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US Healthcare Is So Screwed I Fly to Britain for My Medication

44 points by AdeptusAquinas 12y ago

ptaipale 12y ago
Is the author actually right to live and work in the US, and only fly back to Britain for getting medication subsidised by British taxpayers? And is the fact that he can do this just an indication of US healthcare being screwed? The post doesn't tell too much about facts and I don't know the British rules for eligibility to NHS, but I think it's possible he could be committing fraud. If he were doing the same with my country's national system, it certainly would be fraud (though it would probably not be possible in the first place, because we have a Big Brother that knows more than the British one).
- mgkimsal 12y ago
  From a moral standpoint, I'd say this person is in the right - they've paid in to the NHS at some point earlier, or their parents had - to cover this sort of thing. Legally, I don't know enough about the NHS to say for sure.
  - k-mcgrady 12y ago
    >> "they've paid in to the NHS at some point earlier, or their parents had" Yeh, to cover them for the time they were paying. If you're no longer paying your taxes or seeking employment or unable to work due disability the money you paid in the past should't cover you morally. Edit: There's no doubt the price the writer has to pay in the US is a disgrace and if they couldn't afford it then I think using the NHS is a good temporary solution but the fact that he could afford it but uses that money for a holiday instead is very immoral imo.
    - droope 12y ago
      I know, we should take this person their medicine away, so they can have a wretched and miserable life! Healthcare should not be something you can or cannot afford, we should all be able to access healthcare. It is just common sense.
      - k-mcgrady 12y ago
        Huh? I didn't say that at all. This person CAN afford their medicine. Instead they spend that money on a trip to the UK to see family but also gets their medicine. Medicine they didn't contribute taxes to pay for.
    - mgkimsal 12y ago
      > Yeh, to cover them for the time they were paying So... what if someone is no longer paying anything in, living there, but is a huge net drain? Should people only be covered while they're able to pay premiums/taxes?
    - mgkimsal 12y ago
      He doesn't really indicate that he can afford it. min $500/month for 6 months is $3k. Trip to UK, staying with family, is far less than $3k.
  - VLM 12y ago
    From a moral standpoint in the USA the international megacorp will say "Oh, your health is worth anything to you? Hmm. Howabout everything you got minus $1" Like a semi-kind mugger. Its not a free market. Pay up or die, sucka! In the UK the .gov will fight for you instead of the corporation so you pay a fair price. The UK gov is under no life and death pressure to pay up or die, and they have regulators who are educated and understand the market. It is a much free-er market than the USA market. Arguably what he's coughing up in hotel fees and surcharges and taxes and hotel prop tax is Exactly how a visitor should be paying for medical care, so on an individual level he's moral and ethical. Not getting screwed over when someone else gets screwed over does not imply some kind of survivors guilt is ethical.
    - ancap 12y ago
      >From a moral standpoint... From a moral standpoint it is immoral to force person A to pay for person B's misfortune. You and I call that stealing. >they have regulators who are educated and understand the market It is impossible to "understand the market" without market prices. >It is a much free-er market than the USA market The USA is not a free market. Anyone who claims otherwise is lying.
    - refurb 12y ago
      It is a much free-er market than the USA market Umm...no. The UK is a single payer system, that is, the government holds a monopoly over healthcare purchasing (or nearly all healthcare delivered). If a really skilled doctor wanted to charge a higher rate for their services, tough, he/she would get the same as every other doc. It's not a "freer" system.
      - DanBC 12y ago
        This is false. The UK has a national health service and private provision running side by side. Any doctor is free to work outside the NHS to provide private practice. Maybe you're thinking of Canada?
        refurb 12y ago
  - adwf 12y ago
    Not to mention that most young ex-pats do eventually come back to the country and contribute. I'd rather they came back alive and well, even if it is me footing the bill for them in the meantime. That's one of the big missing parts of the US healthcare debate. It's not just about immediate cost, it's about potential future tax revenue and economic value that you're losing when you let people die before their time.
- jjoonathan 12y ago
