe, but all three can happen, at the same time! Crazy!
US pharma industry: "Crap, we had to lower prices. We need more diabetus!"
US food industry: "I'm on it, brother!"
You nailed it!!!!!!👏👏👏👏💯💯💯💯
Most drugs on the US market aren't actual cures but are just maintenance drugs to treat people's bad habits and terrible diets.
Lipitor the anti-cholesterol drug only exists because the American consumer does not want to give up their hamburgers and pizza. There are no Vegans on Lipitor.
👍
@@Carewolf Thing is, in every other field, being slightly under the price of your competition means getting ahead on sales and thus making more profit. Just with medication in the US that doesn't seem to be the way of thinking looking from afar.
@@nirfz It's effectively a cartel, even though they sometimes manage t fly just below the legal line, or avoid consequences by other means.
Thank you Ashton. One thing that I'm missing is the fact that a majority of the medical research is not done by big pharma. Big pharma is just good at monitoring research being done around the world and buying this knowledge at the right time. The only thing they really do with it is marketing. US companies have always been good at doing just that.
Quite most drug discovery work and all target identification work is done in universities and is funded by the taxpayer. What drug companies do is deal with clinical trials and formulation
@@davidwright7193 and often in those EU countries with those EU pricing regulations.
@@davidwright7193 And when a drug patent runs out, looking for slight variations on the drug that might allow them a new patent, then try to sell those differences as must-haves to doctors and patients.
@@davidwright7193 Well drug companies also go from a target and a "lead compound" to a working molecule, do the safety and efficacy tests. This is expensive and important work. And very risky.
Very true, hence the incentive argument she said doesn't hold much water, yes profit motives is a good incentive but as you said, a lot of this work is being done at a small scale and by universities, in many ways, being funded by taxpayers.
But big corporations are much better at PR and buying these small ones out.
The irony is in what she's said, it could actually be the opposite, if big corporations have less incentive to invest, it would allow the smaller ones to flourish, we could actually end up with more competition, lower prices and more drugs on the market.
Friend of mine needed to cure his Hepatitis C. He flew to India, got the same drug that costs between 54K and 95K in the US, for1,5 K, which included hospital visit etc. He stayed in a nice condo by the beach for three months, and the whole thing incl. flight cost him about 5% of what he would have paid in the US. I needed serious dental repair 9 years ago, all new crowns for my upper jaw. Was quoted 35K here on Maui, and it would take 3 months. Flew to Hungary two days later, stayed in the hotel atop the 'all in house' dental clinic for 5 days, was taken care of in the most professional manner possible, and paid just over 3K. They actually did not charge me for the hotel, because my price tag was over 3 K.
There is a meme about the bull run in Pamplona:
An American that need hip replacement surgery could, for the same amount of money:
1 - go to Spain for a year and learn Spanish by immersion.
2 - get their hip replacement surgery paying full cost.
3 -partake in the bull run and damaging their hip so they need another hip replacement surgery.
And they would still pay less than a single hip replacement surgery would cost in the US.
Health tourism has some serious risks. When the doctors in hungary fuck anything up you're screwed. There's some impressive horror stories especially about dental work or beauty operations in countrys specialized on health tourism. There's no way to do necessary follow up operations, there's no way of legal action in case anything goes wrong, there's no documentation that might be needed later.
It may still be an option for US citizens I guess. Turkey or hungary can't be that much worse.
@@miskatonic6210 But you are speaking of places specialized in health tourism, with plastic surgery and dental rework.
These are dangerous and delicate operations regardless of where you do them.
But you are right, complications can happen in all major surgeries, and the costs of those can easily overshadow the cost of the initial operation. Which is true in the US as well.
@@57thorns I am to have hip replacement surgery in November - we are paying cash to jump the queue caused by Covid 19. It will cost, including private hospital, and ALL after treatment, $Australian 30K. That's about $18K US. The quote I have from the surgeon is $A 20K but does not include physical therapy after the first 3 days. What does hip replacement cost in the USA?
@@SusanMadge-vl9gx in holland i would have to pay nothing just my own risk of 380 euro after which themedicine would be free
It's not as if big pharma doesn't make huge profits in Europe . And it's also not the case that all these profits are used to develop new drugs. Most of it end up in profits for share holders. A lot of innovations happen in universities that sell their patens to big Pharma.
Here in Europe research is mostly done by smaller companies and independant labs, not so much at universities. While some research is done at universities their primary function here in Europe is to train and educate people, not to conduct research.
That's also the reason why in US rankings of the best universities European universities usually fall behind US american colleges: Part of that evaluation is the research done at the univiersities, not only the quality of the education (which is a bit weird to say the least).
big pharma literally IS europe. why are people so dense as to not even try to realize these things?!? lmao
@@HH-hd7nd also because those rankings rank only by research published in english. Obv. a German uni will make many more papers in german...
I work in a pharmacy here in Germany and most medications here are generics because of our lovely (/s) Rabattverträge.
And generic produces do not develop new drugs.
@@justADeni Good joke - scientific papers in German.... - This was 80 years ago.
"United we bargain, divided we beg". A standard capitalist procedure - called "socialism" in the USA?
Anything that benefits society but reduces corporate profits is labeled "socialism" in the U.S. and the project is politically dead.
It's as simple as that.
u mean like those eeeevil unions? xD
Well, beggars are rugged individualists exercising their right to free speech!
The idea that people can’t unite to negotiate in ‘Merica is historical irony of the highest order...
@@K__a__M__I and people calling the police on them and politicians forbidding it within city limits are simply protecting their property investments.
Yes, i know you were joking.
Slight correction - as Atorvastatin in the UK is considered a drug to counter a chronic condition, high cholesterol, and is used more or less, for the rest of your life, it actually costs the user £0 (nothing), and not the normal £9 per prescription charge.
Same for all chronic diseases, insulin, and all other diabetic drugs are free in the uk
I think she was researching the market value of the medication, not the consumer price. here in Germany atorvastatin is usually perscribed for 100 days, which costs in the end roughly 20€, give or take, but if you have public health insurance, which more than 70% of German citizens have, you only pay 5€ copay
@@lauramarschmallow2922 yes, after paying for the insurance, most costs (doctor visits, the prescriptions themselves, etc) are already included for free as some kind of "flatrate". what has to be paid is a very low copay: 10% of drug costs, with a lower cap of 5€ and an upper cap of 10€ per pack (usually for 100 days, around a quarter of a year), thus i pay for ASS (which costs less than 5€ per pack) all by myself, and 5€ for each of the other drugs (eg blood pressure) that cost below 50€ per pack, and in no case will it be more than 10€ per pack even when "market value" is in the hundreds, thousands, or more. for hospital stays, my only copay is 10€ per day (capped to 28 days = 280€ per year) for bed and food, but doctors, nurses, procedures, drugs, and whatever else is needed during the stay is included for free in the "flatrate".
in addition to all these caps, there are caps per year for chronic illnesses, when the costs would add up to more than a small percentage (1% or 2%?) of the income. but i don't know those details since my yearly copays are much lower (yet).
ps: insurance in germany is mandatory for everybody and costs around 15% of the income, either the full amount for selfemployed, or split 50:50 for employer and employee. most people seem to think that if the employer pays half of it, it only costs you 7.5%, but if you would pay the entire 15% and the employer nothing, the employer could raise wages by that amount, and thus your income will be lower than theoretically possible by 15% in any case. the difference is probably only how those costs, taxes, and other things are calculated, who can get how much tax reductions for it, etc.
Most U.K. sub-countries have free prescriptions, only England has semi-nominal prescription charges. Americans are told by the industry and their friendly (!) politicians that the *National Health Service* is evil communism and socialism and ‘liberalism’ are just as _bad._
@@lauramarschmallow2922 And even that 5€ is not fixed depending on contracts the pharmacies have. Many times I got asked If I am fine with another identical generic that would not need me to pay 5€. It's just that the doctor writing the prescription can't know that. Your options here might be limited by allergies.
