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Ugh. That is sickening. Since it seems like you have some expertise in the area, is this antipattern actually codified In regulations, or more of a de-facto/sta

Ugh. That is sickening. Since it seems like you have some expertise in the area, is this antipattern actually codified In regulations, or more of a de-facto/status quo thing?

Alex3917 9y ago
> is this antipattern actually codified In regulations, or more of a de-facto/status quo thing? A lot of drug purchasing things are codified. For example, Medicare is banned from negotiating drug pricing with manufactures. So even though they're buying billions of dollars worth of drugs in bulk, they're literally paying the retail price, which is just whatever the Pharma companies ask for. In terms of why they're buying the branded version in the first place, not entirely sure what the exact situation is right now. I'm sure someone will write a great article on it in a few years though after all the money has already been siphoned off.
- zanny 9y ago
  > why they're buying the branded version in the first place Probably doesn't take a psychic to see its because the brand bought the right politicians at the right time.
- refurb 9y ago
  Medicare does negotiate on drugs, just not in a direct way. For injected drugs, Medicare pays no more than the average price that private insurers pay. They basically piggy back on the deals. If you look at heavily discounted drugs, Medicare is paying no where close to list price. For peals, Medicare doesn't negotiate because they buy them. Private insurers adjudicate all claims and they certainly do negotiate drug prices. Those lower prices get passed to consumers who purchase their plans. And this doesn't even include the 340B discount which is mandatory. Medicare doesn't negotiate, it creates laws that lower it's drug costs.
- pmoriarty 9y ago
  "Medicare is banned from negotiating drug pricing with manufactures." Where can I read more about this? I've heard the exact opposite.
  - krakensden 9y ago
    Medicare Part D is the bit of law involved. Here is a randomly googled column with some history from a reputable paper: http://www.latimes.com/business/hiltzik/la-fi-hiltzik-medicaire-negotiate-20170111-story.html http://www.latimes.com/business/hiltzik/la-fi-hiltzik-medica...
- deleted 9y ago
  [deleted]
FireBeyond 9y ago
A similar thing happened in Washington (but seems to be on the way out), that all ambulances were mandated to carry EpiPens. Not epinephrine, but an EpiPen. Even those that carry vials and syringes.
- snuxoll 9y ago
  This absolutely blows my mind, the whole point of an epi-pen is it can be self-administered - what is the point of making paramedics have one in their vehicle when they've already got vials of epinephrine and syringes (and can be used for a lot more than anaphylaxis).

Ugh. That is sickening. Since it seems like you have some expertise in the area, is this antipattern actually codified In regulations, or more of a de-facto/status quo thing?

Alex3917 9y ago

> is this antipattern actually codified In regulations, or more of a de-facto/status quo thing? A lot of drug purchasing things are codified. For example, Medicare is banned from negotiating drug pricing with manufactures. So even though they're buying billions of dollars worth of drugs in bulk, they're literally paying the retail price, which is just whatever the Pharma companies ask for. In terms of why they're buying the branded version in the first place, not entirely sure what the exact situation is right now. I'm sure someone will write a great article on it in a few years though after all the money has already been siphoned off.

zanny 9y ago
> why they're buying the branded version in the first place Probably doesn't take a psychic to see its because the brand bought the right politicians at the right time.
refurb 9y ago
Medicare does negotiate on drugs, just not in a direct way. For injected drugs, Medicare pays no more than the average price that private insurers pay. They basically piggy back on the deals. If you look at heavily discounted drugs, Medicare is paying no where close to list price. For peals, Medicare doesn't negotiate because they buy them. Private insurers adjudicate all claims and they certainly do negotiate drug prices. Those lower prices get passed to consumers who purchase their plans. And this doesn't even include the 340B discount which is mandatory. Medicare doesn't negotiate, it creates laws that lower it's drug costs.
pmoriarty 9y ago
"Medicare is banned from negotiating drug pricing with manufactures." Where can I read more about this? I've heard the exact opposite.
- krakensden 9y ago
  Medicare Part D is the bit of law involved. Here is a randomly googled column with some history from a reputable paper: http://www.latimes.com/business/hiltzik/la-fi-hiltzik-medicaire-negotiate-20170111-story.html http://www.latimes.com/business/hiltzik/la-fi-hiltzik-medica...
deleted 9y ago
[deleted]

FireBeyond 9y ago

A similar thing happened in Washington (but seems to be on the way out), that all ambulances were mandated to carry EpiPens. Not epinephrine, but an EpiPen. Even those that carry vials and syringes.

snuxoll 9y ago
This absolutely blows my mind, the whole point of an epi-pen is it can be self-administered - what is the point of making paramedics have one in their vehicle when they've already got vials of epinephrine and syringes (and can be used for a lot more than anaphylaxis).