11–20 of 86 posts
Note: this is less than one half of one percent of total Medicare spending.
It’s important to point out how vast this spending is so that headlines that give dollar figures are balanced and the hyperbolic rhetoric can be put in context.
I would point out that it may end up costing more to source and administer generic drugs than $3.6B and could end up harming the pharmaceutical research economy.
Not just generics. Ever get a coupon from a drug manufacturer that drops your copay from hundreds of dollars to $10 or $20? Ever wonder why? It’s because Medicare gets an automatic discount (I think 20% these days but I’m no longer in the biz) from the manufacturer’s official price. So they simply set the official price at some huge figure and rake in huge bucks from the largest buyer, Medicare. Then they negotiate w…
Then they start issuing rebates instead of discounts?
Or yeah, sure, everyone's definitely paying $100 for this quantity of this drug, then we kick insurance back $80 for advertising for every unit that makes it to an end consumer through them.
There's no easy way out of price discovery when you are the largest buyer, because it becomes more than profitable enough to structure sales to exploit your policy to make up for the loss in doing the structuring.
Not just generics. Ever get a coupon from a drug manufacturer that drops your copay from hundreds of dollars to $10 or $20? Ever wonder why? It’s because Medicare gets an automatic discount (I think 20% these days but I’m no longer in the biz) from the manufacturer’s official price. So they simply set the official price at some huge figure and rake in huge bucks from the largest buyer, Medicare. Then they negotiate w…
Australia [1] uses a broader spectrum of metrics but price of drugs in other international markets is a substantial part of it's analysis and negotiations.
[1] https://www.pbs.gov.au/industry/pricing/pbs-items/historical...
This is comparing to generic drugs from one specific company, based on the notion that the specific company is capable of providing a cheaper generic drug in a situation most favorable to the drug maker (a bulk purchase). It doesn’t actually go into if the generic will actually be a suitable replacement for each patient. For people with complex health needs, like the over 65+ folks on Medicare, it makes total sense t…
Yeah no. Generics -are- equivalent and regulated to be as such. [1] If you are hearing anything different it's just BS. [1] https://www.fda.gov/drugs/questions-answers/generic-drugs-qu...
A really good example where this fails miserably is Adderall for ADHD. The generics are absolutely miserable. And if you actually find a generic you tolerate you can never switch pharmacies because they’ll be different.
I’m no pharmacological expert but when I asked my pharmacist they explained it to me they said it was because Adderall is a mix of two drugs and it’s expensive to refine them into a balanced ratio but the FDA doesn’t care so generics don’t bother.
Not just generics. Ever get a coupon from a drug manufacturer that drops your copay from hundreds of dollars to $10 or $20? Ever wonder why? It’s because Medicare gets an automatic discount (I think 20% these days but I’m no longer in the biz) from the manufacturer’s official price. So they simply set the official price at some huge figure and rake in huge bucks from the largest buyer, Medicare. Then they negotiate w…
This is comparing to generic drugs from one specific company, based on the notion that the specific company is capable of providing a cheaper generic drug in a situation most favorable to the drug maker (a bulk purchase). It doesn’t actually go into if the generic will actually be a suitable replacement for each patient. For people with complex health needs, like the over 65+ folks on Medicare, it makes total sense t…
Not just generics. Ever get a coupon from a drug manufacturer that drops your copay from hundreds of dollars to $10 or $20? Ever wonder why? It’s because Medicare gets an automatic discount (I think 20% these days but I’m no longer in the biz) from the manufacturer’s official price. So they simply set the official price at some huge figure and rake in huge bucks from the largest buyer, Medicare. Then they negotiate w…
I'm on a med that's $12k every two months. If I were on a high deductible plan, they'll happily cover that $12k for the first go, because I meet my deductible and then insurance pays the other five doses. The cost to them is basically nil; chances are the actual one mililiter of fluid costs them a marginal $20 or so to make.
Not just generics. Ever get a coupon from a drug manufacturer that drops your copay from hundreds of dollars to $10 or $20? Ever wonder why? It’s because Medicare gets an automatic discount (I think 20% these days but I’m no longer in the biz) from the manufacturer’s official price. So they simply set the official price at some huge figure and rake in huge bucks from the largest buyer, Medicare. Then they negotiate w…
> It’s a huge rip off. Medicare should be paying a discount to the median price actually paid on the open market. But apparent nobody has an incentive to fix this. Then they start issuing rebates instead of discounts? Or yeah, sure, everyone's definitely paying $100 for this quantity of this drug, then we kick insurance back $80 for advertising for every unit that makes it to an end consumer through them. There's no…
This is comparing to generic drugs from one specific company, based on the notion that the specific company is capable of providing a cheaper generic drug in a situation most favorable to the drug maker (a bulk purchase). It doesn’t actually go into if the generic will actually be a suitable replacement for each patient. For people with complex health needs, like the over 65+ folks on Medicare, it makes total sense t…
Generics are literally identical to the original drug.
There’s more than just the raw chemical in play in a lot of meds.