Because all pills contain padding material (sugar, starch among other things). And this is where generics can vary. That's a restriction of the pressing process of such small amounts some things need. Molds for 20mg would have CRAZY variation percentages. (Also it's kinda handy to have them at a size you can feasibly handle without special tools at home. :P)
The BEST line: "Medications are not iPhones!"
Always great Ashley !!! Thanks for sharing so much informed info. From a US person in DE for a couple decades.
What. people in other countries allow the state to control what drugs can be sold and their prices. this cannot be allowed by free market capitalism. the communism country was the first to do this. Of course, this is an evil policy to control drug companies to submit to the state.
if an idea comes from a communist country. then the idea is evil. including forcing drug companies. to sell the medicine at a cheap price. cannot have a monopoly and sell their products at the highest possible prices or create advertisements to get people to buy their products.
The assumption seems to be also that if you lower prices the amount of people buying the drug stays the same. But if you lower the prices, as mentioned in the video, more people are able to afford the drug, thus spending money on it. So it hard to say if, when lowering the prices, companies would actually make that much less than they are making now.
you got it its like supermarkets sell thousands of items with lower profit to make a bigger profit overall
It doesn't work like this with medication drugs. You wont consume more medication drugs, if they suddenly would become more affordable, because it is a fricking medication drugs, not some fricking vitamins.
Just look at the average consumption of the drugs in European countries. They are a measure how much would be sold in the USA if the prices were normalized.
How does this happen? Because it *can* . Because corporations will do as much wrong, as they are allowed to, and as little good as they are forced to.
And in the US corporations are considered to have the same rights as individuals. But in practice the difference is that unlike individuals, corporations have no conscience, no moral compass and almost infinite resources. Guess who wins every time in any face off...
@@PropagandasaurusRex And then there is the government, that has even more resources. You need to *force* corporations to go good, and government *can* do it if it *wants* to. Works quite well in EU. Of course they'll whine, protest and grumble, but leaving a 500 million wealthy consumer market they will not (point in case - Apple and USB-C). And neither will they leave the US.
@@wolcek Corporations will never do good because that is not their instinct. No CEO ever has received a bonus because of responsible leadership, only for targets and dividends. And it is government's duty to its people to keep the corporations in check.
So far this goes fairly well in the EU (although we have to remain vigilant), but in the US this dynamic is completely lost. In the US government is often the protector of corporations against the people.
@@PropagandasaurusRex Corporations have no instincts, and the notion that a biologist or chemist who signs up with a company - or, god forbid, founds one! - immediately becomes a corrupt devil is rather facile.
@@wolcek "And then there is the government, that has even more resources"
Depends on the government and is not really relevant, because the development of a drug is in all regularity an international process outside the remit of a single individual government.
Lobbying should be illegal everywhere, it's just coruption with fancy name and legal status.
Many charities engage in lobbying for free.
It's not that simple. Goverment officials need the opinion of industrie representatives sometime because they can't be knowledgeable about every topic
@@berndb3141That is completly not true information. There is a reason gov have different branches to control different parts of economy. Activly giving money to politicians so they vote for companies instead of people that choose them is wild concept.
Giving money to politicians is obviously bad. What I said, is still true. Officials can't know the ins and outs of every industrie so they need to talk to them when it affects their decisions
Which is why non corrupt countries have permanent apolitical professional civil services to routinely administer, support and advise the strictly monitored and regulated bribe-less politicians. Only the U.S. puts money far ahead of its people.
I’d like to write pages on my experiences with healthcare and drug costs since coming to live in the USA 14 years ago after retiring in the UK. But I won’t. Thank you Ashton for highlighting the evil, yes evil, that is the American healthcare and pharmaceutical industries. As we didn’t pay Medicare taxes, my wife and I pay $19000 per year for Medicare A, B, D & G and we still get bills that we have to pay in addition. And we worry about needing tier 4 or 5 drugs. Our CPA told us we should go back to the UK as we would be 50% better off financially. We have five grandkids in the USA, so we stay … and get poorer … and worry!
I bet it would still be significantly cheaper if you went to the UK and simply travelled to the US a couple of times per year to visit your grandkids, that's just an excuse you're making.
@@funfactsfactory620 Interesting assumption, that "johnkitchen" only wants to see his grandchildren for a short spell twice a year. We lived near ours and saw them frequently, week in week out, while they were kids. We wouldn't have considered seeing them for a week or two twice a year in any way equivalent!!!!
exactly this nation medical system is Evil at its core , they capitalized health? poor? fu die off, this gov has systematically killed groups of people here before they are doing it again, now its via Economic output , who wants a country full of old people with large bank accounts?
I agree with macs here; At 19k$ a year, you could afford to travel to the US 6 times a year for several weeks and then travel back home to get your prescriptions, catch up with the neighbours and get some traveling done locally as well; Maybe some new stories and souvenirs for the grandkids while you're at it.
Ultimately, at those numbers, you staying in the US just doesn't make financial sense. Nor does it make sense for your health. And unless you want to be in your grandkids' business 24/7 (don't do that), it's still a perfectly fine way to spend time with your family.
Are you sure that the extra money that goes to the pharmaceutical companies is used for research? Not on new condos for salesmen and jets for executives and other things that “benefit” patient 🙃Medical research takes place in every developed country, but not every country generates billionaires from this business.
Das wäre auch meine Frage
💯
Many Americans close to our (Canada) border come here to buy their subscriptions - particularly insulin. I just lost my oldest sister a few months ago. She was an 84 year old woman who had been Type 1 diabetic since she was 24 years old! Insulin not only saved her life, but prolonged it for many years! Thank you Frederick Banting and to my Canadian and provincial (Manitoba) Governments!! But my heart is still broken over losing her - even at 84.
ruclips.net/video/He7X5jGt8lY/видео.htmlsi=oL_0jbL91DfqNe6l
This puts things into perspective for me.
In Sweden, we do have to pay for medication, but only up to a certain amount. I was angry that they raised the amount to about $300 per YEAR. In comparison, I should be happy it's not more.
Insuline however is 100% free here. I know that the government pays for it, but I don't know how much - I just know that it doesn't cost me anything.
I'm always baffled by the fact that some countries do not see it as a matter of course, or right, to live.
Especially the USA who are so pro-life in general that they take away women's right to decide over their own bodies.
I've been a type-1 diabetic for most of my life and I literally moved to Europe because I couldn't get affordable access to the insulin and medical technology I need for a good quality of life in the United States. Insulin cost is just the tip of the iceberg of the "affordability challenges of Diabetes." When you factor in Insulin Pumps and Continuous Glucose Monitors... the cost is insane, it can be thousands of dollars per month.
The insulin patent was sold to the University of Toronto for $1.
Also, healthy food is easier to find. I’m Type 2 and my grocery bills tripled when I had to cut carbs. 😢
@@larryheim917 It's not illegal for private use. I know many people who go to Canada or Mexico to buy insulin and bring it back to the US for their own use.
@@peterjackson4763 I'm aware, not sure why you're telling me something I would already know and is also stated in the video?
@@erica.explores Sorry. I missed the mention in the video
The U.S. is a cesspool of corruption in so many areas. My asthma inhaler would cost about $180 per month here versus $40 sourced from New Zealand from a Canadian drug dealer (even less if they can get it from Turkey). Also the reason I went to Germany in 2004 for cancer surgery to avoid bankruptcy.
When I wrote some similary thing minutes before you did, they call me bot, troll and all negative shit they could, lol. I hope you doing fine.
@@user-xx2dw5fz3o Um, no, you didn't write what JD wrote. Maybe you _wanted_ to write it, but you just didn't. Had you mentioned an inhaler or the word "drugs" in your comment, that would have helped a lot.
@@peter_meyer
Medicine.
@@peter_meyer
The thing I didnt write was about me as a patient, and thats probably why you got hard on me and easy on him. Also I said most people are idiots, which is always truth. Anyway, good luck with life, hope you solve the problems you have. Me went out of system 15 years ago, no taxes only buisiness, if need treatment then private. Doctors usually come to me at home. 50m2 private med clinic upgrading nonstop. So no, its not impossible to diy today. Will and connection is all that is needed, money not so much, only in beginning.
