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The Hidden Monopolies That Raise Drug Prices

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Re: The Hidden Monopolies That Raise Drug Prices

#161

Post by ch4s3 »

TheAdamAndChe wrote: post #159
ch4s3 wrote: post #157

Earlier quoted context omitted.

Socialism and populism are not necessarily mutually exclusive. Quite often socialism takes the form of populist socialism (think Bernie Sanders or Chavez). Also, I think anyone who voted Trump to generate populist change, are likely getting a raw deal. The administration is loaded with Billionaires and business leaders, the opposite of populism. And, they've already set about enacting changes that negatively affect a…

Thank you, I wasn't aware of that. I thought they were completely different. How would Trump's direction be described, then? Nationalism? Also, I agree that electing Trump was a raw deal. But between the two presidential candidates, Trump was the Change candidate and Clinton was the Status Quo candidate. From what I understand, a lot of studies show that Sanders would have won the election if he wasn't suppressed on…

Trump is more or less a (far-ish)right populist and economic nationalist.

Not to rehash the election unnecessarily, but I seriously doubt Sanders had any chance nationally. The US has a political center that is center right to right wing on an absolute scale, meaning the average American Democrat would fit comfortable in most moderate/centrist conservative parties in the rest of the developed world. No judgement there, it's just a historical fact and likely the result of some political realignments in the 20th century due to the Cold War. That is to say that someone as far left of center as Sanders would have no chance in most swing states where the election is decided.

Re: The Hidden Monopolies That Raise Drug Prices

#163

Post by kgwgk »

refurb wrote: post #124
kgwgk wrote: post #117

Earlier quoted context omitted.

Now the prices are lower... and the profits as well.

Yes, but insurance companies haven't loosened the reins on these drugs. Even with the lower prices, patients are being denied.

Not completely true (the restrictions have been eased a bit) but how does this fact support your claim? ("If they had priced lower, they probably would have seen even greater profits.") Profits were higher when prices were higher.

Re: The Hidden Monopolies That Raise Drug Prices

#164

Post by AstralStorm »

refurb wrote: post #136
triangleman wrote: post #86

Earlier quoted context omitted.

Someone had just posted a really useful post that was deleted about 15 minutes later. Here is the post copy/pasted in its entirety: EDIT: Wall of Text warning. >The average is almost 20% of revenue. This isn't exactly true. In fact the pharma industry lies so prodigously about it's own costs that it's almost impossible to know what they actually are spending on R&D. We can trace back the source of these numbers to va…

Ummm... the numbers reported by pharma companies has nothing to do with the estimate DiMasi's group did. The pharma numbers are SEC approved financial statements. That real cash going to R&D, not some pie in the sky estimate.

But no idea how much of that is going into new or more effective versions of the drugs, how much to manufacturing process research, how much on sales research etc.

Re: The Hidden Monopolies That Raise Drug Prices

#165

Post by dredmorbius »

joshuaheard wrote: post #24
torpfactory wrote: post #20

I'm going to make the statement that perscription drugs aren't like other products and shouldn't be viewed as such. People literally need them to survive. This whole system of having something you need to survive being subject to market forces like some other widget is ridculous. Price fixing is absolutely a reasonable tactic to employ when the market for prescription drugs in the US is as completely useless at deliv…

We need food to survive, and market forces work fine. In fact, I would say that the U.S. supermarket is a model of market efficiency.

Are you claiming that hunger, malnutrition, and diet-imposed diseases (diabetes, obesity, vitamin deficiencies) don't exist?

If that's the case, then perhaps the market is working find.

If it isn't, then ... perhaps your assertion fails.

Re: The Hidden Monopolies That Raise Drug Prices

#166

Post by jessriedel »

chimeracoder wrote: post #158
jessriedel wrote: post #156

Earlier quoted context omitted.

> patients pay for most drugs out of pocket, and their generic prices are actually not much lower than they are in the US[0] But rayiner's entire point is about incentivizing R&D by allowing the collection of monopoly rents on patented drugs; he's not talking about generics. How the market for generics is structure has essentially no impact on R&D. And as you say, since Canada's generics are nearly as expensive as in…

> But rayiner's entire point is about incentivizing R&D by allowing the collection of monopoly rents on patented drugs. I'm pointing to the generics as an illustration of Canada's pharmaceutical prices not being as controlled as people often think. (In fact, in Canada they're not controlled directly at all - they're simply pegged by law to other countries which set their own prices). I actually agree with rayiner's p…

Ahh, I see. Thank you for clarifying.