  Well the fact that drugs are twice as expensive (or more) in the US* and the fact that the US accounts for a huge chunk of government funding into the relevant sciences are part of the reason why drugs are so cheap overseas. British taxpayers buying drugs in Britain are effectively getting a subsidy from US taxpayers even though they don't pay into the pot, so this all seems like a stroke of cosmic justice where I'm standing. Of course, I doubt the British tax authorities care much about what I think. * Why? Remember how bargaining works: the biggest customer gets the best deal. First imagine Kaiser, Wellpoint, and Aetna sitting down at the bargaining table. Now imagine Canada sitting down at the table. Now imagine the European Union sitting down at the table. But at least our insurance companies are more efficient due to competition, right? Spoiler: not even close, and that's before you take into account the costs they offload onto the rest of the system in the form of incompatible claims policies, paperwork, and exploitation of information asymmetry against consumers.
  - giarc 12y ago
    I don't know figures, but I imagine Kaiser represents more than 35 million people (the approx population of Canada). Shouldn't they be able to negotiate the same price?
    - refurb 12y ago
      Bingo! The largest US private insurer (United) cover 40M lives in the US. They pay higher prices than nearly all European countries (even the ones with smaller populations). Drugs aren't cheaper in places like the UK because the gov't negotiates lower prices. Drugs are cheaper because the gov't mandates lower prices. People shouldn't confuse the two.
      - zaroth 12y ago
        So is the UK not concerned about mandating lower prices and squeezing the R&D funnel for new drugs... because Americans are making up the difference?
        12y ago
- sveiss 12y ago
  The rules aren't written in a particularly clear way, but in general the idea is that NHS eligibility is residence-based, and people who aren't ordinarily resident are entitled to urgent treatment only. Flying back just to pick up prescriptions is definitely against the spirit of the rules. Enforcement -- or even understanding -- of the rules on a local level seems spotty. I've helped overseas visitors find their way through the NHS. Some GPs and out of hours services have treated them like a local patient and when asked about payment had no idea, whilst one GP pulled their wallet out in the consulting room and demanded cash there and then. Hospitals are supposed to be more consistent, but I haven't any experience there.
- DanBC 12y ago
  EDIT: strikeout [In my opinion it's fraud.] /strikeout http://www.nhs.uk/chq/pages/1086.aspx?categoryid=68 http://www.nhs.uk/chq/pages/1086.aspx?categoryid=68 http://www.nhs.uk/chq/pages/1087.aspx?categoryid=68&subcategoryid=162 http://www.nhs.uk/chq/pages/1087.aspx?categoryid=68&subcateg... But the rules are a bit complicated so maybe it's fine. It's weird that he gets a six month drop of medications each time -- that is very unusual behaviour from the prescribing doctor and the prescription-filling pharmacist.
  - geographomics 12y ago
    It's not fraud. Such charges for overseas visitors only apply for hospital treatment - prescriptions are explicitly excluded, and are subject to the statutory price that everyone pays (unless they are exempt and get their medicine for free), see: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/210439/Overseas_Visitors_Charging_Review_2012_-_Summary_document.pdf https://www.gov.uk/government/uploads/system/uploads/attachm...
    - soneil 12y ago
      Thank you for finding that - a surprisingly readable source. Para 23+24 spell it out quite clearly, as does "Powers to charge those not ‘ordinarily resident’ were introduced through the NHS (Amendment) Act 1949, but were not enacted through regulations until 1982. These charges were and remain only applicable to hospital treatment." Really doesn't seem that complicated at all.
pacofvf 12y ago
why not Mexico? it's a big destination for Health Care tourists, it's cheaper than Canada or Europe and you would only need to go to a doctor once to get a prescription and re-use that prescription. Also you would get to spend a few days in places like the mayan riviera.
- IvyMike 12y ago
  He mentions both Canada and Mexico in the article.
vonmoltke 12y ago
> Otsuka’s patent on Abilify will expire in April, costing it an estimated $65 billion over the next four years. That statement is false, and demonstrated clearly in the author's source: > Drug makers face another patent cliff in which the industry will lose roughly $65 billion in revenue through the end of 2019, according to a research firm’s report. ... > GlobalData estimates Otsuka will lose $6.2 billion in annual sales due to competition from generics by 2019. Edit: Continuing on this theme, according to Google finance Otsuka's net profit margin is 10%, which I think is on the higher end of reasonable. Now, I'm not saying the price they charge in the US is fair (for some definition of fair), but one does need to consider how much the ridiculous American drug prices are subsidizing the $24/year NHS prescriptions. A government can regulate the price of drugs, but can't force the companies to sell them in the first place. Not directly, anyway.
- CHY872 12y ago