Thank you Germany for helping American medical refugees.
Healthcare in the USA is shockingly poor. I didn’t really understand how bad it is until I left the USA for a more developed nation…
😂
You had a huge number of more developed nations to choose from!
Great video, but I personally consider the assumption that revenues of big pharma are reinvested in research highly optimistic. Maybe I didn't know that shareholders are all researchers.
Well the statement is not exactly false....it just doesn't mention the percenteges of how much is reinvested into research and how much dissappears forever into the pockets of shareholders and CEOs. Even of they only reinvest like 2 % of the revenue into research it's still a reinvestment....
Well the Welcome Trust was set up to fund scientific and medical research so there used to be a proportion that were. They developed the first leukaemia drug, immune suppressants and AZT. But the pharmaceutical business was sold about 25 years ago. They still fund research and are worth about $38 billion. They paid a large part of the cost of the human genome project.
I've been talking about this for years but I get mostly crickets from people, who are actually in need of certain meds. I'm flummoxed as to why hardly anyone seems to care about this. It's almost as if we are conditioned, to not question the outrageous mark ups for certain meds. People go bankrupt over here, over their medical and pharma bills. It's a travesty and national shame.
Because sOciALisM!!!
if an idea comes from a communist country. then the idea is evil. including forcing drug companies. to sell the medicine at a cheap price. cannot have a monopoly and sell their products at the highest possible prices or create advertisements to get people to buy their products.
I think it's already about 8 years ago that I've heard in a radio broadcast that pharmaceutical companies are spending significantly more for advertising than for research. That would render any claim of regulated drug prices hindering progress in pharmaceutical research irrelevant.
Hey Ashton, another interesting video. The drug companies fail to mention how much research funding they get from various governments. There was a great video of US COngresswomen Katie Porter interviewing big pharma executives about how they are spending the money they are making (stock buy backs, marketing, management compensatoin). During my last visits to the US, I was shocked at the number of ads running on TV promoting prescription drugs.
I also find it maddening when drug makers are like "oh look! I'll lower the cost and make it affordable for YOU because I care"!
"wait, didnt you have to lower it because otherwise you'd be fined and it would cost you more money?"
"Shhhh....."
Also drug companies aren't allowed to market their products via ads in many european countries. That will also reduce costs for them, money that can be spent on innovation. And lets not forget the increased use of AI that may well revolutionize their R&D going forward. What savings will that bring, without americans having to pay through the nose ?
In the US, drug companies spend more on advertising than they do on research
@ernestmccutcheon9576 There's a similar video here on RUclips of a hearing where AOC questions a Big Pharma guy.
@@catherinedeschryver1036 If you mean prescription drugs, only US and New Zealand allows ads for these in the world
I get Dupixent too for my Neurodermitis (I don't know how you call that in English). Ii is a real gamechanger. After 40 years hearing from Doctors that I "have to learn to live with it". This is an unbearable illness, itching 24/7. You scratch yourself until you bleed because then finally you hurt and then the itching stops. Now that I take Dupixent I am free again. My skin is beautiful again.
More unbearable than having this illness and not having a cure however would be to know there is a cure and not be able to afford it.
Thank you German health system!
You forgot to mention that it is forbidden for the private insurances in the US to create their common negotiation organization. They're not allowed to work together in this would result in antitrust proceedings...
Sweden has a "high cost protection"-system for drugs. This means that after you have spent a set amount on drugs in a year (currently around €220), the government will cover any subsequent costs. The caveat is that it only covers the cheapest drug variant (unless the prescription expressly forbids substitution). You can still choose to buy another variant, but will have to cover the excess cost yourself. So while the government do negotiate drug prices as described in the video, the system also somewhat increases the incentive to make the cheapest drug.
The generic drug is as safe and effective as the brand name variant. You’re really paying more for the brand label! Saving money on prescription drugs means realising the Big Pharma marketing for the brand name drug never mentions more affordable alternatives. As s patient, you have to educate yourself and be proactive in keeping your health care expenses under control.
You said "So while the government do negotiate drug prices as described in the video, the system also somewhat increases the incentive to make the cheapest drug." and make it sound like a bad thing. It isn't. A simple list : en.wikipedia.org/wiki/List_of_ibuprofen_brand_names
And they all are identical. The same goes for alternative drugs.
@@houghi3826 Not at all. It's great because there's double pressure to keep the price down. I'm certainly not saying that the alternatives are worse. I just mentioned that you can choose not to buy that one if you want, i.e. there is some freedom of choice in the system.
@@houghi3826generic drugs share the active ingredient, of course, but filler ingredients can be different, and yes, there can be different outcomes, e.g. when a patient is allergic to certain filler ingredients.
In The Netherlands it is practically the same, only the amount is €385 a year, but for all healthcare, not only medications.
I feel lucky to live in Europe 😅
Collective bargaining is not allowed in the US due to successful lobbying of their health care industry. Translated to Germany this woukd mean that different sickness funds like AOK, DAk, TKK ... woukd not be allowed to negotiate collectively due to anti-trust laws. Even worse, a sickness fund could also not negotiate over state boundaries. That means that AOK Hamburg had to negotiate separately from AOK Berlin ...
Divide and conquer this is called.
The part I don't get is the poor negotiation power of big US healthcare providers. Australia has a population of 20 million which I assume some US providers have more patients but they don't get as good a deal.
U.S. doesn’t have health care providers, it has sharks out to rake in as much money as possible from dumb stupid ignorant voters who perpetuate being ripped off by electing and re-electing bribe takers who enthusiastically legalise bribe taking. Land of the free and home of the brave?
@@v.sandrone4268 Its probably the Market size. 60 million is just around 2% of all People in America. So not selling the drug at all to one Healthcare Provider would only result in a 2% loss. The Equivalent would be a Australian Health Care Provider with just 1 million people under them.
The USA and New Zealand are the only two countries in the world where it is permissible to advertise medicinal drugs to the general public (i.e. not just to specialists).
And Canada
Yes but having worked and lived in NZ I can tell you that you almost never see direct to patient drug adverts n NZ and the reason is that NZ Min of Health has an agency that reviews all pharma drugs sold in NZ and set out tenders for drugs on a national list and if your drug is not on that list then you cannot sell it in NZ and there is no point in advertising.
@@MK-hi3lj No, advertising prescription drugs to the general public is NOT allowed in Canada. As in Germany, you can advertise food supplements and home remedies ("is traditionally used as").
We get advertising for medications on the tv etc here in New Zealand too, like the USA does. Interesting how that hasn’t influenced the New Zealand culture the same way as the US; I’ve never paid attention to an ad for a drug and then ‘asked my doctor about it’, that sounds like a bizarre action to me.
Health is a human right in Europe, but a product to be sold to the highest bidder in the USA. In my 70's I am so fed up with unbridled greedism disquised as capitalism here in the USA.
Both my wife & I have gotten sick in Europe, and paid less for doctor & prescription than we would through our insurance at home. Plus we each saw a doctor same day, one in Spain, the other in Italy.
Americans with insurance pay sky high premiums from their paychecks due to lack of regulation. Plus their employer pays the larger portion of insurance premiums. Imagine how much more your salary could be if that was paid to the worker!
What seems to be missed in the US where healthcare is concerned, is that the administration of the complicated system is big business in itself. About 30% of the total costs is just for the administration, incredibly wasteful, but there is no incentive to reduce it.
It's not much better in Europe. In Austria they tried to reduce the costs be merging a lot of insurances in only a handful of organizations. I don't know if it really worked.
49% of the NHS budget is non clinical
@@sandersson2813 .
What do you mean by 'non-clinical'? Nearly half the budget goes for staffing.
@@grahvis Half tje NHS budget goes on things which aren't clinical in nature, so buildings, Managers, electric, heating, food, non medical staff etc.
The NHS is a mismanaged ruin of a health system.
@@sandersson2813 ,
Well there is a strange thing, fancy buildings, food, staff, heating being needed to run a healthcare system, who would have thought.
Only about 5% of the NHS budget goes to administration.
