3 ms·

It's because the government can say "this drug shall cost no more than X units of currency" and if that is above marginal cost, it can still makes sense to sell

It's because the government can say "this drug shall cost no more than X units of currency" and if that is above marginal cost, it can still makes sense to sell it. The flip side is that drugs in the US are extra-expensive because the expected recuperation of R&D rests on the US market. If the US government started doing price fixing, existing drug prices would come down, but new drugs would be less likely to be developed. On the other hand, much of regulatory burdens that make drug development more costly are also due to the US government.

Nursie 6y ago
> It's because the government can say "this drug shall cost no more than X units of currency" and if that is above marginal cost, it can still makes sense to sell it. Not really for generic, over-the-counter stuff in the UK. Meds that are funded by the public purse and given out on prescription, sure. But £7 is the market price for that over the counter drug in the UK. There's no entity doing price fixing there.
- gridlockd 6y ago
  Without better information, I have no way to look into the details of your anecdote, but if it really is a generic drug then the US price probably is that of a brand for which no FDA-licensed competitor exists, likely due to regulatory cost. If it's over-the-counter in the UK, it might also be the same brand but two different drugs. It might also be two different drugs entirely, and you just mixed things up.
  - jen20 6y ago
    I suspect the GP has mixed up several things here. Many drugs in the UK are available “over the counter” in the UK for pennies - next time you’re in Heathrow Airport, if that ever happens again, check out a “Boots” store and you’ll find you can buy Ibuprofen for £0.25 for 24 tablets. I have never seen even a drug such as Ibuprofen for sale in the US for a price remotely comparable. However, if a GP or secondary care doctor _prescribes_ Ibuprofen and you fulfill it via an NHS-servicing pharmacy, the price is whatever the prevailing rate of the NHS prescription charge is - currently £9.15 - though substantial discounts are available in many situations. Further, a friendly pharmacist will often advise patients not to fill the prescription at all and to buy the over-the-counter equivalent in such cases. Also in the UK, generic drugs are issued _by default_ where possible, and only if the bioavailability of a particular medicine is important is it considered acceptable to dispense specific brands upon request.
    - Nursie 6y ago
      In the UK aciclovir is available over the counter. There are generics available and the major brand of it is Zovirax. Zovirax costs a few pounds (Approx £5 from a quick google). Generics are available for less, I can immediately find one for £4.50. No prescription. We were quoted $200 as the on-prescription price in the US, and not available otherwise. Please don't assume I'm confused. (I am sometimes, but please don't assume!)
  - Nursie 6y ago
    Aciclovir. Brand name Zovirax. Approximately £5 in the UK when I searched a few minutes ago. Generics are available cheaper. We were quoted $200 and it needed a prescription in New Mexico about 5 years ago. It sticks in the mind because of the disparity. No, they aren't different drugs. Maybe it's an outlier, it's just a single data point after all. But there's no government-set price there, there's no government purchasing involved there.
    - gridlockd 6y ago
      Looks like there's only a single generic brand for topical Aciclovir, which is prescription-only for around $70. Zovirax is not sold in the US. Being prescription-only of course greatly limits the revenue potential, which a hypothetical competitor would have to weigh against the costly FDA approval. The over-the-counter alternative would be Abreva, which uses Docosanol instead.
      - Nursie 6y ago
        Zovirax cream, 5%, is listed on drugs.com at almost $200 per gram... for a cream, but only $10 per gram for an ointment. Looks like this particular med has been the subject of all sorts of market shenanigans - https://www.latimes.com/business/la-fi-lazarus-20150306-column.html https://www.latimes.com/business/la-fi-lazarus-20150306-colu... So perhaps is not going to be very representive of anything much.

Nursie 6y ago

> It's because the government can say "this drug shall cost no more than X units of currency" and if that is above marginal cost, it can still makes sense to sell it. Not really for generic, over-the-counter stuff in the UK. Meds that are funded by the public purse and given out on prescription, sure. But £7 is the market price for that over the counter drug in the UK. There's no entity doing price fixing there.

gridlockd 6y ago
Without better information, I have no way to look into the details of your anecdote, but if it really is a generic drug then the US price probably is that of a brand for which no FDA-licensed competitor exists, likely due to regulatory cost. If it's over-the-counter in the UK, it might also be the same brand but two different drugs. It might also be two different drugs entirely, and you just mixed things up.
- jen20 6y ago
  I suspect the GP has mixed up several things here. Many drugs in the UK are available “over the counter” in the UK for pennies - next time you’re in Heathrow Airport, if that ever happens again, check out a “Boots” store and you’ll find you can buy Ibuprofen for £0.25 for 24 tablets. I have never seen even a drug such as Ibuprofen for sale in the US for a price remotely comparable. However, if a GP or secondary care doctor _prescribes_ Ibuprofen and you fulfill it via an NHS-servicing pharmacy, the price is whatever the prevailing rate of the NHS prescription charge is - currently £9.15 - though substantial discounts are available in many situations. Further, a friendly pharmacist will often advise patients not to fill the prescription at all and to buy the over-the-counter equivalent in such cases. Also in the UK, generic drugs are issued _by default_ where possible, and only if the bioavailability of a particular medicine is important is it considered acceptable to dispense specific brands upon request.
  - Nursie 6y ago
    In the UK aciclovir is available over the counter. There are generics available and the major brand of it is Zovirax. Zovirax costs a few pounds (Approx £5 from a quick google). Generics are available for less, I can immediately find one for £4.50. No prescription. We were quoted $200 as the on-prescription price in the US, and not available otherwise. Please don't assume I'm confused. (I am sometimes, but please don't assume!)
- Nursie 6y ago
  Aciclovir. Brand name Zovirax. Approximately £5 in the UK when I searched a few minutes ago. Generics are available cheaper. We were quoted $200 and it needed a prescription in New Mexico about 5 years ago. It sticks in the mind because of the disparity. No, they aren't different drugs. Maybe it's an outlier, it's just a single data point after all. But there's no government-set price there, there's no government purchasing involved there.
  - gridlockd 6y ago
    Looks like there's only a single generic brand for topical Aciclovir, which is prescription-only for around $70. Zovirax is not sold in the US. Being prescription-only of course greatly limits the revenue potential, which a hypothetical competitor would have to weigh against the costly FDA approval. The over-the-counter alternative would be Abreva, which uses Docosanol instead.
    - Nursie 6y ago
      Zovirax cream, 5%, is listed on drugs.com at almost $200 per gram... for a cream, but only $10 per gram for an ointment. Looks like this particular med has been the subject of all sorts of market shenanigans - https://www.latimes.com/business/la-fi-lazarus-20150306-column.html https://www.latimes.com/business/la-fi-lazarus-20150306-colu... So perhaps is not going to be very representive of anything much.