Nitpick - that piece of scum got jailed for something else. Everyone cheered because of his drug gouging.
Does pharma advertise in Canada?
Not on TV and stuff, no. They market through doctors, though.
The quoted article was written in 2014, before Trump withdrew from the TPPA, so it does mention what the US wanted to do to all the signatories’ drug buying or price negotiating processes, which was an extension of that in the AUSFTA. It looks like the US wants to re-enter the CPTPP under their own terms, including increasing patent protection periods, even more than in the original plan. Typically increasing by 12 years current patent protection periods.
It looks like it would be necessary for the US to conclude agreements with all countries that have a central pricing or buying agent for drugs, in order to “get rid of the freeloaders” as Trump has been reported as saying.
PHARMAC is the New Zealand government agency that decides which pharmaceuticals to publicly fund in New Zealand. PHARMAC makes choices about District Health Boards’ (DHBs) spending on vaccines, community and cancer and other hospital medicines.
It also funds those drugs through an annual budget. The end user (me) pays $5 for funded medicines and nothing for funded vaccinations.
District Health Boards operate the public hospitals throughout NZ.
This system has big benefits for users and for the country. It keeps the cost to the user down.
It also means that some drugs are not funded because the agency works within a cap. If you have a disease or illness that could be treated by one of those drugs, then you could be paying serious money. An example is a Hepatitis C drug. One woman was advised of a cost of $US100,000 for a treatment course. That was when it was unfunded. It is now funded by PHARMAC, but every time a new drug is funded, either the budget needs increasing, or something else may be dropped.
I’m aware of that since I’ve been following the gentleman’s career with interest ever since the Daraprim fiasco. He was jailed for being a crook, an unethical asshole with the morals of a sewer rat, yet he was also heavily invested in the pharma industry and was at various times the CEO of at least two different pharmaceutical companies. Unethical and extortionate drug price hikes were essentially his business strategy (he pulled the same stunt with a rare drug called Thiola) because he thought it would be profitable to get manufacturing licenses for unusual out-of-patent drugs for which no generics were available and then hike the prices as high as the market would bear. The interesting thing is that the extortionate drug price manipulations were the one thing he did NOT get in trouble for. That, to me, speaks to an appalling lack of regulatory oversight.
Interesting. Have there been scandals with doctors who prescribe a lot of an expensive drug getting kickbacks and sweet speaking deals?
There is some low grade complaining about it, but I don’t recall one story that’s really blown up about it. It is a known issue but I’m not sure it has a lot of public traction yet.
My daughter’s pediatrician insisted we should use the name brand, rather than generic, versio0n of a drug she was taking, and went so far as to give me a couple of coupons (no kidding) for it. I was immediately suspicious; was his claim that the name brand was better based on science, or was it because he has a business interest in it?
From what I understand of it, there are some generics that are seeing their prices skyrocket.
Making it legal to import drugs from overseas would likely solve this issue.
Got it…Thanks.
Not so insane. While it’s hard to construct a believable development cost for an individual drug, especially if you’re trying to divy up there cost of failed drugs, pharmaceutical development does require a large investment of time and money. Half of Pfizer’s revenue comes from the US. Their 2017 net income was $21B ($16B adjusted) If we suddenly cut that by $17 billion (very rough estimate using $26B 2017 US revenue and the US/Canada patented drug price ratio of 2.9), that’s looking like a lot less attractive an investment. I’ll take my money elsewhere.
Obviously it’s inappropriate to hold all else equal. They would have to change how they operate. But people put money in because they expect to get more money out.
Possibly but pharma generally is among the most profitable private businesses out there. Profit margins of 20-25% of gross revenue are not unheard of. Most other private enterprises are lucky if they post a 3% profit margin.
Its like I said earlier, I have no real hope for Trump’s plan because any true reform that actually cuts prices will cut into the business model of pharma, and neither party wants to do that (especially not the republicans).
I’m certainly not weeping for Pfizer or their investors (I am one, I think.) The point is that investment in pharmaceutical development competes with investment elsewhere. And decreasing revenue by a large enough amount will make that investment less worthwhile.
