General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsHealthline.com: Should Multiple Sclerosis Drugs Cost $62,000 a Year?
(This may be overkill, but I find this discussion a lot more enlightening than a post about Victoria Jackson).
http://www.healthline.com/health-news/ms-why-are-ms-drug-prices-so-high-071913
For those who suffer from multiple sclerosis (MS), perhaps the only thing more shocking than receiving their diagnosis is learning how much the disease modifying drugs (DMDs) used to control it will cost. Patient demand, research and development costs, and competition all affect the pricing of these life-altering medications.
MS is a chronic, progressive, and often debilitating autoimmune disease that affects the central nervous system, including the brain, spinal cord, and optic nerves. More than 400,000 people in the U.S. have been diagnosed with MS, while worldwide that number is in excess of 2.1 million.
The first MS DMD to be approved by the U.S. Food and Drug Administration (FDA) was Betaseron, which came on the market in 1993. Drug makers predicted there would be such a high demand for the product that it was initially prescribed by lottery. Only one in five patients who applied received it.
Since then, nine other DMDs have joined the ranks of medications proven effective at reducing the number of relapses an MS patient suffers. Some have even been shown to slow the disease progression. With no cure in sight, many patients must take these medications indefinitely.
The fact that there are so many options available to patients is the good news; the bad news is that they all come with a substantial price tag. The chart below shows today's drug prices, as quoted by Walmart and Walgreen’s pharmacies in northeast Florida.
(I can't get the chart to post, but the average 30 day supply of pretty much every drug is $5K).
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I have to say no. They should not cost so much. You can buy a whole house in some places for that.
There has to be a way to fix those prices. Government funded or run drug companies?
kelliekat44
(7,759 posts)Last edited Wed Mar 19, 2014, 07:39 PM - Edit history (1)
either to biomedical research institutions or to research individuals working for drug companies. The problem is this...they use the money for research, development, and then get licenses to hold the public hostage to whatever price they want under the guise of recouping research and development costs. The American people always pay twice for what the grand 'ole capitalistic system provides. Perhaps it's not healthcare that needs to be socialized but drug companies.
bravenak
(34,648 posts)Socialize the drug companies!!! Make drugs cheap and there so many possibilities that will open up. I want that legislation so bad now. 5000 dollars a month is obscene to ask for medicine. No wonder the ins companies are scared of the price. What a large number. How can they even justify it?
theboss
(10,491 posts)The Senator from Dogpatch can shut down all drug funding because that new birth control patch is going to turn his grandbabies into harlots.
bravenak
(34,648 posts)I felt so hopeful for a second. Somebody, help me out!! Help me find a way around Sen. dogpatch!! I hate that guy.
Hard to get around a jerk senator. 
kelliekat44
(7,759 posts)elected!!
Gormy Cuss
(30,884 posts)When there's only one big client per country, the prices seem to drop. Go figure.
bravenak
(34,648 posts)Its just going to take awhile in this country because we have so many people who fear socialism but use it every day. Same thing with unions, they hate unions but rely on them for the benefits they have provided and do provide. Its hard to drag the fearful along with us and i feel impatient, but i know how encompassing irrational fear can be so i try to take every tiny step forward as a win. As long as we keep moving forward and not back, it gives me enough energy to keep pushing for that next step. Progress is slow in a nation full of fear.
cui bono
(19,926 posts)Did the Dem Party leaders fight for single-payer? No. They are afraid to. If they do that they lose campaign financing from the corporations that have all the money to give them.
Perhaps if they weren't beholden to corporations at the very least the Dem Party could come out fighting for the people again. The Republicans? I don't know. I don't think it would matter though because I think the people would flock to the Dem Party.
Secondly, the corporate controlled media still controls the message. Which leads into your take on what people fear. They are fed this fear by corporate controlled media, same people who are controlling our elected officials.
pnwmom
(108,980 posts)with national health systems.
bravenak
(34,648 posts)I wanted to put a bill so far left that they had to fight it back to the middle, but i would never get the votes to get to the senate because i have strange ideas of landownership that people even on the left would scream at. I also believe in a basic minimum living benefits thats would keep people out of poverty and keep us all fed.
I know that we messed up by not giving a full on single payer bill and letting them fight us down to a public option. Too many of our own senators and congressmen were scared for their own seats. I would have just voted for it and not have worried about my seat. But i am strange.
We need to fix the problems with it now and come up with plans and discuss improvements. And by improvements i mean moving the system closer to what we want in steps. Thats all we can do now.