We Americans do get a raw deal when it comes to pharmaceuticals or any health care for that matter. We are at the mercy of these big corporations if we need drugs to treat illnesses. Thank you for sharing this. I would gladly trade off innovation go get lower prices. The government needs to get serious about negotiating and regulating prices. The free market just doesn't work for health care. This video was spot on.
Thank you! So glad you enjoyed it.
"The government" cough-cough, who exactly in the government has been successfully preventing that for the last 50 years I wonder? Hmmm. Almost like there are two factions and exactly one of them has sabotaged every effort to do something about it.
They spend a very minimal amounts on research...the NIH funded by tax $s does the research as well as universities across the globe they swoop in and they profit from bringing it to the market...inflating the cost to increase their bottom line ...people are dying because they cannot afford lifesaving meds...rationing insulin...not eating because they need the meds only to die a slow death 😢 for profit meds should warrant criminal prosecution!
The most scray thing that USA Doctors are allowed to basicly give you way to hard or dangerous dose of drugs.
Wich we all know has resulted in Americas Opiode crisis.
A German Doctor sometimes with a cold for example could say get yourself a Chickensoup and get rest that should be enough to get well.
hahaha, chickensoup, thats cute. But it really helps if its fresh made. A russian Doctor once told me "go home, open the window (in january) and drink 2 liter of ice cold water in 30 minutes". I did it and 60 minutes later i was cured. I swear, ice water is the best when you got the flu.
In most countries health comes from good food and exercise - in the USA it comes from the pharmacy.
Back in 2013 my daughter needed som prescription migraine medication in San Fransico. Pris for 8 pills was $195. Back in Denmark she bought 12 pills, same brand and content. Pris $8.45.
But Denmark is a backward country, not like the US, so everything is cheaper there.
@@PropagandasaurusRex you can say that. I underwent aorta surgery in 2019 with annualt chech-ups for tge rest of my life. Price DKK 0
@@PropagandasaurusRexI presume this us some kind of sarcasm......either that or you need to get a passport and get out (of America) a bit more. I've had an American passport since birth and I do not live there for many reasons, the cost of medical care being the main one.
Europe is very backward if you are a luxury sports car driving U.S. health industry drone.
@@PropagandasaurusRex I would say the other way around, I would say US is backwards, overflowing in homeless, drug epidemic, violent police, people voting for one clown in office after another, A legal system more based on storytelling.
The follow up on this should be how much of R&D is actually paid by the companies and how much is paid by governments via universities etc.
Paying more for one drug does not ensure more invest in searching for new medications. It only guarantees a higher profit for the manufacturer. Investing in research on the other hand reduces his profit, possibly for a longer time. So the "promise" of new medications looks a lot like an advertisement to me, a bet on the honesty of shareholders and billionaires working for my interests rather than theirs.
Here in Spain, I pay $2.50 for my monthly prescription for the statin Atorvastatina (10mg) that you mentioned in the video. That seems to be less than one percent of the price that I would pay in the USA.
How dare you! Spain? I see language barrier and a 4th world medicine man killing 20 years of your life. Just kidding, I tried today explain to them sheeps that Spanish doctor could write prescription to them. Youre welcome to read their answers, I was first today comment.
Is that before or after insurance? I mean, it can be hard to determine, e.g. in Belgium, insurance pays the pharmacy directly for prescription drugs. You wouldn't even know how much it costs without unless your insurance has lapsed, and you have to claim it back from your new insurer (with or without a penalty for being uninsured, depending on the duration of that period).
In Germany the receipt/proof of purchase from your pharmacy will show the price of the package (usually in the middle of the line) AND your co-payment (usually on the right side of the line) if you’re covered by a Gesetzliche Krankenkasse.
Therefore everybody can see what a drug actually costs.
Of course for privately insured no copayment will be shown, they have to submit the receipt to their private health insurance company for reimbursement.
I pay a co-payment of 5€ for the prescription with atorvastatin in Germany. Since it doesn't matter how many pills the pack contains for this co-payment, I always have the largest available pack with the quantity designation N3 (the pack sizes are designated via N1 to N3, which is the largest pack) prescribed by the doctor. I usually get by with that for 3 months. So I only pay a good €1.66 per month for the drugs.
I pay a co-payment of 5€ for the prescription with atorvastatin in Germany. Since it doesn't matter how many pills the pack contains for this co-payment, I always have the largest available pack with the quantity designation N3 (the pack sizes are designated via N1 to N3, which is the largest pack) prescribed by the doctor. I usually get by with that for 3 months. So I only pay a good €1.66 per month for the drugs.
In the Italian healthcare system you don't pay anything for any drug you have to take for chronic conditions. There is a 1-4 euro tax on each prescription (depending on the region), but patients over 65 or with particularly low incomes are dispensed with these taxes. A caveat is that the pharmacy will have to sell you the cheapest version of the drug available, unless there are specific issues (like allergies to some non active components, i.e. a colour or filler). This helps keeping the costs low, but also to lower the prices of the original branded drug.
Yup,as an asthmatic for example an inhaler and medications cost me....0€😅
The idea to die of asthma because I couldn't afford drugs is something that scares me honestly
I'm old enough to remember when pharmaceutical ads on TV were illegal in the US. And the ads they show now are absolutely stupid and have nothing to do with the drug.
It wasn’t all that long ago. I did 16 years in Pharma. Pharma companies saved big money by changing their marketing from a push to a pull strategy. They got rid of all of the overhead of a sales force and really took the prescribing decision away from the provider to the patient because if a pt requests a medicine the prescriber will write the scrip to avoid pushback from the insurer.
The term "popular medication" gives me the chills. No medication should ever be "popular" but at best a hopefully temporary necessity against an ailment until the root cause is found and cured.
Absolutely!
Basis research also doesn't pay and is still done. so they use state funding.
and once the results look promising, the private companies swoop in, do the last few optimizations and then pretend they did it all themselves...
There was a reason why Americans, by the thousands every year, would cross the Canadian border and head straight to pharmacies. And they would head home with the exact same pharma drugs, made in Canada, at far less cost.
The same happens at the mexican border.
They most likely are not made in Canada, just bought in Canada. They can be made anywhere, including in the US itself, but more likely in India.
@@jbird4478 I am certainly no expert, however, all of the big companies have a large presence in Canada. And I always assumed manufacturing was a part of that. I can't imagine why they would have such large buildings otherwise.
@@philipberthiaume2314 There are certainly also medicine manufactured in Canada, but medicine is a very international market. There are a gazillion types, and shipping costs for medicine are negligible, so it mostly just depends on the available resources and manufacturing costs. My main point was that where you buy it (and for what price) has no relation to where it is made. And India is pretty much the China of medicine. Almost half of the US's own supply of medicine is made there, so that's likely also true for Canada. And it's indeed also quite likely that some of those medicine are made in the US itself, shipped to Canada, and then brought back by US customers. It's a strange world sometimes.
I'm from Poland and on one hand, we'd really like to be able to buy some medication that was not approved for a financial reason, example being some American acne gels or pills and it's not like we don't have a lot of options already but when there's a high probability of intolerance some ppl would be willing to pay up. On the other hand, my country entirely refunds life saving treatments like Zolgensma, so I guess I'm ok with having to take a few more steps and not bankrupt over healthcare.
One point you didn't speak about are those billion dollar law suits against Big Pharma in the US. Pharma has to cover these costs somehow. In Europe there are no such big Lawsuits. Everybody looses if someone is awarded non logical sums for a problem with a drug.
Two things to add: A lot of pharmaceutical research is done by (publicly funded) academic hospitals and universities in Europe. Granted often that research is also sponsored by pharmaceutical companies to be first on the registration by the EMA in Finland. So, a good chunk of new medicine was invented in Europe as well as the USA. So that evens out. And orphan drugs know their price limits too. I remember a Dutch girl having a rare disease and the medicine cost 1000.000 Euro per year for her alone. That medicine was blocked by the Dutch health minister and she died. The reason was obviously that for that money, 10 more people could be saved and the price in itself was outrageous.
To be honest to me that looks like the responsible health minister and the responsible person at the drug company should be trialed for murder in that case. And the pharma company to be banned.
