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Showing posts with label Drug Pricing. Show all posts
Showing posts with label Drug Pricing. Show all posts

Tuesday, December 10, 2019

Medicare for All: Would It Work? And Who Would Pay?

Ezekiel (Zeke) Emanuel
Podcast - Wharton
Originally posted 12 Nov 19

Here is an excerpt:

“If you want to control costs, there are at least three main areas you have to look at: drug costs, hospital costs to the private sector, and administrative costs,” he said. “All of them are out of whack. All of them are ballooned.”

On drug costs, for example, it is not clear if that would be achieved through negotiations with drug companies or by the government setting a price ceiling, Emanuel said. He suggested a way out: “We should have negotiations informed by value-based pricing,” he said. “How much health benefit does the drug give? The more the health benefit, the higher the price of the drug. But we do need to have caps.”

Emanuel also faulted Warren’s idea to limit payments to hospitals at 110% of Medicare rates as unwise. He suggested 120% of Medicare rates, adding that it would “probably have no real pushback from most of the health policy people, especially if you do have a reduction in administrative costs and a reduction in drug costs.” he said.

Emanuel pointed to a recent Rand Corporation study which showed that on average, private health plans pay more than 240% of Medicare rates for hospital services. “That seems way out of whack,” he said. “There are a lot of hospital monopolies, and consolidation has led to price increases – not quality increases as claimed. We do have to rein in hospital prices.” The big question is how that could be achieved, which may include placing a cap on those prices, he added.

On reining in administrative costs, Emanuel saw hope. He noted that the private sector spends an average of 12% on administrative costs, and he blamed that on insurance companies and employers wanting to design their own employee health plans. He suggested a set of five or 10 standardized plans from which employers could choose, adding that common health plans work well in countries like the Netherlands, Germany and Switzerland. Japan has 1,600 insurance companies, but standardized health plans and a centralized clearinghouse helps keep administrative costs low, he added.

The info is here.

Wednesday, November 20, 2019

The ‘cancer growing in cancer medicine’: pharma money paid to doctors

Money and medicineVinay Prasad
statnews.com
Originally posted October 30, 2019

Here is an excerpt:

The fundamental problem is that, as a profession, cancer physicians are not interested in addressing conflict of interest. Too many people in prominent positions benefit from the current lax policies. Disclosure is not the solution —ending these payments is.

I want to be clear: I’m all for doctors interacting with and working with the pharmaceutical and device industries. I have lectured at major pharmaceutical companies, but without accepting money, travel expenses, or meals. Researchers should be free to work with pharmaceutical companies on trials, but there is no legitimate reason why a well-paid physician needs to take personal payments, gifts, meals, or travel expenses from the pharmaceutical industry. That practice must end.

Conflict of interest is the cancer growing in cancer medicine. It poisons the field. It leads us to celebrate marginal drugs as if they were game-changers. It leads experts to ignore or downplay flaws and deficits in cancer clinical trials. It keeps doctors silent about the crushing price of cancer medicines. It is rampant in guidelines that lead to off-label prescribing and that mandate payment. It is surely a calculated maneuver by the industry to increase their profits.

The info is here.

Wednesday, October 17, 2018

Huge price hikes by drug companies are immoral

Robert Klitzman
CNN.com
Originally posted September 18, 2018

Several pharmaceutical companies have been jacking up the prices of their drugs in unethical ways. Most recently, Nirmal Mulye, founder and president of Nostrum Pharmaceuticals, defended his decision to more than quadruple the price of nitrofurantoin, used to treat bladder infections, from about $500 to more than $2,300 a bottle. He said it was his "moral requirement to sell the product at the highest price."

Mulye argues that his only moral duty is to benefit his investors. As he said in defending Martin Shkreli, who in 2015 raised the price of an anti-parasite drug, daraprim, 5,000% from $13.50 to $750 per tablet, "When he raised the price of his drug he was within his rights because he had to reward his shareholders."

Mulye is wrong for many reasons. Drug companies deserve reasonable return on their investment in research and development, but some of these companies are abusing the system. The development of countless new drugs depends on taxpayer money and sacrifices that patients in studies make in good faith. Excessive price hikes harm many people, threaten public health and deplete huge amounts of taxpayer money that could be better used in other ways.

The US government pays more than 40% of all Americans' prescription costs, and this amount has been growing faster than inflation. In 2015, over 118 million Americans were on some form of government health insurance, including around 52 million on Medicare and 62 million on Medicaid. And these numbers have been increasing. Today, around 59 million Americans are on Medicare and 75 million on Medicaid.

The info is here.

Tuesday, October 13, 2015

The way to fix outrageous drug pricing in the US is simply to do what all other rich countries do

Written by Annalisa Merelli
The Quartz
Originally published September 25, 2015

Here is an excerpt:

The US is an outlier among industrialized nation: it’s the only rich country that does not offer a publicly funded health system, relying instead largely on private insurance. This affects the pricing of drugs in several ways that are independent from the actual regulations imposed on pharmaceutical companies.

First, and perhaps most importantly, the power in setting the price for drugs is skewed toward drug manufacturers. Unlike countries where universal health coverage is in place, the negotiating is left to individual care providers rather than being in the hand of a large, publicly funded buyer that’s able to negotiate since it purchases most (if not all) of the drugs.
For those with health insurance, high drug prices result in higher premiums, but it’s hard to notice the price increases directly. This means consumers lack awareness of the actual medication prices, and consequently, any pressure to keep them under control.

Plus, the costs of bringing a drug into the US market are higher, partially because of marketing expenses. The US is one of only two countries (the other being New Zealand) that allows direct-to-consumer advertisement of prescription drugs, while elsewhere promotion is limited to medical professionals. This raises the already steep marketing bill of drugs manufacturers. As Robert Yates, former World Health Organization senior health economist told Quartz, “the amount [pharmaceutical companies] spend on marketing is massively more than they do on research and development.”

The entire article is here.