
In its fight to keep drug prices high, big pharma leans on charities - pseudolus
https://www.latimes.com/business/la-fi-drug-prices-charity-20190429-story.html
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kristianc
The main issue is the way drugs are regulated and priced up. In the EU (and
most of the world), the discussion on regulation is tied to pricing. Part of
getting clearance on getting to sell into the EU is gaining an understanding
on how much you plan to charge.

In the US on the other hand, the FDA requirements are more stringent, but are
disconnected from pricing completely. Achieve FDA clearance, and you can
negotiate whatever price you want. US consumers subsidize the rest of the
world.

~~~
umvi
> US consumers subsidize the rest of the world.

What are we subsidizing exactly? Development of new drugs? Does this mean if
US started tightly regulating drug prices, then drug prices would go up
everywhere else in the world? Or just that the rate of new drug development
would slow down?

~~~
kristianc
> What are we subsidizing exactly? Development of new drugs? Does this mean if
> US started tightly regulating drug prices, then drug prices would go up
> everywhere else in the world? Or just that the rate of new drug development
> would slow down?

A bit of both, most likely. The US tends to see drugs that are not available
elsewhere in the world, but the cost of drugs is much, much higher.

Quick example - Generic Walgreens ibuprofen costs $3.29 for 20 in the US. The
same thing in the UK at Boots (same parent company) costs $0.50.

~~~
9HZZRfNlpR
But Ibuprofen was discovered by the Brits in 60's.

~~~
evandijk70
Why does it matter where it was discovered? Most drugs are marketed globally,
so it does not matter where the pharmaceutical company is based. The cost-
benefit analysis is the same for a British company and a US company.

It is still possible that the US market subsidises drug development if it
happens in the UK.

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aj7
Obviously, big pharma leans on the LA Times too. The headline buries the lead.
It should say, “In it’s fight to keep drug prices high, big pharma funds phony
charities”

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kevin_b_er
Call them what they are: A front organization. Lies created by corporations to
deceive the public and our elected officials for their own interests.

This is what under-regulated capitalism does, the wealthy corporations engage
in propaganda to protect their profit lines at the expense of the public.

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ptah
how is this not fraud

~~~
lotsofpulp
Because there is plausible deniability.

~~~
ptah
that only means it can't be proven...yet

~~~
roywiggins
There's nothing illegal about refusing to disclose your donor list and calling
yourself Americans For America (or whatever). Corporate lobbies have been
doing this for decades and they know exactly what these entities can legally
get away with.

~~~
ptah
i guess you can't have an oligarchy AND plug these kinds of loopholes

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LinuxBender
Slightly off topic:

Has anyone made an exhaustive table that contains prescription drugs on one
side, and their supplement equivalent(s) on the other side, where applicable?

For example, I am using Berberine (supplement) [1] instead of Metformin
(prescription). In this case, the supplement may be superior to the
prescription. I would love to find the equivalent to my blood pressure drug
losartan potassium (an orally active, nonpeptide angiotensin II (AII) receptor
antagonist.)

[1] -
[https://examine.com/supplements/berberine/?PageSpeed=noscrip...](https://examine.com/supplements/berberine/?PageSpeed=noscript)

~~~
tzs
Why do you prefer berberine to metformin? Even if it is as effective (and the
research on this seems to be quite sparse and uncertain), metformin seems to
be less expensive.

The berberine I'm finding at assorted online sellers seems to be around $20
for 120 capsules of 500 mg.

Metformin is $4 for a 30 day supply or $10 for a 90 day supply at Walmart [1].
Same price regardless of whether the prescription calls for 1 pill a day or 2
pills a day, and regardless of the pill size (500 mg, 850 mg, or 1000 mg), so
that means if your doctor will give you the right prescription you could get
180 1000 mg metformin tablets for $10. That's something like 6 times as cost
effective as berberine!

[1] This is the cash price. No insurance or GoodRX coupon required.

