Drug prices

[Pyrrho]

Link: https://twitter.com/Gizmodo/status/1136585123900604416

[sparks]

Fuck. Just fuck.

[shemp]

Hey I've got a coupon for $5 off! Anyone need it?

[Anaxagoras]

It really is nuts. It really infuriates me. They are literally taking advantage of sick people.

The government is legally prohibited from negotiating drug prices.

The United States is the only country in the world that does this, apparently. So a drug that costs $8/month in Australia costs $2000 in . But your insurance will pay for it, so why do you care, right? Because that's what drives up everyone's insurance premiums including your own.

On my way to work this morning I was listening to a podcast about another case.

This Drug Could End H.I.V. Why Hasn’t It?

A solution to the AIDS epidemic may be at hand. But not everyone who needs it has access to it. June 5, 2019

Truvada, a drug manufactured by Gilead Sciences, is taken once daily to prevent infection with H.I.V. It currently costs about $20,000 annually.

Could it wipe out the disease like small pox? Maybe not entirely, but it could, if everyone who was "at risk" for HIV took it, probably cut down on new infections by about 90%. But, it's more important for the company that makes the drug to maximize their profits than to wipe out a deadly disease, so here we are. It'll supposedly be coming off patent in 2020 but the company is making a new, slightly different version of the drug which they claim causes fewer side effects, so it's a little unclear whether cheap generic versions of the old drug will still be the drug of choice after it comes off of patent.

Essentially, Americans pay huge markups for drugs that are available to people in other countries for a bargain.

[Anaxagoras]

Or is it Americans (or their insurance companies) paying the true cost, as distinct from government subsidy?

No. A drug that was being sold for $40 in 2000 is now almost 1000 times more expensive. True cost has nothing to do with it.

[Rob Lister]

What's not clear from the tweet is that the DOJ is going after them.

The pharmaceutical company responsible for one of the largest drug price increases in US history "knowingly paid illegal kickbacks" as part of an elaborate scheme to make millions and stick the American taxpayer with the bill, the US Department of Justice said Wednesday in a lawsuit filed against Mallinckrodt Pharmaceuticals.

In its complaint, the government demanded a jury trial that would put front and center the actions of the company at the heart of a 97,000% drug price hike. The price of Mallinckrodt's anti-inflammatory drug Acthar -- best known for treating babies with a debilitating seizure disorder -- has gone from $40 a vial in 2000 to nearly $39,000 today.
The complaint was filed in the US District Court for the Eastern District of Pennsylvania by US Attorney William McSwain. Mallinckrodt could face fines of nearly $240 million if found liable.

https://www.cnn.com/2019/06/05/health/m ... index.html

They've made about $2 billion from this so that $250 million is 1/8 their profit.

Short Story: they set up a fund wherein you could get the medication for free if you were uninsured. In turn, they only charged Medicare the 40K price.



On the other hand, this drug is the only thing on the market that works BUT it is a dangerous drug and there are likely hundreds of pending lawsuits.

Spoiler:

https://citronresearch.com/fda-faers-da ... se-events/
They have to raise the price to cover the costs!

That will be their argument, anyway.

On the gripping hand, the huge increase in deaths appears to be them lobbying doctors to provide the drug for off-label uses.

[Anaxagoras]

I'd say that's not entirely true. Even with private insurance companies, the government is involved. Often they have no choice but to put up with it. Then instead of saving money on the cost side of the equation, they just have to raise prices (premiums) for everyone to cover the increased cost. This is why inflation is much higher in the health care sector than in, say, consumer goods.

As for your second question, it's the pharmaceutical industry. They lobby congress, they donate generously to their reelection campaigns. Maybe they even hire family members of congress people. I'm sure you know all about how political influence works.

[Anaxagoras]

So a political corruption story more than anything else.

I was on my phone earlier, but here's some more information;

https://en.wikipedia.org/wiki/Medicare_ ... zation_Act

The Medicare Prescription Drug, Improvement, and Modernization Act,[1] also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003.[2] It produced the largest overhaul of Medicare in the public health program's 38-year history.

The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin.[3]

The MMA's most touted feature is the introduction of an entitlement benefit for prescription drugs, through tax breaks and subsidies.

In the years since Medicare's creation in 1965, the role of prescription drugs in patient care has significantly increased. As new and expensive drugs have come into use, patients, particularly senior citizens at whom Medicare was targeted, have found prescriptions harder to afford. The MMA was designed to address this problem.

The benefit is funded in a complex way, reflecting diverse priorities of lobbyists and constituencies.

It provides a subsidy for large employers to discourage them from eliminating private prescription coverage to retired workers (a key AARP goal);
It prohibits the federal government from negotiating discounts with drug companies;
It prevents the government from establishing a formulary, but does not prevent private providers such as HMOs from doing so.

According to the New York Times December 17, 2004 editorial W.J."Billy" Tauzin, the Louisiana Republican who chaired the Energy and Commerce Committee from 2001 until February 4, 2004 was one of the chief architects of the new Medicare law.[6][7] In 2004 Tauzin was appointed as chief lobbyist for the Pharmaceutical Research and Manufacturers of America (PhRMA), the trade association and lobby group for the drug industry with a "rumored salary of $2 million a year,"[6] drawing criticism from Public Citizen, the consumer advocacy group. They claimed that Tauzin "may have been negotiating for the lobbying job while writing the Medicare legislation."[7][8] Tauzin was responsible for including a provision that prohibited Medicare from negotiating prices with drug companies.[9]

There you have it. A congressman who chaired a key committee and "was one of the chief architects" of the law, retired and was then hired as a lobbyist by the pharmaceutical industry for $2 million/year (rumored). Who knows, really. Whether you call it "corruption" or just "money influences politics," the result is the same.

