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The great generic drug rip off
Posted on 12/17/14 at 12:38 am
Posted on 12/17/14 at 12:38 am
3
Posted on 12/17/14 at 12:43 am to Eurocat
Maybe a little more competition in the generic drug space would help keep prices down. Of course, our FDA makes it hard for new entrants to bring in generics...
Posted on 12/17/14 at 12:49 am to Eurocat
quote:Probably could leave it as the great US drug rip off in general. We need to fix our medico-legal system to approximate international markets. We need to fix our tax system to approximate international markets. Then we need to open pharmaceutical purchase options to include identical drugs available for a fraction of US cost in international markets.
The great generic drug rip off
Posted on 12/17/14 at 1:37 am to NC_Tigah
quote:
to approximate international markets
quote:
to approximate international markets
How do you feel about allowing most drugs to be sold OTC without a prescription like you can in many international markets?
Posted on 12/17/14 at 1:39 am to Asgard Device
quote:support
How do you feel about allowing most drugs to be sold OTC without a prescription like you can in many international markets?
Posted on 12/17/14 at 1:42 am to HailHailtoMichigan!
What are you guys talking about? I have lived in Europea (for over 20 years) and Asia (not that long, but still...) and in both places it is much harder to get anything without a prescription. I fly back to Europe with a lot of Mucinex and similar over the counter stuff because I want to simply take that and not have to go to a doc every time I get a minor case of the sniffles.
What is the source of your information?
What is the source of your information?
Posted on 12/17/14 at 1:52 am to Eurocat
When I lived in the UK if I had a minor infection like conjunctivitis I just went straight to the pharmacy. No doctors note necessary.
Posted on 12/17/14 at 2:07 am to Mephistopheles
Must be a continent vs UK thing then. Strange.
Posted on 12/17/14 at 2:12 am to Asgard Device
quote:
How do you feel about allowing most drugs to be sold OTC without a prescription like you can in many international markets?
Posted on 12/17/14 at 3:29 am to NC_Tigah
quote:
Then we need to open pharmaceutical purchase options to include identical drugs available for a fraction of US cost in international markets.
I'm not saying don't do this, but don't do this.
The savings realized after paying a middle man importer will end up at 10-15% even on those products and that will disappear over time.
The real issue is AWP and how Medicare and Medicaid reimburse. And of course, the back issue is the fact that the federal government is such a huge percentage of the market and consequently, the entire pay scheme is derived from bilking as much money as possible from it.
Here's an overview and some of the changes upcoming:
LINK
Posted on 12/17/14 at 3:33 am to Mephistopheles
quote:
When I lived in the UK if I had a minor infection like conjunctivitis I just went straight to the pharmacy. No doctors note necessary.
Yeah, I travel to Central America regularly and when you want a "prescription," you walk into the pharmacy and buy it. Presto - Levaquin!
Posted on 12/17/14 at 6:24 am to the808bass
quote:
I'm not saying don't do this, but don't do this.
The savings realized after paying a middle man importer will end up at 10-15% even on those products and that will disappear over time.
Hilliary Clinton noted that if NY pharmacies could simply send a driver across the boarder into Canada and buy drugs at retail from Canadian Pharmacies, they would save significantly over wholesale US costs. Currently such international purchase is against the law. Sen. Clinton proposed the law be changed. Big Pharma shut the effort down.
In a day and age of the internet, worldwide purchase outlets, international shipping, etc., I have no idea what you are referring to when you discuss "middle man importers ending up with 10-15%." The "middle man" would be UPS/FedEx.
quote:You need to clarify what it is you think you're addressing here. What you seem to be asserting is bizarre.
The real issue is AWP and how Medicare and Medicaid reimburse. And of course, the back issue is the fact that the federal government is such a huge percentage of the market and consequently, the entire pay scheme is derived from bilking as much money as possible from it.
Here's an overview and some of the changes upcoming:
This post was edited on 12/17/14 at 6:29 am
Posted on 12/17/14 at 6:32 am to the808bass
quote:Mexico too. However, 1st World Pharmacies, not so much.
Yeah, I travel to Central America regularly and when you want a "prescription," you walk into the pharmacy and buy it. Presto - Levaquin!
Posted on 12/17/14 at 6:38 am to NC_Tigah
quote:
Hilliary Clinton noted that if NY pharmacies could simply send a driver across the boarder into Canada and buy drugs at retail from Canadian Pharmacies, they would save significantly over wholesale US costs. Currently such international purchase is against the law. Sen. Clinton proposed the law be changed. Big Pharma shut the effort down
So, you're proposing completely deregulating prescriptions. If "FedEx" is the importer, then there's no regulations on drugs in the US. I'm not sure that's the situation you want. If it is, I can get on board. The tort lawyers will be furious, though.