And forcing Canadian prices onto the US market would result in a massive decrease in revenue.
But with due respect, you’re trying to prove something I didn’t say at all. What I said was unlikely was that the Canadian model, specifically, today, results in drugs not being researched; that is just a near impossible thing. Canadas represents a very small part of the world drug market; the delta between the profits made there now and the profits that would be theoretically made if Canadians paid American prices is just not entering into any pharma company’s mind.
It is of course possible that the United States forcing down drug prices would affect the industry - well, it’s not likely, it’s certain. What precisely that would do to the general welfare of the world regarding drug innovation I do not know.
It doesn’t seem like rocket science to me, if you want the best price negotiate as a larger group. That’s how other nations manage it. But your system is purposely fragmented to increase profits. Hundreds of plans, each negotiating different prices, for various sized groups, will never be able to match the prices negotiated by one much, much larger group.
Tinker with the market all you want, I don’t think it will overcome this very basic reality.
For what it’s worth, there are certain drugs (with eg narrow therapeutic window, intrinsically variable bioavailability or for conditions where there is a critical need for control) where you just can’t change supplier - once you start with one supplier you have to stick with them or have a full restart to the dose titration process (tho obviously I don’t know if this is what you were describing). Antiepileptics tend to fall into this category. The UK (and I think EU) solution is that for such drugs, generics have to have a brand name in the same way that the original brand has, so if you are using a generic it will be identified by a unique brand name. Not sure if this also happens in the US.
So that’s a piece of the science.
j
You responded to a post about Canadian prices being applied everywhere, including the US. Not to a post about the Canadian model, specifically, today. So maybe you intended something else but to refresh your memory:
Underlining mine, bolding jshore’s
“That” being that a profitable drug today may not have been profitable in a world where we’ve forced low prices in all markets. I don’t think that is at all unlikely if we cut revenue by over 25%. And I think it’s quite likely that we would see investment (e.g. the $10B VCs pumped into biotech startups last year) going elsewhere.
That doesn’t mean it’s a bad idea.
I am optimistic, only because the current business model is not sustainable no matter who is in office. I offer the case of an otherwise healthy MS patient currently on an injectable medication that costs $7,000 a month, retail. The current model obviously does not depend on the consumer coming up with this cash, and hasn’t for a long time. It depends on third-party payers.
But because America is a plutocracy, doing things that reduce revenue for health care providers will be the last resort solution to the issue. Neither democrats or republicans are willing to do anything that’ll reduce medical prices. As a solution to our overpriced health care system, Republicans push for shittier and shittier health insurance, democrats push for government funding of health insurance. Neither party pushes to make health care more affordable. Democrats on the state level talk about health reform that’ll lower costs (single payer) but at the end of the day, all they do is talk.
That is what the ACA did. The ACA didn’t reduce medical spending, it just let the government pick up more of the tab for it.
I agree with that mostly, it’s led to our situation today, where on one hand the high costs are killing people, and on the other they represent employment, investment, steady returns on your mutual funds, and $7,000/month injections that actually work. Exploitative pricing and gaming the system are the low-hanging fruit, so it’s not surprising that the Trump administration made it an early priority.
Yes, I suppose they would object to the TIA as well 
Lacking any native big pharma, the TIA is the drug-development arm of Aus Government funding.
Oral Tretinoin. For cancer or for severe drug-resistant acne.
Retin-A cream, even the concentrated versions, is not a significant issue: the drug is, in fact, so reactive with the skin that you’d get severe skin burns before significant blood levels.
Which is why the cream is an OTC drug in some/most countries. You can buy it as a cosmetic in Aus, but that costs a lot more (cosmetics!) than the product marketed for acne treatment, also OTC but perhaps drug-store only??? (could check, haven’t done so).
Dunno why it is prescription-only in the USA, but I don’t assume that necessarily a bad thing: sometimes the USA is a medical leader, sometimes it’s just superstition.