4 ms·

> Undo the laws that prevent retailers from driving over the border themselves This is goofy, though. If it's the same product, there's a real reason it's more

> Undo the laws that prevent retailers from driving over the border themselves This is goofy, though. If it's the same product, there's a real reason it's more expensive here. It could be anything from excessive regulatory hurdles to a cash grab, but there's something wrong. Address the underlying issue.

sodality2 4y ago
Reducing demand by choosing external sources will indirectly cause a subsequent price drop in the US. That would be the "free market, deregulation" approach to solving the pricing issue.
vlunkr 4y ago
Exactly, maybe it's not a bad start, but it would be better to strike at the heart of the issue. I don't know exactly the story with insulin, but I'm sure it's got something to do with our bad patent laws in the medical world.
perryizgr8 4y ago
Underlying issue is regulations and obstructions. One of those is what the parent is proposing to remove.
- dehrmann 4y ago
  It's not fundamentally expensive because you can't import it from Canada, though. That might lower the cost, but it's expensive for some other reason.
max51 4y ago
One of the main difference between US and Canada is that in canada the government negotiates prices for the entire province. They have a lot of leverage because the contracts are for the entire system, not a single hospital. They have a public bidding process and companies from around will fight for it and offer competitive pricing. It's not a new concept and it works with almost all commodities. If you need to buy iphones, you are likely to get a better price for them if you call Apple directly and ask to buy a batch of 10M than if you show up to an apple store to get 5 units.
- junofan 4y ago
  My PBM serves many, many more people than the population of Canada. The Canadian Patent Act permits the granting of compulsory licenses. That is the leverage the Canadian government has.
  - forum_ghost 4y ago
    Every country can grant compulsory licenses. India does that a lot, and supplies the entire developing world with medicines. Canada doesn’t have that much leverage. It often receives brand medications much later, and some cases medications aren’t marketed in Canada. Try to buy Nuvigil in Canada, let us know how that leverage worked out for this drug.
rswail 4y ago
The UK/CA/AU/NZ all have similar models of an independent review of a drug's overall cost/benefit. In Australia, the Pharmaceutical Review Board reviews a drug for its cost/benefit and expects the pharma company to justify its cost. If the cost/benefit ratio is sufficient, a recommendation is made to the government, which then decides whether it will subsidize the drug. If it does, then the drug is provided to patients at a capped price (currently ~AUD40 for non-welfare recipients, ~AUD7 for welfare recipients), with the remainder of the cost paid by the government. This provides a direct incentive to the pharma company to get their drug listed under the PBS, because it ensures that they have a large market available. Drugs that are not available under the PBS are still available, but at full price to the patient. However, because of the expectations of pricing in our market, the pharma companies have to keep their prices lower overall.

sodality2 4y ago

Reducing demand by choosing external sources will indirectly cause a subsequent price drop in the US. That would be the "free market, deregulation" approach to solving the pricing issue.

vlunkr 4y ago

Exactly, maybe it's not a bad start, but it would be better to strike at the heart of the issue. I don't know exactly the story with insulin, but I'm sure it's got something to do with our bad patent laws in the medical world.

perryizgr8 4y ago

Underlying issue is regulations and obstructions. One of those is what the parent is proposing to remove.

dehrmann 4y ago
It's not fundamentally expensive because you can't import it from Canada, though. That might lower the cost, but it's expensive for some other reason.

max51 4y ago

One of the main difference between US and Canada is that in canada the government negotiates prices for the entire province. They have a lot of leverage because the contracts are for the entire system, not a single hospital. They have a public bidding process and companies from around will fight for it and offer competitive pricing. It's not a new concept and it works with almost all commodities. If you need to buy iphones, you are likely to get a better price for them if you call Apple directly and ask to buy a batch of 10M than if you show up to an apple store to get 5 units.

junofan 4y ago
My PBM serves many, many more people than the population of Canada. The Canadian Patent Act permits the granting of compulsory licenses. That is the leverage the Canadian government has.
- forum_ghost 4y ago
  Every country can grant compulsory licenses. India does that a lot, and supplies the entire developing world with medicines. Canada doesn’t have that much leverage. It often receives brand medications much later, and some cases medications aren’t marketed in Canada. Try to buy Nuvigil in Canada, let us know how that leverage worked out for this drug.

rswail 4y ago

The UK/CA/AU/NZ all have similar models of an independent review of a drug's overall cost/benefit. In Australia, the Pharmaceutical Review Board reviews a drug for its cost/benefit and expects the pharma company to justify its cost. If the cost/benefit ratio is sufficient, a recommendation is made to the government, which then decides whether it will subsidize the drug. If it does, then the drug is provided to patients at a capped price (currently ~AUD40 for non-welfare recipients, ~AUD7 for welfare recipients), with the remainder of the cost paid by the government. This provides a direct incentive to the pharma company to get their drug listed under the PBS, because it ensures that they have a large market available. Drugs that are not available under the PBS are still available, but at full price to the patient. However, because of the expectations of pricing in our market, the pharma companies have to keep their prices lower overall.