I'd like to tell you how prescription drug prices work in Australia.
1. Around 1000 prescription drugs are in the Pharmaceutical Benefit Scheme (PBS). The Scheme negotiates the cost of these drugs with the drug companies.
2. The PBS heavily subsidies the cost to consumers. The MAXIMUM anyone will pay for a prescription drug (unless it's prescribed off label) is A$30 a month.
3. Those on low incomes are granted a Health Care Card (HCC). This cuts the cost of a prescription to A$7.40
4. The PBS has a further feature called the Safety Net. If a general patient spends A$1,563.50 in the calendar year, they are entitled to the HCC rate for the rest of the year. If a HHC holder spends $262.80, their prescriptions become *free*.
5. Those prices don't apply if the drug is prescribed "off label"; but the consumer is still entitled to the reduced price negotiated by Medicare. For example, Ozempic isn't covered by the PBS if it's prescribed for weight loss rather than diabetes; but is still only around A$250 a month.
It is; I've been sitting here staring at it, and thinking that something doesn't look right. I don't think Photoshop existed when that photo was taken, but maybe it's been edited? Never liked the guy anyway.
I pay a maximum of $16.50 per prescription for the meds I take. The rest is covered by the govt. My parents get their meds for free as they are pensioners. In spite of this evil socialistic imposition on my freedumbs I can still get eaten by crocodiles or kicked to death by a murder budgie. What kind of a socializms do you call that?
$16.50? Come to a real socialist paradise and you'll pay nothing. Of course you have to eat fried food at every meal and drink yourself to death but potato, tomato. The latter of which is apparently a vegetable, and the former is only ever deep fried. Or is a tomato a fruit? Discuss.
I was working in pharmaceutical market research when Part D was first rolled out. The healthcare professionals we interviewed--for medications, mind you--were so pissed off and never failed to take a portion of their sessions--again, being interviewed for specific medications--to go off on how their elderly patients were getting screwed left, right and center.
My point is, this is long, LONG overdue, and hopefully heralds a coming overhaul of the entire system.
Yeah, the US and NZ are the only industrialized countries that allow advertising prescription drugs. Everywhere else regards it as beyond bizarre and on obvious bad idea.
The Big Pharma companies complain about such rules, I suspect, because they consider any rules at all unnecessary and unreasonable. They'll no doubt insist that competition generated by market forces keeps things in line. The problem is that huge corporations mostly evade market forces due to their sheer size. They don't even need to break any laws or "conspire" to do it: they can all charge sky-high prices and not worry about public dissatisfaction with those prices, so why would they bother lowering them? Healthcare premiums seem to go up something like 10-15% every year -- if that keeps up, sometime soon Americans will be spending ALL of their money on healthcare insurance and delivery.
"Healthcare premiums seem to go up something like 10-15% every year -- if that keeps up, sometime soon Americans will be spending ALL of their money on healthcare insurance and delivery. "
See if you can read "Sleepwalking Through History" without getting extraordinarily pissed about the '80s. In his own way, Reagan almost single-handedly destroyed the way this country was governed since the New Deal.
Here's a hint: maybe if the US outlawed the advertisement of Rx drugs the way that other countries do, then the companies making those drugs could reinvest all of that ridiculous marketing money into R&D and/or offset the lost revenue from government-negotiated prices.
I work in the industry in a role where I'm actually getting product to patients (if I fuck up, the market might be shorted). We are such a tiny sliver of the overall pie-chart for corporate expenses.
It would also make watching cable shows so much less terrible. We only ever have MSNBC on once in a while in our house, but when I stayed with my Mom during her recovery, it was almost ALL pharma ads all day in between whatever she had on. I sometimes saw an ad for a product that the company that I work for makes during every single commercial break. It was absolutely absurd.
I think pharma companies' marketing budgets need to be tied to R&D, like for every $1 for R&D 10 cents can go to marketing. THAT could show some real breakthroughs, and funnel a lot of money to colleges/universities that actually do the work developing drugs.