  > Now, I'm not saying the price they charge in the US is fair (for some definition of fair), but one does need to consider how much the ridiculous American drug prices are subsidizing the $24/year NHS prescriptions. A government can regulate the price of drugs, but can't force the companies to sell them in the first place. Not directly, anyway. Remember that the cost to the NHS is far more than $24 - which refers to the £8 prescription fee paid in the UK, twice per year. It's actually £220.41 per patient per month for the NHS - about $335. So whilst it's still somewhat more expensive in the US, it's not much more expensive - and well within the bounds of shrewd negotiating (which I'd imagine insurers would normally do). [1] - http://www.awp.nhs.uk/handlers/downloads.ashx?id=9572 http://www.awp.nhs.uk/handlers/downloads.ashx?id=9572
  - vonmoltke 12y ago
    I figured it was costing the NHS much more than that, but I did not know they were covering so much. Thanks for the information. The issue of what insurers actually pay versus what the uninsured are expected to pay is a tangential hot button issue for me, especially since I started treatment for my sleep disorders.
S_A_P 12y ago
This article doesn't really make a compelling case. Facts would have been nice.(I would spend x dollars for the drug I need in the US which is more than I would spend flying to the UK and getting 6 months worth at a time. Or something like the drug I need is in short supply in the US so I go to where it's plentiful in the UK) What is so screwed about it in the authors eyes?
- k-mcgrady 12y ago
  >> "What is so screwed about it in the authors eyes?" Maybe I missed something but it seems blantantly obvious. In the US he has to pay for health insurance PLUS $720 a month for drugs he needs. In the UK this is provided at almost no cost to the patient through taxes. No health insurance and no huge drug cost.
  - refurb 12y ago
    So maybe a more fair comparison would be to compare total costs in the US (insurance premium and drug cost) to the total costs in the UK (higher taxes and small Rx cost)? Of course the end result would all depend on your salary level.
- Cowen 12y ago
  Vox did something a while back that's more along those lines.[1] The cost of care in the US is much higher than in other countries. There are a bunch of reasons for this, and everyone has their preferred scapegoats and solutions, but the end result is that healthcare prices in the US are astronomically higher than in other countries. So it's often cheaper to just go somewhere else and buy the care you need there at a fraction of the cost. [1] http://www.vox.com/cards/health-prices/america-is-getting-gouged-on-health-care-prices http://www.vox.com/cards/health-prices/america-is-getting-go...
- deleted 12y ago
  [deleted]
pskittle 12y ago
I studied in the US for a bit, inspite of the university having a decentish setup for medication. I preferred getting treated by local doctors in my home country. Studying about the healthcare system in the US makes me sad. It shouldn't be so painful and expensive
- strictnein 12y ago
  It isn't that bad in the vast majority of cases, and in many ways it's better. 5 year cancer survivability rates for instance are top notch, ability to see specialists with little to no wait, etc. Example: My friend's son was diagnosed with leukemia on Monday. They went to their primary care doctor Monday morning for some gum bleeding that wouldn't stop, were referred to a specialist Monday afternoon, and is already in a children's cancer hospital receiving treatment where he will be for the majority of the next 8-9 months.
  - nerfhammer 12y ago
    And if your friend doesn't have good insurance it would mean total financial ruin
    - refurb 12y ago
      Or go on Medicaid? Or receive an ACA benefit that pays for insurance?
    - strictnein 12y ago
      Which is a different issue than the quality of care. Again, we have some of highest (if not the highest) cancer survival rates in the world, and you're apparently more worried about if he will have to declare bankruptcy. His son living is just slightly more important and with the ACA the chance of him having to declare bankruptcy is significantly decreased.
      - DanBC 12y ago
        The US government spends more on healthcare per capita than countries with "socialised medicine". That funding is skewed to the over-65s on the Medicare system - the group where you see most cancer. That large spend on over 65s is what gives the US good cancer survival rates.
IvyMike 12y ago
I don't know exactly what's going on, but I'm on a mediocre Obamacare plan that costs less than the author's plan. Even though it's in the most expensive drug tier, as far as I can tell Abilify would cost me $70 a month. > I arrived in America just as Obamacare was rolling out. Since I couldn’t meet the deadline for insurance Well it's been rolled out for a while now. Can't he switch now?
- dragonwriter 12y ago
  > Well it's been rolled out for a while now. Can't he switch now? Not sure if the annual open enrollment periods are nationally synchronized or differ per state, but Covered California (California ACA Exchange) currently has an open enrollment period (ending 2/15.)
- maxerickson 12y ago
