Maybe 20 years back I remember reading an article describing how many generics were intentionally ineffective - missing key ingredients - and secretly created by the drug manufacturer themselves in order to increase sales. It was a big article in the New York Times if I recall.
Insulin Wars: How insurance companies farm out dirty work to doctors patients
21–30 of 95 posts
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#22I always say this, but reading that makes me think thank God for the NHS in the UK. Health and education should never be a business. The pharmaceutical companies are so strong and greedy in the US they want people on their drugs, rather than look for preventing the problems. They often lambast and send confusing scientific studies out to ensure no alternative therapies succeed over their drugs.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#23> This pricing is, of course, hidden from most patients, except those without insurance, who have to pay full freight.
The rest of the story flows from this. The ordinary price mechanism is broken because the patient isn't the customer, and the customer is paramount to any business. As long as most patients don't care what it costs most of the time, it will stay broken.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#24I still think the approach I proposed years ago would be a big help: Turn the usual arguments on their head, prohibit all negotiation. Drug companies would be required to sell to all customers at the same price. This would end all cost-shifting, it's fair for all and forces the drug companies to actually compete on the end price. This would end this sort of preferred drug shifting, it would end the game of state Medi…
I agree 100%. The approach I like is what I call "lowest negotiated price". How it would work is that buyers (i.e. insurance companies) could still negotiate for a lower cost, but whatever that cost ends up being is the cost _everyone_ pays. This allows buyers to continue to try to get a better price if they can, while likely making sure the price that is agreed upon is fair to all.
That sounds like an interesting solution.
It makes me ponder a "highest negotiated salary for $position" approach to combat income inequality
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#25Interestingly, Walmart sells generic insulin. The same stuff used decades ago, for only $25 a vial. However, the advances in insulin since then mean it’s a much more burdensome therapy. https://insulinnation.com/treatment/why-walmart-insulins-are...
So this implies that the articles blame on greedy drug manufacturers tweaking formulas to keep patent protection isn't really correct since they have made progress in actually improving the drug.
Not to say there is no greed here, but our policy has been that if you do the work of making a new drug, you get to charge whatever you want for an extended period of time.
This is the result of the policies we have chosen.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#26This is exactly what you get when there is no transparency, and everything is driven by non-market forces. Why not create an actual market where all medications, medical services, tests, etc, have a known price and people can make decisions based on cost, quality, and other factors?
Kenneth Arrow showed in 1963 that markets can't work for Healthcare.
Well, the current heavily regulated cronyism isn't working, so what else you got?
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#27I still think the approach I proposed years ago would be a big help: Turn the usual arguments on their head, prohibit all negotiation. Drug companies would be required to sell to all customers at the same price. This would end all cost-shifting, it's fair for all and forces the drug companies to actually compete on the end price. This would end this sort of preferred drug shifting, it would end the game of state Medi…
> Drug companies would be required to sell to all customers at the same price. This would end all cost-shifting, it's fair for all and forces the drug companies to actually compete on the end price.
Then you only sell the drugs that do profit, and stop making the ones that cost money. You cant make people do what they don't want to do, pharma is no exception.
The source of this problem is patent law, importation restrictions, etc. In short, competition.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#28Luckily I never had to take insulin, as I am not diabetic. I had a dog, however, who needed it. She was prescribed Humulin-N, which is not generic. The generic insulin would not be adequate for her, according to the vet.
When I got to the pharmacy, I was amazed to learn that it would cost us ~200 USD each time I needed a vial, which I would not be able to afford; I had pet insurance, but it wasn't any help.
I have family in Brazil. Identical medication is sold there for around 10 USD. By "identical" I mean exactly the same -- including brand name (Eli Lilly). Thus, every time a family member was coming to the USA, they'd bring me a few vials purchased from a local pharmacy that honored our US-issued prescription.
The price difference is shocking. I can only imagine the despair of many Americans who cannot afford the insulin they need and have no access to alternative markets such as I had.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#29I still think the approach I proposed years ago would be a big help: Turn the usual arguments on their head, prohibit all negotiation. Drug companies would be required to sell to all customers at the same price. This would end all cost-shifting, it's fair for all and forces the drug companies to actually compete on the end price. This would end this sort of preferred drug shifting, it would end the game of state Medi…
I agree 100%. The approach I like is what I call "lowest negotiated price". How it would work is that buyers (i.e. insurance companies) could still negotiate for a lower cost, but whatever that cost ends up being is the cost _everyone_ pays. This allows buyers to continue to try to get a better price if they can, while likely making sure the price that is agreed upon is fair to all.
There is evidence that this would actually increase prices across the board. How do we know? Such a system already exists.
The price that Medicaid plans pay is either 23% less than the average price paid or the “best price” (if lower).
When this was instituted, drug companies actually pulled back on their discounts to non-Medicaid accounts, so as to not trigger the “best price”.
Re: Insulin Wars: How insurance companies farm out dirty work to doctors patients
#30I still think the approach I proposed years ago would be a big help: Turn the usual arguments on their head, prohibit all negotiation. Drug companies would be required to sell to all customers at the same price. This would end all cost-shifting, it's fair for all and forces the drug companies to actually compete on the end price. This would end this sort of preferred drug shifting, it would end the game of state Medi…
You realize this could potentially increase prices right?
Every pricing decision undergoes a cost-benefit analysis. If I know that offering a small account a lower price means everyone gets that price, I’d be willing to lose all business to the smaller account because in the end I get more money.
A much better proposal would be no net pricing. The price that everyone pays is public knowledge.