First step to me is to fill in the gaps of people left uncovered while at the same time reducing drug costs in order to reduce insurance premiums. The 80/20 rule helps because the less they spend on meds the more refunds they have to give. I hope states start their own public lower costs options too. The profits are too high to justify this level of cost. It is obsene.
Fantastic Anarchist
(7,309 posts)... provide the R&D, then the Big Pharma scoops in and patents the shit out of it.
kelliekat44
(7,759 posts)
MineralMan
(146,317 posts)There need to be some controls over drug prices. That's obscene.
theboss
(10,491 posts)Would the solution be as simple as requiring drug companies to publish the costs of each drug somehow?
Aren't we also told by right-wingers that the key to campaign finance reform is simply open records?
MineralMan
(146,317 posts)There's no regulation of pharmaceutical prices, other than the willingness of various programs to pay for them.
I think there should be, though. Those prices are obscene, and limit the use of the medications to the wealthy, in many cases.
theboss
(10,491 posts)I got a B- in Econ 101.
MineralMan
(146,317 posts)I'm far from being an economist, too.
Fantastic Anarchist
(7,309 posts)... that since Big Pharma operates by the profit-motive, drugs that are needed, but cost a lot to develop just aren't being made.
Case in point is antibiotic resistant bacteria strains. The most recent is the bacteria that causes Gonorrhea. It has become resistant to some antibiotics, so they have to cycle back through older antibiotics (since most strains would be selected to have lost the resistance once the drug hasn't been used in awhile). However, new drugs could be created (new methods for antibiotics, other methods by other means, etc.), but are prohibitively expensive to research and create (even on the tax-payer dime), so Big Pharma develops other drugs that increase the bottom line (like boner pills).
In other words, the whole system is fucked.
MineralMan
(146,317 posts)of antibiotics. Not ready for release yet, though.
Trust me, they'll be very expensive, indeed, for a while.
Vashta Nerada
(3,922 posts)
they shouldn't
hamsterjill
(15,222 posts)How much are the CEO's of these drug companies paid? THAT would be my first question...
I was just reading a piece of Facebook about how income inequality is going to be the real doom for our planet. This problem exemplifies that.
theboss
(10,491 posts)And pretty much eliminates the profit motive for doctors, most attorneys, and - I dunno - certain filmmakers.
hamsterjill
(15,222 posts)"Getting rich" is a very different thing than "making a good living". There most assuredly has to be a profit incentive for the pharmaceutical companies, doctors, etc. to do their job and produce drugs, etc.
But a CEO who makes millions in bonuses is a little too arrogant for me, particularly when there are people dying because HIS/HER product is too costly for patients to benefit from.
http://www.huffingtonpost.com/ethan-rome/big-pharma-ceo-pay_b_3236641.html
Fantastic Anarchist
(7,309 posts)And it is an excellent point.
hamsterjill
(15,222 posts)I don't know if it's fair that they NOT be allowed to advertise, but I think money spent on advertising things which can only be acquired with a valid prescription, is not quite right.
smokey nj
(43,853 posts)prescription medication is legal and pharmaceutical companies spend more on marketing than they do on R&D.
http://en.wikipedia.org/wiki/Direct-to-consumer_advertising
http://www.sciencedaily.com/releases/2008/01/080105140107.htm
theboss
(10,491 posts)That's probably my number one issue right now.
1000words
(7,051 posts)If everyone receives 1% income.
one_voice
(20,043 posts)that much.
The drug prices in this country are out of control. I'll tell you what needs to be regulated, Pharmaceutical companies.
Talk about getting rich on the backs of the sick. It's disgusting.
City Lights
(25,171 posts)
steve2470
(37,457 posts)steve2470
(37,457 posts)theboss
(10,491 posts)What is the right price?
steve2470
(37,457 posts)If we go the democratic socialist route, then it would be the actual cost of production.
theboss
(10,491 posts)Goes back to my we need to know what these things cost to produce argument.
steve2470
(37,457 posts)My understanding is, they have to actually open their "books" to the FPSC to prove their rate increases. Maybe I'm wrong. I'm sure other states do this as well.
Same thing with medications: open your books, prove your costs, then we give you an extra 10%.
hfojvt
(37,573 posts)and the retailer is making a profit too, right?
I mean, having been in the book business, a book that cost $17 by the cover price, I would usually pay $10.2 for. And sell it for $13.6.
