The answer is that our insurance and medical billing system is a complete tirefire and needs to be burned to the ground and replaced with something sane.
Yes, this is true. There are other things that would change too. We could have these (or other) pills for pennies. However, we can't have a 24 hour drive through pharmacy on every other corner and an Urgent Care on the other AND pills for pennies. Yes, the companies are making tons but a lot of that money pays for people to make it convenient for you to get your pills. And as someone else commented, we are basically subsidizing the pharmaceuticals for the rest of the world. (But before you get too upset about that remember we also get slave labor in China to build our iPhones and TVs that now cost comparatively nothing compared to if they were made here.)
Neither do drug distributors aka pharmacy's. Remember, this is a retail operation they could be selling guns and the only change is the type of regulations and who their suppliers are.
Even if it was true that the extra money paid for pharmacuticals in the US was funding 24hr drive-through pharmacies, that would still be an idiotic system that needs burned to the ground. People who need drive through pharmacies should pay for them. People who want to order things online shouldn't be subsidizing them. Hiding the cost in a pill helps no-one and is obviously sub-optimal.
Similarly, if you really wanted to subsidize pharmaceuticals for the rest of the world (and I'm not convinced you actually do) then again, hiding the cost in the pills, is a silly way to do it.
If on the other hand, you wanted to charge as much as you could get away with, and could pay off politicians in order to be allowed to take advantage of sick customers to line your own pockets then putting that in the cost would make perfect sense.
I was exaggerating slightly. I was mainly trying to make the point that pills for pennies comes with other consequences. There are indeed better ways to do it but those have ripple effects that people ignore. If you change the rules, the companies will adjust and our access and jobs will change too. You can't just say I want all the good things of today and none of the bad and lower costs.
Yes, cheap medication and cheap accessible care is impossible. Its not like you can get $2 tetanus shot without any waiting in china in a walk in clinic or anything.
Since drugstores mostly aren't owned by the pharmaceutical companies, I'm not sure you're correct about that part. At minimum, the wholesale price could be pennies, and the retail store could mark up by whatever amount they need.
The problem is that insurance costs continue to rise for no real reason. They even made costs rise when more people were insured because of ACA. In what world does that make sense?
> They even made costs rise when more people were insured because of ACA. In what world does that make sense?
I'm surprised you don't remember the reason because it was in the news 24/7. It's because insurance costs 10X for sick people (because they also draw 10X in insurance), those sick people could not afford their insurance, and the ACA gave those uninsured sick people deeply subsidized insurance, raising the average cost to insurance companies of each insured person
You and sol_remmy are talking about two different things. You are talking about overall expenditures in the health care system. He is talking about insurance prices charged to individual purchasers, in particular ones that are relatively young and healthy.
I'm not sure that's a fair characterisation of either position.
sol_remmy seems to be making the case that lots of sick people didn't have coverage before ACA (Which would be a massive plus point for it if true) and that the number of new sick people buying insurance outweighed the number of new young, healthy people entering the pool, driving costs up.
There seems to be a lot of conflicting info on this, but at least Brookings made the case that the expected effect of ACA did actually happen, lots more people started paying for insurance and the average cost paid by individuals therefore went down (even while the average coverage they could recieve went up).
So we seem to be talking about the same thing, just with radically different facts about the same situation.
There is a very real and obvious reason. Thanks to the ("Affordable" Care Act, aka Obamacare), insurance companies have a captive audience of citizens (but interestingly, not illegal aliens) who MUST purchase their insurance product under threat of fine/imprisonment. There is no incentive to lower prices in this arrangement, and the insurance companies are immune from the pressures of a true competitive marketplace. The insurance marketplace is the equivalent of a prison commissary.
My wife and I both had insurance when our son was born-- and gold plated insurance, at that. I still went back and forth with the hospital for over a year arguing about bills, until they sent us to collections, even though they owed us $800 for overpayment. I had to threaten to take them to court before it was resolved. Our son was walking, and they still hadn't figured out how to bill us for it.
I'm still not 100% sure they aren't going to resurrect those bills in another 6 months.
There's no free healthcare. You either pay it directly, or through taxes. Europeans pay high taxes, social security and VAT on most things. My brother in law pays almost 55% on his 80k salary in Italy. I don't think I ever paid over 38% even when I was making $160K in the US.
If you look at the median salaries, $4.7K in premiums over a year is not a big deal, and then you spend another $7K in case you need to max out your insurance, which most people don't do until much later in life.