  Apparently it varies based on the plan: http://www.phrma.org/sites/default/files/pdf/exchanges-mental-health.pdf http://www.phrma.org/sites/default/files/pdf/exchanges-menta... (In some bronze plans, up to $4300 of deductible applies to medications) The article is not very careful. It goes from saying the drug is cheaper over in Queens to the "$720 a month my medication costs in America".
wyager 12y ago
I would like to share my very positive experience with private Mexican health care. A family member got in a kayaking accident. They were in severe pain (mostly from their chest area). We had a concierge doctor drive out to our remote hotel. He did a basic checkup, gave us some pain meds, and called ahead to the nearest private hospital. $100 We drove about an hour and a half to the hospital. A doctor was waiting at the door for us. She was with us for the whole two hours we were there. We got 2 x-rays and an ultrasound. We also got more pain meds at the pharmacy. $150 It was the best medical service I've ever experienced in my life. I would be very happy if U.S. medical care was the same as Mexican medical care. I realize I never checked up on this: how is the Mexican private medical system regulated? I remember we did very little paperwork, and it seemed like there was much less red tape than at US hospitals.
- zaroth 12y ago
  "It was the best medical service I've ever experienced in my life. I would be very happy if U.S. medical care was the same as Mexican medical care." What you are actually saying is you would be very happy if U.S. medical care was the same as Mexican medical care for tourists carrying US dollars. The real question is, what is the standard of care for a 50th percentile Mexican national after their own kayaking accident? What percent of their annual discretionary spending does this incident cost them? And is the existing system improving, stable, or on the verge of collapse?
  - wyager 12y ago
    Well, yeah. I said "private", didn't I? And it's not like the good hospitals in Mexico rely on the bad hospitals to exist. One would expect the average standard of care to be lower because Mexico is much poorer than the U.S.. If you took whatever the good Mexican hospitals are doing and brought it to the U.S., it would presumably be roughly as high-quality and inexpensive.
tsuyoshi 12y ago
I think a better title might be: I Missed the Obamacare Open-Enrollment Deadline, So I Fly to Britain for My Medication. There are exceptions to the open-enrollment deadline. The author is not completely clear on his situation, but two exceptions may apply: gaining "status" (i.e. permission to work, or permanent residency) or moving to a new area. Either will allow you 30 days to apply through the insurance marketplace. It would be interesting to know if neither of these applied, or if even Obamacare-subsidized insurance wouldn't cover the drug he needs. The fact that prescription drugs are more expensive in the US than anywhere else is not news to me, at least...
refurb 12y ago
You could write the same article in reverse if you had atypical haemolytic uraemic syndrome (aHUS). Soliris, the only drug available to treat aHUS, was launched in the US back in 2011 (and all payers cover it), but only just this year did the NHS decide to fully fund it in the UK.[1] [1]http://www.pharmaphorum.com/articles/nice-backs-full-nhs-funding-for-alexions-soliris http://www.pharmaphorum.com/articles/nice-backs-full-nhs-fun...
- koyote 12y ago
  > but only just this year did the NHS decide to fully fund it in the UK So that means it is covered by the NHS now?
  - refurb 12y ago
    Yup, but for 3+ years it wasn't where it was available in the US.
    - DanBC 12y ago
      It was available on the NHS. It was available under the "named patient" scheme which is a bit more complex than just a doctor prescribing it but suggesting people couldn't get it on the NHS is false. The cost to the patient would have been exactly the same - about £8 per item per month with a range of discounts and exemptions.
      - refurb 12y ago
        Named patient scheme is different. That allows access to a drug before it receives market authorization, not before the NHS funds it. Patients in the UK that could have benefited from Soliris were not able to receive it (without paying full price). "Up to 70 patients are in the same position as Dianne Illingworth, 41, who have been forced to put their lives on hold, and risk their condition deteriorating, while ministers and officials argue over whether the NHS can afford the drug, Eculizumab, which costs more than £300,000 per patient per year."[1] [1]http://www.independent.co.uk/life-style/health-and-families/health-news/at-what-cost-lifesaving-drug-withheld-8632371.html http://www.independent.co.uk/life-style/health-and-families/...
stickperson 12y ago
Is there a way to find out how much drugs cost in other countries? I take a biologic that runs me $300/mo after insurance.
- DanBC 12y ago
  For England: http://www.ppa.org.uk/ppa/edt_intro.htm http://www.ppa.org.uk/ppa/edt_intro.htm
6t6t6 12y ago
So, if I understand well, people with mental disorders cannot access to medication if they cannot pay for it? People with mental disorders use to have trouble to find a proper job if they cannot threat their issue with medication. So maybe they just end up in jail or living as homeless?

