Why Do Americans Pay SO Much More for Prescription Drugs?
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- Опубликовано: 17 сен 2024
- A fairly large percentage of Americans don’t take important medications as prescribed due to issues of high cost and/or low supply. How did we get here, and what can we do about it?
Thanks in part to support from the National Institute for Healthcare Management, that’s the topic of this week’s Healthcare Triage.
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Series Playlist: • Prescription Drug Pricing
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Credits:
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After moving to Japan I was floored to find my $350 prescription in the US cost $7 in Japan 🤯
We got here because of insurance, pharma, and hospitals colluding on arbitrary pricing structures. Say it with me, "Insurance never actually makes anything cheaper for anyone in the long run". Free market principles don't work when you have a captive audience (someone with a disease).
America also got where you are because Congress had consistently adopted a piecemeal, crisis-response approach to regulating drug prices, rather than following the European model of having an agency which regulates prices in order to prevent crises before they happen. If pharmaceutical companies know that drugs need to be not just effective, but *cost*-effective, to be approved for use, that alters the calculations for senior executives.
Great Country? I think not.
PBMs and the rebate system encourages higher drug prices. It’s a perverse system that discourages cheaper generics.
Pharmacy Business Managers are the latest money-making machine for the Insurers. "You want us to provide rebates on your drugs? Here's how much it'll cost you up front". There is NO competition, since the entire market is operated as an internally connected cartel.
To put this a bit more in perspective, I'd just like to point out that I just received my first shipment of a medication I ordered from a reputable, well regulated pharmacy in Canada ... a member of two well respected regulatory agencies. The process was very straightforward and professional. This medication is priced at approx $620 per month in the US. There is a generic form that has been approved by the FDA, but the drug company has pulled strings so that it won't be available until 2028. I received the generic form from a Canadian pharmacy at a cost of less that $65 for a THREE MONTH supply. The lab that manufactures the drug has been in business since the 1950s, so it's not some sort of fly-by-night operation. It's not illegal for me to import this medication, since it's approved for use by the FDA.
How does that work, do you have to ask your doctor to call in a prescription to Canada?
@@Hayley-sl9lm My cardiologist just gave me the prescription in pdf form, which I forwarded to the pharmacy. They also have licensed MDs on staff to do a second sign-off in Canada. The one hitch was that they can't do credit cards (some pharmacies accept AmEx) b/c Mastercard, Visa, etc, have been pressured by pHarma not to permit drug import transactions. They do accept personal checks, etc. This pharmacy also did direct debit from a bank account ... just provide acct # and routing #. I didn't want to give them access to my main account, so I just opened up a second account specifically for this purpose, which never has more than a $200 balance.
BTW, this pharmacy also does price matching, so if you find your drug for a lower cost (from an accredited pharmacy), they will match or beat it. I think many Canadian pharmacies do this.
Let me know if you want more details, but this is pretty much it.
@@Hayley-sl9lm Looks like my reply to you was deleted. I don't know why. It was a fairly detailed answer, but I didn't provide medical advice or links. The simple answer is that it was sent to me so I could submit it.
A like is a good thing .. engagement in the comments is important as well. Thanks to the powers that be, I currently require no prescription medication, but it would sure be swell if (well, probably when) I have the need, affordability won't impact medical decisions.
One of my meds costs $40k a month. So glad my insurance covers orphan drugs, it's ridiculous
Would've loved to hear more on why non-prescription drugs are so cheap, to the point of driving companies out of the market.
Weird. Almost like the profit motive has no business being involved in healthcare.
2:00 "This is a logarithmic chart! It's logarithmic, oh my god!" -Hank Green
we all know the US loves its free market, no matter the cost (literally) for the average folk.
So thankful for hct
Money serves as a medium of exchange; however, it is important to recognize that it cannot restore a life that has been permanently affected or lost. We must acknowledge the realities of our collective perceptions of value and worth. Healthcare should be regarded as a fundamental human right rather than a profit-driven endeavor for a select few.
I'm confused, why the extreme gap between generic and brand name? If generics aren't profitable, how can the price be so low? Is it bigger companies doing a 'loss leader' type of strategy to limit competition in the long run?
Not profitable in comparison. My dad's lyrica generic is $5. The brand is $600 minimum. Before the generic was available, it was around $1600. When you can make a take-home profit of $400-$1000+ per filled prescription, a return of $1 is not "profitable"
@@ghostratsarah It costs ~$2-4B to translate a new drug. Assuming the lower end of $2B, you'd need to sell at least 1,250,000 $1600 drugs to break even before even making any profit at all. If the regulatory burden isn't reduced, neither will prices. In the face of price limits that would make investments not worthwhile, instead of having less expensive drugs, we'll have no drugs.
The FDA, as it is, is too overburdened with its current regulatory workload (not to mention conflicts of interest or not taking the task seriously enough). The problem is such that problems known about earlier than 2010 had not been addressed for nearly a decade or more (eg: cybersecurity in networked medical devices - which they pushed off onto the NIST because they were ill-prepared to regulate it themselves).
What is needed is a union of disabled people, able bodied people and healthcare workers to crush the existing system and recreate a system that works equally for these 3 groups. Talk to people about starting a union.