Except the US government already spends more public money per capita than Canada and doesn't have universal care. Your government is spending more and getting much less.
Ok, for two+ person household it's $14k, but then it's double income.
And the premiums are not horrible either. It took me two minutes to find a bronze level plan for $398.56 ($4782 per year). It's not much at all. It's cheaper than paying much higher taxes in most of the EU.
No way Americans pay more in taxes than most of Europe. That's absolutely not true. If you want to compare to third world countries, I suggest you try and live there before telling us how great it is.
You also have to consider that the US develops most novel drugs and therapies, by a wide margin. Are you taking and Chinese or Russian or African drugs? Neither do I.
You can't compare Europe's total taxes with just American healthcare costs. They've made similar choices to pay for stuff like college via taxes instead of privately that heavily affect that comparison.
Americans pay more than Europeans (and anyone else in the world) for healthcare. This is demonstrable fact.
We're paying as much or more than most of the OECD in healthcare from a tax perspective, then adding on a bunch of private spending they don't have, for a total spending wildly larger than any of them.
As far as healthcare is concerned, we pay about the same amount of taxes as Europeans, plus more to private insurers/hospitals, for a total healthcare spending significantly larger than theirs.
We also have worse outcomes for all that extra spending - stuff like life expectancy, child mortality, etc.
I call that a broken system.
Your continued attempts to conflate total taxes with healthcare spending are either silly/odd or deliberately intellectually dishonest, as we'd have to factor in every other variable between us and Europe in that comparison - road funding, foreign aid, military spending, college costs, social welfare programs, etc.
No one is really really suggesting to burn it down. It is just an expression of how frustrated we are becoming with a system that is not working out. It is hurting us. It is hurting the country.
As long as burning down the system includes allowing US residents and hospitals to import medicine from other first world countries then I suspect that it might actually be superior to the current system. If it doesn't then no, expensive and sometimes inferior drugs are better than nothing.
If the pill retailed for $0.04 in the US could the R&D be recouped?
Americans should feel good about high drug prices: that's your aid to the Third World right there. Not the most efficient technique but still better than not doing it at all.
While in general I agree with you that is not the case here. The drug's patent expired decades ago. The issue is that there is only 1 US manufacturer giving them pricing power.
It's unclear to me why another drug manufacturer doesn't come in and undercut the price. This is what happens in most other industries. My gut suspects the arduous FDA approval process, but I have no real evidence for this hypothesis.
> It's unclear to me why another drug manufacturer doesn't come in and undercut the price.
From the sound of things these diseases were until very recently isolated to poorer countries. Even today, with the increased number of cases, there might not be enough money to be made based on a few sick North Americans to justify tooling up to make a new drug. (Some of that is about FDA regulatory approval, but not much since it's not a new drug. They'd be manufacturing something that has already been tested and approved.)
Ideally the drug company making this thing would just stop being boneheads about pricing. Having this in the news will probably help.
>>From the sound of things these diseases were until very recently isolated to poorer countries. Even today, with the increased number of cases, there might not be enough money to be made based on a few sick North Americans to justify tooling up to make a new drug.
The article also says albendazole, the drug in question, can be purchased in the UK for $2. Why can I not start a pharma company that A) imports albendazole (and other rare disease drugs) from the UK and other 1st world country at a reasonable markup or B) orders albendazole, and other rare disease drugs, from the same manufacturer that makes it for the UK, and other 1st world countries, at a reasonable markup?
I'm genuinely curious about the regulatory landscape of that question.
I think our system is so fundamentally broken, you should be able to do that. But if you could, it would be an end run around the FDA. Might as well shut the FDA down in that case.
If you add burdensome regulatory costs to some competitors (domestic pills) but not others (foreign pills), the others will win all business. That is an unfair playing field. So part of the deal with regulating drugs in America is that you can't import drugs from other countries.
I think I'd probably allow importation of the exact drug, by the exact manufacturer. Or just set a price control saying you cannot sell a drug for more than 120% of the average price in the EU + Japan + Canada + Australia + NZ etc.
> I think I'd probably allow importation of the exact drug, by the exact manufacturer.
Well, right. It's pretty impossible to justify not allowing importation of the drug for any safety-related reasons if it is literally the same product from the same manufacturer.
Ideally the drug company making this thing would just stop being boneheads about pricing.
I think this is silly. We don't expect that companies "stop being boneheads" (by which I assume you mean act more ethically) when it comes to the pricing of televisions, or food, or household goods, or practically anything else. Why should we expect it for these pills? That expectation will be doomed to failure in many instances.
