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Old 03-19-2020, 03:58 AM   #3
Insequent
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Quote:
Originally Posted by BandB View Post
I think they make too much from the US market and from certain drugs and types of drugs. I think they need to be able to recover costs of developing drugs and if there wasn't an incentive, they'd not develop. However, I don't think they should be receiving double, triple, quadruple and more for drugs in the US compared to any other country. If US costs were just equivalent to Canada costs I'd be happier.

I think there are other structural things that need to be addressed. For instance, the involvement of insurers adds a third party in the US and you're talking profit for the pharmaceutical, the insurer and the pharmacy. Also, Medicare is not allowed to negotiate rates.

Also, there's the question of how researched should be financed. Today it's done through government grants, private and charity grants, and selling the product. Perhaps if it was refined the costs of the drugs could be adjusted.
All valid perspectives. But if the costs in the USA reduced to the Canada levels, would pharma remain profitable, and be able to stay in business? Yes, its unjust that USA is subsidising other countries costs, but all the health stuff is a difficult thing to get right and few, if any, places have.

The high cost drugs here are subsidised as part of the Pharmaceutical Benefits Scheme, but access is limited. When a drug is added to the PBS it is for a very specific condition/situation, and each new patient case has to be approved to qualify for the subsidy. I don't know how good the people are that make those calls, and it has to be a difficult job. My own experience: During cancer treatment my wife's oncologist wanted to prescribe a drug on the PBS scheme. The request was denied on the basis that for her particular cancer the drug would not provide sufficient extension of life. This was not an assessment of her condition at the time. She did not fit the criteria that had been determined and set in stone at the time the drug first went onto the PBS We could not afford to pay the full cost (it could have ended up as 7 figures), so were unable to test the oncologist's opinion that it might save her life. Was he right? Had the evidence for use changed since it was first listed on the PBS? Her cancer was at an advanced stage, perhaps nothing could have saved her. But it was still very hard for us to accept at the time. Oh, and we had the highest level of private health insurance cover at the time, but that made no difference.

Pharma needs to be able make enough money to fund research, and given the very small probability of getting a breakthrough they have to cover the cost of a huge number of failures for that one success. Another issue is the expiry of patents and impact of generics. Somehow the lack of incentives for pharma to continue research in those areas also has to be fixed.

Right now, with covid-19, its a good thing that the world has the amount of pharma research capability that it does. I would hope there is enough scrutiny of the industry to ensure that unreasonable profits do not occur, but do worry about the capacity of some people to exploit gaps. Detailed disclosure and big sticks required? The carrot being reasonable profit - hard to define that too I guess.

I think not a simple question, or a simple answer.
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