Re: The Hidden Monopolies That Raise Drug Prices

#167

Post by dredmorbius »

replicatorblog wrote: post #54
torpfactory wrote: post #47

Earlier quoted context omitted.

Almost all other developed economies use this approach and it works for them. Many Of these very companies are based on those very countries. We need a reasonable price for these medications. The market isn't delivering them. The scandal here isn't the pay these companies researchers receive. I'm happy to have them paid more for their work. To me the scandal is how much profit is being taken while many people go with…

How much are you willing to pay the nine teams of scientists whose experimentation fails to yield any useful medications for every one that works? The problem is that most people only want to pay for the ones that work. Thankfully there are companies that manage that market risk taking on our behalf and take a fee for the service.

In any labour market, the minimum you pay is what it takes to keep the worker, and the workforce capability, viable. That's straight out of Adam Smith, Wealth of Nations (Book 1, Chapter 8, "Wages of Labour").

You'll want to consider additional premia for the expenses of education and risk. Again, as a minimum.

The question of whether or not to reward successful teams on top of that really comes down to whether or not success is based on characteristics of the workers or is some random chance attribute. Giving high rewards for what are effectively spins of the roulette wheel doesn't strike me as particularly valid. Rewarding effective methodology and procedure, however, does.

Re: The Hidden Monopolies That Raise Drug Prices

#168

Post by kansface »

maxxxxx wrote: post #39

This is just another example of how messed up the US medical "market" is. Almost everywhere you look there are hidden prices, hidden middlemen and so on. I am not aware of any other market where things are so opaque and convoluted. If the current administration was serious about markets they should mandate that all pricing becomes transparent so a real functioning market can actually develop.

What good would that do when the customers of the service do not pay for it nor can they even evaluate differences in quality?

Consider eg, the cost of higher education in the US. Tuition is listed up front and students may trivially price compare... yet prices continually go up all the same.

Re: The Hidden Monopolies That Raise Drug Prices

#169

Post by dredmorbius »

ch4s3 wrote: post #157
TheAdamAndChe wrote: post #122

Earlier quoted context omitted.

Remember, Donald Trump was elected because people want change. Most people are aware at this point that the system is rigged, and are looking to change it. It's unclear currently whether populism or socialism will win in the long run, but don't lose hope yet.

Socialism and populism are not necessarily mutually exclusive. Quite often socialism takes the form of populist socialism (think Bernie Sanders or Chavez). Also, I think anyone who voted Trump to generate populist change, are likely getting a raw deal. The administration is loaded with Billionaires and business leaders, the opposite of populism. And, they've already set about enacting changes that negatively affect a…

"Demagoguic populism" vs. "Progressivist populism" might be a more useful axis.

The socialism vs. market capitalism division has been dominant since the 19th century, but isn't the only such division. I found the introductory chapter of A.H.M. Jones, Augustus, to be a particularly telling parallel of the interests and divisions of politics, this being Rome, ~40 BCE, and the optimates vs. the populares, the former being the propertied oligarchs, and hangers-on, the latter the larger (and generally disenfranchised) population.

(I've posted exerpts at G+ and Ello, search under my handles there.)

The Chartist movement and general populist reforms of 19th century Europe (especially in the Year of Revolutions, 1848) are also telling.

Increased electoral franchsie, judicial reform, and a number of other rights were key among issues raised. Unionisation as well.

Re: The Hidden Monopolies That Raise Drug Prices

#170

Post by vilmosi »

spangry wrote: post #77
kellanem wrote: post #27

The article does a good job of starting to explain the forces, but it's actually even more complicated. A number of the PBMs are cross invested in pharmacies and insurance companies, and the incentives of 2-3 large pharmacies that control the majority of the market (and how they get paid) is very different than how small pharmacies get paid. Additionally the way the generic market works vs the branded (patented) meds…

"Finally one of the challenges with moving to a centrally managed pricing solution like what works so well in Canada and most of Western Europe is right now R&D into pharmaceuticals is largely financed by the opportunity size available in the US market. If you were to just adopt the centralized model tomorrow R&D would grind to a stop, at least for some period of time until we found new ways to finance it." That woul…

>> So, on behalf of my fellow Australians, I'd just like to thank J&J for selling into my country at a substantial loss

Are they really making a loss in Australia? Your source doesn't say that.

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