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Why drug prices in America are so high (2016)

economist.com

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Re: Why drug prices in America are so high (2016)

#2
"The simple answer is because they can. European governments control prices in various ways—Britain has the strictest system, refusing to pay for medicines that fail to meet a threshold of cost-effectiveness. But in America companies set whatever official price they like."

Re: Why drug prices in America are so high (2016)

#6
post #2

"The simple answer is because they can. European governments control prices in various ways—Britain has the strictest system, refusing to pay for medicines that fail to meet a threshold of cost-effectiveness. But in America companies set whatever official price they like."

If anyone's interested, England's system of health technology assessment (HTA) for the NHS is extremely transparent and world-leading.

It's one of the things that we Brits should be extremely proud of (although pharma-sponsored sob story campaigns in tabloid newspapers may suggest otherwise).

All new technologies are investigated in terms of incremental quality of life gain (vs current treatment norms) and changes in costs.

Furthermore, they consider everything in a wider context of opportunity cost of adopting a new treatment and budget constraints.

For a lot more detail, have a look at the NICE reference case here: https://www.nice.org.uk/process/pmg9/chapter/the-reference-c...

Re: Why drug prices in America are so high (2016)

#7

> And it is illegal for Medicare to negotiate with drug companies Why is this the case ? Also, this is from September 2016.

It was part of the Medicare part D program - and likely put in via lobbying of Drug companies to politicians:

https://en.wikipedia.org/wiki/Medicare_Part_D#Criticisms

https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Im...

Re: Why drug prices in America are so high (2016)

#8
post #2

"The simple answer is because they can. European governments control prices in various ways—Britain has the strictest system, refusing to pay for medicines that fail to meet a threshold of cost-effectiveness. But in America companies set whatever official price they like."

> "The simple answer is because they can.

The easiest way to fix the fact that 'they can' would be to permit re-importating drugs that were manufactured within the US.

Shortly before Obama left office, there was a bill that would have fixed that, but nine Democrats joined the Republicans in voting it down: https://www.senate.gov/legislative/LIS/roll_call_lists/roll_...

Re: Why drug prices in America are so high (2016)

#9

> And it is illegal for Medicare to negotiate with drug companies Why is this the case ? Also, this is from September 2016.

It was politics from a couple decades ago. Medicare historically didn't cover prescription drugs, until Part D was enacted during the Clinton administration.

A tactic to get Republicans to support the measure was to pledge that Medicare wouldn't interfere in the drug market by developing its own formulary – Medicare Part D plan providers would compete for members and negotiate with pharmaceutical companies themselves.

There has been a bunch of talk over the last decade about repealing that particular restriction, but it's never made it over the finish line.

Re: Why drug prices in America are so high (2016)

#10

> And it is illegal for Medicare to negotiate with drug companies Why is this the case ? Also, this is from September 2016.

This has background:

http://kff.org/medicare/issue-brief/searching-for-savings-in...

A summary is that when the coverage was established, the law was written so that Health and Human Services is prevented from participating in price discussions, it's left to the private companies that underwrite the policies.

You can bet that if Medicare did establish a formulary, we'd be talking about the problems with that instead.

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