Apart from the huge moral problem i have with both sides with what you mentioned, it might be a rare disease, but a price that nobody is going to pay means they earn 0 revenue for the manufacturing company. With lowering the price they at least would make some money and get positive publicity. (Which in turn would bring them money from people buying non presciption drugs from a company they "trust")
"A lot of pharmaceutical research is done by (publicly funded) academic hospitals and universities in Europe."
You're conflating a whole lot of different things. On the one hand, there's research on drug candidates, which is often, but not always, publicly funded. Then there's clinical research of drugs in humans to test whether they are safe and effective. These are of course done in hospitals, because especially for more serious diseases, that's where the patients are. But they are funded by the industry, both by providing the drug (as it's not approved yet, it cannot be sold) and by compensating investigators and everyone involved for their extra work. That's the big, expensive part, because it is in all regularity done globally, across many sites on different continents, especially at stage 3, where effectiveness is tested and less frequent safety signals are observed
" Granted often that research is also sponsored by pharmaceutical companies to be first on the registration by the EMA in Finland."
The EMA is in Amsterdam, and the sponsoring has little to do with "being first".
Could you reference the specific case?
@@nirfz "With lowering the price they at least would make some money and get positive publicity."
No, that would mean that the company and the government would lose money and a lot of resources that could have been used to safe the live of many more people.
@@ABaumstumpf Example: Why did Mr. Hershey try to manufacture the cheapest chocolade? Because cheaper chocolade meant more people were able to afford chocolade and people would by his instead of the more expensive competition.
Same here: if you lower the price a bit, more people can buy the damn stuff and thus you get more income or at least the same, and the same is true for the taxmoney...
There are farmaceutical companies outside US also and they manage to develope new medicines. Most of the base studies are done in universities who have governement funding.
US citizens generally think a free market is better than any regulation and will solve all problems. But one precondition of functioning market is equal information between producers and consumers. But in healthcare, producers neccessarily have far more information than consumers. That market can not work, and it doesn't.
It is not a problem to support capitalism and free market, but it is (maybe) schizophrenia to not behave capitalistic. Businesses - joint venture = OK, Employees - unions = socialist. And of course, free market works until you are free to make a choice on such market. Pay or die is not kind of free choice. If you do that in shadows of side passage with an arm it is robbery, If you will do that everywhere else it is same, but in some cases it is enough to wear white jacket and .... (and the worst scenario is when you hope for help and some guy will prescript you chemotherapy because he is driven by profit - one case in US, 20 useless chemo therapies proven)
I don’t know where you got the drug price for the UK from but that is the price the NHS pays. At worst that months supply will cost the patient $12, most likely the Dr will write a script for 3 months bring the cost down to $4 per month (the charge is $12 per item, whatever that item is and however much of the item is prescribed.). That is in England in the devolved nations the prescription will be free to the patient.
This highlights one issue which is that the price charged to the patient and the price paid to the manufacturer are not the same. The other is that in the US you have monopoly suppliers and individual buyers in the UK you have a monopoly buyer and the rest of Europe has traditionally bought their drugs on the UK market.
"USA vs. Europe" is a very American politics way of saying it. Outside America, you can get drugs cheaper or not at all, framing it as a USA vs. Europe way of doing things skips over the fact that essential drugs and essential and making sure people have access to the essentials is one of those things that a furnishing government do.
America is the “land of the brave and free”. I understand it that way. Americans are free to be brave enough to resist the price expectations of the pharmaceutical giants. In American eyes, we Europeans may all be communists - at least until these Americans - like you too - come to us and experience the advantages of a welfare state. In contrast to Soviet communism or Chinese communism, I can live quite well with this European "communism" and I sincerely hope that we will be spared certain parts of the American way of life forever.
Dear Ashton, thank you very much for this informative video and for the hard work you do every time. All the best to you and your family.
Have a nice Sunday everyone.
Great video Ashton! Also, I find myself reading many of the high quality remarks in the comments of your videos much more than other channels. You created quite the community here. Kudos to you and looking forward to next week already.
And don‘t forget, that in many cases „innovation“ means just another drug for a already well treated disease with maybe a small improvement over existing drugs. Innovation doesn‘t always mean that there are drugs being developed in totally new indications where no drug exists to treat the disease. So it‘s probably difficulty. We should always look at how much of the revenue is spent in R&D and not in marketing or ends up on shareholder’s bank accounts.
ITS far more sinister: Just alter the drug in the slightest, cheapest manner top be able to apply for a new Patent....
@@jamesdenton3725 Oh dear... You neither understand patent law, nor do you understand how the medical field works.
cf my other comments regarding "marketing". Marketing is far more than advertisement. Not the least, since local subsidiaries are invariably classified as "marketing and sales" structures, plenty of postmarketing studies are being formally paid out of a "marketing" budget, even if they are not funded by actual marketing functions but by the medical affairs department.
It's a myth that for-profit drug companies invest that much in R&D. It's pennies on a dollar, especially regarding still uncurbable diseases.
Most research is done by non-profit organizations, universities, etc. Or funded by government grants and subsidies or donations from charity organizations for a specific disease or chronic condition.
You should compare the budget of an R&D department to the marketing department of those companies. You will be shocked at how little R&D gets.
Vielleicht habe ich es überhört, aber ich glaube eine Sache hast du nicht erwähnt: falls meine (gesetzliche) Krankenkasse ein in DE zugelassenes Medikament nicht bezahlt, habe ich immer die Möglichkeit, dieses mir auf Privatrezept verschreiben zu lassen, das ist dann natürlich abhängig von meinen finanziellen Möglichkeiten, aber es ist möglich. Das gilt auch für Behandlungen.
Research and development is unfortunately a very small area for pharmaceutical companies.
The lion's share goes into marketing and advertising (via TV, Internet or directly to doctors).
Unfortunately, I don't remember what the difference was between the two, but it was in a range between 1/5 to 1/10 of what is spent on research versus marketing.
Basically, pharmaceutical companies develop marketing and only as a by-product medicines.
Basically, you neither understand what marketing is nor what research is, nor do you understand what jobs are critically necessary to distribute a drug.
GlaxoSmithKline spent $15 billion on sales and marketing in 2020 compared with $7 billion on research and development. Bayer spent $18 billion on sales and marketing compared with $8 billion for research and development.
Do they spend more on sales and marketing? Yes. But neither 1/5 nor 1/10 - and it is not that difficult to understand why this can happen when you put a little bit of thought into it. Sales and marketing structures need to exist in pretty much every country out there. Research, on the other hand, is done only in select locations. There is way less redundancy of functions in R&D until the point a candidate enters stage three - which is where the bulk of research costs are incurred. Secondly, local non-R&D structures are regularly budgeted under sales and marketing - but not only does "marketing" involve much more than simply promoting - it also involves understanding what's needed by doctors and patients, what improvements would be welcomed etc. The local structures also include functions that not only verify that sales and marketing don't promise everything under the sun, but they also work with local researchers who'd like to run studies of their own and where interests align support them. Yes, there's plenty of studies out there funded formally from marketing budgets because the sub-organization which decided to support it is formally a marketing and sales entity.
Also, Bristol Myers Squibb, Merck and Roche spent more on R&D than sales and marketing.
www.beckershospitalreview.com/pharmacy/top-10-pharma-companies-spent-more-on-sales-marketing-than-r-d-in-2020.html
Do you have a source for this because I find it hard to believe. Big pharma spends vast money on R&D and in many parts of the world almost nothing on marketing
Another great video. Thank you! I think the biggest problem left in a world that has managed to stave off many of the causes of premature death is that we have to acknowledge the fact that "mature death" is something we cannot avoid. That always must be taken into account in any cost/benefit contemplation. If I ever get to be 95 years old, please do not operate on me or give me some painful drug treatment to save my life. Simply ease my pain, please. I am just passing through anyway.
Some people are quite comfortable at 95 and do not want to die any more than you do. Perhaps your opinion will change if you ever hit 95.
I think you might be wrong. At least I hope so. I would like to be brave enough to accept the unavoidable.
