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States sue generic drug makers over price fixing

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Posted 5/12/2019 11:13 PM (GMT 0)
Interesting story on 60 minutes. Here is an article related to the story.

https://www.google.com/url?sa=t&source=web&rct=j&url=https://m.huffpost.com/us/entry/us_5cd79844e4b054da4e8a9a70/amp&ved=2ahUKEwj_g__6j5fiAhUq11kKHZ--CrAQyM8BMAB6BAgHEAQ&usg=AOvVaw0N7sKX-LiuFFnT2pa9Wnwv&cf=1
Posted 5/13/2019 12:09 PM (GMT 0)
Whatever they can do to lower prices. IT;s crazy when generics are only $20 less than a $1,200.00 a month brandname.
https://www.huffpost.com/entry/drug-prices-states-sue_n_5cd79844e4b054da4e8a9a70
Posted 5/13/2019 1:05 PM (GMT 0)
Another example why the Economics of the American Healthcare System are broken and the American System pays 2 to 6 times more for the same drugs that other countries in the world pay.

The buyers (people who make the buying decision — patients and doctors) are disconnected from the pricing part of decision making. Stelara costs $46,241 an injection but costs me $5, what do I really care what it costs? My insurance willingly accepts the prices, pays it and my premiums go up 5-8% a year. The same thing goes for generic drugs.
Posted 5/13/2019 2:00 PM (GMT 0)
I just noticed the other day that the new Canasa generic is made by the exact same company that makes the brand name. The price did drop from $1200-$1500 to about $500, which is still approx 6x what it costs in Canada. In any case, the whole pharmaceutical industry is full of crooks, and those guilty of price fixing should go to jail IMO.
Posted 5/13/2019 2:53 PM (GMT 0)
Essentially the drugs are priced at what "the market will bear," which in a normal competitive, free-market would spur others to innovate and come in with cheaper, and cheaper alternatives. However, it isn't a true free-market, as you/and I do not normally know the cost we pay at the pharmacy nor do we research the cheaper options. If you want to buy a new television, you know there are a variety of brands/costs, it is all transparent online pricing and you can research it and get the best deal. If you want to know the prices of the meds, it is all smoke and mirrors, and nowhere as simple as the tv example. Worse yet if you want to get a procedure like a colonoscopy, and want to shop around facilities for the price.

Whether they can make healthcare and meds function like a true free-market, just go single-payer medicare for all, or somewhere in the gray area in between those two extremes, *shrug* who knows. There's no putting lipstick on this pig though, and calling it a fix. Rather they need to essentially take a sledge hammer to the whole system and start over from the ground-up. There's a variety of different approaches (some more free-market, others socialized) the world over that work and are cheaper. Seems, an honest conversation and comparison of what works elsewhere and what could work here with the political realities would help. Not a political forum, but my general message is there's lots of possible ways to cover all the full spectrum of opinions that could be used to solve it. And at this point, anything would be better, cheaper, and more cost effective than what we have now (excluding the lipstick). smile
Posted 5/13/2019 4:24 PM (GMT 0)

iPoop said...
Essentially the drugs are priced at what "the market will bear," which in a normal competitive, free-market would spur others to innovate and come in with cheaper, and cheaper alternatives. However, it isn't a true free-market, as you/and I do not normally know the cost we pay at the pharmacy nor do we research the cheaper options. If you want to buy a new television, you know there are a variety of brands/costs, it is all transparent online pricing and you can research it and get the best deal. If you want to know the prices of the meds, it is all smoke and mirrors, and nowhere as simple as the tv example. Worse yet if you want to get a procedure like a colonoscopy, and want to shop around facilities for the price.

Whether they can make healthcare and meds function like a true free-market, just go single-payer medicare for all, or somewhere in the gray area in between those two extremes, *shrug* who knows. There's no putting lipstick on this pig though, and calling it a fix. Rather they need to essentially take a sledge hammer to the whole system and start over from the ground-up. There's a variety of different approaches (some more free-market, others socialized) the world over that work and are cheaper. Seems, an honest conversation and comparison of what works elsewhere and what could work here with the political realities would help. Not a political forum, but my general message is there's lots of possible ways to cover all the full spectrum of opinions that could be used to solve it. And at this point, anything would be better, cheaper, and more cost effective than what we have now (excluding the lipstick). smile

Try putting that in a 15 second sound bite that effectively conveys the actual situation to most voters, many of whom are uninformed on this subject.
Posted 5/13/2019 4:34 PM (GMT 0)
Everybody agrees that things are too expensive, and that's where all agreement ends. Easy to point out a problem and all nod heads, very hard to come up with an agreement that everyone can get behind. Always tons of interest in maintaining the status-quo for as long as is possible (cuz lots of money is being made off of our backs, and special-interests and others blowback the winds of change) whether directly by the company or through investors or even our retirement accounts with stocks in those pharmaceuticals.

