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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsA solution to high drug prices...just a small tweak from congress to Medicare
Even though there is no direct negotiation by Medicare with drug co's for drug pricing, there is a provision for CMS to obtain drugs at prices lower than retail. Congress has instructed Medicare to never pay more than the U.S. average wholesale price...the solution is to tweak the rule to where Medicare never pays more than the worldwide average wholesale price...
This explains...
Let the Market Control Pharmaceutical Costs
http://www.minyanville.com/businessmarkets/articles/pharmaceutical-pricing-congress-democrats-republicans-pharmaceutical/9/30/2010/id/30328#ixzz4Ht4jEFUG
Congress has directed CMS to never reimburse more than the average wholesale price available in the US marketplace. This policy is a subtle way around the negotiation prohibition because it essentially lets CMS piggyback on price breaks negotiated by private health-care providers, wholesalers, and insurers. CMS can get quite feisty when wielding this limited cost control club, taking drugmakers to court for fraud if they try to hide price breaks given to private parties. This system allows the US government to not pay "over retail," which pretty much everyone can agree is a wise protection of taxpayer dollars.
This system has one certain side effect. US drug consumers get the shaft. The price for any given drug is almost always higher in the US than it is in other developed economies. And it's not just the price. To get their blood cancer drug Velcade approved in the UK, Johnson & Johnson (JNJ) had to agree that it would rebate the government the cost of the drug if Velcade didn't improve the patient's condition.
Everyone raise their hand if they'd like that money-back guarantee on their own health-care expenditures!
Cost controls are more broadly used overseas. That's a fact. The effect of this on American consumers is we bear more than our fair share of drug company profits and R&D expense. When Pfizer (PFE) blew $800 million on its torcetrapib failure, someone had to pay for that. Americans, who pay more for a Lipitor pill than nearly anyone else in the world, paid for more of that R&D failure than anyone.
It should be noted that drug manufacturers go into these negotiations and cut their prices more or less willingly. Sure, some countries threaten to invalidate a patent if a drugmaker doesn't play ball, but to actually do so would ensnare the country in international patent and trade litigation and make them a pariah nation. Drug companies make deals like the makers of Velcade did with the UK because they know they can make up the difference in the US marketplace.
The solution to the unfair burden American consumers bear is pretty simple. In fact, Congress already thought of the mechanism and CMS has the procedures in place to make it workable.
All Congress needs to do is tweak its instructions to CMS. Instead of directing CMS to never reimburse more than the average price in the US marketplace, direct CMS to never reimburse more than the average price in the worldwide marketplace. If a drug company wants to cut a sweetheart deal with another country, that's fine. They just have to cut the same sweetheart deal here in the US.
cali
(114,904 posts)thanks so much for posting this.
I don't believe this is THE answer, but it sounds like a good step.
FreakinDJ
(17,644 posts)What you don't think these greedy fuckers would collude to jack up prices - think again - they already did
deathrind
(1,786 posts)Last edited Sat Aug 20, 2016, 12:59 PM - Edit history (2)
to be revamped all together with a single payer system put in place. Like many other developed nations have. The for profit system we have is a failed model.
Our healthcare is not the best in the world contrary to what we hear. But it is the most expensive. My grandmother died in a hospital a yr ago yesterday. The last 16 hours of her life she spent in a hospital in ICU...and was just basically monitored. Given some anitbiotics and a meal...the bill for that 16 hours was $85k.
True Dough
(17,294 posts)Was it 16 weeks? 16 months? Don't tell me it was 16 days at $85k!?!?!? I'm Canadian and cannot imagine such an outrageous sum.
Sorry to hear about your grandmother.
FreakinDJ
(17,644 posts)deathrind
(1,786 posts)I put it in but I think autocorrect nixed the abbreviation.
She was in ICU for 16 hours. There was no surguery, no resuscitation events, no extrordinary measures. She had MRSA and the infection had spread...ironically an infection she got from a previous hospital stay.
$85k for 16 hours! That's insane!
There must be a lot of Americans suffering (and dying) at home in order to avoid a costly hospital stay.
deathrind
(1,786 posts)Last edited Sun Aug 21, 2016, 12:04 PM - Edit history (1)
My mother died at home in 2004 from cancer because of cost. Half way through the chemo therapy treatment after her surguery her insurance called and said she had reacher her policy limit that they would no longer cover the chemo. She had already leveraged all the assets she had at that point to pay what she could and had nothing else.
I have had a lot of exposure to our for profit system and have the greatest of contempt for it...
I don't know what I would have done had it not been for Hospice...they are a fantastic organization and well worth any donation anyone would want to make to them.
True Dough
(17,294 posts)One of the most rewarding endeavors I have ever engaged in.
deathrind
(1,786 posts)Respect the world could use more humans like you. That's a hard thing to do.
True Dough
(17,294 posts)And I feel the same way about the vast majority of nurses and doctors that I see in action when I do my shifts at the hospital, or when they come into the patient's home. These health care professionals are sometimes spat on, sometimes punched, kicked, have their hair pulled, etc. by patients who are not in their right mind. And the most amazing part is that, other than taking some basic precautions, the doctors and nurses are right back there hours later, offering care without any hard feelings.
I have not been subject to that sort of abuse. Most of the people I have had the privilege of spending time with in their waning days have been appreciative (if they are aware at all). So what the doctors and nurses do is just awe inspiring.
Calculating
(2,955 posts)I feel like were always gonna be gouged so long as healthcare is a 'for profit' system though.
dixiegrrrrl
(60,010 posts)Makes me want to cry just thinking about that.
awoke_in_2003
(34,582 posts)Too bad it won't happen.