A more ideal scenario would be to examine the underlying reasons that allow the company to charge so much for something that apparently costs so little to make. If we can understand that problem we should be able to implement fixes that lead to proper pricing without the expectation that profit seeking corporations will magically decide to forgo profit just to be nice.
> We don't expect that companies "stop being boneheads" (by which I assume you mean act more ethically) when it comes to the pricing of televisions, or food, or household goods, or practically anything else. Why should we expect it for these pills?
Sure we do. Companies react to non-market concerns like ethics, civics, reputation, government and public pressure at the expense of short-term profit all the time, in addition to reacting to market competition.
Even if you accept the notion that the corporation (if it were a person) should be considered a sociopath, it is not at all obvious that market factors or regulation will be as effective in any given case at moving a company's leadership to behave ethically as, say, negative PR that will keep the CEO from getting laid. (not that you'd want to base an economic system on that...)
> A more ideal scenario would be to examine the underlying reasons that allow the company to charge so much for something that apparently costs so little to make.
That is not the important question at all. (do you really want to argue that charging a lot for something that "costs so little to make" is inherently a bad thing?) The important question in this case is why the same company can sell the same thing in two different markets with a 10,000x price difference.
That explains it with this drug but wouldn't explain why the US just as EpiPen as our one adrenaline injector (in practice) with a single manufacturer while there are a half dozen competing manufacturers.
And if the FDA recognized that Europeans aren't particularly dying off from poor quality medicine and maybe we should allow import of EMA accepted drugs then maybe economies of scale would be less of a problem.
You are correct. The FDA is insanely parochial. They won’t allow importation of generics approved by their European, Canadian or Japanese equivalents of generics with decades of use. The only reason Martin Shrkeli was able to jack up the price of the drug he did, a generic, is because the FDA won’t white label or fast track drugs from other jurisdictions.
Because there is no price the competitor can charge that the original supplier can't match. There is no profit to be made, unless there is only a single manufacturer.
Also, it's difficult to acquire approval needed from the FDA to demonstrate the new drug is safe and equivalent to the already approved because the original producer won't cooperate and provide relevant samples to their competition so they can demonstrate equivalence.
Because there is no price the competitor can charge that the original supplier can't match.
This is a commonly cited reason but I don't buy it. They're selling these things for 4 cents in tanzania so we're talking about something that is practically free to make. There are lots of things that cheap where we see competition in the US: paperclips, reams of paper, chewing gum, whatever.
Why is there competition for these things but not cheap drugs?
At a guess because then that other manufacturer would undercut the first manufacturers cash cows. In other words: it could easily be a cartel of sorts with some regulatory capture thrown in to ensure the cake stays divided between entrenched parties.
Situations like these should count as evidence that something isn't quite as it should be.
Yes, it definitely could be this which is why I said "my gut suspects the arduous FDA approval process." This could be the source of a lot of that fixed cost. I'd be generally curious to see data on what is involved in starting up a new production line for these kinds of pills.
Look for the explanation by Derek Lowe in the linked article. Key points:
> The FDA grants market exclusivity to companies that are willing to take ‘grandfathered’ compounds into compliance with their current regulatory framework.” Once a company does that, it gains an effective monopoly through the "generic bioequivalence" rules.
Setting up the production line isn't the issue, because the pharmaceutical company will outsource the actual manufacturing of the drugs anyway.
If fixed prices inherent to the production of the drug were the key then I wouldn't expect a manufacturer would be able to provide this same drug in the UK for $2 without going out of business. Now, there are probably reasonable health and safety procedures done in the UK but not in Tanzania that bump the price up that much which I want done to my drugs as a wealthy resident of the first world but which I might not be able to afford if I were a Tanzanian. But $400 is clearly not required to make the drug up to reasonable safety standards.
The company typically outsources the actual manufacturing of the pill, as well as the packaging and shipping. Those are real costs.
The largest expenses are marketing and sales. Doctors won't prescribe drugs they don't know exist, so "educating" doctors about the benefits of a drug is a paramount. Contracts have to be negotiated with all insurance companies, and that's expensive too.
How profitable the business of generics actually is, we don't know for sure. The pharmaceutical industry is notoriously vague about how much profit they make, and the numbers they report are questionable. For instance they'll call market research into which drug to buy next "R&D".
This often repeated line about the high drug prices in the US being a good thing because it subsidizes R&D for the rest of the world sounds like very self serving propaganda by pharmaceutical companies. I don't believe it a single second.