So my own "profit" (in quotes, because the only profit I ever made from seven years in business was only a theory) would be 33.3%
Some of the books I got from overstock, I would mark up even more. For example, the "One small square" books had a $7.99 cover price. I got them from the wholesaler for Half Price Books for perhaps $1.49. And ordered perhaps 5 copies of each (in hindsight, I wish I had ordered twenty copies of each). Priced the first one at $2.99 the second at $3.99 the third at $4.99 and the last one at $5.99 (or something like that, although it was kinda rare for me to get multiple copies iirc).
On the last copies, my mark-up was pretty substantial.
My price was 20% off cover price - trying to compete with Wal-mart and groceries stories and my competitor who was 10% off.
Berenstain Bears was another example. I ordered a huge spin rack of them, like five copies of 30-40 titles. The cover price was $2.99. As years went by, the cover price went up to $3.99.
So I took my last two copies and marked the price up to $3.99.
Since I need to have those books in stock, there would be NO point to selling a book for $2.39 and then restocking my store by ordering the same title for $2.39 (plus shipping) from my wholesaler.
So again, the mark-up could be substantial.
Not sure how pharmacies price things.
On some items though, Wal-mart would be selling items below my wholesale costs. I got $10.95 calendars for $6.57. See the exact same calendar at Wal-mart for $4.99. I had to wonder if they were really making money on them, or selling them below cost to help drive me out of business.
steve2470
(37,457 posts)Whether democratic socialist or capitalist, those have to be paid. I can't imagine ANY drug costing $4400 a month long term. I obviously haven't worked out all the details with this, but the bottom line is that R&D costs have to be paid.
A commission to study this and make recommendations would be in order.
theboss
(10,491 posts)Some of these drugs have been on the market for nearly 20 years. So, the R&D argument doesn't really fly with them.
steve2470
(37,457 posts)I'm only referring to drugs that are newly introduced. Again, how a company recoups its R&D costs, I have not worked out. The only way to avoid it is to completely subsidize the company with tax funds, or, establish a government pharma firm.
CountAllVotes
(20,876 posts)Do these DMD drugs work?
How long have they been studied before being pushed through the FDA?
Lots of questions and no clear answers.
The latest out there is called Tecfederia and costs $75,000.00/year (pill from). One of its more horrific fatal side effects is a rare form of encephalitis.
Too many questions and no answers. 
blindersoff
(258 posts)that patients receive when deciding which one to take, they are about 30% effective in preventing or slowing disability progression. And they really don't even know if or why they work on some people but not on others. So a person who is on one of these drugs can still have relapses and progression of the disease. I've been on one of the interferons for almost 3 years now and so far haven't had any problems or progression. Which is not to say that I might wake up tomorrow with major problems. MS is a weird weird disease; no two people are alike in symptoms or progression.
CountAllVotes
(20,876 posts)Very true. Been dealing w/this crap for over 30 years now ...
Still around needless to say! 
Travis_0004
(5,417 posts)Bringing a drug to market can cost 1 billion dollars, and even more when you factor in drugs that turn out to be failures and never make it to market.
Lets say a drug costs 50 bucks to assemble the actual ingredients. If the drug was only sold for 55.00, R&D would grind to a halt overnight. I agree with you that 60k a year for a drug is way too expensive, but due to R&D, I don't think new drugs will ever be dirt cheap.
steve2470
(37,457 posts)
Ms. Toad
(34,075 posts)Or the cost of inventing/testing of the potential drugs that don't work (including several levels of drug trials) for that same medical condition by that same company, several levels of drug trials, rounds of seeking approval, etc., all of which are a cost of bringing the drug to market?
I agree that drugs cost way more than people can afford - but most people only think about production costs. Without the iceberg below the production/marketing tip we see, there would be no new drugs.
steve2470
(37,457 posts)Sorry I was not more clear.
uppityperson
(115,677 posts)Jenoch
(7,720 posts)I met a lady with MS. She seemed to be doing ok but she said how much the medications cost. She even told me the name of one of the pharmaceutical companies and said I should buy their stock. I wish I had listened to her. Biogen Idec stock at the time was $160. It is now at $350. I bet the company president has a net worth of hundreds of millions of dollars. It's obscene.
truebrit71
(20,805 posts)That is nothing more than extortion.
Fantastic Anarchist
(7,309 posts)... says the parasitic capitalist.
reformist2
(9,841 posts)No more. Now it's all about the $$$$.
magical thyme
(14,881 posts)Maedhros
(10,007 posts)
pnwmom
(108,980 posts)exclude a whole class of drug, like these M.S. drugs, from their formularly (their list of approved drugs). But they can approve only specific ones, rather than all of them.
And there are appeals processes under the ACA, if a patient's doctor feels that s/he needs a drug that's not on the formulary.
