Secretary Of Health And Human Services Alex Azar has released a plan for reducing the cost of pharmaceuticals in the US (at the moment they are about double the cost as in other OECD nations). Here it is:
The document doesn’t spare much time before diving into the hardcore lingo, so parsing out what they actually have a concrete plan for is rather difficult (a lot of things are presented as solutions, but are actually statements of issues they plan to solve later). I would encourage you to point out anything that I have missed.
I’ve identified five categories of things that they plan to do or have “already done”:
Note: CMS = Medicare and Medicaid
Promote generic medications.
[indent] a) Streamline the process of getting FDA approval for generics.
b) Determine some rules & regulations to tinker around with to prevent Big Pharma from blocking the entry of new generics from entering the marketplace.
c) Allow Medicare’s drug cost subsidizing program (Medicare Part D) to buy generics.
d) Remove a gag rule that prevents pharmacists from pointing out generics to customers.
e) Some minutiae.
Allow CMS and health insurers to negotiate with pharmaceutical companies better.
a) Pharmaceuticals have to make their list price completely public, including displaying it in ads.
b) Various minutiae particular to Part D that will allow them more leverage and leeway to negotiate.
Get the Pharmaceutical companies to lower their costs, on average.
a) Some minutiae related to how Part D calculates things.
Get other nations to pay more to Pharmaceutical companies, so that the US isn’t doing it all.
a) No really, dude. We have a plan. It’s awesome. I’d tell you, but then I’d have to pick up your brains off the floor, cause it would BLOW YOUR MIND. So I’m just gonna chill and let you see once it’s all done.
Enforce regulations on Big Pharma more stringently and let them not get away with sneaky/sleezey shit.
a) Do what we’re already supposed to be doing, only better than the last guy did it.
[/INDENT]
One thing I’ll note is that a lot of the “already done” items are things like, “We have put a thing for this in the 2019 Budget Plan that we submitted to Congress that we ignored.” And, “We made an announcement that we would plan to do this in the future, six months ago!” I don’t know that any of the already done things are already done. By my reading, I don’t believe that any of it has been done yet (except one court case that probably started before Trump started office that resulted in a fine); consequently, I haven’t made any note of which are which.
To debate:
Notable recommendations? Tiny beans? Bad ideas? Good ideas?
Study countries where it is working better, and copy them word for word. This problem is already solved, the solution has already been successfully implemented, and “not invented here” is the US government’s only obstacle.
I’m not saying other countries are perfect, of course they’re not. But better methods are in use right now.
The current system is too big to fall. Any goal would have to be to get the cost in the US to get onto a trajectory towards joining the rest of the world at some point in the future, not to drop it down to match today. Copying the UK works on paper, but in reality it would destroy the health industry in the US and wound Europe and other modern nations.
I don’t see how you can have it both ways, support the existing behemoth for profit structure, or attempt to reduce drug prices while also giving big pharma the profit it feeds on? Are you imagining they will forgo profit for the greater good.
(How exactly does making Other nations pay more work. We got a shitty deal and you have to join in?)
Any attempt to tinker a solution for one little piece, of the whole rotting thing, seems doomed to failure to me.
Best practice is the Australian Pharmaceuticals Benefit Scheme.
Every time there are AUS:USA trade talks US Big Pharma table a demand that it is dismantled, which is duely noted and ignored.
“in reality it would destroy the health industry [as it currently exists] in the US.”
You are saying that like it’s a bad thing.
I followed your link, and found it to be, frankly, a bit of a daunting enterprise to try parsing. Do you suppose you could point me to the section that US Big Pharma finds so objectionable?
What superb nonsense! Pitched perfectly to the sweet spot where credulity merges with stupid. Say what you will about the Forces of Darkness, they got this whole propaganda thing down solid!
One of the first things I would do is declare the importation of prescription drugs legal or announce the laws would not be enforced on certain drugs.
My son uses Retin-A creme for acne. I used this stuff when I was a kid. In Mexico, it ranges from 25 to 35 dollars per 45gm tube. Here in the United States, it ranges 250 to 450 dollars for the same amount. I realize this won’t solve the health care cost crisis in the USA but this doesn’t make any sense. Not only that, I don’t understand why I need a prescription anyway. Outside of eating the stuff, the side effects are minimal. You don’t need the supervision of a physician.
I think that all we need to know about this plan is the fact that US Pharma stocks rose after Trump’s announcement. Price reduction takes a back seat to Profit stabilization.
I think one big problem is that the Veterans Administration, Medicare, and Medicaid are not allowed to negotiate prices unlike private insurance and other countries.
Is there anyone that DOESN’T believe that this was quickly tossed together as a response to a Trump crony getting caught taking payoffs from a pharmaceutical manufacturer?
Can you provide a link? I’m guessing it’s not prescription strength. Retina-A is available in very small dosages but enough to be very effective in acne treatment.
As for pregnant women, many normally safe products should be avoided to protect the fetus so I do not consider that enough to make using it require a prescription. Many countries allow you to purchase it without prescription.