Is the author actually right to live and work in the US, and only fly back to Britain for getting medication subsidised by British taxpayers? And is the fact that he can do this just an indication of US healthcare being screwed? The post doesn't tell too much about facts and I don't know the British rules for eligibility to NHS, but I think it's possible he could be committing fraud. If he were doing the same with my country's national system, it certainly would be fraud (though it would probably not be possible in the first place, because we have a Big Brother that knows more than the British one).

mgkimsal 12y ago
From a moral standpoint, I'd say this person is in the right - they've paid in to the NHS at some point earlier, or their parents had - to cover this sort of thing. Legally, I don't know enough about the NHS to say for sure.
- k-mcgrady 12y ago
  >> "they've paid in to the NHS at some point earlier, or their parents had" Yeh, to cover them for the time they were paying. If you're no longer paying your taxes or seeking employment or unable to work due disability the money you paid in the past should't cover you morally. Edit: There's no doubt the price the writer has to pay in the US is a disgrace and if they couldn't afford it then I think using the NHS is a good temporary solution but the fact that he could afford it but uses that money for a holiday instead is very immoral imo.
  - droope 12y ago
    I know, we should take this person their medicine away, so they can have a wretched and miserable life! Healthcare should not be something you can or cannot afford, we should all be able to access healthcare. It is just common sense.
    - k-mcgrady 12y ago
      Huh? I didn't say that at all. This person CAN afford their medicine. Instead they spend that money on a trip to the UK to see family but also gets their medicine. Medicine they didn't contribute taxes to pay for.
  - mgkimsal 12y ago
    > Yeh, to cover them for the time they were paying So... what if someone is no longer paying anything in, living there, but is a huge net drain? Should people only be covered while they're able to pay premiums/taxes?
  - mgkimsal 12y ago
    He doesn't really indicate that he can afford it. min $500/month for 6 months is $3k. Trip to UK, staying with family, is far less than $3k.
- VLM 12y ago
  From a moral standpoint in the USA the international megacorp will say "Oh, your health is worth anything to you? Hmm. Howabout everything you got minus $1" Like a semi-kind mugger. Its not a free market. Pay up or die, sucka! In the UK the .gov will fight for you instead of the corporation so you pay a fair price. The UK gov is under no life and death pressure to pay up or die, and they have regulators who are educated and understand the market. It is a much free-er market than the USA market. Arguably what he's coughing up in hotel fees and surcharges and taxes and hotel prop tax is Exactly how a visitor should be paying for medical care, so on an individual level he's moral and ethical. Not getting screwed over when someone else gets screwed over does not imply some kind of survivors guilt is ethical.
  - ancap 12y ago
    >From a moral standpoint... From a moral standpoint it is immoral to force person A to pay for person B's misfortune. You and I call that stealing. >they have regulators who are educated and understand the market It is impossible to "understand the market" without market prices. >It is a much free-er market than the USA market The USA is not a free market. Anyone who claims otherwise is lying.
  - refurb 12y ago
    It is a much free-er market than the USA market Umm...no. The UK is a single payer system, that is, the government holds a monopoly over healthcare purchasing (or nearly all healthcare delivered). If a really skilled doctor wanted to charge a higher rate for their services, tough, he/she would get the same as every other doc. It's not a "freer" system.
    - DanBC 12y ago
      This is false. The UK has a national health service and private provision running side by side. Any doctor is free to work outside the NHS to provide private practice. Maybe you're thinking of Canada?
      - refurb 12y ago
- adwf 12y ago
