Posted on 06/24/2015 11:22:00 AM PDT by Oldeconomybuyer
Expensive specialty medicines used to treat cancer and chronic illnesses have forced some very ill Americans to choose between getting proper treatment and paying their rent.
To ease the financial burden, the California agency that governs the state’s Affordable Care Act marketplace issued landmark rules recently that will limit the amount anyone enrolled in one of those plans can be charged each month for high-end medicine.
Covered California board member Marty Morgenstern said the agency should do even more by going to the root of the problem: the pharmaceutical companies.
“They charge irrational prices,” Morgenstern said, “on specialty drugs, and on all drugs, as a matter of fact.”
Insurers say it’s only a matter of time before the costs of specialty drugs will force them to raise monthly premiums for everyone in the health plan.
The pharmaceutical industry adamantly defends its prices.
“The cost and time it takes to bring new medicines to the marketplace is increasing, as biopharmaceutical companies go after harder and harder to treat diseases,” said Robert Zirkelbach of the Pharmaceutical Research and Manufacturers of America, the drugmakers’ trade group known as PhRMA.
(Excerpt) Read more at khn.org ...
Patients will simply be told to do without.
look for another double-digit premium price increase next year.
The beginning of the end of medical research.
I believe the ACA actually prohibits them from doing this. Big Pharma would have killed it otherwise.
I may have to. My former employer dropped retiree medical and a “specialty drug” I’ve been taking for >8years will now cost over $4500/yr instead of $160/yr. So.............. The actual drug cost is $3120 for a 28 day supply retail so woo hoo! I suppose “only” needing to pay the $4500 is a bargain. Unless it ain’t in the budget. Which it ain’t. Still working on how to keep on it without selling everything.
Insurers will just refuse to cover these drugs as they do now with certain drugs. So it will come out of pocket and for some people, even if prices are capped, they will not be able to afford the cost.
Insurance companies are annoyed at being pressured to cover drugs like Harvoni, although it is effectively a cure for Hep C.
The public payers (Medi-cal, etc) in particular care only about the cost per instance of care rather than the total cost of patient. They would rather a patient need a liver transplant, which they could deny, down the line rather than cover a pharmaceutical cure for Hep C.
It is only a matter of time with the rest of the whole free riding that similar price controls would come to the US. As long as the US is available to pay the fixed R&D costs of drug development the pharms would go along with accepting marginal costs to sell to the rest of the world. But if the same mentality becomes US public policy medical research will come to an end.
Pricey = Effective
Generic = 10%-15% formula difference - OFTEN INEFFECTIVE!!!
Hurray! How soon before EVERYTHING is FREE? Free! Free! Free!
Free Stuff for Everyone!
If I recall, California’s “Gray” Davis did the same thing on their energy costs to the citizens. The state couldn’t keep up with the growing demand and had to start importing the energy from out of state. Unfortunately the out of state costs kept growing to the point Calif. couldn’t afford it any more and finally had to pass the cost on to the citizens. Their energy bills literally doubled over night.......
And then they will sue.
The drug companies will raise the price of those expensive drugs to patients in the other states to cover California patients, or raise premiums on everyone. They are not in business to lose money but to maximize profits. I own stock in pharmaceuticals and wouldn’t have it any other way.
California democrats continue to do stupid s***.
Lesson: if you get sick, make sure it’s a disease with a vocal advocacy group, willing to dress up in costumes or whatever it takes to make a spectacle and put political pressure on payers to cover the most effective treatments.
The price of these hep C drugs in dropping due to competition.
When Gilead came out with theirs, they thought they had a monopoly and could charge anything they liked. Then AbbVie came out with one and got a big contract by offering a deal. Once a third one comes along, the pressure to cut the prices will be enormous.
Agreed. An this competition is ultimately good for consumers as well as the pharmaceutical companies.
What a bunch of sick $*&&S. Mandating insurance, raising premiums, cutting back on covered meds, and if you can’t afford health insurance you are penalized and if you can’t afford the meds you die.
There is a difference between just compensation and outright greed, there are drugs that have been on the market for many years that still are overpriced. Fair or not Americans pay 30 to 50% more for meds than those in say Canada or Europe.
Unfortunately you are very correct.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.