A $20 drug in Europe requires a prescription and $800 in the U.S. • Hacker News Board

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

#221

Post by Insanity » Sat, Dec 06, 2025, 5:52 AM UTC

fy20 wrote: post #167

eszed wrote: post #117

Earlier quoted context omitted.

> 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 fr…

Right, and in my country you can even mix and match it. I went to see my GP, paid for by public health, they referred me to a specialist. I chose to pay €100 to see a private doctor who was available sooner (the next day) and had better ratings. They referred me for an MRI which was done at another private provider, paid for by public health. I went back to the private doctor and paid for a non-surgical treatment, wh…

Honestly one of my main healthcare related complaints about living in Canada is not having centralized health records. Sometimes Europe feels like living 2 decades in the future lol.

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

#222

Post by scottjg » Sat, Dec 06, 2025, 6:14 AM UTC

wrs wrote: post #175

cogman10 wrote: post #137

Earlier quoted context omitted.

Anyone know what's going on with the ACA marketplace? I like to take a peek at it every so often and it's just stupendously worse than employer healthcare. There is no plan in my market (Idaho) which doesn't have extreme out of network deductibles. The cost is also identical to what I and my employer pay for insurance. Is it just that the ACA is mostly used by sick people or something?

For one thing, as I understand it, the ACA was pretty effectively sabotaged by removing the mandate, which destroys the math that makes insurance work. Because pre-existing conditions have to be covered, you're free to wait until you have a serious (expensive) condition, then sign up for an ACA plan. And there's no mandate that spreads that risk around to healthy people, so the population is severely skewed. I have n…

this is mostly right, but it's not true that you can just sign up at any time. there's an open enrollment period for the aca marketplace and if you miss it, you won't have the opportunity to buy health insurance until next year.

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

#223

Post by autoexec » Sat, Dec 06, 2025, 6:15 AM UTC

OutOfHere wrote: post #212

autoexec wrote: post #159

Earlier quoted context omitted.

> Visomitin (Emoxipine/Mexidol) eye drops are a Russian-developed antioxidant medication known for treating dry eyes, fatigue, radiation damage, and improving vision I wouldn't recommend it. A quick search shows that it's not proven to do anything at all but it's also advertised as being the cure for parkinson's, asthma, back pain, high cholesterol levels, anxiety, blood clots, glaucoma, and Huntington’s disease whil…

I wouldn't be too sure or cocky because it does have a very broad mechanism of action that does cast a wide net. Humility is warranted.

I'd happily be proved wrong, but all the usual red flags are there. About the best that can be said for it at the moment is that there doesn't seem any more evidence that it's harmful than there is for it being helpful. Hopefully it gets the research to back up the claims. It certainly purports to be effective for conditions there's plenty of interest in developing effective and safe treatments for so you'd think that nations around the globe would be eager to look into it.

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

#224

Post by watwut » Sat, Dec 06, 2025, 6:44 AM UTC

dmix wrote: post #129

victorbjorklund wrote: post #78

Earlier quoted context omitted.

Trust me it doesn’t work perfectly in other countries. Yes, americas system is messed up but in countries like Sweden you will still have to navigate the system to actually get the healthcare you need. There are people who are denied healthcare in Sweden because the govt has deemed that it’s too expensive to save them (while people with similar conditions and a good insurance in the US are covered).

Also inflexibility, large backlogs, quality of staff, etc. In Canada all of our best doctors go to the US and there's often nurse shortages. It's not just a private incentive either, the US gov pays out far more in public healthcare coverage as a percentage of GDP and per capita than Canada and almost all of Europe. Despite their reputation the US doesn't have a lack of public healthcare spending (ranking #1-3 in the…

USA spends the most to get worst results. Spending just dont go to people who meed healthcare.

And usa have shortage of nurses. And waitlists. And people actually bankrupt by medical bills. It was number 1 reason for bankrupcy.

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

#225

Post by bobro » Sat, Dec 06, 2025, 7:45 AM UTC

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…

>So a lot of people who take this drug in the US actually pay $0 because they sign up for this card.

You do typically pay for insurance or otherwise have a reduced salary because your employer provides insurance, so saying you pay $0 isn’t really fair.

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

#226

Post by aucisson_masque » Sat, Dec 06, 2025, 7:57 AM UTC

Ancapistani wrote: post #20

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 m…

> 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.

That's absolutely incredible. Yeah if you can't even get a pricing,i don't see how you could make any decision whatsoever.

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

#227

Post by dotancohen » Sat, Dec 06, 2025, 7:57 AM UTC

andy99 wrote: post #136

dotancohen wrote: post #97

Earlier quoted context omitted.

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.

Being dispersed in the environment is not the same as being concentrated into our drinking water supply with each measure resulting in 1ppt contamination of a trillion measures of water.

I suggest that you read about food chains and water cycles.

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

#228

Post by aucisson_masque » Sat, Dec 06, 2025, 8:01 AM UTC

exasperaited wrote: post #93

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, This is satire? I can’t tell anymore. I mean the USA is the only country where someone can allegedly murder a healthcare executive for denying treatment and popular culture is engaged in drooling about how well the alleged killer fills out a tailored shirt.

When I say market, I'm referring to economic and more specifically to health market.

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

#229

Post by aucisson_masque » Sat, Dec 06, 2025, 8:06 AM UTC

guywithahat wrote: post #92

autoexec wrote: post #62

Earlier quoted context omitted.

> I would think that americans would be much more vigilant about what medication they take This is why I always check to make sure it's fiscally responsible before I start chemotherapy, or before buying that emergency inhaler for asthma, or before accepting paralytics and anesthesia when undergoing surgery. How fortunate that in America diabetics have the freedom to die rather than take overpriced insulin. Let the fr…

I mean you're joking but there are maybe ~20 brands who produce and sell inhalers. Maybe I need the inhaler but I also have a certain amount of choice, and presumably some are more expensive than others. Insulin is a famous example, because you can buy a vial for ~$30 or a nicer one for $300. They all effectively do the same thing but there is a quality difference between them, usually in regards to release time and…

I just checked insulin price in France, we have SANOFI 100 UI/ml 15ML for the price of 20€.

How is it possible to have 300$ Vial ? Sanofi ain't exactly a charity and they are doing extremely well financially, 300$ is obscene. If they sell it at 300$, there must be people buying it. Who are they ?

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

#230

Post by aucisson_masque » Sat, Dec 06, 2025, 8:11 AM UTC

autoexec wrote: post #62

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 This is why I always check to make sure it's fiscally responsible before I start chemotherapy, or before buying that emergency inhaler for asthma, or before accepting paralytics and anesthesia when undergoing surgery. How fortunate that in America diabetics have the freedom to die rather than take overpriced insulin. Let the fr…

> Sure, in America millions will die or be bankrupted by healthcare costs every year, but that's better than spending a single $ from your own wallet if even a tiny fraction of it might help pay for someone else's medications right?

I do believe your question is false, we don't spend a tiny amount of our money on healthcare.

Around 20% of our revenue, in France, goes to the universal healthcare.

And yes, I would rather manage that money myself because I believe I am better at doing so that my government. Isn't that one the core beliefs of Americans ?

The issue is that there must an actual free market, enforced by government, and not some kind of oligarchy where drug price are kept artificially high amongst reseller.