There are price discrepancies all over the world with relation to every product. Pharmaceuticals are no exception. Other countries do allow reimportation with limited cost cutting success demonstrated.
And there's safety issues as well.
LINK
Posted on 12/17/14 at 7:06 am to the808bass
quote:
Yeah, I travel to Central America regularly and when you want a "prescription," you walk into the pharmacy and buy it. Presto - Levaquin!
Yea I'm not cool with anybody just going to their local pharm and getting whatever antibiotic they want whenever they have any kind of sniffle. Terrible idea.
Posted on 12/17/14 at 7:18 am to the808bass
quote:Not really. I'd certainly back safe OTC sales. But that could be a slippery slope.
So, you're proposing completely deregulating prescriptions.
E.g., the "simple conjunctivitis" example cited earlier. Very appropriate treatment for some forms of conjunctivitis can make other forms far worse.
So I am proposing exactly what I said. US retail outlets be able to purchase drugs from international wholesalers/retailers, and that insurance be required to reimburse patients for filling their prescriptions from the same sources.
Total deregulation might lead to nonequivalent and/or scam drugs purchased from dubious outlets. So we'd need some sort of "approved" list ensuring quality products for patients.
But to give an example, Celebrex 200 mg sells at US discount pharmacies for $5.81/pill vs Canadian source retail pricing at 85¢/pill --- nearly a 7-fold difference. That is a ridiculous differential.
Posted on 12/17/14 at 8:04 am to NC_Tigah
The greatest mark up is at the wholesale level. Wholesalers that do zero in the way of pt care make the most profit on the sale of the meds. And hospitals and other "institutional" pharmacies get meds wholesale by at least 50% less than any retail store and often times much less than that. At the same time, they are reimbursed at much higher prices than retail. If retail pharmacies got the same prices, prices could be cut by at least half to consumers. Our system is fricked up. And you can't blame doctors or pharmacists or even big pharma. It's politics plain and simple. Our dysfunctional insurance system has no rhyme or reason to it. Hospital lobbyists affect it as much or more than big pharma. So does private insurance. Not to mention medical supply vendors. It's ridiculous when a saleperson gets more in commission for selling a back brace (used to be up to $900/brace commission) than a doctor does for a colonoscopy with removal of polyps or even cutting out a melanoma of certain size and location. Hell, last I checked Medicaid paid $1200 for global care and delivery for an entire pregnancy. The whole system is bullshite and obamacare just made it worse...especially on drug prices. Drug prices have skyrocketed since this shite storm hit land.
Posted on 12/17/14 at 8:18 am to the808bass
quote:
Yeah, I travel to Central America regularly and when you want a "prescription," you walk into the pharmacy and buy it. Presto - Levaquin!
Well, they tell you it's Levaquin...
Posted on 12/17/14 at 9:00 am to Eurocat
I take three daily medications - two are generic, one is name-brand (no generic available). All are one pill a day.
One generic retails for $1.71 for 30 days
One generic retails for $3.18 for 30 days.
The name brand retails for $378.14 for 30 days.
My insurance covers generics at a $15 copay, or retail, whatever is less. So I pay retail for the two generics.
My insurance covers brand name in tiers. The tier for my medicine has a $40 copay. So I pay $40. However, my doctor gave me this card from the drug manufacturer that waives the copay up to $50. I believe the pharmacy gets the money from the drug manufacturer.
Looking at that list, the 2nd one, albuterol, both of my kids took that for a time when they were younger and both of them got a lot of chest infections. It was a wonder drug, and I don't think we ever paid more than about $10 for a supply.
One generic retails for $1.71 for 30 days
One generic retails for $3.18 for 30 days.
The name brand retails for $378.14 for 30 days.
My insurance covers generics at a $15 copay, or retail, whatever is less. So I pay retail for the two generics.
My insurance covers brand name in tiers. The tier for my medicine has a $40 copay. So I pay $40. However, my doctor gave me this card from the drug manufacturer that waives the copay up to $50. I believe the pharmacy gets the money from the drug manufacturer.
Looking at that list, the 2nd one, albuterol, both of my kids took that for a time when they were younger and both of them got a lot of chest infections. It was a wonder drug, and I don't think we ever paid more than about $10 for a supply.
Posted on 12/17/14 at 9:13 am to SmackoverHawg
quote:"blame" is not the term i'd necessarily choose. Big Pharma is big business. Big business games the political system where it can. If that opportunity presents, it's almost a fiduciary duty to take advantage. So rather than "blame" I'd say Big Pharma is responsible, along with US tort and tax policy.
And you can't blame . . . big pharma
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