@@nerdyali4154
In Poland most companies with serious medicine WANT to be subsidised by the government, since more peoole will buy them and the goverment will pay (or co-pay) for it. Yes, the government negotiates proces and they'll earn less per tablet. But they'll sell way more drugs.
I work in a goverment organisation and when a pharma company wants to be subsidised they have to show the efficacy of the drug, safety AND the prices they are going yo charge the government. We then determine if the balance of safety, efficacy and cost is acceptable. We can also say, yes the drug is good but the proce is too high you should lower it. It works quite well, most of the time.
That is something i don't understand why pharma companies in the US don't even think of: This would mean steady, calculable, reliable "guaranteed" income for them. Meaning they probably wouldn't even earn less than they do today, as more people get access to the medics they need and the companies can sell. And it would mean positive publicity.
As most things in Poland, it only looks good on paper. In practise there are conditions the patient needs to meet, that result in hardly anyone qualifying for receiving the subsidized price. The new diabetes drugs, like Trulicity are a good example. Pretty much all doctors agree that they are life-changing and in the milder cases can even reverse the disease's progress. They are however very pricy and to qualify for subsidy you need to be diagnosed with such a bad case of the ilness, that the only benefit would be having to medicate less frequently compared to just living on insulin. The country is simply too corrupt for any system to work properly there. Thus the atrocious quality of healthcare.
@@Fossil_Frank well, I disagree. That you can't get onto all Programy Lekowe doesn't mean the whole system isn't working. I see the amount of money pouring from the system. Its heaven compared to the US
@@Fossil_Frank a masz np. liraglutyd, do ktorego nawet nie musisz mieć cukrzycy, żeby uzyskac
@@dominika3762 Nawet jeśli na niektóre specyfiki łatwiej o refundację, to pacjent nie będzie przecież wertował katalogów i korygował decyzji lekarza. Jeśli sugerujesz, że pacjent powinien powątpiewać, iż polscy lekarze przepisują najlepiej dopasowany lek do ich przypadku, to jedynym rozwiązaniem jest likwidacja wymogu recepty i niech każdy sam się kuruje.
Sama sytuacja, że na którykolwiek specyfik o refundację trudno jest porażką państwa na skalę niespotykaną poza miejscami gdzie szaleje głód i wojna. Nie mówimy tu o pryszczach na nosie. Cukrzyca to choroba cywilizacyjna, kraj który nie podchodzi poważnie do walki z nią, nie można uznać za cywilizowany.
I havent read all comments yet, but i want to raise another point in this debate which i think hasnt been talked about yet.
When we negotiated Health insurance for our staff in the US were repeatedly told that the insurance Premium is basically a very simple calculation. The health cost we collectively have, plus a percentage for administration as profit for the insurance. By that rule, the insurance has NO incentive to promote lower cost for health care. If this would be different i could easily see american health insurance company jointly negotiate. :)
The US isn't subsidizing the cost of medicines anywhere. Actually the US is being milked by pharmaceutical companies due to lack of regulation.
Despite all the expensive medications, life expectancy in the USA is about 4 years lower than in Europe (USA men 73.5 - women 79.3 years, European Union men 77.7 - women 83.3 years).
More important than the price of a medication is its availability and accessibility for everyone.
As you mentioned the argument that pharmaceutical research costs money, and that this justifies the enormous profits of the industry, it might be interesting to look where most of the ground breaking research is done: mainly in universities and public research institutions.
Even mRNA vaccines have been studied for decades at universities.
Taking a new drug to the market is expensive, and yet there are 100s of almost identical drugs to lower blood pressure on the market and not a single new antibiotic for decades.
The role of big pharma in real research is generally grossly overstated.
Quite frankly, if your main source of health advice and reminders come from televised pharma ads... You know you're living in a dystopia.
I suspect that another factor driving prices up to unhealthy levels in the US is the risk of court cases with huge penalties without strong evidence of the drug being "as bad as claimed".
The baseline is that healthcare is considered a human right everywhere except in the United States. Without considering the drugs for my autoimmune disorder, my cost (using a cost-discount program GoodRx cost estimate) is about $2,000 per month. With insurance, the cost drops to $300 per month, plus the premiums of $1,900 per month for family coverage. Anecdotal for sure, but more common than may be imagined.
In the U.S. sick (and pre-sick) people are a commodity.
Mine cost $AU32 for two months in Australia - about $US 20.
There is one point you did not address regarding new medication and innovation, the problem that they remove often better medication from market and tells Dr's to push the new drug on you instead, so they remove a medication that has been life changing for me because it is out of patent and there are not enough money in it, or enough users of it, to make it viable for someone else, so they discontinue it and pushes a new and better version of it at 10x the price that suddenly have undisclosed massive side effects, which were the reason I had to use that specific medication in the first place. I have been burned by these practices before. So they have no consciousness for what they do to us. Like if the medication you use to a degree also became unavailable and a new and "better one" that you can't use is all that's available.. So innovation would not decrease if they got regulated better in the US because the greed will always be there, their god of mammon will live to the end of time.
If the patent had lapsed you could just make it yourself. Some medication is surprisingly simple to make. It's just the development that has a high price.
Now I get that just making medicine is an oversimplification. But if you have a patient group, you could just pay a lab to do so. Make a simple pill with the main ingredient needed.
German here. I have had diabetes since 1983. I use Dexcom G6 blood glucose sensors and Omnipod insulin pumps. Additional payment for this equipment: €0. Paid in full by my health insurance. A sensor has a lifespan of 10 days before it needs to be changed. American RUclipsrs show how you can restart it and use it for another 10 days. I would never dream of that.
Additional payment for insulin: €10 per pack of 5x10 ml. Enough for 3 months.
My wife has rheumatism. She injects MTX and Cosentyx. Additional payment: also €10 per pack.
There are people who grumble about the German healthcare system. But that's whining at a high level. They don't know other countries. An acquaintance is married to an Englishman. She always came to Germany to give birth to her children and stayed for several months until all the medical checks were completed. The British NHS is still waiting for the £350 million a week that Boris Johnson once promised.
The main cost for many pharmaceutical companies is advertising, sometimes followed by share buy-backs - not research.
Hello Aston, congratulations again, very good video. I'm living in Brazil and, if you published here the price of some medicines for continuous use, it would probably trigger tourism to buy medicines... The public health system here is far from perfect, but they will treat EVERYONE for free, including foreigners who are passing through.
Cannot be the case as they have to be members of the National German Health System or any other european counterparts…,someone from a non EU country have to pay unless its an emergency
Finally someone who talks about the real reason why health care prices are so different in the US compared to everywhere else: The US government does not control the price of drugs (or hospital stays, or ambulance services, or anything). The discussion in the US is always about public health insurance vs private health insurance vs universal health insurance. None of that matters without tackling the actual problem: Free market pricing.
Thank you!
But its AMERICA, its freedom, freedom to pay insane prices
Okay but... having a single buyer (aka universal healthcare) does in fact drastically shift the ability of the "free market" to bullshit drug prices into the stratosphere by shifting the entire balance of the negotiation into the hands of a state-funded, publicly-owned agency.
Then again, just having the drug companies themselves be non-profits would remove the entire discussion, because then you don't have to waste money buying investors more yachts.
You don't have a clue, the government is extremely involved in charges for healthcare in the USA.
It's kinda worse than free-market capitalism. In free market capitalism, at least for common drugs, someone would take the common European-made drug like let's say blood pressure medication buy it in bulk in Germany and sell it will a profit but much smaller than the local price in the US.
This will not happen because of the amount of FDA red tape which is not built to protect patients but established company profits.
Its monopolism on a product you literally can not survive without...
@@shingshongshamalama, unfortunately, that is not what would happen. If the single payer agency forces pharmaceuticals to provide their goods at below market prices, the result is a reduction of supply, and most likely shortages. Here is Europe, there tends to be a rationing of drugs, which is not really better.
American drug prices are ridiculously overpriced, but that is due to regulation and trade barriers.
I wonder if certain fringes of USA population think the following monstrosity:
"If they can't pay 405$/month, they do not deserve to stay alive".
