How wouldthe Feds negotiate prescription drugs work?

[napi21]

I've been listening to the House on cspan this morning, and thinking about just how this would work. I know the Veterans admin. does thisand I hear their costs are much lower than what seniors pay, but since the Part D program actually is run through many individual insurance companies, how would the feds be able to negotiate the drug pricing? The vet program is more like a single payer system and can demonstrate that they buy billions of a particular drug, but can the feds show that same thing for quantities purchased through so many individual ins. companies?

I have always though it was a BIG mistake for Congress to have put that restrictioninto the program, but I'm now questioningjust how they could make it work.

[Rosemary2205]

1. All they have to do

is allow the insurance companies to negotiate part D prices just like they negotiate prices for other prescription programs.

[napi21]

2. But the Pubs are saying the ins. companies are doing that NOW!

The bill they are discussing now is to allow the Health & Welfare dept. to negotiate the pricing.

[Rosemary2205]

3. I don't think that's accurate.

the original Part D legislation specifically says insurance co's have to pay whatever price the Pharms set and senior must pay the full retail price in the donut hole. The only thing they did allow for is insurance companies are allowed to keep their own formulary. IOW if a pharm is demanding too much money then the insurance co can just drop that drug and go to a generic only or other brand only. (for instance playing Zocor and Lipitor off each other)

I could be mistaken on this but I'm pretty sure this is how it's working.

[w4rma]

4. The same way it worked *before* Bush/Repukes banned it. (nt)

[Benzene25]

5. how about this . . .

Save all the time and money negotiating. The feds and part D plans should simply pay the average of the top 3 insurers in the state for an individual drug. If Blue cross, United, and Aetna pay an average of $50 for a month's supply of a drug that's what the feds should pay.

Frankly i feel that the states should negotiate with providers at all. Medicaid reimbursement rates for service should be handled in the same way. It's complete BS to me that the best payer (rate-wise) for the services my company provides is the state. if my company will accept $50 from blue cross for a service the state shouldn't pay any more than that.

[heinz]

6. They will just screw it up like everything else

I think its a bad idea period to let the government have anything to do with your medicine. They will just screw it up like they have with every freaking thing they have ever attempted. Take a look at any price controls the government has ever done. Not one of them has ever worked and in every case it ended up leading to higher prices , not lower. Until people start paying for their medical bills straight out of their pockets every time they goto the doctor or pharmacy its just going to get worse. What we need is for the doctors and pharmaceutical companies to have to compete in the market like everyone else. All this regulation has just led to astronomical prices.

[Warren Stupidity]

7. Yeah that is why single payer UHC is so screwed up

in every other modern industrial democracy. Oh wait, single payer UHC is not screwed up in every other modern industrial democracy, in fact single payer UHC routinely delivers better healthcare at lower costs than our massively corrupt 'market' based system.

Oh and welcome to DU.

[Warren Stupidity]

8. Government could actually purchase

bulk quantitites of standard medications. It would then transfer the savings directly to the consumer, via scheduled prices incorporating fixed retail prices.

Oddly enough the bush administration does exactly this, although a little indirectly, with medicaid, where it has to actually provide the benefits rather than the corrupt part D scam giveaway to big pharma that is in Medicare.

"HHS Secretary Mike Leavitt today approved plans by three states -- Louisiana, Maryland and West Virginia -- to pool their collective purchasing power to gain deeper discounts on prescription medicines for their state programs.

This is the second multi-state purchasing plan using the framework established by the Centers for Medicare and Medicaid Services in 2004. The first multi-state plan, approved in April 2004, included five states: Michigan, Vermont, New Hampshire, Alaska and Nevada. Since its approval, Hawaii, Minnesota, and Montana have joined that original pool.

"These pooling plans will help lower drug costs for the states involved," Secretary Leavitt said. "The ability to purchase drugs at a lower cost will help the participating states continue to provide critical medications to the millions of low-income citizens who depend on the Medicaid program."

Louisiana estimates that it will save $27 million in its Medicaid program in 2006 as a result of the arrangement. Maryland reports that its Medicaid program will save $19 million in 2006 because of the purchasing pool, while West Virginia expects to save $16 million. Altogether, the pooled purchasing program will cover over 1.3 million beneficiaries. "

http://www.medicalnewstoday.com/medicalnews.php?newsid=25342