  Not to mention that most young ex-pats do eventually come back to the country and contribute. I'd rather they came back alive and well, even if it is me footing the bill for them in the meantime. That's one of the big missing parts of the US healthcare debate. It's not just about immediate cost, it's about potential future tax revenue and economic value that you're losing when you let people die before their time.
jjoonathan 12y ago
Well the fact that drugs are twice as expensive (or more) in the US* and the fact that the US accounts for a huge chunk of government funding into the relevant sciences are part of the reason why drugs are so cheap overseas. British taxpayers buying drugs in Britain are effectively getting a subsidy from US taxpayers even though they don't pay into the pot, so this all seems like a stroke of cosmic justice where I'm standing. Of course, I doubt the British tax authorities care much about what I think. * Why? Remember how bargaining works: the biggest customer gets the best deal. First imagine Kaiser, Wellpoint, and Aetna sitting down at the bargaining table. Now imagine Canada sitting down at the table. Now imagine the European Union sitting down at the table. But at least our insurance companies are more efficient due to competition, right? Spoiler: not even close, and that's before you take into account the costs they offload onto the rest of the system in the form of incompatible claims policies, paperwork, and exploitation of information asymmetry against consumers.
- giarc 12y ago
  I don't know figures, but I imagine Kaiser represents more than 35 million people (the approx population of Canada). Shouldn't they be able to negotiate the same price?
  - refurb 12y ago
    Bingo! The largest US private insurer (United) cover 40M lives in the US. They pay higher prices than nearly all European countries (even the ones with smaller populations). Drugs aren't cheaper in places like the UK because the gov't negotiates lower prices. Drugs are cheaper because the gov't mandates lower prices. People shouldn't confuse the two.
    - zaroth 12y ago
      So is the UK not concerned about mandating lower prices and squeezing the R&D funnel for new drugs... because Americans are making up the difference?
      - 12y ago
sveiss 12y ago
The rules aren't written in a particularly clear way, but in general the idea is that NHS eligibility is residence-based, and people who aren't ordinarily resident are entitled to urgent treatment only. Flying back just to pick up prescriptions is definitely against the spirit of the rules. Enforcement -- or even understanding -- of the rules on a local level seems spotty. I've helped overseas visitors find their way through the NHS. Some GPs and out of hours services have treated them like a local patient and when asked about payment had no idea, whilst one GP pulled their wallet out in the consulting room and demanded cash there and then. Hospitals are supposed to be more consistent, but I haven't any experience there.
DanBC 12y ago
EDIT: strikeout [In my opinion it's fraud.] /strikeout http://www.nhs.uk/chq/pages/1086.aspx?categoryid=68 http://www.nhs.uk/chq/pages/1086.aspx?categoryid=68 http://www.nhs.uk/chq/pages/1087.aspx?categoryid=68&subcategoryid=162 http://www.nhs.uk/chq/pages/1087.aspx?categoryid=68&subcateg... But the rules are a bit complicated so maybe it's fine. It's weird that he gets a six month drop of medications each time -- that is very unusual behaviour from the prescribing doctor and the prescription-filling pharmacist.
- geographomics 12y ago
  It's not fraud. Such charges for overseas visitors only apply for hospital treatment - prescriptions are explicitly excluded, and are subject to the statutory price that everyone pays (unless they are exempt and get their medicine for free), see: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/210439/Overseas_Visitors_Charging_Review_2012_-_Summary_document.pdf https://www.gov.uk/government/uploads/system/uploads/attachm...
  - soneil 12y ago
    Thank you for finding that - a surprisingly readable source. Para 23+24 spell it out quite clearly, as does "Powers to charge those not ‘ordinarily resident’ were introduced through the NHS (Amendment) Act 1949, but were not enacted through regulations until 1982. These charges were and remain only applicable to hospital treatment." Really doesn't seem that complicated at all.

