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Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

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Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#111

Post by maxerickson »

chmaynard wrote: post #57

From the article: "In the years following albendazole's price hike in 2011, Medicaid spending on the drug went from under $100,000 in 2008 to more than $7.5 million in 2013." To most Congressional Republicans, this is beautiful music begause it means one of their constituents is getting rich by ripping off taxpayers. (Indeed, it may be the only form of music they can appreciate.)

I would really like to see a detailed analysis of why Medicaid is paying these higher prices.

It seems to be because their payments are benchmarked to what private insurers pay and the private insurers don't fight price hikes on drugs with (for them) small total costs.

One fix might be to use a benchmark that is less dependent on whether private insurance bothers to negotiate. Another would be to allow HHS (working with FDA) to arrange for import of certain drugs.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#112

Post by bufferoverflow »

ceejayoz wrote: post #106
bufferoverflow wrote: post #105

Earlier quoted context omitted.

Ok, for two+ person household it's $14k, but then it's double income. And the premiums are not horrible either. It took me two minutes to find a bronze level plan for $398.56 ($4782 per year). It's not much at all. It's cheaper than paying much higher taxes in most of the EU.

> It's cheaper than paying much higher taxes in most of the EU. This is demonstrably false. https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...

You're confusing GDP with taxes

https://randomcriticalanalysis.files.wordpress.com/2014/11/t...

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#113

Post by notyourday »

mikeash wrote: post #108
notyourday wrote: post #99

Earlier quoted context omitted.

We do not have reciprocity agreement with Canada regarding drug approvals.

Anything approved in both countries ought to be OK, no?

You are describing this:

Canada->US, approved US->Canada, approved

i.e. Canadian companies are successfully selling to the united states medicine that is manufactured in Canada and is regulated by the US. US companies successfully selling products to Canada that are manufactured in the US and regulated in Canada.

If we had a reciprocity then we would have:

US->Canda->US auto-approved Canada->US->Canada auto-approved

i.e. if a product is sold to Canada then it can be re-imported into the US.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#114

Post by IWeldMelons »

snarf21 wrote: post #107
ZeroGravitas wrote: post #89

Earlier quoted context omitted.

Even if it was true that the extra money paid for pharmacuticals in the US was funding 24hr drive-through pharmacies, that would still be an idiotic system that needs burned to the ground. People who need drive through pharmacies should pay for them. People who want to order things online shouldn't be subsidizing them. Hiding the cost in a pill helps no-one and is obviously sub-optimal. Similarly, if you really wante…

I was exaggerating slightly. I was mainly trying to make the point that pills for pennies comes with other consequences. There are indeed better ways to do it but those have ripple effects that people ignore. If you change the rules, the companies will adjust and our access and jobs will change too. You can't just say I want all the good things of today and none of the bad and lower costs.

None of developed countries have healthcare in any way worse than US, but drugs are waaay cheaper.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#115

Post by justin66 »

harryh wrote: post #50
justin66 wrote: post #31

Earlier quoted context omitted.

> It's unclear to me why another drug manufacturer doesn't come in and undercut the price. From the sound of things these diseases were until very recently isolated to poorer countries. Even today, with the increased number of cases, there might not be enough money to be made based on a few sick North Americans to justify tooling up to make a new drug. (Some of that is about FDA regulatory approval, but not much sinc…

Ideally the drug company making this thing would just stop being boneheads about pricing. I think this is silly. We don't expect that companies "stop being boneheads" (by which I assume you mean act more ethically) when it comes to the pricing of televisions, or food, or household goods, or practically anything else. Why should we expect it for these pills? That expectation will be doomed to failure in many instances…

> We don't expect that companies "stop being boneheads" (by which I assume you mean act more ethically) when it comes to the pricing of televisions, or food, or household goods, or practically anything else. Why should we expect it for these pills?

Sure we do. Companies react to non-market concerns like ethics, civics, reputation, government and public pressure at the expense of short-term profit all the time, in addition to reacting to market competition.

Even if you accept the notion that the corporation (if it were a person) should be considered a sociopath, it is not at all obvious that market factors or regulation will be as effective in any given case at moving a company's leadership to behave ethically as, say, negative PR that will keep the CEO from getting laid. (not that you'd want to base an economic system on that...)

> A more ideal scenario would be to examine the underlying reasons that allow the company to charge so much for something that apparently costs so little to make.

That is not the important question at all. (do you really want to argue that charging a lot for something that "costs so little to make" is inherently a bad thing?) The important question in this case is why the same company can sell the same thing in two different markets with a 10,000x price difference.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#116

Post by IWeldMelons »

bufferoverflow wrote: post #110
vorotato wrote: post #83

Earlier quoted context omitted.

When you get robbed, you pay and you don't get shot. Yeah it's not cheap....

There's no free healthcare. You either pay it directly, or through taxes. Europeans pay high taxes, social security and VAT on most things. My brother in law pays almost 55% on his 80k salary in Italy. I don't think I ever paid over 38% even when I was making $160K in the US. If you look at the median salaries, $4.7K in premiums over a year is not a big deal, and then you spend another $7K in case you need to max out…

You and your employer pay for the insurance. This is the hidden 10% of tax, plus your out of pocket expenses you'd end up paying, if you get sick.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#117

Post by ceejayoz »

bufferoverflow wrote: post #112
ceejayoz wrote: post #106

Earlier quoted context omitted.

> It's cheaper than paying much higher taxes in most of the EU. This is demonstrably false. https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...

You're confusing GDP with taxes https://randomcriticalanalysis.files.wordpress.com/2014/11/t...

No, I'm not.

As indicated in my link, Americans pay the highest per-capita costs (be it via premiums/copays, taxes, etc.) for healthcare in the world.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#118

Post by slededit »

bufferoverflow wrote: post #110
vorotato wrote: post #83

Earlier quoted context omitted.

When you get robbed, you pay and you don't get shot. Yeah it's not cheap....

There's no free healthcare. You either pay it directly, or through taxes. Europeans pay high taxes, social security and VAT on most things. My brother in law pays almost 55% on his 80k salary in Italy. I don't think I ever paid over 38% even when I was making $160K in the US. If you look at the median salaries, $4.7K in premiums over a year is not a big deal, and then you spend another $7K in case you need to max out…

Except the US government already spends more public money per capita than Canada and doesn't have universal care. Your government is spending more and getting much less.

http://www.businessinsider.com/us-spends-more-public-money-o...

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#119

Post by xellisx »

SaintGhurka wrote: post #92
Retric wrote: post #58

Earlier quoted context omitted.

McDonald's can have 24/7 drive though windows while selling burgers and fries, but most pharmacy's are not open close to 24/7.

Burgers and fries don't require clinical trials.

We've had clinical trials for burger and fries. Results: America is now a lot heavier.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#120

Post by Retric »

notyourday wrote: post #96
Retric wrote: post #64

Earlier quoted context omitted.

You don't get competition on day one, and one week of 8000x prices is worth more than 10 years of 1x prices. However, you can and will drop prices when competition shows up, so you see 8000x profits when competitors see a competitive market.

neither AT&T nor Samsung were able to do it against MCI or Vizio. But, sure, lets pretend it is different this time.

AT&T did not have a total monopoly and the ability to charge 8000x prices. Remember the drug company is already ahead even if they never sell this drug again. That's not true of less extreme price increases.
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