Honestly, this topic is not being treated seriously in this video. Lots of maybes and nuances and covering up for the MASSIVE bilking of captive populations either at risk of death or serious harm. If this video were covering the topic of slavery, it would call it a very difficult supply chain issue requiring nuanced legislation and an uphill battle.
What is happening is disgusting, inhumane, and unacceptable at any degree. We don’t need nuanced legislation, we need to flood the country with cheap medications from European sources (which have more safety controls than we do, thanks to the defanged EPA) and PUT THESE CORPORATIONS OUT OF BUSINESS. If they want to compete in a free market, let them try and watch them fold when they can’t compete with a dozen different manufacturers all making profits with generic drugs.
Really appreciate the thoughtful commentary. Do you think that the U.S. disproportionately bears the cost of global medical innovation? The U.S. evidently accounts for ~40-50% of pharma revenue - maybe this burden can be replaced with international mechanisms to fund R&D more equitably? I'd be eager to hear your thoughts.
Pharmaceutical companies =/= Fine chemical industry. Fine chemical industry does R&D and manufacture engineering and planning. Pharmaceutical companies does the actual production and gallenics (packaging). Yet, pharmaceutical companies are the ones taking the lion's share of medication cost.
Pharma companies are doing very well and invest relatively little in R&D. Don't worry about them. The most developed countries in the world have single payer universal healthcare. Pharmaceutical companies are not fleeing
More money is spent on advertising medications than EVER goes into the research and development. The US isn't necessarily leading "innovation" either with all this money. Lots of pharmaceutical companies in other countries with different funding methods are making just as much, or better, strides in the field. I'm inclined to say that profit motive shouldn't be involved in medicine for lots of perverse reasons. Most people don't have options when it comes to getting care, and that simple fact alone leads to people losing their livelihoods and everything they killed themselves at work for over something they have almost no control over. Sure, you can try to PREVENT disease and illness, but you can't guarantee it. For example, can you "shop around" for care when you're in the middle of a heart attack or negotiate your drug prices with the pharmacy after the fact? Just something to think about.
The vast majority of the R&D is tax funded. Especially for brand name drugs purchased by Medicare. The top 50 drugs purchased by Medicare in 2023 were majority or entirely tax funded.
Not just cost preventing access. The limited applicability of different insurance plans for an increasingly mobile generation makes access to drugs at different locations unavailable. Considering a lot of those people fit into the extremes of affordability difficulties, that's a significant problem. That's not even mentioning drug shortages / drug contamination /etc. My insurance plans prevent me seeking prescription drugs in some cases out of state. Others I CAN get but it depends on the prescription drug.
One more thing: if you overregulate rare disease drugs, you will likely have a problem even getting these people treatments at all. Stuff like CRISPR/Vertex drugs will be inaccessible (arguably already a problem given their extreme costs). We haven't even touched on durable medical equipment access and the extreme prices of prosthetic limbs / neural interface implants.
Drugs you need to stay alive/healthy should be free, period.
Nothing is free
Nationalize pharmaceutical companies.
No, you commie
When will we cure blindness caused by retinal vein occlusion?
Or the US government could start a generic pharmaceutical service that pays for itself like the postal service. And then we don't need as many regulations.
How can you do this to your own people!?
If you need prescriptions then companies have a customer for life?
Do you really think that the drug companies are paying taxes on those profits?
Did you consult pharmacists with this video? As a pharmacist, I found a ton of small but important inaccuracies with this video, most of which would have been corrected by a pharmacist.
@bryce4071 I would be really interested in your take on this, if you don't mind sharing your professional insight. I just received a prescription from Canada and saved almost $1,800 over 3 months. The generic was FDA approved in the US, but the drug company blocked sale until 2028, so no alternative here.
Just to clarify, I'm asking about the inaccuracies in the above video, not necessarily your take on Canadian drugs ... although you might want to weigh in on that, too. 😀
Why not list your notes here? You can put time stamps like 0:45 for reference.
@@LabGecko Excellent idea. I hope s/he follows up on this.
Why do Americans pay so much for prescription drugs? TL;DR: rent-seeking in the pharmaceutical industry.
Polls are only as accurate as the knowledge of the individuals polled. Healthcare and regulation are complicated topics, how is the average person going to know whether increased regulation will be good or bad? How would the average person know whether a drug is too expensive or not? What does 'too expensive' even mean?
There are certainly reforms needed but populist opinion is never good at producing good policy when it comes to complicated, nuanced issues.
They list the study names when mentioned. You can look up the methodology. A lot more care goes into most medical polls than you're suggesting.
@@LabGecko Did they poll average people or experts?
@@Waldohasaskit210 I said you could look it up. I don't have time. 😁
The CIA watched this video using my account (I have residual psychosis)
Such a long, complicated video when the answer is greed.
No it's not
Me before watching the video: Pretty sure it's due to capitalism and government corruption.
After watching: Yep.
Capitalism is the right reason. It doesn't care if people live or die as long as profit is still made
Found a commie
Because RACISM. Next question?
Lmao
Thanks Trump
Because in the USA, "Healthcare" is very good, very high-profit "business", hence the financial standing of all those "Healthcare Insurers" on, e.g. the Dow Index and others. The entire system is an internally-connected cartel, designed solely to extract as much from the "forced subscribers" as is possible.