Fun anecdote. About 25 years ago, I was on a flight to Chicago sitting next to a middle-aged guy who was going to a medical conference. He was a research professor at (I think) Cornell Medical Center in NYC. He was a cardiologist specializing in the connections between obesity and heart disease. I myself was on my way to a publishing conference, so I asked him what sessions and presentations he was going to see and what new research he was going to present.
He looked at me like I was from Mars and said, "Oh, I don't go to that stuff. I'm going to be meeting with pharmaceutical companies to talk about the rollout of the drug I've been working on." He was very excited because obesity and heart disease are very prevalent in the US and lots and lots of people were going to want this drug.
I asked him if he liked teaching or research better. Dumb Martian me. He said, "Oh, I don't teach" (he spat the word). He then told me he was going to share the patent with Cornell. After which he also told me that the entire research program that had developed the drug had been funded by the NIH and other federal sources. All of it. So I said, "Shouldn't the US government hold the patent, then?"
We didn't talk any more after that. Awkward flight.
I'm wondering how long it's going to be before the whole medical industrial complex collapses and we have to bail them out with our tax dollars ala the mortgage companies way back in '08?
I know a LOT of faculty and a good number of "faculty." The latter REALLY suck. And they remain high-minded about it, too, which makes me wanna punch 'em but it's not allowed.
Even though this was a long time ago, the guy's smugness sticks with me. He was really gloating about what a win he had scored.
I come from an academic family - I respect faculty (not so much the ones who bitch and moan about how awful it is to have to teach undergrads, tho). But the medical research people are in another league - they are all about the massive multiyear grants and the high salaries and the patents.
Reminds me of a high-end digital research outfit I dealt with at one time called Thinking Machines. They referred to any government grant of under $5 million as a "sugar grant." Youknow - just a lil sweetener. Of course, they were doing lots of high-minded noble research for the DOD.
Why didn't your suggest that workers, peasants and students should seize the means of transportation production and fly the airplane for the rest of the trip?
I have to take Elquis until I die. I also live in England. I sometimes have up to 6 different medications. I pay nothing. Even get free delivery from the pharmacy.
I'm about to enter this brave new world, as I will be switching to Medicare at the end of the year. I've just learned that one medication - which I will be taking for the rest of my life - is considered "off-label" by Medicare, even though its use for my condition has been approved by the FDA. It is not covered and costs $900/month.
I assume there are dozens of such meds. It still staggers me that Big Pharma has gotten away with this game well into the 21st century, all while being Fortune 50 companies whose compensation scale for their middle managers exceeds the best pay scale in most fields.
"And in 2025, out-of-pocket costs for Part D will be capped at $2,000 annually, which again will be a huge savings for seniors facing the highest drug prices even before the negotiated prices kick in".
Worst case, you might have to pony up until 2025, but before signing up for anything spend some time with a Medicare specialist who can advise you about all the options. There are so many different Part D plans, you really need someone who does this for a living to advise you about your best option.
Also, no matter what, DO. NOT. sign up for a Medicare Advantage Plan. Once you realize it is a massive rip off, it is too late, You will be ineligible to switch to a Medicare Supplement plan. The supplement plans do cost more per month, but the comprehensive coverage is well worth every penny. Even if you think you don't "need" that much coverage, if you are old enough for Medicare eligibility, you are old enough for a bad diagnosis that may come seemingly out of nowhere. Then you'll be glad for the comprehensive coverage, and really glad you didn't sign up for a shitty Medicare Advantage plan.
I am absolutely THERE regarding "Advantage" plans - what a fucking scam.
I'm not sure the cap on meds includes a medication that is considered "off-label" but that would be amazing if true and would make a massive difference in my life. So thank you so much for flagging that. And yes, I am trying to wade through all the for-profit Part D plans, and the Medigap plans, and I keep thinking about friends my age in Europe who literally never give this a moment's thought.
Exactly. I try to be gentle with my friends who saddled themselves with Advantage plans when they get bitten in the ass by them. But hey, they got a free gym membership and a Contego water bottle, so it was worth it, I guess.