> If the pill retailed for $0.04 in the US could the R&D be recouped?
The same tired old and wrong argument. The article clearly states that the patent expired decades ago. So why not read the article and see that this old excuse is WRONG ?
What do you stand to gain by putting out these lies? What will it take for idiots like you to stop doing so??
[Note to "dang" or any other mod: yes, I called this person an idiot. I was trying to be restrained. I am tired of people making excuses for the greed of pharma companies. They always use "recoup R&D costs" as an excuse for price gouging, and killing people.]
What the article leaves out is that the real reason is that there are laws that were specifically passed to make import of drugs nearly impossible and illegal in most cases. The system is tightly controlled such that no price arbitrage can be had. This shit wouldn't fly with any other product. If it wasn't illegal, companies would be buying in bulk and importing to the US since the US price is literally 10,000x higher. Price would converge quickly. But Congress decided that should be outlawed. And to be clear, we're not talking about off-brand or fake pills that are manufactured in violation of the patent owners wishes. We're talking about the same pills manufactured by, for example, GSK and shipped to different locations around the world. The current system is simply global welfare that everyone in the US pays for.
This seemed a great comment until the very last sentence. Are you really claiming that Congress wanted to fund the advancement of medicine globally, and they did so by banning imports of pharmaceuticals?
Surely there's simpler explanations for this that fit the facts better?
No, that's not what I'm claiming. I'm claiming that pharmaceutical companies wanted a way to increase profits. They concluded that if they raised prices that would be bad PR because of the poorer nations that couldn't afford it and they would be seen as villains. Yet, the US had the potential to pay more. So they found a way to go right down the middle and lobbied congress hard to pass those laws. Now they get to be the benevolent rich guys who get to prattle about how many doses they donate globally and how cheap they can make the pills in the lesser developed nations while simultaneously ripping off US citizens to cover all that, and more.
Nope. It's actually against the law. There are some in congress that have been fighting for years to allow US citizens to personally import from Canada. There used to even some be surreptitious "tourism" along the border for day trips to Canada get prescriptions filled, but they put a stop to that shortly after the ACA passed.
In line with the enduring trend of public discourse, all nuance is cast aside.
We self-evidently need regulation of medicines and medical devices, at least until we hit some glorious future utopia of flawless consumer knowledge. Otherwise, people will come along, and they will sell products and devices that will harm people, and they will do it by lying about them and covering up their problems.
On the other hand, it's possible that the relatively slow pace of regulation and medical testing could cause problems bringing potentially beneficial treatments to market. This might represent an excess focus on safety at the expense of the benefits in access to new and innovative treatments.
Naturally the argument should be something along the lines of "I think we should reform medical testing to enhance the availability of innovative treatments" versus "I think that the loosening of medical regulation will result in an increase in the harmful outcomes of dangerous and untested treatments". Both ideas that are totally reasonable to think might be the case, and for which you can imagine undertaking some kind of evidence-based process to establish if reform is needed, and if so what form it might take.
FDA is given power to do a necessary job: keep us from eating poison instead of medicine, or whatever. But the same power is abused to prevent competition by "suggestion" of the industry that provides these medicines.
Exactly: it is a very simple situation - we collectively as the society decided that we do not want garbage peddled as medicine. FDA established how we determine "not garbage". Full stop.
Edit: yes, based on our current position Export from US->Other Country->Import to US for medicine violates "Not Garbage" state. It is no different than importing USB chargers that sell in China for $1.02. We do not want the vast majority of the population engaging in this though those who know how to are allowed to do it themselves.
I think you are jumping to a conclusion without having enough supporting evidence.
Regulation on drugs didn’t suddenly get 8,000x more expensive for drug companies in the last few years.
An alternative theory, which I can’t prove any more than you can prove yours, is that due to some pharmaceutical companies realizing they were leaving serious money on the table, they tried hiking prices. Once they realized there would be little repercussions, all jumped in and we have a new industry norm.
It contradicts basic economics. If you raise prices 8000x and I will go into competition with you and raise prices 7999x i.e. do what MCI did to ATT and Vizio did to Samsung.
Not if there is collusion or cartel pricing. There are also regulatory means of limiting competition. The basic economics notion works in a market that is mostly free. I suspect that most things related to the American health care system do not qualify as a free market.
There's no cartel pricing in medicine. If there was there would be a competing cartel as it is the case everywhere.