pacofvf 12y ago

why not Mexico? it's a big destination for Health Care tourists, it's cheaper than Canada or Europe and you would only need to go to a doctor once to get a prescription and re-use that prescription. Also you would get to spend a few days in places like the mayan riviera.

IvyMike 12y ago
He mentions both Canada and Mexico in the article.

vonmoltke 12y ago

> Otsuka’s patent on Abilify will expire in April, costing it an estimated $65 billion over the next four years. That statement is false, and demonstrated clearly in the author's source: > Drug makers face another patent cliff in which the industry will lose roughly $65 billion in revenue through the end of 2019, according to a research firm’s report. ... > GlobalData estimates Otsuka will lose $6.2 billion in annual sales due to competition from generics by 2019. Edit: Continuing on this theme, according to Google finance Otsuka's net profit margin is 10%, which I think is on the higher end of reasonable. Now, I'm not saying the price they charge in the US is fair (for some definition of fair), but one does need to consider how much the ridiculous American drug prices are subsidizing the $24/year NHS prescriptions. A government can regulate the price of drugs, but can't force the companies to sell them in the first place. Not directly, anyway.

CHY872 12y ago
> Now, I'm not saying the price they charge in the US is fair (for some definition of fair), but one does need to consider how much the ridiculous American drug prices are subsidizing the $24/year NHS prescriptions. A government can regulate the price of drugs, but can't force the companies to sell them in the first place. Not directly, anyway. Remember that the cost to the NHS is far more than $24 - which refers to the £8 prescription fee paid in the UK, twice per year. It's actually £220.41 per patient per month for the NHS - about $335. So whilst it's still somewhat more expensive in the US, it's not much more expensive - and well within the bounds of shrewd negotiating (which I'd imagine insurers would normally do). [1] - http://www.awp.nhs.uk/handlers/downloads.ashx?id=9572 http://www.awp.nhs.uk/handlers/downloads.ashx?id=9572
- vonmoltke 12y ago
  I figured it was costing the NHS much more than that, but I did not know they were covering so much. Thanks for the information. The issue of what insurers actually pay versus what the uninsured are expected to pay is a tangential hot button issue for me, especially since I started treatment for my sleep disorders.

S_A_P 12y ago

This article doesn't really make a compelling case. Facts would have been nice.(I would spend x dollars for the drug I need in the US which is more than I would spend flying to the UK and getting 6 months worth at a time. Or something like the drug I need is in short supply in the US so I go to where it's plentiful in the UK) What is so screwed about it in the authors eyes?

k-mcgrady 12y ago
>> "What is so screwed about it in the authors eyes?" Maybe I missed something but it seems blantantly obvious. In the US he has to pay for health insurance PLUS $720 a month for drugs he needs. In the UK this is provided at almost no cost to the patient through taxes. No health insurance and no huge drug cost.
- refurb 12y ago
  So maybe a more fair comparison would be to compare total costs in the US (insurance premium and drug cost) to the total costs in the UK (higher taxes and small Rx cost)? Of course the end result would all depend on your salary level.
Cowen 12y ago
Vox did something a while back that's more along those lines.[1] The cost of care in the US is much higher than in other countries. There are a bunch of reasons for this, and everyone has their preferred scapegoats and solutions, but the end result is that healthcare prices in the US are astronomically higher than in other countries. So it's often cheaper to just go somewhere else and buy the care you need there at a fraction of the cost. [1] http://www.vox.com/cards/health-prices/america-is-getting-gouged-on-health-care-prices http://www.vox.com/cards/health-prices/america-is-getting-go...
deleted 12y ago
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pskittle 12y ago

I studied in the US for a bit, inspite of the university having a decentish setup for medication. I preferred getting treated by local doctors in my home country. Studying about the healthcare system in the US makes me sad. It shouldn't be so painful and expensive

strictnein 12y ago
It isn't that bad in the vast majority of cases, and in many ways it's better. 5 year cancer survivability rates for instance are top notch, ability to see specialists with little to no wait, etc. Example: My friend's son was diagnosed with leukemia on Monday. They went to their primary care doctor Monday morning for some gum bleeding that wouldn't stop, were referred to a specialist Monday afternoon, and is already in a children's cancer hospital receiving treatment where he will be for the majority of the next 8-9 months.
- nerfhammer 12y ago
  And if your friend doesn't have good insurance it would mean total financial ruin
  - refurb 12y ago
    Or go on Medicaid? Or receive an ACA benefit that pays for insurance?
  - strictnein 12y ago
    Which is a different issue than the quality of care. Again, we have some of highest (if not the highest) cancer survival rates in the world, and you're apparently more worried about if he will have to declare bankruptcy. His son living is just slightly more important and with the ACA the chance of him having to declare bankruptcy is significantly decreased.
    - DanBC 12y ago
      The US government spends more on healthcare per capita than countries with "socialised medicine". That funding is skewed to the over-65s on the Medicare system - the group where you see most cancer. That large spend on over 65s is what gives the US good cancer survival rates.

IvyMike 12y ago

I don't know exactly what's going on, but I'm on a mediocre Obamacare plan that costs less than the author's plan. Even though it's in the most expensive drug tier, as far as I can tell Abilify would cost me $70 a month. > I arrived in America just as Obamacare was rolling out. Since I couldn’t meet the deadline for insurance Well it's been rolled out for a while now. Can't he switch now?

dragonwriter 12y ago
> Well it's been rolled out for a while now. Can't he switch now? Not sure if the annual open enrollment periods are nationally synchronized or differ per state, but Covered California (California ACA Exchange) currently has an open enrollment period (ending 2/15.)
maxerickson 12y ago
Apparently it varies based on the plan: http://www.phrma.org/sites/default/files/pdf/exchanges-mental-health.pdf http://www.phrma.org/sites/default/files/pdf/exchanges-menta... (In some bronze plans, up to $4300 of deductible applies to medications) The article is not very careful. It goes from saying the drug is cheaper over in Queens to the "$720 a month my medication costs in America".