Have you met someone that raised a similar argument?
I always found it funny that big-farma think they’re protected by anything except the good will of their patients... who enforces the laws that let them keep their monopolies?
Americans should recognize that the pharmaceutical market is no free market. As long as the state guarantees protection by patents, he has the right and duty to regulate the price in return.
LOL. How many drugs will be invented, if there are no patents? This is even worse than the current ripoff, nobody will pay.
@@urlauburlaub2222There are no patents on Beer, Bretzel, Brot or Brötchen. And what exactly is your problem with that?
@@wora1111 😀 No problem.
@@wora1111 Funny you mention beer. The Rheinheitsgebot was an early for of patenting. Bakeries often had guilds, making it not possible for others to be a baker. And often the guilds are confused for unions. The guild protects the profession, the union protects the people. i.e. if I change my profession, or do not even HAVE one, I can still be a member of a union.
That said, I do agree with what you said.
@@houghi3826 The Reinheitsgebot was an early form of healthcare regulation. some people created beer from unclean and/or poisonous ingredients.
In terms of the UK, Wales, Scotland and Northern Ireland all provide prescribed medication free of charge. In England, the flat rate prescription fee for all medication required per month is £14 and if someone takes more than three medications, they can pre-pay for the year, taking it to roughly £8 per month. These charges charges cover as many medications as required.
I’m not sure where the $25 in the UK figure in this video came from. Maybe it is if someone goes and gets a private prescription, however that is not common practice or necessary.
But no charge in England either if the patient is over 60 or is subject to a bunch of other medical or welfare based exclusions.
Yeah all of the stats for UK are wrong. It isn't clear where she's getting them from tbh.
Maybe she doesn't want to give the real stats because it makes USA look even worse lol. Americans are always in denial about how much better the NHS is than their system.
I'm in Italy, I was diagnosed with hepatitis C and have never paid for insurance or taxes since I was overage but still young and still lived with my parents and have rarely worked legally.
Once I was diagnosed of HCV by a public hepatologist he gave an exempted status for all exams and blood work related to my disease and I even got the most recent super expensive anti-hcv drugs for free, the montly pricetag on the box for the most expensive pills was about 17000 dollars and i got everything i needed for free, without insurance, without nothing.
My treatment lasted 6 months, I was cured from HCV and plus I got to get free blood work whenever I wanted for a few more years, price? ZERO.
Benefit for Italy: You are a healthy working citizen contributing to the GDP - helping other citizens to get healthy and contributing to the GDP - helping other citizens to get healthy and contributing to the GDP - helping other citizens to get healthy and contributing to the GDP - helping other citizens to get healthy and contributing to the GDP - helping other citizens to get healthy and contributing to the GDP ..........
If you want better medical products, you don't fill the pockets of big pharma,, you spend government money. The research that leads to better products in the first place is predominantly done in publicly funded institutions worldwide. Frequently big pharma only arrives when there is already an almost finished product, as in Biontech's Covid vaccine.
Governments also tend to focus more pn what's actually NEEDED instead of what's profitable. There's a huge discrepancy there.
Another great and well researched Video, thank you Ashton. Maybe two facts should be more intense pointed out, which you mentioned in previous Videos:
1.) e.g. in Austria every prescripted medication is payed by health insurance (except some low prescription-fee, € 6,85 which practically everybody is able to effort comparing to the amout of money you mentioned), and this insurance by the way is required by law, when you even work only an hour per week.
2.) e.g. in Austria advertisement for prescripted medication ist de facto prohibited, because here we see it as a human right to get medical treatment and drugs. And it should not be a business, to unethically misuse the disadvantage of life threatening illnesses or promoting magic effects of drugs like a quack. And by the way: ads costs a lot of money, which customers pay with the medicine.
The US allowing drug advertising coincided with limiting and eliminating most cigarette advertising, but this was in no way a bribe to the media industry to prevent them from talking up 'tyranny' around public health.
Hi Ashton, nice video, explaining alot about the differences. One aspect however you seem to have forgotten to mention. In Europe in most Countries commercials for prescription drugs are prohibited.
And yeah... People in the USA are being ripped off when they need drugs... and even worse... they appear to want to get ripped off when they go to the ballot-box.
BTW... in many cases drugs or treatments developed were funded with public money, but the Corporations are usually the onlyones profitting. That has to change too.
" in many cases drugs or treatments developed were funded with public money,"
A common misconception. That public money funding only applies to the initial research on potential treatment strategies. The development to an actually proven treatment is regularly not funded by the government, and there wouldn't even be a singular government which could be called responsible for funding it, since these are developed through multicentric international clinical trials done within the jurisdiction of half a dozen governments or more.
You are NOT wrong about the ballot. The choice seems to come down to a senile geriatric Vs a criminal geriatric? WOW! Glad I am Australian!
Here in Norway, what you pay per month for prescription drugs isn't really an issue. Because there's an annual limit to what you have to pay for healthcare, which includes meds, doctor, treatment, and even transport related to healthcare. This year, that limit is is 3,040 NOK (around $300).
I'm on quite expensive meds that I'll need the rest of my life. Typically, I reach that limit already in February. After that, I don't pay for meds or doctor at all, and I even get paid per kilometer when I have to drive to any appointment related to my health.
Americans loves to brag about living in the best country in the world. Well, if I lived there, I'd probably die since I wouldn't afford my meds.
Good video. But I agree with others here: Lower prices doesn't mean less research and development. That's a story we've been fed by US companies for a very long time. And it seems their framing works for them.
To many Americans, unions are pure socialism.
And they wonder what happened to the middle class.
It's all about bargaining power, which is all in the hands of the companies, unless people get together to negotiate.
Like in a union, or some other instance where someone does the bargaining for a large group of people.
That said I have seen unions in the US with some weird political agendas, which isn't really helping promote unions as a positive thing.
In the Nordics unions and employers are good at coming together and negotiating for the good of both parties.
While some of the stuff in the US seems very adversarial.
Unions in the US just aren't as good as they are in Europe. Europe also has better support for them. The WGA didn't hire lawyers or a chief financial officer going into their strike, I wonder if they even have an economist. In the Netherlands, we have the Social-Economic Council, the most important advisory body to the government, which contains Union representatives, employer's organization representatived, and independent experts. There's an incentive to work together for a common good.
Second comment, sorry.
Free market only works where both negotiating parties have the same powers, both in size and ability to test and verify claims. A customer vs big pharma has uneven power balance so the outcome is easy to predict. Different story with EU or big governmental bodies doing the negotiations in behalf of customers, as described in your video.
No. There is no singular customer, there is always a mass. Via the individual payer of medical insurance, the companies and drugs in general get a fair market price. This isn't any different in Germany, just that the Germans as a whole can pay the drugs. (Even though in the last years, refugees/migration/demographics the costs run out and have to be cut. This "new US power balance", that a state forces lower prices, will not and never result in private people working or selling it for the same. They are not government run facilities, but require constant private investment.
@@urlauburlaub2222 so in your argument before buying a drug an individual, as part of the mass, test the drug, verifies the claims of the maker before making purchase decision?
Because that what is done in Europe by the institutions on behalf of customers. As described in the video. Have you watched it and understood?
@@urlauburlaub2222 Again, utter nonsense. Instead of answering to the comment, you fill in some completely off topic nonsense.
@@ukrytykrytyk8477 You sentences are hard to understand, please rewrite them. The government institutions doesn't do anything real here. You have drugs. They are good, people buy them. They are bad, people don't. Now, the US Socialist government forces different prices opon private companies. In Europe you have way different systems in every Nation State, and different owners, so there is no "central institution" doing anything for costumers. They are only focussed on standards, but the prices are private. Biden wants to regulate PRIVATE prices.
@@urlauburlaub2222 "You have drugs. They are good, people buy them. They are bad, people don't." -- Except, people in general are not able to determine if drugs are good or bad. That's why in the EU the European Medicines Agency assesses that. And each member state has a procedure to negotiate prices with producers. That can be a government departement, or an independent body of stakeholders (like in Germany).