I'm posting this in part as supplement to Mineral Man's thread on why these formularies exist.
Anthem has likely negotiated the price way down on the drugs that they allow in their formulary. That's how this works.
frazzled
(18,402 posts)the issue that has been discussed here for the past few days concerns ACA health insurance policies and whether they will pay for the drugs. There was a great outrage about it, but the truth is that (a) ACA policies are no different than either work-related or traditional individual policies, or than Medicare Part D, in this regard; and (b) doctors often, and easily, may apply for an exception to a insurer's formulary, and the drug will be covered.
From ThinkProgress, a response to right-wing complaints that people can't keep their drug coverage under Obamacare. "No, Obamacare Won’t Cover Every Drug — Just Like Every Other Insurance Policy":
The ACA requires that issuers provide the greater of one drug from each category or class, or offer as many drugs in each category as are covered by a benchmark plan. The law allows states the choice of four different benchmarks, which Gottlieb helpfully lists in his article: 1) One of the three largest small group plans in the state by enrollment; 2) one of the three largest state employee health plans by enrollment; 3) one of the three largest federal employee health plan options by enrollment; or 4) the largest HMO plan offered in the state’s commercial market by enrollment.
States — not the federal government — select the benchmark and insurers then offer coverage for the drugs listed in those formularies.
...
But yes, there are certain limits: a formulary, for instance, may cover three drugs for treating a certain condition but not two others. Obamacare — like all insurers currently operating in the market — has a fix for that. ACA regulations demand that a health plan must have an “exceptions process” in place that allows patients to request and gain access to clinically appropriate drugs that aren’t covered by the health plan (in addition to internal and external appeal processes). So, if a health plan does not cover a particular drug that a patient absolutely needs, their doctor can certify medical necessity to extend coverage. Insurers have relied on drug formularies before the law went into effect and already have exceptions processes in place, meaning that most “will not have to implement significant changes.”
http://thinkprogress.org/health/2013/12/10/3042741/drugs-obamacare-coverage/
kristopher
(29,798 posts)The price of the drug is secondary to the fact that they are required for life. And while I know the abundance of treatments can be explained by the fact that discoveries give a research track that leads to other similar discoveries, I have trouble believing that the pharma companies are putting anywhere near the same resources into finding less profitable cures as they are expensive lifelong treatments.
It's a profit motive with a payoff that takes drug addiction and drug pushing to an entirely new level.
CountAllVotes
(20,876 posts)It is coined to be an auto-immune disease whatever that means.
What is it? They do not know.
We've got over 10 carts before the horses here and a load of $$$ off of these drugs being sold to people that are sick. What an absolute disgrace!!
Sad but true.
passiveporcupine
(8,175 posts)Necessary drugs should be socialized. No patents. As soon as a new drug that saves lives is available, it should be made by anyone who will/can compete to bring the cost down, even if another country. Elective drugs like rogaine, viagra, perhaps should not be under the same system. Let them be part of a capitalist system, where demand will drive pricing and availability, just like medical procedures that are cosmetic only. If they were not covered by insurance, I bet the prices would drop for them anyway.
We are already paying to develop these drugs, and all other countries pay less than we do for the drugs we've paid with our taxes to develop. I believe the cost of more expensive life saving drugs needs to be socialized, but just taking them out of the hands of for-profit companies will help keep the costs down.
The median household income per year is about 51K. How can anyone possibly afford a drug that costs 62K a year? Especially if it isn't covered by insurance?
There may be 350,000 people in the US with MS. At 62K a year, that would cost us 21.7 billion a year. If we were paying for that with our taxes, I can guarantee you, we would be getting better prices than that.
Until we do this, insurance companies are not going to want to take this bite out of their profits.
CFLDem
(2,083 posts)my insurance company is taking a 99.9% bite out of Mrs. CFLDem's MS drug costs. They must receiving subsidies of some sort for us to only pay $10/mo.
And when we were poorer, we didn't pay anything at all.
But it's definitely a racket. Its $450/ea for the DIY version of the drug, and $1500/ea for them top prefill the syringe.
theboss
(10,491 posts)Why would anyone work in this field?
Also, define "save lives."
None of these drugs even existed twenty years ago. From what I can tell, none of them really "save lives" in the traditional sense. What do you mean exactly?
passiveporcupine
(8,175 posts)Why should you make an obscene profit off of a medication necessary to keep people alive and functioning? Then if they can't afford it, they suffer or die? Medicine is not like a car or stereo. When people are sick, they need the medicine that keeps them alive, it's not just that they want it. If they need it, they will pay whatever you charge, or go without and pay the consequences. You can live without a car or stereo or ipad.
