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A $20 drug in Europe requires a prescription and $800 in the U.S.

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Re: A $20 drug in Europe requires a prescription and $800 in the U.S.

#11

Post by Aurornis »

ghostDancer wrote: post #5

Nothing says capitalism and free market like good extortion on health products and services. That's the way to go USA.

There is no free market at play here. This is the result of FDA regulations not allowing anyone to sell it unless they did a New Drug Application first, which could cost a billion or more. Therefore nobody in the free market was allowed to sell it without putting up the capital first, which they have to collect back now.

You could actually order this from amazon.de up until recently and have it shipped to you. That seems to have disappeared, though.

Re: A $20 drug in Europe requires a prescription and $800 in the U.S.

#12

Post by Insanity »

Aurornis wrote: post #8

FYI for anyone who isn't familiar with the wacky US insurance situation: Nobody in the US actually pays $800 for the drug. That's the "list price" for insurance companies to pay. Even insurance companies don't pay that price because they negotiate their own rates with the drug companies, which are lower. Then the drug companies come in and offer a "savings card" which you apply at the pharmacy like another layer of i…

I think that might be worse than just having the high price. Such a kafka-esque systems just to get medicine.

Re: A $20 drug in Europe requires a prescription and $800 in the U.S.

#13

Post by ThePowerOfFuet »

Aurornis wrote: post #8

FYI for anyone who isn't familiar with the wacky US insurance situation: Nobody in the US actually pays $800 for the drug. That's the "list price" for insurance companies to pay. Even insurance companies don't pay that price because they negotiate their own rates with the drug companies, which are lower. Then the drug companies come in and offer a "savings card" which you apply at the pharmacy like another layer of i…

All that handwaving and apology but yet

>the actual cash-pay price is $225

So still 11x the price, plus whatever the prescription costs.

Unforgiveable.

Re: A $20 drug in Europe requires a prescription and $800 in the U.S.

#14

Post by brianherbert »

Aurornis wrote: post #8

FYI for anyone who isn't familiar with the wacky US insurance situation: Nobody in the US actually pays $800 for the drug. That's the "list price" for insurance companies to pay. Even insurance companies don't pay that price because they negotiate their own rates with the drug companies, which are lower. Then the drug companies come in and offer a "savings card" which you apply at the pharmacy like another layer of i…

These "savings cards" have a maximum annual benefit applied to them so for those on insurance that do not cover those expensive medications or who are self-paying use up the benefits before year end and do in fact eventually pay full sticker price.

Re: A $20 drug in Europe requires a prescription and $800 in the U.S.

#15

Post by xp84 »

aucisson_masque wrote: post #9

in some part of europe, we have national healthcare so basically people don't think they are paying their medications, like there was some magic money. in that case, you don't care if you drug cost 10€ or 2000€ because you aren't spending a single € from your own wallet, at least if you don't factor in taxes. Contrary to the USA where it's a much more responsible market, people do pay for the medications or they get…

> I would think that americans would be much more vigilant about what medication they take, the price it cost, and so would have much lower pricing.

> Is it the proof that a true unregulated free market doesn't work ?

The market is heavily regulated (frequently crazily) by the FDA, and the actual amount anything costs is heavily obscured from the eyes of any consumers by the fog of bureaucracy and insurance.

Many people have 3-4 tiers of fixed copays that the insurance company makes up - some pharmacies won't even tell you when there is a cash price or a "coupon" that would be cheaper than your insurance copay! And pharmacies don't publish a plain list of what the cash prices are, and it would be hard for most people to even produce the tier formulary, it's buried as a PDF in some obscure page of a horrible website. So we just go to the pharmacy and see what it'll cost us.

Also, one major insurer owns a major pharmacy benefits manager and one of the big 2 pharmacy chains, so they use that to put their thumb on the scale however they can, while the other insurers and PBMs play games to lock consumers into restrictive exclusive deals that are to their detriment.

Anyway we don't have a market at all when it comes to healthcare, because the majority of price information is withheld from consumers until the opportunity to make any choice, if it even existed, is well past.

Re: A $20 drug in Europe requires a prescription and $800 in the U.S.

#16

Post by Ancapistani »

brianherbert wrote: post #14
Aurornis wrote: post #8

FYI for anyone who isn't familiar with the wacky US insurance situation: Nobody in the US actually pays $800 for the drug. That's the "list price" for insurance companies to pay. Even insurance companies don't pay that price because they negotiate their own rates with the drug companies, which are lower. Then the drug companies come in and offer a "savings card" which you apply at the pharmacy like another layer of i…

These "savings cards" have a maximum annual benefit applied to them so for those on insurance that do not cover those expensive medications or who are self-paying use up the benefits before year end and do in fact eventually pay full sticker price.

Then you switch to a difference card.

That's pretty much the entire business model of GoodRx.

Re: A $20 drug in Europe requires a prescription and $800 in the U.S.

#17

Post by thrwwXZTYE »

aucisson_masque wrote: post #9

in some part of europe, we have national healthcare so basically people don't think they are paying their medications, like there was some magic money. in that case, you don't care if you drug cost 10€ or 2000€ because you aren't spending a single € from your own wallet, at least if you don't factor in taxes. Contrary to the USA where it's a much more responsible market, people do pay for the medications or they get…

The funny thing is that when you have one big customer (a country) - you get good prices.

When you have 30 insurance companies, 10000 companies buying insurance policies and millions of individuals - you get shit prices.

That's why the drug in question is 200 USD in US (after deductions) and 20 in Europe (including taxes).

Re: A $20 drug in Europe requires a prescription and $800 in the U.S.

#18

Post by DangitBobby »

aucisson_masque wrote: post #9

in some part of europe, we have national healthcare so basically people don't think they are paying their medications, like there was some magic money. in that case, you don't care if you drug cost 10€ or 2000€ because you aren't spending a single € from your own wallet, at least if you don't factor in taxes. Contrary to the USA where it's a much more responsible market, people do pay for the medications or they get…

Part of the problem is that the way our healthcare system is setup, it's not even a remotely free market. It's pretty much a worst of all worlds situation.

Re: A $20 drug in Europe requires a prescription and $800 in the U.S.

#20

Post by Ancapistani »

aucisson_masque wrote: post #9

in some part of europe, we have national healthcare so basically people don't think they are paying their medications, like there was some magic money. in that case, you don't care if you drug cost 10€ or 2000€ because you aren't spending a single € from your own wallet, at least if you don't factor in taxes. Contrary to the USA where it's a much more responsible market, people do pay for the medications or they get…

> Contrary to the USA where it's a much more responsible market, people do pay for the medications or they get it paid by their own insurance but it cost them directly a lot of money.

That's the idea, but in practice there are so many layers of indirect government incentives, disincentives, and direct interventions that market is no longer effective for this purpose.

It's virtually impossible to find out how much a medical procedure actually costs. Most hospitals and clinics refuse to even estimate as a policy, which has led to the creation of things like pre-paid services for labor and delivery. Those are quite rare.

I'm 100% in favor of allowing the market to work - but at this point, we have the worst of both worlds and the best of neither. Either extreme would be better than what we have.

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