Another great video Ashton, well researched and the presentation is top notch.
Also really glad to see so many commentators mentioning how drugs are developed through primarily public funds.
In the end like almost everything yhis is about striking the right balance between corporate power and the public good.
Some countries are better at achieving this balance but some have not.
I am curious to know if you ever looked into Milton Friedman and his impact on corporate behaviour (his economics were adopted by Reagan and Thatcher for instance).
Anyways have a great sunday and looking forward to next weeks video.
Not just cost. I'm shocked how easy people use antibiotics in the USA. Some other countries too, but I didn't expect this from the USA, due to proven risks if you develop resistance. You do NOT want to become resistant. In my country it's sincerely difficult to get antibiotics. It's also highly regulated in animals especially if they will end up on our plate.
This topic alone deserves a video in my opinion.
I'm not directly nor indirectly affected by the problem of drug pricing (not American btw, but do live in Germany, as an immigrant of the EU nearing a decade now)
Just my own opinion, but the last question you proposed, "Innovation or Affordability?" Especially for people who're RIGHT NOW suffering, is a really difficult question to answer, if my mother gets heart disease, or my sister has ALS, well of course I want all the money to go to innovation as much as possible if only we can accelerate the R&D process! And on the other hand, why is the patent law abused so much that the pharma industry (hey, Disney does it too) that generic medicine can't be made and sold?
So I propose a question...
All these Pharma industries...how much do they ACTUALLY spend for R&D? How much do they spend for daily administration and production? How much for marketing? How much for lobbying the government? How much for stock buybacks? Lastly, how much is their profit margin, and how much has it grown? I'm all for more R&D. It'd cost us more, sure, but as long as the R&D moves forward, I'd accept the cost. What I wouldn't want to, is paying more because of the greed of executives that just want to line their pockets with money that they don't even need more of. Like seriously, who "needs" 1 billion dollar every year? How can you even use that?
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I have another theme, that you might be able to research in the future, Ash.
I got interested on why stock buybacks is so rampant in the US, and yet I don't hear it so much here in Germany. In short, there is such a thing as stock buybacks here as well, but they're regulated by government for it to be up a certain limit (here's a link from Finanztip, Ash, that explains more about this, it'd be great if you do research and explain about this, Ash!) www.finanztip.de/aktien/aktienrueckkauf/, www.gesetze-im-internet.de/aktg/__71c.html, buybacks can only be done when: Stockholders have allowed it, and they can only buy a maximum of 10% of the base capital in the last 5 years.
I found this as something that sounds reasonable for us as consumers (but to be honest, I haven't done the math...), and from my opinion, also reasonable for investors, though there's still the critique of "this doesn't really bring any added value", which I believe is a good critique.
those two topics are both really interesting!
As far as I know only a small fraction of R&D projects eventually turn into a medication, so NOT doing any R&D is not an option for these companies. They have to build up a pipeline of projects and KEEP that pipeline filled, if they want to stay in business in the decades to come.
I am pretty sure lower prices would have mostly just one effect: less money for stock holders via dividends or stock purchase programs.
But here’s the rub: if you invest in stocks e.g. for your retirement, which stock do you prefer? The „altruistic“ but cheaper stock or the greedy but higher one?
@@gneumann92 But a lot of the R&D goes into just slightly improving already existing drugs for pretty common illnesses, because that's where the money is.
Extremely informative video. It explains a lot about the insane health care costs in the USA! Thank you.
In the UK we pay a flat rate for prescriptions no matter what the y cost. Each prescription costs around £10 each. If you’re on a low income or you’re over 60 or a child it costs nothing. If you are on multiple prescriptions regularly you can buy a prepaid certificate to keep the cost down.
I worked for Hoffmann LaRoche in Switzerland and we had a phrase: "You can only earn more money when you print it yourself". Once on nightshift I wrecked a charge of a medicine that costs over 1,5 million Euros, and that were production costs not selling prices. I thought that they would fire me but nothing happened. They were not even interested. The QA controlled the documents and there was a minor mistake, not with the product only with the packaging, so everything was destroyed. I spoke with a mechanic from an external company and he said that we had more spare parts for our machines then his company and they build this machines. One time we needed a specific part from Rotterdam and they send it with a Taxi, nearly a thousand km. The best thing was, it wasn´t even the right part so they send a second driver before the first one left our compound.
In the UK, the NHS pays about £1 for a pack of 28 x 10mg generic Atorvastatin, or about £2 for 28 x 80mg.
Wrong, you mean ‘England’, free in Scotland, Wales and Northern Ireland.
@@givenfirstnamefamilyfirstn3935 No, I’m talking about what the NHS pays the manufacturer.
@@katrinabryce OK!
The market mechanism can only work correctly if there is some power balance between supply and demand. Before drugs are allowed to become "generic", the original supplier has a legal monopoly - and even if the same drug is produced as "generic" by multiple suppliers, they are still only a few, and many of them are even affiliated with each other, not really competing with each other, but dividing the market between them. To balance those monopolies and oligopolies, the customers on the demand side have also to work together, like a demand cartel or trade union. Only then a free market can work as intended - otherwise you simply have no think like a "free" market. And in a market economy one of the main tasks of the state is to secure fair competition by either breaking up monopolies and oligopolies or organizing counterbalance (and at the same time do regulations to avoid tipping over the balance to one or the other side).
Price fixing is illegal, the law has to be enforced.
@@Anonymous-sb9rr Which is a regulation.
Living in Austria for the last 57 years I never ever paid more than the prescription fee which is 6€ right now. Never thought about prices of drugs until I saw this video.
Also worth noting that even with the 70% price cut of insulin, the US is still the most expensive country for insulin in the World by 2-3 times compared to the wealthy European countries
Great video from Ashton as usual! There is a psychiatric clinic near me, pharmaceutical representatives are banned from entering there!!! I knew one of these pharmaceutical representatives (regional boss) who earned 5 figures per month. Have a beautiful Sunday
There is something similar with generics, equipment and even procedures. In a country where almost everyone get their healthcare through a social or subsidised system your main consumer is that system and they can represent as much as 98% of the total market in that country.
That is called a monopsony and makes price gouging impossible. For generics like common anti-biotics and painkillers it means both price and quality demands are set in stone and the industry has no room to negotiate anything.
Humbug. Of course they can negotiate. They are not forced to sell they product. They only have the risk of some competitor stepping in and picking up their market share. It is called capitalism. So, no problem there.
In fact negotiated prices in Germany for some common generics are meantime so low that the generic pharma manufacturers cannot derive any profit at all, so they might choose to stop productions or supply to other countries where they get a bit more … causing delivery shortages in Germany. Worsening this situation is that many drugs are manufactured in India and other countries far away from Europe, that caused quite a few shortages especially during the Covid pandemic.
@@wora1111 How can you negotiate if you sell something your few customers can source anywhere for a lower price?
This is different for high tech or patented medicals but for example a penicillin plant including FDA and EMA certifications is pretty much an off-the shelf product and anybody and their maiden aunt is producing that stuff. The market for such generics is VICIOUS.
You sell for what they want to pay or you walk way, that is not a negotiation.
@@DutchLabrat Your customers can buy their stuff, where they want to. If they want to pay less, you should stop whining and maybe calculate with a smaller profit margin?
But it is not negotiation, that is just taking a deal or leaving.
You know the meaning of negotiating???
The current cost of a prescription in the UK is £9.65 (~$12) per item so that's what a month's supply of Lipitor will cost not $25.
I really appreciate this new format.
Glad you enjoy it!
Very informative show. Another variable in US drug prices are the individual retailers. The non-generic Lipitor 10mg tablet 30 day supply, costs range $367-$417 in local retailers where I live.
i just checked my lipitor 30mg (generic) and I paid less than USD$ 10 per month here in Australia.
US prices are insane.
PS name brand Lipitor is only 10-15% more expensive than generics. Lack of advertising really pays off when no patients use them as the basis of medical decisions. My doctor has only once indicated that I shouldn't buy a generic. Every prescription has a box that asks the doctor if there is a reason not to prescribe a generic.