We need to socialize every aspect of health care. We still need to pay for the doctors, surgeons, specialists and inventors, because they work hard and go to school to get the education necessary to do the job, so they deserve decent pay. But they don't need to make huge profit on new discoveries, or on doing their job. They should have gotten into the profession for altruistic reasons. Helping people should be as important to them as living well.
Why not just get paid a good wage for inventing it? If they are good, and enough people buy them, you will still make plenty of money, even at a reasonable cost (a competitive cost with other drug manufacturers). If they are good but only help a small group of people who have a rare disease, you would either have to charge a million a pill or not develop them at all? Is that the way we want medicine to work?
TrollBuster9090
(5,954 posts)Those who are saying that pharmaceutical companies pay large R&D costs, and those who are saying that the taxpayer-funded universities are actually doing the research are BOTH right.
Most of the R&D is done by universities, not by pharmaceutical companies, per se. (In most cases the only people who are burning the midnight oil in a pharmaceutical company are the patent lawyers!) It's done as follows:
A) Either universities do the original work, make a discovery, then PATENT it, and SELL the patent to a pharmaceutical company, or,
B) Pharmaceutical companies fund the research that goes on in university labs directly.
So, you're both right. The universities do do the research, but (theoretically) they're reimbursed by the pharmaceutical companies, so pharmaceutical breakthroughs are not funded (again, theoretically) by taxpayers. However, having said that, its an artificial economy, because only the winner discoveries at universities are patented and sold to companies. But there are 100 duds for every winner, and the taxpayer is basically eating the costs of all the dud research that never turns out to be useful. So, in that sense, it's entirely fair to say the the public is ultimately footing the bill for pharmaceutical R&D, and they get a PARTIAL reimbursement from the pharmaceutical companies.
mr blur
(7,753 posts)I don't get asked to pay for them.
But then again, we have universal healthcare here.
Nye Bevan
(25,406 posts)In Britain the drug has always been surrounded by controversy. In 2001 The National Institute for Clinical Excellence (NICE) ruled that the drug was not cost effective and should not be provided on the National Health Service (NHS). The organization argued that the £10,000 a year cost for each patient would be better spent on other forms of MS treatment. This caused uproar among patient groups.
The row was eventually diffused when the government announced that the drug would be made available free to certain patients under a pioneering "risk share" scheme with the manufacturing drug companies. The manufacturers agreed to lower the cost of the drug if it failed to live up to expectations after a period of several years. It is only available on the NHS to treat relapse remitting patients and those who have secondary progressive MS in which the relapses are dominant. Only one in eight Multiple Sclerosis patients in the UK meet these criteria.
Under NICE guidelines the drug's effectiveness will be monitored on an annual basis. If the drug is not fully effective the NHS will receive a rebate from the manufacturing drug companies. The four manufacturers involved in the scheme are: Biogen http://www.biogen.com, Teva http://www.tevapharm.com, Schering http://www.schering.fi and Seronon http://www.serono.com.
Because of this controversial drug rationing, whether or not a patient receives Beta Interferon in the UK is a postcode lottery. The drug's cost and availability of funds in different health authority region mean the chances of being treated with beta interferon vary widely, depending on where a patient lives and the policy of the local hospital.
........
In America the drug has been licensed to treat relapse-remitting MS since 1993. Depending on the level of health cover its use is normally paid for by insurance companies.
http://www.guide4living.com/multiple-sclerosis/beta-interferon.htm
Note that I am not criticizing this approach. When a drug is this expensive it obviously is impossible to give it out free to anyone who wants it.
LiberalEsto
(22,845 posts)Just saw this on BBC
Link:
http://www.bbc.com/news/health-26630025
CountAllVotes
(20,876 posts)Heard this over 5 years ago.
ProfessorGAC
(65,076 posts)There's only one drug i know about that cost that much.
I'm on betaseron for MS. Have been for 18 years. The retail price of the drug is just under $2k per month. My copay is $125. Not cheap, but not $5,000 per month either.
That being said, the drugs for these maladies that strike a fairly small proportion of the population are ridiculously high.
theboss
(10,491 posts)Here is a website that discounts it to under $5K a month:
http://www.goodrx.com/betaseron
ProfessorGAC
(65,076 posts)Then their estimate is too high. Avonex and Betaseron don't cost nearly that. Trust me, i'm glad they don't or my copay would be 2x what it is now.
GAC