4 ms·

Why is there a specific list? Why don't we just let Medicare negotiate.

mportela 2y ago
Unfortunately, that's all the Biden administration could get written into law. The Big Pharma lobby is too strong and definitely battled to keep this list as small as possible.
- ourmandave 2y ago
  At least the door is cracked open and it's a start. Of course, Big Pharma will fight to slam it shut again.
- refurb 2y ago
  That's because it's not really a solution. It's not a negotiation between two parties with equal power, it's just the government saying "either pay this price or you'll be penalized". The better solution is to allow parallel trade of pharmaceutical across borders. It will force countries paying far less to pay more and conversely the US paying less.
  - Auracle 2y ago
    Or simply set our prices to the average or median of something like 5 hand-picked other countries - and make that not only for Medicare/caid but also for everyone else. It's ridiculous that hasn't been done yet.
    - refurb 2y ago
      That doesn’t work because other countries already do that - set price reference to a basket. You end up with a circular reference that spirals prices down. At some point that price is lower than the net positive profit point.
  - autoexec 2y ago
    > The better solution is to allow parallel trade of pharmaceutical across borders. No, no it's only a global economy when companies want to manufacture products using slaves in third world countries or they want to outsource programmers and call center employees, but not when consumers want to buy medications or DVDs at the prices they sell for in those same countries or even just want to get higher quality products they refuse to sell you here (https://www.cbsnews.com/news/hershey-sues-shops-importing-british-cadbury-chocolate/ https://www.cbsnews.com/news/hershey-sues-shops-importing-br...)
dboreham 2y ago
Because corruption.
- croissants 2y ago
  Pat and cynical oversimplifications are bad for discourse, because they suggest that a default angry response is correct and, coincidentally, frees you from having to think harder about anything. Don't give in!
  - KevinGlass 2y ago
    We can debate the merits of various drug pricing schemes but at the end of the day, prices are set by a small group of interested actors who want the prices to be as high as they possibly can without causing a violet revolt. So call it what you will but let's not pretend there's some deeper, more important meaning to be sussed out here.
twoodfin 2y ago
Because this isn’t really a “negotiation” as configured by the statute: Medicare doesn’t have a formulary, it doesn’t pay for drugs, the Part D plan providers (some quite large and with their own negotiating heft) do. It’s a price-setting exercise. Yes, the drug-maker can walk away, but at the cost of massive punitive excise taxes on selling their drug to anyone in the US, not just Medicare Part D plans.
- gnkyfrg 2y ago
  [dead]
- refurb 2y ago
  Exactly. It's like saying taxes are a "negotiation for a contribution to the state government".
- knuckleheadsmif 2y ago
  A little more complicated because in some settings drugs are covered by Medicare part B but generally not if administered yourself at home. Then yes it’s part D and the most out of pocket in Part D from 2025 going forward is $2K. Also, they do negotiate for a very few drugs and the number is climbing. This was part of the IRA. However only drugs that are FDA approved for your issues are covered. Before the IRA the government was not allowed to negotiate any drug prices by law which was/is crazy.
  - twoodfin 2y ago
    What, specifically, wasn’t HHS allowed to do? They weren’t purchasing the drugs. Certainly the VA can and does negotiate prices for the drugs it buys (that’s one input to the HHS Medicare price-fixing formula), but it has a formulary and is buying drugs for its patients directly.
gnkyfrg 2y ago
[dead]

Unfortunately, that's all the Biden administration could get written into law. The Big Pharma lobby is too strong and definitely battled to keep this list as small as possible.

ourmandave 2y ago
At least the door is cracked open and it's a start. Of course, Big Pharma will fight to slam it shut again.
refurb 2y ago
That's because it's not really a solution. It's not a negotiation between two parties with equal power, it's just the government saying "either pay this price or you'll be penalized". The better solution is to allow parallel trade of pharmaceutical across borders. It will force countries paying far less to pay more and conversely the US paying less.
- Auracle 2y ago
  Or simply set our prices to the average or median of something like 5 hand-picked other countries - and make that not only for Medicare/caid but also for everyone else. It's ridiculous that hasn't been done yet.
  - refurb 2y ago
    That doesn’t work because other countries already do that - set price reference to a basket. You end up with a circular reference that spirals prices down. At some point that price is lower than the net positive profit point.
- autoexec 2y ago
  > The better solution is to allow parallel trade of pharmaceutical across borders. No, no it's only a global economy when companies want to manufacture products using slaves in third world countries or they want to outsource programmers and call center employees, but not when consumers want to buy medications or DVDs at the prices they sell for in those same countries or even just want to get higher quality products they refuse to sell you here (https://www.cbsnews.com/news/hershey-sues-shops-importing-british-cadbury-chocolate/ https://www.cbsnews.com/news/hershey-sues-shops-importing-br...)

dboreham 2y ago

Because corruption.

croissants 2y ago
Pat and cynical oversimplifications are bad for discourse, because they suggest that a default angry response is correct and, coincidentally, frees you from having to think harder about anything. Don't give in!
- KevinGlass 2y ago
  We can debate the merits of various drug pricing schemes but at the end of the day, prices are set by a small group of interested actors who want the prices to be as high as they possibly can without causing a violet revolt. So call it what you will but let's not pretend there's some deeper, more important meaning to be sussed out here.

twoodfin 2y ago

Because this isn’t really a “negotiation” as configured by the statute: Medicare doesn’t have a formulary, it doesn’t pay for drugs, the Part D plan providers (some quite large and with their own negotiating heft) do. It’s a price-setting exercise. Yes, the drug-maker can walk away, but at the cost of massive punitive excise taxes on selling their drug to anyone in the US, not just Medicare Part D plans.

gnkyfrg 2y ago
[dead]
refurb 2y ago
Exactly. It's like saying taxes are a "negotiation for a contribution to the state government".
knuckleheadsmif 2y ago
A little more complicated because in some settings drugs are covered by Medicare part B but generally not if administered yourself at home. Then yes it’s part D and the most out of pocket in Part D from 2025 going forward is $2K. Also, they do negotiate for a very few drugs and the number is climbing. This was part of the IRA. However only drugs that are FDA approved for your issues are covered. Before the IRA the government was not allowed to negotiate any drug prices by law which was/is crazy.
- twoodfin 2y ago
  What, specifically, wasn’t HHS allowed to do? They weren’t purchasing the drugs. Certainly the VA can and does negotiate prices for the drugs it buys (that’s one input to the HHS Medicare price-fixing formula), but it has a formulary and is buying drugs for its patients directly.

gnkyfrg 2y ago

[dead]