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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.

#111

Post by brandonmenc »

terminalshort wrote: post #43

If a drug isn't one of the following it should be available over the counter. 1. heinously addictive 2. incredibly dangerous when not used exactly correctly 3. an antibiotic (due to the resistance externality) And for drugs that do meet one of these conditions, doctors should be able to write lifetime prescriptions for cases where the medication is used to treat a permanent condition. This probably covers 95% of non-…

We'd have to grant some form of blanket immunity to drug companies the way we currently do with vaccines.

Also, aren't most mostly benign drugs dangerous when combined with the wrong other mostly benign drugs? The gatekeeping protects against that.

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

#112

Post by ahtihn »

oakesm9 wrote: post #68
BeetleB wrote: post #29

If Americans didn't pay $800 for it, how would Europeans afford it?

Such an easily debunkable line with even the tiniest bit of critical thinking. You’re basically saying the drug companies subsidise a loss in Europe by over charging Americans, right? As the drug company is a private and doesn’t have to sell everywhere, why wouldn’t they just skip the loss making Europeans and just sell to Americans? They’d make more profit that way! That must mean they make some profit from the Euro…

It's a bit more complicated than that. R&D for new drugs is incredibly expensive while the cost to actually produce most drugs is reasonably low.

The price of drugs that make it to market needs to not only cover the cost to produce the drug, but also the cost of R&D and the cost of R&D of all the drugs that fail to get to market.

Now this gets complicated when a company sells in different markets with actors that have different negotiating power. It makes sense to sell in any market where the company can get a profit per unit sold without including R&D. But if none of the markets allow enough profit to cover R&D, then it's not really worth developing any new drugs at all anymore.

That's why people say that the US is basically subsidizing drug development. It's not that it's not profitable to sell in the rest of the world, it's just that margins are much lower which allows for a lot less risk-taking on R&D.

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

#113

Post by terminalshort »

jaggederest wrote: post #95
terminalshort wrote: post #79

Earlier quoted context omitted.

That would be 1 liter of the active ingredient, not 1 liter of the eye drop. Also I don't believe that 1 ppt of this stuff is harmful when people are putting it directly in their eyes without severe harm.

There's only a single ingredient, these eyedrops are 100% pure PFAS And people put asbestos on their christmas trees back in the day - I don't think "obvious harm" is a high enough standard.

I think obvious harm at 1 trillion parts per trillion is a pretty good standard to meet if you want to claim harm at 1 part per trillion.

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

#114

Post by trashface »

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…

> 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.

This isn't really true on obamacare/ACA plans, even the high-end ones like gold PPOs. The formularies are much worse than employer-based plans. Insurers are required to cover one drug in each therapeutic category, but its usually an older generic. Most brand name drugs like this one have really bad coverage or not at all, which means the insurer won't even negotiate with the pharmacy to lower the drug.

Yes you can use coupons, sometimes, but the pharmacy can't always process them and the manufacture is always change the conditions and expiring them. I got one for my glaucoma drops directly from my eye doctor, and it was expired immediately when I tried to use it. I have paid $650 (for a 3 month supply, the full retail cost) for my drops when the coupon didn't work, and I couldn't get them any other way - I can't interrupt the med or else my eyes get damaged. So that falsifies your "nobody" assertion.

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

#115

Post by petercooper »

However, it’s not all roses. Try getting melatonin in the UK. You can buy it almost anywhere in the US. Same for any first generation antihistamines. Or a jar of painkillers - packets are limited to 16 here. Or lidocaine cream. Whenever I go to the US, I have a shopping list to restock our medicine cabinet.

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

#116

Post by autoexec »

dotancohen wrote: post #97
andy99 wrote: post #73

Earlier quoted context omitted.

Is all the Miebo/Evotears that’s manufactured being dumped directly into the drinking water supply?

Where do you think it goes after it gets to your eyes? The valid choices are: A. Absorbed into your body forever. B. Becomes a part of the water cycle. C. Is broken down. And even choice A eventually becomes choice B, ideally after significant time though.

One thing you can be sure of is that the vats of PFAS being produced year after year for this drug aren't going away anytime soon. They're called "forever chemicals" for a reason.

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

#117

Post by eszed »

christkv wrote: post #67
xnorswap wrote: post #39

Earlier quoted context omitted.

The best thing about universal healthcare isn't how much money I may or may not have to pay, it's that I literally don't once have to think about a bill or filling out a form to avoid paying too much. I wouldn't care if I ended up paying more in tax than I would in an insurance model. The benefit is being able to 100% focus on my health instead of navigating a system to try to reduce what I'm paying. When you're diag…

Most countries have both public and private. In Spain I have public and then private on top of that which 220 eur a month for a family of four all services included and no co-pay. The public option works to set a roof on what private insurance can charge.

> The public option works to set a roof on what private insurance can charge.

Exactly! This is what no one in the US seems to understand. My encounters with private clinics and hospitals in the UK (all 10+ years ago, at this point) were unbelievably luxurious, at prices that (totally, completely free-market driven, mind you) were affordable on middle-class incomes. Or, yeah: there's private medical insurance, also free-marketed to "shockingly reasonable", by US measures. Americans on good salaries have been bamboozled into believing that a single-payer system will trap them into some kind of hell-hole hospital° with no recourse, when in fact the exact opposite is true.

---

°And, of course, the "hell-hole hospital" examples are cherry-picked. Bad on their own, of course, but not representative of a system as a whole, nor recognize that equally awful anecdotes are abundant in the USA.

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

#118

Post by OutOfHere »

nkmnz wrote: post #96

The drug in question is perfluorohexyloctane, which is part of a class of substances known as PFAS or „forever chemical“. I‘m a chemist, I love modern medicine and material technologies based on chemistry, and I don’t hesitate to take vaccines or other meds, and I also happen to have SEVERE dry eyes syndrome - but hell no, I’m not going to put that stuff into nature!

Precisely. Just because a medicine is an approved medicine increasingly shouldn't automatically mean that any sensible patient should ever use it. The PFAS in question is not even short chain, it is medium chain, which means it's likely to accumulate inside the body, albeit at a slow pace. One doesn't even have to be a chemist to know these things.

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

#119

Post by rootusrootus »

autoexec wrote: post #45
philip1209 wrote: post #38

What's to stop congress from passing a blanket "most favored nation" law for VA + medicare on all pricing, inclusive of insurance rates and discounts? Seems like it would be fair and useful.

The same thing that stops them from just joining the rest of the first world nations and giving us universal healthcare. Greed.

We're working our way towards it little by little. We're up to ... around 40% on public healthcare now? Or thereabouts.

Maybe the next dem president will write an executive order directing the HHS to drop the enrollment age for Medicare to zero.

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

#120

Post by Someone1234 »

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…

This varies wildly by medication; and makes a ton of assumptions that all happen to benefit the drug company's position/parrots their PR.

For example, my partner needs $100/pill medication, which also had a "savings card." That card only lasts for 12-months or 8-pills (whichever comes first). Then it is $100/pill. After insurance (High Deductible), we pay out of pocket $100/pill up until $3200. Insurance discount: 0%.

So the cash price and the insurance price are identical, except the insurance price counts towards deductible. UK price of the same medication? £10/pill, and that isn't via the NHS, that is full-price private (NHS could be as low as FREE, depending on several factors).

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