3 ms·

> Medicaid gets "best price" which is the lowest price the drug sells for anywhere. I'm guessing you mean anywhere in the US. Apparently Florida is currently p

> Medicaid gets "best price" which is the lowest price the drug sells for anywhere. I'm guessing you mean anywhere in the US. Apparently Florida is currently pushing to import drugs from Canada. https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-allow-florida-import-cheaper-drugs-canada-2024-01-05/ https://www.reuters.com/business/healthcare-pharmaceuticals/...

refurb 3y ago
Yes anywhere in the US. Private insurers often get discounts of 50%+, which then Medicaid gets. And sure Florida can try to import Canadian drugs. They tried that 20 years ago. The companies capped sales to Canada at no more than 10% of last years sales. Canada then put export restrictions in place to put prevent shortages. The US government has talked about price referencing Europe. Which would actually be great. Companies would be forced to increase European prices and lower US prices.
- silverquiet 3y ago
  I often find myself saying the US should do things like they do in Europe, but I'm told it's impossible for one reason or another (American Exceptionalism in some form or other no doubt), so that does have an appeal to me at least. I wonder though, given that these companies are generally (all?) for-profit entities, what stops them from raising prices in Europe now? It's always seemed a bit grim mixing market economics with human morbidity and mortality, but I would think the upshot is that you can really squeeze people for lots of money when their life is on the line.
  - nradov 3y ago
    Most European countries impose some form of price fixing on pharmaceuticals. The details vary by country but this is often done based on an economic value calculation, such as the number of quality-adjusted life years (QALYs) that the drug would add for a typical patient. It's not impossible to do this in the USA, at least in the sense that it wouldn't violate the Constitution. But if would somewhat slow down the pace of new drugs. The US pharmaceutical industry launches far more new drugs every year than all of Europe, largely due to the outsize profit potential in the US domestic market. With price fixing we would lose out on some percentage of those new drugs.
    - silverquiet 3y ago
      I have approximately zero interest in new drugs, but better drugs would be great. Is that the case? My impression is that the latest two blockbuster drugs that I’m aware of - mRNA vaccines and GLP1 agonists, had substantial European development, such that Novo-Nordisk is substantially impacting the GDP of Norway today.
      - justinclift 3y ago
        > Norway Denmark, not Norway. Novo Nordisk's market capitalization exceeded the GDP of Denmark's domestic economy in 2023, and it is the highest valued pharmaceutical company in Europe. https://en.wikipedia.org/wiki/Novo_Nordisk https://en.wikipedia.org/wiki/Novo_Nordisk
    - deleted 3y ago
      [deleted]
  - refurb 3y ago
    This is a wildly uninformed view. They do raise prices in Europe. And what happens? The government says “no” so patients don’t get access. Or the companies just don’t launch the drug at all. https://www.pmlive.com/pharma_news/bms_will_not_launch_cancer_drug_opdualag_in_germany_due_to_pricing_pressures_1489095 https://www.pmlive.com/pharma_news/bms_will_not_launch_cance... Bristol Myers Squibb (BMS) has decided against launching its cancer drug Opdualag (nivolumab and relatlimab) in Germany due to pricing pressures.
    - silverquiet 3y ago
      Oh I was just curious about the logistics of raising prices in Europe in order to lower them in the US; as you say, it doesn't seem so simple. I wonder, how much does this Opdualag cost and how much benefit does it provide? My naive reading of your article seems that it adds an average of 3 months to the average patient's life? Here the math is quite simple but grim - how much would you pay for 3 more months of life?

refurb 3y ago

Yes anywhere in the US. Private insurers often get discounts of 50%+, which then Medicaid gets. And sure Florida can try to import Canadian drugs. They tried that 20 years ago. The companies capped sales to Canada at no more than 10% of last years sales. Canada then put export restrictions in place to put prevent shortages. The US government has talked about price referencing Europe. Which would actually be great. Companies would be forced to increase European prices and lower US prices.

silverquiet 3y ago
I often find myself saying the US should do things like they do in Europe, but I'm told it's impossible for one reason or another (American Exceptionalism in some form or other no doubt), so that does have an appeal to me at least. I wonder though, given that these companies are generally (all?) for-profit entities, what stops them from raising prices in Europe now? It's always seemed a bit grim mixing market economics with human morbidity and mortality, but I would think the upshot is that you can really squeeze people for lots of money when their life is on the line.
- nradov 3y ago
  Most European countries impose some form of price fixing on pharmaceuticals. The details vary by country but this is often done based on an economic value calculation, such as the number of quality-adjusted life years (QALYs) that the drug would add for a typical patient. It's not impossible to do this in the USA, at least in the sense that it wouldn't violate the Constitution. But if would somewhat slow down the pace of new drugs. The US pharmaceutical industry launches far more new drugs every year than all of Europe, largely due to the outsize profit potential in the US domestic market. With price fixing we would lose out on some percentage of those new drugs.
  - silverquiet 3y ago
    I have approximately zero interest in new drugs, but better drugs would be great. Is that the case? My impression is that the latest two blockbuster drugs that I’m aware of - mRNA vaccines and GLP1 agonists, had substantial European development, such that Novo-Nordisk is substantially impacting the GDP of Norway today.
    - justinclift 3y ago
      > Norway Denmark, not Norway. Novo Nordisk's market capitalization exceeded the GDP of Denmark's domestic economy in 2023, and it is the highest valued pharmaceutical company in Europe. https://en.wikipedia.org/wiki/Novo_Nordisk https://en.wikipedia.org/wiki/Novo_Nordisk
  - deleted 3y ago
    [deleted]
- refurb 3y ago
  This is a wildly uninformed view. They do raise prices in Europe. And what happens? The government says “no” so patients don’t get access. Or the companies just don’t launch the drug at all. https://www.pmlive.com/pharma_news/bms_will_not_launch_cancer_drug_opdualag_in_germany_due_to_pricing_pressures_1489095 https://www.pmlive.com/pharma_news/bms_will_not_launch_cance... Bristol Myers Squibb (BMS) has decided against launching its cancer drug Opdualag (nivolumab and relatlimab) in Germany due to pricing pressures.
  - silverquiet 3y ago
    Oh I was just curious about the logistics of raising prices in Europe in order to lower them in the US; as you say, it doesn't seem so simple. I wonder, how much does this Opdualag cost and how much benefit does it provide? My naive reading of your article seems that it adds an average of 3 months to the average patient's life? Here the math is quite simple but grim - how much would you pay for 3 more months of life?