Does your state have a drug plan that can help with that, can you get a deal from the drug manufacturer, are you eligible for LIS (I think the 2024 income limit is about $15K)? Look around, because there are ways around this.
Thank you. I only learned this a week ago and haven't yet done much research. I am probably above the income level to qualify. I think I can swing it for a decade or so, and then will have to either sell my home and move someplace cheap, or die. Retirement planning is so much fun!
Talk to the drug manufacturer. By law they have to offer some drugs for reduced prices/free. Some states have programs, probably also income based. Or if there's a drug study you can find. Also, if you are close to Canada or Mexico, try that. Although my dad did get counterfeit Wellbutrin once from Mexico.
great . . . now get all my $100+/month drugs on a list before i die!
I'd like to tell you how prescription drug prices work in Australia.
1. Around 1000 prescription drugs are in the Pharmaceutical Benefit Scheme (PBS). The Scheme negotiates the cost of these drugs with the drug companies.
2. The PBS heavily subsidies the cost to consumers. The MAXIMUM anyone will pay for a prescription drug (unless it's prescribed off label) is A$30 a month.
3. Those on low incomes are granted a Health Care Card (HCC). This cuts the cost of a prescription to A$7.40
4. The PBS has a further feature called the Safety Net. If a general patient spends A$1,563.50 in the calendar year, they are entitled to the HCC rate for the rest of the year. If a HHC holder spends $262.80, their prescriptions become *free*.
5. Those prices don't apply if the drug is prescribed "off label"; but the consumer is still entitled to the reduced price negotiated by Medicare. For example, Ozempic isn't covered by the PBS if it's prescribed for weight loss rather than diabetes; but is still only around A$250 a month.
Americans, you deserve much better.
How many people's pension funds are invested, in part, in Big Pharma?
https://www.pionline.com/article/20190308/ONLINE/190309869/states-are-suing-opioid-manufacturers-but-their-pension-funds-embrace-them
That picture of Ray-gun is bizarre -- ginormous melon, narrows and pencil waist.
It is; I've been sitting here staring at it, and thinking that something doesn't look right. I don't think Photoshop existed when that photo was taken, but maybe it's been edited? Never liked the guy anyway.
reagan should have been toking on a Chesterfield for that one.
I pay a maximum of $16.50 per prescription for the meds I take. The rest is covered by the govt. My parents get their meds for free as they are pensioners. In spite of this evil socialistic imposition on my freedumbs I can still get eaten by crocodiles or kicked to death by a murder budgie. What kind of a socializms do you call that?
$16.50? Come to a real socialist paradise and you'll pay nothing. Of course you have to eat fried food at every meal and drink yourself to death but potato, tomato. The latter of which is apparently a vegetable, and the former is only ever deep fried. Or is a tomato a fruit? Discuss.
WTF? When did Oz become part of Denmark, huh?
I was working in pharmaceutical market research when Part D was first rolled out. The healthcare professionals we interviewed--for medications, mind you--were so pissed off and never failed to take a portion of their sessions--again, being interviewed for specific medications--to go off on how their elderly patients were getting screwed left, right and center.
My point is, this is long, LONG overdue, and hopefully heralds a coming overhaul of the entire system.
If we banned advertising for prescription drugs then drug manufacturers would be forced to compete by making better drugs.
In other words, actual capitalism.
Ask your doctor if taking medical advice from TV commercials is right for you!
Yeah, the US and NZ are the only industrialized countries that allow advertising prescription drugs. Everywhere else regards it as beyond bizarre and on obvious bad idea.
The Big Pharma companies complain about such rules, I suspect, because they consider any rules at all unnecessary and unreasonable. They'll no doubt insist that competition generated by market forces keeps things in line. The problem is that huge corporations mostly evade market forces due to their sheer size. They don't even need to break any laws or "conspire" to do it: they can all charge sky-high prices and not worry about public dissatisfaction with those prices, so why would they bother lowering them? Healthcare premiums seem to go up something like 10-15% every year -- if that keeps up, sometime soon Americans will be spending ALL of their money on healthcare insurance and delivery.
