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> 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 marke

> 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 ago
The 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.

dv_dt 10y ago

The 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.