The reality is that companies that make generics are simply too small to be able to compete with Pfizer, Merc, Glaxo etc and for all big talk our scientists in R&D and FDA are bought and sold like trading cards and their opinions change with the opinions of their owners, which is, for example, why FDA accepts garbage studies from Pfizer and does not from itty bitty company that competes with it.
A survey of hundreds of published economic studies and legal decisions of antitrust authorities found that the median price increase achieved by cartels in the last 200 years is about 23%.[1] Private international cartels (those with participants from two or more nations) had an average price increase of 28%, whereas domestic cartels averaged 18%. Less than 10% of all cartels in the sample failed to raise market prices.
Cartels do exist and do not always have a competing cartel. Especially if the cost to entry is too great for a competing cartel to get started. There is also the fact that competition doesn’t just instantly occur. There is a lag in the market and during the lag cartel pricing occurs.
It’s not some immutable law of the universe that completion always springs up in economics. This isn’t always the case and it isn’t always the case that a cartel, oligopoly, or monopoly will instantly lose its pricing power simply because a new player arrives. Sometimes the new player gets absorbed, or becomes part of the cartel.
If there was there would be a competing cartel as it is the case everywhere.
Providing two examples of where there are competing cartels is not an argument that this phenomenon occurs everywhere (emphasis originally yours). Your logic is off.
In the examples you gave, they were huge markets and they were ripe for disruption. As the article laid out, most of the drugs which have experienced this huge hike are ones with very limited markets. It’s not worth it for a pharmaceutical company to jump into a new drug with almost no market for it.
That’s such a vague statement you could either be wildly wrong or mostly right. If you’re talking average profit margin, yes medications generally have higher, but electronics are fairly good margins generally too. If you’re talking market cap / overall market size, you definitely aren’t correct. Even the biggest pharmaceutical company pales in comparison to the electronics top three.
You don't get competition on day one, and one week of 8000x prices is worth more than 10 years of 1x prices. However, you can and will drop prices when competition shows up, so you see 8000x profits when competitors see a competitive market.
AT&T did not have a total monopoly and the ability to charge 8000x prices. Remember the drug company is already ahead even if they never sell this drug again. That's not true of less extreme price increases.
During the days where MCI had a pronounced savings over AT&T (aka mid to late 90s), it was only 5-6x difference [0]. Based on that, I agree, totally different ball game with pharmaceuticals (like 3 orders of magnitude difference).
[0] Source: I worked for MCI during that era. When we were selling flat rate 10¢/min, most of the folks we talked to were paying 40-60¢/min with AT&T for intra and inter-lata calls. Folks thought the price was so low that there was some hidden charge or it was some kind of scam. Of course AT&T (pre-SBC acquisition) responded and dropped their prices, but they took a long time to do it.
And it is - you can import those drugs just fine. It simply means you have to jump through some hoops.
What we do not want as a society is that the guy on a corner stall that sells $4.00 USB chargers that may or may not explode sell a million pills to little old ladies which may or may not do what they are supposed to. This is the current societal contract.
[Edit:] Now I personally think we should live in the more Darwinian society and in my view we should allow dude on a corner sell pills just like he can sell chargers and should some benefit manager buy the pills from the corner dude from Nigeria without vetting the corner dude from Nigeria and his suppliers and therefore killing and maiming a few thousand old ladies, we should throw the book at the benefits manager and not the corner dude from Nigeria (who should be thrown a book based on fraud and not manslaughter) but that's just me.
1. The vast majority of the cost of FDA regulation is in ensuring the effectiveness of medicines, yet whenever someone defends the purpose of the FDA they cite examples of medicine safety.
2. The FDA keeps arsenic out of our medicines and that's totally related to fulfilling arbitrary and expensive effectiveness regulations! Ineffective and dangerous medicines like fen-phen getting through just proves we need more regulations! Baaa!
We have one very interesting and totally unregulated market that is quite similar. The market is cosmetics and beauty products. As long as products make no medical claims it is total buyer beware. I seriously doubt anyone in the United States wants that to be applied to medicine and medical instruments.
They have different rules than we do. Adjusting rules is fairly easy: change the bloody FDA. Agency lives at the pleasure of administration. We had (D)s in control of all three branches of government. Now we have (R)s in control of all three branches of government. The reason why this is not changing is because a compelling case is made that the current rules for !Garbage are better than the proposed alternatives.
Safety might be a good reason to prohibit imports from a place like Tanzania, but it makes no sense as a reason to prohibit imports from Canada. Canada has some equivalent to the FDA which is about as good as ours, so there should be no safety problem when it comes to importing their medicine.
i.e. Canadian companies are successfully selling to the united states medicine that is manufactured in Canada and is regulated by the US. US companies successfully selling products to Canada that are manufactured in the US and regulated in Canada.