wyager 12y ago

I would like to share my very positive experience with private Mexican health care. A family member got in a kayaking accident. They were in severe pain (mostly from their chest area). We had a concierge doctor drive out to our remote hotel. He did a basic checkup, gave us some pain meds, and called ahead to the nearest private hospital. $100 We drove about an hour and a half to the hospital. A doctor was waiting at the door for us. She was with us for the whole two hours we were there. We got 2 x-rays and an ultrasound. We also got more pain meds at the pharmacy. $150 It was the best medical service I've ever experienced in my life. I would be very happy if U.S. medical care was the same as Mexican medical care. I realize I never checked up on this: how is the Mexican private medical system regulated? I remember we did very little paperwork, and it seemed like there was much less red tape than at US hospitals.

zaroth 12y ago
"It was the best medical service I've ever experienced in my life. I would be very happy if U.S. medical care was the same as Mexican medical care." What you are actually saying is you would be very happy if U.S. medical care was the same as Mexican medical care for tourists carrying US dollars. The real question is, what is the standard of care for a 50th percentile Mexican national after their own kayaking accident? What percent of their annual discretionary spending does this incident cost them? And is the existing system improving, stable, or on the verge of collapse?
- wyager 12y ago
  Well, yeah. I said "private", didn't I? And it's not like the good hospitals in Mexico rely on the bad hospitals to exist. One would expect the average standard of care to be lower because Mexico is much poorer than the U.S.. If you took whatever the good Mexican hospitals are doing and brought it to the U.S., it would presumably be roughly as high-quality and inexpensive.

tsuyoshi 12y ago

I think a better title might be: I Missed the Obamacare Open-Enrollment Deadline, So I Fly to Britain for My Medication. There are exceptions to the open-enrollment deadline. The author is not completely clear on his situation, but two exceptions may apply: gaining "status" (i.e. permission to work, or permanent residency) or moving to a new area. Either will allow you 30 days to apply through the insurance marketplace. It would be interesting to know if neither of these applied, or if even Obamacare-subsidized insurance wouldn't cover the drug he needs. The fact that prescription drugs are more expensive in the US than anywhere else is not news to me, at least...

refurb 12y ago

You could write the same article in reverse if you had atypical haemolytic uraemic syndrome (aHUS). Soliris, the only drug available to treat aHUS, was launched in the US back in 2011 (and all payers cover it), but only just this year did the NHS decide to fully fund it in the UK.[1] [1]http://www.pharmaphorum.com/articles/nice-backs-full-nhs-funding-for-alexions-soliris http://www.pharmaphorum.com/articles/nice-backs-full-nhs-fun...

koyote 12y ago
> but only just this year did the NHS decide to fully fund it in the UK So that means it is covered by the NHS now?
- refurb 12y ago
  Yup, but for 3+ years it wasn't where it was available in the US.
  - DanBC 12y ago
    It was available on the NHS. It was available under the "named patient" scheme which is a bit more complex than just a doctor prescribing it but suggesting people couldn't get it on the NHS is false. The cost to the patient would have been exactly the same - about £8 per item per month with a range of discounts and exemptions.
    - refurb 12y ago
      Named patient scheme is different. That allows access to a drug before it receives market authorization, not before the NHS funds it. Patients in the UK that could have benefited from Soliris were not able to receive it (without paying full price). "Up to 70 patients are in the same position as Dianne Illingworth, 41, who have been forced to put their lives on hold, and risk their condition deteriorating, while ministers and officials argue over whether the NHS can afford the drug, Eculizumab, which costs more than £300,000 per patient per year."[1] [1]http://www.independent.co.uk/life-style/health-and-families/health-news/at-what-cost-lifesaving-drug-withheld-8632371.html http://www.independent.co.uk/life-style/health-and-families/...

stickperson 12y ago

Is there a way to find out how much drugs cost in other countries? I take a biologic that runs me $300/mo after insurance.

DanBC 12y ago
For England: http://www.ppa.org.uk/ppa/edt_intro.htm http://www.ppa.org.uk/ppa/edt_intro.htm

6t6t6 12y ago

So, if I understand well, people with mental disorders cannot access to medication if they cannot pay for it? People with mental disorders use to have trouble to find a proper job if they cannot threat their issue with medication. So maybe they just end up in jail or living as homeless?