The fact that the federal government is prohibited by the law from negotiating discounts with drug companies makes no sense from the government's (taxpayers') perspective. It only makes sense if you are a pharmaceutical company.

[Doctor X]

The government is legally prohibited from negotiating drug prices.

Thanks Obama.

--J.D.

[Paulie Cicero]

Link: https://twitter.com/Gizmodo/status/1136585123900604416

Fuck you, pay me!

[Boss Paul]

Now get to work.

[Paulie Cicero]

I got a crew what does that.

[Boss Paul]

Got their mind right?

[Paulie Cicero]

Them that doesn't, oh you won't see them no more.

[Morrie]

They got cannoli?

[Jimmy the Gent]

They got everything there! Over on the boulevard.

[Paulie Cicero]

Cannoli? A million bulls are watching us and you guys are sucking down espresso and cannoli over on the boulevard. You guys gotta start eating sangwiches. Like I told Vinnie.

[Henry]

No no Paulie, Clemenza took the cannoli. Used to get real good cannoli at the Bamboo Lounge, hey!

[Teddy Bass]

If I cared, Gal. If I fucking cared. If I gave a solitary fuck about cannoli.

[Pyrrho]

So yeah my benefits requires that prescriptions be filled by OptumRx. Sign in securely with 2-factor authentication...and NoScript blocks a DoubleClick tracker/information gatherer attached to what must be a transparent pixel:

Code: Select all

NoScript detected a potential Cross-Site Scripting attack

from https://www.optumrx.com to https://8560775.fls.doubleclick.net.

Suspicious data:

(URL) https://8560775.fls.doubleclick.net/activityi;src=8560775;type=optum00;cat=lpg_o0;dc_lat=;dc_rdid=;tag_for_child_directed_treatment=;tfua=;npa=;ord=14775127823640156? width='1' height='1' frameborder='0' style='display:none'

[Anaxagoras]

Another example:

Fixed Dose Combination Drugs: Consensi Is a Bad Example

The FDA recently approved Consensi, a combination of treatments for two very different diseases. It contains amlodipine, a common drug used to treat high blood pressure, and celecoxib, a non-steroidal anti-inflammatory drug (NSAID), used to relieve the pain of osteoarthritis. It comes in 3 strengths with varying doses of amlodipine, but all formulations contain the same amount of celecoxib: 200 mg. The company website says “ConsensiTM is under patent protection in the U.S. until 2030 and will be the only NSAID whose labeling indicates a reduction of blood pressure and consequent risk reduction of heart attack, stroke and death.”

The Medical Letter recently reviewed Consensi. Their conclusion:

There is no good reason to use the fixed-dose combination…The cost of the combination is much higher than the cost of the two components taken separately, and continued daily use of celecoxib can result in serious adverse effects, including renal and cardiovascular toxicity. Elderly patient should minimize their use of any NSAID, including celecoxib.

The cost for 30 days of treatment with Consensi is $1,287. Generic amlodipine alone costs $1.10. Generic celecoxib alone costs $34.40. Consensi is available at Costco with a free coupon for a reduced price of $1,104.13. Consensi carries a boxed warning of the risk of serious cardiovascular and gastrointestinal events.

The Coeptis and Kitov companies have entered into an agreement for commercialization under which Kitov will receive millions of dollars in royalties, milestone, and reimbursement payments.

Conclusion: An irrational product

It doesn’t make sense to combine these two ingredients for such very different diseases. How many patients have both diseases and would benefit from Consensi?

High blood pressure is seldom controlled on a single anti-hypertensive drug. In the best possible scenario, if a patient happens to have high blood pressure that is already well-controlled with amlodipine alone and also happens to have osteoarthritis that is already well-controlled with 200 mg of celecoxib alone, it would be more convenient to take one combination pill than two single pills. But does that convenience justify an added cost of over a thousand dollars a month, over $12,000 a year? I don’t think so! Patients might argue that they don’t have to pay for it, that insurance pays; but if insurance expenses go up, someone has to pay, and it ultimately impacts all of us.

The idea that insurance pays for it anyway, so why care about the price: I don't understand how people can be so dumb as to think that way. You pay for your insurance one way or another. Ultimately you pay, (I.e., we all collectively pay) it's just that insurance makes it so that the costs are shared among a larger group of people. Here you have two drugs that combined cost less than $40/month, and they combined them into one pill to be sold for over $1,287?? (or $1,104.13 if you use a coupon and shop at Costco )

[Doctor X]

Wow.

– J.D.

[shemp]

Conclusion: An irrational product

Actually, it's very rational, from the POV of the profiteers. I wonder what the doctor's kickback is for prescribing this. Fucking thieves ought to be hanged by their balls until the wind whistles through their vulture-picked and sun-bleached bones.

[Paulie Cicero]

I got a drug what's going generic, all of a sudden I can't get a thousand bucks a hit, so I mix it up with another one I can't get five bucks a hit for and fuggetaboutit, I got a ringer worth two grand a hit and I get the licensing fees, no generic for another ten years, I'm set until I gotta mix it up again to make another ringer. It's a very good system. Got high blood pressure? My ringer gave you a stroke? Fuck you, pay me!

[Rob Lister]

I'll see your ringer and raise you the chemo drug pralatrexate. $120,000/yr