I’m saying that even if we don’t have reciprocity, if the drug is separately approved in both countries, it should be legal to buy in Canada and take to the US.
The reconciliation is that some countries have what appears to be perfectly adequate regulations to address #1, but much smaller effect of #2, suggesting that some aspect of the US regulatory environment is suboptimal.
The issue is that there is no real competition for drug pricing in Canada due to the fact that the Canadian government imposes price controls. You are, of course, free to argue that this is a better way of doing things. But it's not "competition."
From the article: "In the years following albendazole's price hike in 2011, Medicaid spending on the drug went from under $100,000 in 2008 to more than $7.5 million in 2013." To most Congressional Republicans, this is beautiful music begause it means one of their constituents is getting rich by ripping off taxpayers. (Indeed, it may be the only form of music they can appreciate.)
I would really like to see a detailed analysis of why Medicaid is paying these higher prices.
It seems to be because their payments are benchmarked to what private insurers pay and the private insurers don't fight price hikes on drugs with (for them) small total costs.
One fix might be to use a benchmark that is less dependent on whether private insurance bothers to negotiate. Another would be to allow HHS (working with FDA) to arrange for import of certain drugs.
This is a great case where unregulated free markets absolutely fail to solve the problem. Companies like Impax Laboratories are sole-suppliers, and the cost to produce is the smallest cost, once initial capital costs are laid down to build the factories to produce them.
What would happen if a challenger appeared? A new company gets some funding to try to make a small number of high profit drugs, competing with Impax? Impax can drop their price on those drugs lower than the challenger until the challenger is out of money.
Any incumbent has already paid the initial capital costs, while challengers haven't. Challengers can't win unless they've got big enough pockets to equal the incumbent, or new techniques that let them undercut even the lowest price the incumbent can do. But in a field like this, where the lowest price is apparently in the pennies, I can't really see how you can undercut enough.
I don't really see any simple solution to this problem.
But is that the problem here? I mean, yes, if the rules about importing went away this problem would vanish over night, but let's ignore that for just a moment and imagine this same problem exists on a world-wide scale (it very well could!).
How can a newcomer get into this market and undercut a competitor who can essentially drop prices as low as they want without losing their profitability?
No mention that the average wage in Tanzania is $45 to $50 a month? As a proportion to wage it is actually more comparable than at first glance.
As a solution though, I think we need reciprocity between drug regulatory agencies and open up drug sales between countries that have reciprocity. For example, if a drug is approved for sale in Canada it should be purchasable by people in the US and visa versa. It would allow competition between regulatory agencies (which should in theory make them more efficient because they have to compete) and lower the cost of bringing a drug to market because you no longer need to get approval in as many countries. Which in theory should lower consumer costs.
Combine that with transparent pricing so that everyone knows what the costs are before they need to make a purchasing decision and we might be part way to a solution.
Correct, if you were to go purely by the wages, the pill should cost $4 in the US not $400. It is still high, I was just pointing out that there are market differences. And to expand on that, the illness the drug in question is more common in Tanzania (per the article) so I can only presume the drug company can sell an order of magnitude more and might actually be making almost as much profit in aggregate on that $0.04 as they do the $400 here.
> "In other countries, there are price control methods. The government steps in to ensure drug prices do not increase by a certain amount," Alpern says. "There are no price control mechanisms in the U.S."
> Between 2011 and 2016, mebendazole's price jumped more than 8,000 percent, from $4.50 to $369.
So it was indeed $4.5 in the U.S. - until the company decided to get greedy.
I'm not sure your conclusion follows from the article. The lack of controls may contribute but the reasoning may have not been greed. There are many market factors in play. It may very well be greed but I don't see much evidence in this article either way.
In other words, the article explains why the price growth was not capped. It does not explain why it grew in the first place.
In general I wish the drug company had taken time to contribute to this article and show their side of the story.
From what I can tell, there are no patents. That means the only thing making this expensive is the lack of competition. The company bought the marketing rights and took over manufacturing.
I would imagine after a second supplier enters the market prices will crash.
While the article talks about big pharma, we can solve this specific parasite issue by switching to another approach: Traditional Chinese medicine. At $60/week per tea made of 8-12 ingredients one can completely expel parasites from the body in a few weeks. Of course, big pharma never makes that known or even knows about it themselves. People in rural areas of East Asia certainly do.