~~~
LinuxBender
Berberine appears to have less side effects than Metformin and treats many
more issues [1] at the same time. The link above links to some of the studies.
I will try Berberine for 2 months, take a small break to reactive mtor and
replenish muscle mass, then 2 more months on. If I don't see good results, I
may try metformin as a last resort. Anything that keeps me away from dealing
with doctors and prescriptions is a big win and I would happily pay more.

For my other BP meds, I am trying to find a way to buy them in bulk. Doctors
and delays induce life threatening risks.

[1] -
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839379/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839379/)

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wpdev_63
I don't understand why people don't just drive to canada/mexico for their
proscription medicine.

edit--- Apparently people don't like the idea of affordable pharmaceuticals?

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i_am_proteus
> A sign lines the drive up to rural doctor Emory Lewis' family practice on
> Dec. 12, 2011, in Reedville, Va., where he serves about 65 percent of
> patients insured by Medicare.

How does one doctor claim to serve 38 million patients? Another example of
Medicare fraud?

~~~
himlion
65% of medicare patients suffering from a specific disease?

~~~
i_am_proteus
This is the LA Times, a major US newspaper. The article says "65 percent of
patients insured by Medicare."

I guess we get the journalism that we pay for.

~~~
rat9988
I thought it was 65 percent of patients insured by medicare in Reedville. I
don't know Reedville, but they say he is a rural doctor, so I guess there
aren't many patients.

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rayiner
How can you have an entire article on Medicare negotiating with drug
manufacturers without using the word "monopsony?"[1] Is it simple ignorance or
deliberate deception?

> The negotiation issue has a tortuous history. When Medicare was expanded to
> cover prescription drugs in 2003, it became the single-biggest buyer of
> medicines in the U.S. But while other federal agencies, such as the
> Department of Veterans Affairs, can use their market clout to seek better
> deals on drug prices, Congress prohibited Medicare from doing so. Instead,
> the scores of private insurance providers that offer Medicare plans are left
> to negotiate individually with drugmakers, with significantly less power.

The idea that giant insurers like Cigna don't have sufficient "market clout"
to negotiate on even footing with drug companies is laughable. Medicare would
not just have "market clout"\--it would control so much of drug purchasing
that it would have monopsony power to drive drug prices below the efficient
level.

It's a very simple proposal. "Use Medicare's monopsony power to drive drug
prices artificially low." Maybe it's even a desirable policy outcome. Trade
future development for cheaper drugs now. But it's intellectually dishonest to
talk about it without really talking about what it means, without using the
relevant concepts and terminology. It obscures what is fundamentally a simple
economic tradeoff (indeed, it obliterates the notion that there even is a
trade off).

[1]
[https://en.wikipedia.org/wiki/Monopsony](https://en.wikipedia.org/wiki/Monopsony)

> Monopsony power exists when one buyer faces little competition from other
> buyers for that labor or good, so they are able to set wages and prices for
> the labor or goods they are buying at a level lower than would be the case
> in a competitive market.

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SilasX
Yep. Everyone and their dog can understand the long-term insidious effects of
Walmart using its clout to force suppliers to accept the bare minimum to keep
operating. Change the topic to governments and pharmaceuticals, and suddenly
the practice is harmless and has zero downsides we should care about.

~~~
cptskippy
No one said it was harmless but Pharmaceuticals companies are making obscene
amounts of money by charging outrageous prices. You're arguing that there's no
middle ground and we must either have exploitative drug companies putting
profits over people's well beings or an oppressive government putting people's
needs over the business's long term viability.

~~~
hackeraccount
Why limit the practice to pharmaceuticals? In theory the government can be a
middle man for any good or service. Why not have the government buy all the
cars in country and the parcel them out to people at a fair rate? I think
everyone (or most everyone) understands that would be a disaster. Switch the
good to pharmaceuticals and suddenly it's reasonable?

~~~
cptskippy
What's the alternative? Keep the status quo?

