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 ...
Yes, I know these are life-saving drugs, but they are pricey for a very valid reason. Drug companies spend hundreds of millions of dollars on research every year only to see a miniscule fraction of said drugs approved and allowed on the market. In order to stay in business, these companies must be able to recoup their losses. These are not philanthropic organizations, they are BUSINESSES. The purpose of a business is to make money.
I know I am preaching to the choir. The short-sightedness and rampant stupidity of the Left makes my head hurt and my teeth itch.
You Served your Nation my FRiend and allow me to thank you for your Sacrifice.
Before you travel to the VA, see if they have a Drug Formulary Listing Posted Online.
We are giving away “free” Healthcare to Illegal Invaders.
I hope you don’t feel that you might be taking advantage the VA System because your problem wasn’t Service Related.
The VA is there to SERVE ALL our Veterans.
I hope they can assist you. It always helps to explore all options that may be available to you.
And then they will be told that they somehow have no standing.
Uh hu, Americans through the actions of their supposed representatives also subsidize a lot of drug research with no return to taxpayers. Also why they make it illegal or next to impossible for Americans to purchase their meds from out of country.
Well then I guess the only option for those with needs for specialty drugs in California is to “hurry up and die” when those Pharmaceutical companies pull there drugs from Cali.
Who knew that moron Grayson from Florida would be so prophetic. Maybe the likes of Soros, Styer and other Marxist billionaires should stop throwing their money around to distroy our country and trully help people in need.
Canada subsidizes its pharma companies and provides socialized medicine to Canadians via high taxes on its citizens.
Here's a side story totally off topic......
Back in the late 70's my company was the premier manufacturer of railway cars in the U.S. which were manufactured at our Red Lion plant in Pennsylvania.
We lost all our contracts to Bombardier of Canada that was being subsidized by the Canadian govt. and our plant was closed down.
Sorry to hear that!
It’s long passed time we address this sort of garbage.
The following came from a WSJ article a few months ago.
On Feb. 10, Valeant Pharmaceuticals International Inc. bought the rights to a pair of life-saving heart drugs. The same day, their list prices rose by 525% and 212%.
Early last year, Mallinckrodt PLC paid $1.4 billion for Cadence Pharmaceuticals, though the Ofirmev pain injections that were the crown jewel of the deal were projected to have just $110.5 million in 2013 revenue, according to a Mallinckrodt conference call with analysts discussing the deal. Three months later, the list price for a package of 24 Ofirmev vials jumped almost 2½ times to $1,019.52, according to health-care data firm Truven Health Analytics, which publishes average wholesale prices based on information from drug companies.
Horizon Pharma PLC upped the price of Vimovo pain tablets after buying the rights from AstraZeneca in late 2013. On Jan. 1, 2014, its first day selling Vimovo, Horizon raised the list price for 60 tablets to $959.04, a 597% increase, according to Truven.
The PhRMA argument that their pricing is necessary for research is simply not true in many cases. What is true is that over the past five years this industry has outperformed the S&P by 3.5:1. This is simply another tool in the transfer of wealth from the shrinking middle class to the 1%. I’m not a fan of price controls or intervention in free markets Venezuela is a prime example of how this works. However the way things are structured now is not going to turn out well for us. The American consumer cannot afford to subsidize the entire world’s price controls.
“Back in the late 70’s my company was the premier manufacturer of railway cars in the U.S. which were manufactured at our Red Lion plant in Pennsylvania.
We lost all our contracts to Bombardier of Canada that was being subsidized by the Canadian govt. and our plant was closed down.”
Actually, your story IS VERY relevant to this drug story. We have very few, if any, pharma plants in the US anymore as Uncle Sugar allowed foreign manufacturing of meds.
This means loss of availability, quality, and higher prices because of that availability issue.
Certainly a possibility ... but the insurance company does send out a denial letter to both the patient and the physicians office providing some documentation that would protect a physician against a lawsuit.
As a physician I have rarely felt concerned about a patient filing a lawsuit against me due to failed insurance coverage. The really critical cases I fight tooth and nail for and keep in contact with the patient every step of the way.
For the "optional" things I may not push quite as hard but still keep in touch with the patient- in general I find that most patients do not harbor fond feelings towards their insurance companies.
When you get a drug for a patient that insurance doesn’t want to pay for, each hoop you have to jump through is smaller than the last one. That is to say, after each “no”, the next one up the line takes more time to contact, a longer explanation or more forms, until eventually (if they don’t give up) the time involved becomes unsupportable.
That is certainly true. The most memorable one that I can recall was a patient of mine on Onfi for seizures where the insurance company denied the patient for refills and then referred me to the appeals division that had a 4 week turnaround. For safety reasons (concern of benzodiazepine withdrawal in a patient with medically refractory epilepsy) I had to change her over to another benzodiazepine. Clearly sub-optimal and potentially risky but discussed with the patient and came to the agreement that is was the only reasonable option under the circumstances.
That’s for one patient. Two patients, three, five? Impossible.
There does come a breaking point. Given the length of the time of appeals and the absence of enough time in the day.
But, the insurance company always has the out of saying, “The doctor did not follow our (impossible) procedure”.
Communication with patients and documentation provide some protection.
Your post #48. Well said. As someone in the wholesale pharma industry, I’ve watched prices double on average over the past three years. Simple, everyday drugs have doubled, many have tripled in price.
“And then they will sue. “
Sue, who? No Dr. Seuss intended, but sue who? Courts have already ruled that patients are not entitled to specific drugs but only common care.
Our doctor was telling us that in India drugs like the Hep C drugs are cheap. The manufacturers purposefully charge more in the US. They have to help those poor developing countries.
Just legalize marijuana and you won’t mind having cancer. It’s cheaper for the government,too.
Stalin and Lenin tried price controls....none of them worked out so well..
The beginning of the end of medical research.
If we pass laws making these new drugs generic as soon as produced then R&D will stop. Many miracle drugs in the pipeline will never exit the pipeline. This is, in fact, what I expect to eventually come about. A socialized medical system will not pay for R&D except possibly for government R&D of antibiotics when the rulers realize that without replacements for constantly fading antibiotics their own lives will be more precarious. Government R&D will only happen when old antibiotics are past replacement time because that is government work and they will always be in very short supply so will be rationed to the "deserving," i.e. those who rule.
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