"Healthcare premiums seem to go up something like 10-15% every year -- if that keeps up, sometime soon Americans will be spending ALL of their money on healthcare insurance and delivery. "
You have Big Healthcare's rapt attention.
God I hate Reagan's rotting corpse. I'm still triggered every time I see his schmarmy face.
In his own way, he did every bit as much harm to the Republic as Trump. Possibly more. And he paved the way for Trump.
See if you can read "Sleepwalking Through History" without getting extraordinarily pissed about the '80s. In his own way, Reagan almost single-handedly destroyed the way this country was governed since the New Deal.
Here's an interview with the author from 1991: https://www.c-span.org/video/?16899-1/sleepwalking-history
Here's a hint: maybe if the US outlawed the advertisement of Rx drugs the way that other countries do, then the companies making those drugs could reinvest all of that ridiculous marketing money into R&D and/or offset the lost revenue from government-negotiated prices.
I work in the industry in a role where I'm actually getting product to patients (if I fuck up, the market might be shorted). We are such a tiny sliver of the overall pie-chart for corporate expenses.
It would also make watching cable shows so much less terrible. We only ever have MSNBC on once in a while in our house, but when I stayed with my Mom during her recovery, it was almost ALL pharma ads all day in between whatever she had on. I sometimes saw an ad for a product that the company that I work for makes during every single commercial break. It was absolutely absurd.
This is adorable. I think we both know that advertising money would go instead to more stock buybacks and CEO bonuses. This is capitalism, after all.
Stock buybacks used to be illegal also.
Thanks, Conservatives!
In the UK there are no adverts for drugs, other than a few over the counter ones, because the NHS buys them for us.
And how would they get the huge tax breaks they get for those "greasy stool" ads?
https://www.congress.gov/bill/117th-congress/house-bill/6392?s=1&r=103
Then who would support the evening newscasts? You want Lester Holt to go broke?
I think pharma companies' marketing budgets need to be tied to R&D, like for every $1 for R&D 10 cents can go to marketing. THAT could show some real breakthroughs, and funnel a lot of money to colleges/universities that actually do the work developing drugs.
Fun anecdote. About 25 years ago, I was on a flight to Chicago sitting next to a middle-aged guy who was going to a medical conference. He was a research professor at (I think) Cornell Medical Center in NYC. He was a cardiologist specializing in the connections between obesity and heart disease. I myself was on my way to a publishing conference, so I asked him what sessions and presentations he was going to see and what new research he was going to present.
He looked at me like I was from Mars and said, "Oh, I don't go to that stuff. I'm going to be meeting with pharmaceutical companies to talk about the rollout of the drug I've been working on." He was very excited because obesity and heart disease are very prevalent in the US and lots and lots of people were going to want this drug.
I asked him if he liked teaching or research better. Dumb Martian me. He said, "Oh, I don't teach" (he spat the word). He then told me he was going to share the patent with Cornell. After which he also told me that the entire research program that had developed the drug had been funded by the NIH and other federal sources. All of it. So I said, "Shouldn't the US government hold the patent, then?"
We didn't talk any more after that. Awkward flight.
Exactly how I always understood it. WE pay for the R&D, they get the profit.
I'm wondering how long it's going to be before the whole medical industrial complex collapses and we have to bail them out with our tax dollars ala the mortgage companies way back in '08?
And the auto industry, for that matter.
The auto industry paid us back. The banks, not so much.
I know a LOT of faculty and a good number of "faculty." The latter REALLY suck. And they remain high-minded about it, too, which makes me wanna punch 'em but it's not allowed.
Even though this was a long time ago, the guy's smugness sticks with me. He was really gloating about what a win he had scored.
I come from an academic family - I respect faculty (not so much the ones who bitch and moan about how awful it is to have to teach undergrads, tho). But the medical research people are in another league - they are all about the massive multiyear grants and the high salaries and the patents.
