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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.

#71

Post by llm_nerd »

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.

>"most favored nation"

There is a weird thing Americans often do when confronted with the incredibly high price of medicine and medical care in the US of imagining that every other country is actually responsible for this (hence the "most favored" nonsense). That it's zero sum and every other country is laughing and taking Americans for a ride and underpaying, and therefore Americans have to cover the bill.

This is the angle Trump has taken in some of his incredibly ignorant and stupid screeds on this topic (as with every single position he has on anything): Get everyone else to pay more and somehow the US pays less!

This...isn't at all how it works, or what the problem is. Americans pay more because of the whole massive scam of your Medical Insurance Racket, where everything has imaginary inflated prices and an absolutely massive middle-tier of suits having nothing to do with medicine are taking their cut. This is your problem, reflected almost nowhere else on the planet, and it is domestic caused and will need to be fixed domestically. Criticizing Europe or Canada or anyone else will never, ever fix the utterly, insanely broken and profoundly stupid American system.

But it won't. It's simply incredibly how easily Americans can be fooled into voting against their own best interests, year after year.

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

#72

Post by sov »

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…

> The FDA is partially to blame for this situation: ...

> The cost of performing a New Drug Application starts in the mid hundreds of millions of dollars range and can extend into the billions for some drugs.

> So nobody could feasibly introduce it to the market here without investing $500 million or more up front. At that price, your only viable option is to stick a big price tag on it and try to milk that money back from insurers.

It's interesting that you seem so passionate about this because you're totally incorrect. The cost of a NDA for a novel prescription drug requiring clinical data (the most expensive application) is ~$4.5mil. In fact, the estimated TOTAL revenue to the FDA from ALL PD application fees in FY 2025 is ~$1.3billion (or, just under 300 novel prescription drugs). So, obviously, FDA fees can't be as much as you're claiming.

What you're actually describing is the total cost of the entire drug development pipeline (research, design, lab costs, chemical costs, application costs, marketing costs, etc.) to develop a brand new, novel drug. And it's only ~$200m, increasing to $500m if you include dead ends / failures in the process, and ~$900m if you include both failures and capital costs--yep, that's right the capital costs alone are almost as much as the entire rest of the drug development pipeline.

See: https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

And that's for novel Prescription Drugs.

> They required a complete New Drug Application before they would let anyone bring it to market, even though it's over the counter in other countries.

No. In that case they would pay the FDA OMUFA fees, not the FDA PDUFA fees, which are ten to fifty times cheaper than the PDUFA fees.

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

#73

Post by andy99 »

dotancohen wrote: post #49
autoexec wrote: post #37

Earlier quoted context omitted.

How many gallons of Miebo/Evotears do you think are manufactured every year?

Multiply that by the t in ppt. How many trillions of gallons of water do you think an average city uses every year?

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

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

#74

Post by actionfromafar »

dotancohen wrote: post #44
averageRoyalty wrote: post #24

Earlier quoted context omitted.

Absolutely. I'd prefer to go to the pharmacy and just pay my $20 and go.

Do you prefer sunny (Greece) or snowy (Norway)? You can just pay your $20 and go. It is an option.

I prefer to pay thousands in tariffs and/or private companies, thank you very much. I'm not a communist.

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

#75

Post by wang_li »

ChrisMarshallNY wrote: post #57
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…

[flagged]

The US has a massively progressive tax system. On a net tax basis about 50% of the country pays nothing. Sure, they pay sales tax and employment taxes, but they also receive some mix of earned income tax credits, child tax credits, snap, medicaid, housing, etc. There is no real way for the US to have a single payer tax system without more people actually becoming net tax payers.

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

#76

Post by actionfromafar »

yread wrote: post #25
ThePowerOfFuet wrote: post #13

Earlier quoted context omitted.

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.

Well but that $225 feeds and clothes a lot of the people who spend all day designing these cards and systems around that

Including Oracle, probably.

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

#77

Post by [deleted] »

picafrost wrote: post #23

The US is a GDP ponzi scheme disguised as an economy. The silly prices exist to shuffle money between pharmaceutical companies, PBMs, insurers, pharmacies, hospitals, and who knows what other intermediaries. Everyone takes a cut and can put large revenues on their balance sheet. The US today is structurally dependent on this sort of cash migration. If all Americans suddenly began to save 10%+ of their income every mo…

[deleted]

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

#78

Post by victorbjorklund »

xnorswap wrote: post #39
Insanity wrote: post #12

Earlier quoted context omitted.

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

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…

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).

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

#79

Post by terminalshort »

wagwang wrote: post #65
terminalshort wrote: post #46

Earlier quoted context omitted.

And water supply is measured in km^3

so 1 liter of eye drop per 1ppt of km^3

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.
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