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> It was part of the Medicare part D program - and likely put in via lobbying of Drug companies to politicians: The prices are still negotiated. They're negot
by chimeracoder 10y ago
> It was part of the Medicare part D program - and likely put in via lobbying of Drug companies to politicians:
The prices are still negotiated. They're negotiated by the plans that provide Medicare Part D, rather than determined unilaterally by Medicare itself (which is what happens for Medicare A and B reimbursement rates).
- dv_dt 10y agoAny private drug negotiator is going to be in a terrible position because they don't have 100% of the market. They can't walk away, the drugs will just flow through another private drug body. The drug makers have no reason to give a discount if the drugs will be sold under plan distributor B vs distributor A. When you compare prices in the US vs nations with governmental bodies controlling drug prices, you can validate that the US way is ineffectual for controlling drug prices.
- chimeracoder 10y ago> Any private drug negotiator is going to be in a terrible position because they don't have 100% of the market. They can't walk away, Having 100% of the market is the definition of a monopsony. That's bad for both patients (in the long run) and pharmaceutical companies (in the short run). In any case, even an ostensible monopsony pharmaceutical purchaser can't really just "walk away", because so so many of the drugs that they're purchasing are deemed essential. Let's say the government just said, "sorry, you've been taking this critical blood-pressure medication since it was released seven years ago, but now we're not going to pay for it, because we're taking a hard-line stance in our negotiation with Pfizer". At that point, there are two possibilities: 1) Patients stop taking the drug, and they die 2) Patients pay for the drug out-of-pocket (if they can afford it), and the remaining patients die. #1 is possible, but a political disaster. #2 is a no longer a monopsony, which defeats the whole premise of "having 100% of the market".
- dv_dt 10y agoThe balance of patients dieing vs not buying the drug at all is there regardless of what price negotiating scheme you implement. The cost is what varys in the end. So when you look at data, a single government representative body can determine efficacy and balance the cost in a way that multiple private bodies have not demonstrated in US drug cost data vs drug costs in nations which implement governmental drug controls.
- lumberjack 10y ago>Having 100% of the market is the definition of a monopsony. That's bad for both patients That's how the rest of the developed world does it.
- chimeracoder 10y ago> That's how the rest of the developed world does it. No, very few countries - even those which regulate prescription prices - have monopsony pharmecutical purchasers. Germany does not. Canada does not. The Netherlands does not. Even France does not. Technically the UK doesn't either, because each England/Wales/Scotland/Northern Ireland are operated separately. And as explained in the article, these systems only work because the US picks up the tab in funding research and development, even for pharmaceutical companies based in Europe. If the US weren't far and away larger than all the countries which do have monopsony purchasers, that setup wouldn't work, because nobody would be funding the development of those drugs in the first place.
- refurb 10y agoAny private drug negotiator is going to be in a terrible position because they don't have 100% of the market. That's absolutely not true. Look at the HCV treatments. The average discount for private insurers is 40%+. And that's just one example. They are tons of drug classes that are very heavily discounts to private payers. Members of a health plan can't just move from one plan to another whenever they want. There is annual enrollment. Members are somewhat captive.