Reminds me of a high-end digital research outfit I dealt with at one time called Thinking Machines. They referred to any government grant of under $5 million as a "sugar grant." Youknow - just a lil sweetener. Of course, they were doing lots of high-minded noble research for the DOD.
Why didn't your suggest that workers, peasants and students should seize the means of transportation production and fly the airplane for the rest of the trip?
So how long until the GQP claims they all supported this?
You mean like the program formerly known as Obamacare?
Look at Uncle Joe getting shit done...but he's old and wears tennis shoes, so pls impeach.
I’m glad the Eliquis that my sister will be taking for the rest of her life will be less expensive.
Maybe. I've read the negotiations will not necessarily lead to cost reductions.
(and yes, I think they should)
I have to take Elquis until I die. I also live in England. I sometimes have up to 6 different medications. I pay nothing. Even get free delivery from the pharmacy.
Well, you’re not in a shithole country.
The Tory scum are working towards a US brand of healthcare and have been for the last two decades.
Ohhhh, I don't know about that, man. After nearly 14 years of Tory rule, we're extremely close to the shithole country moniker.
Socialist commie!
;>)
I'm about to enter this brave new world, as I will be switching to Medicare at the end of the year. I've just learned that one medication - which I will be taking for the rest of my life - is considered "off-label" by Medicare, even though its use for my condition has been approved by the FDA. It is not covered and costs $900/month.
I assume there are dozens of such meds. It still staggers me that Big Pharma has gotten away with this game well into the 21st century, all while being Fortune 50 companies whose compensation scale for their middle managers exceeds the best pay scale in most fields.
See above, Dok states:
"And in 2025, out-of-pocket costs for Part D will be capped at $2,000 annually, which again will be a huge savings for seniors facing the highest drug prices even before the negotiated prices kick in".
Worst case, you might have to pony up until 2025, but before signing up for anything spend some time with a Medicare specialist who can advise you about all the options. There are so many different Part D plans, you really need someone who does this for a living to advise you about your best option.
Also, no matter what, DO. NOT. sign up for a Medicare Advantage Plan. Once you realize it is a massive rip off, it is too late, You will be ineligible to switch to a Medicare Supplement plan. The supplement plans do cost more per month, but the comprehensive coverage is well worth every penny. Even if you think you don't "need" that much coverage, if you are old enough for Medicare eligibility, you are old enough for a bad diagnosis that may come seemingly out of nowhere. Then you'll be glad for the comprehensive coverage, and really glad you didn't sign up for a shitty Medicare Advantage plan.
I am absolutely THERE regarding "Advantage" plans - what a fucking scam.
I'm not sure the cap on meds includes a medication that is considered "off-label" but that would be amazing if true and would make a massive difference in my life. So thank you so much for flagging that. And yes, I am trying to wade through all the for-profit Part D plans, and the Medigap plans, and I keep thinking about friends my age in Europe who literally never give this a moment's thought.
Exactly. I try to be gentle with my friends who saddled themselves with Advantage plans when they get bitten in the ass by them. But hey, they got a free gym membership and a Contego water bottle, so it was worth it, I guess.
Honestly, the people I know who went with those did so because they are simpler. Trying to figure out apples to apples in this morass is insane.
The only one I'd consider is Kaiser, but I was never tempted because their closest facility to me is more than 200 miles distant.
Does your state have a drug plan that can help with that, can you get a deal from the drug manufacturer, are you eligible for LIS (I think the 2024 income limit is about $15K)? Look around, because there are ways around this.
Thank you. I only learned this a week ago and haven't yet done much research. I am probably above the income level to qualify. I think I can swing it for a decade or so, and then will have to either sell my home and move someplace cheap, or die. Retirement planning is so much fun!
Talk to the drug manufacturer. By law they have to offer some drugs for reduced prices/free. Some states have programs, probably also income based. Or if there's a drug study you can find. Also, if you are close to Canada or Mexico, try that. Although my dad did get counterfeit Wellbutrin once from Mexico.
Excellent suggestions, thank you.