Certainty, us chronically ill which are a minority, take the brunt of it at the pharmacy counter. Others are mostly ambivalent as it doesn't affect them, personally...
Posted 5/13/2019 7:14 PM (GMT 0)

iPoop said...

Whether they can make healthcare and meds function like a true free-market, just go single-payer medicare for all, or somewhere in the gray area in between those two extremes, *shrug* who knows. There's no putting lipstick on this pig though, and calling it a fix. Rather they need to essentially take a sledge hammer to the whole system and start over from the ground-up. There's a variety of different approaches (some more free-market, others socialized) the world over that work and are cheaper. Seems, an honest conversation and comparison of what works elsewhere and what could work here with the political realities would help. Not a political forum, but my general message is there's lots of possible ways to cover all the full spectrum of opinions that could be used to solve it. And at this point, anything would be better, cheaper, and more cost effective than what we have now (excluding the lipstick). smile

This is a great point but in the current political environment, which is actually worse than a joke, it is highly unlikely and with the lobbying structure, it is impossible. What amazes me, those who suffer actually vote the politicians that are not even attempting to reduce the costs !!

That said, I have lived in Sweden for 10 years. I have 'experienced' the socialized medical system. It is great when you have a mainstream healthcare issue, but pretty bad when your health issue is not recognized by mainstream medicine. This does NOT imply that the current model here in the US works wonders for a non-mainstream medical issue. The doctors are willing to look into it but the insurance industry waters it down.

I really hope CT AG sues the heck out of these companies.
Posted 5/13/2019 9:13 PM (GMT 0)
The CT AG, Tong, has high political aspirations. I hope he follows through on this and is able to force some change.

Other countries have legislative bodies that regulate drug costs. I'm sure there are legal hurtles to this in the US but it seems like a reasonable starting point to have some sort of cap on pharma pricing.
Posted 5/14/2019 1:41 AM (GMT 0)
Besides prosecuting people guilty of price fixing and other illegal activities, there are other things that could be done. Reducing the cost of getting a drug approved would help. Reducing the length of patent protection is another, as would having some form of regulation of prices. With all the corruption and lobbying in D.C., don't hold your breath. It really bugs me that drug companies waste so much money on advertising, but the courts have ruled it a free speech issue, so that won't be changing any time soon.
Posted 5/14/2019 12:27 PM (GMT 0)

C_G_K said...
Besides prosecuting people guilty of price fixing and other illegal activities, there are other things that could be done. Reducing the cost of getting a drug approved would help. Reducing the length of patent protection is another, as would having some form of regulation of prices. With all the corruption and lobbying in D.C., don't hold your breath. It really bugs me that drug companies waste so much money on advertising, but the courts have ruled it a free speech issue, so that won't be changing any time soon.

The cost of getting drugs approved doesn't seem to be a huge issue for generics.

The fact that a drug sells for $1240 in the US and $170 in other countries indicates that there's no problem with the cost of manufacturing drugs. The reason prices in the US are so much higher than that in other countries is simple: Other countries have price controls, and the US doesn't, and the pharma companies have to make up their profits lost in other countries by raising US prices.
Posted 5/14/2019 12:50 PM (GMT 0)

UCinGV said...

The cost of getting drugs approved doesn't seem to be a huge issue for generics.

The fact that a drug sells for $1240 in the US and $170 in other countries indicates that there's no problem with the cost of manufacturing drugs. The reason prices in the US are so much higher than that in other countries is simple: Other countries have price controls, and the US doesn't, and the pharma companies have to make up their profits lost in other countries by raising US prices.

EXACTLY.

Much of this started when the GOP passed Medicare Part-D in 2003 to help Bush win Florida. They put a clause in there that prevented Medicare from negotiating drug rates with pharmaceutical companies. They are the largest buyer of medication in the World and preventing them from negotiating has seriously trickledown effects in the private insurance market.
Posted 5/14/2019 1:21 PM (GMT 0)
If I was king for a day, and could wave a hand and make it happen:

You get one patent for a new drug, no extensions. No changing inactive ingredients (putting a clear capsule on existing meds, etc etc) and getting a new patent for X-years more.

It would be illegal to bribe generic makes NOT to produce a med in the USA for x-years. Why it took 30 years for a generic asacol in the usa.

Yes, allow negotiation for all med prices, medicare/medicaid, etc etc. In fact, publicly list those prices as benchmarks for all private insurers in their negotiations. Base price negotiations within what other countries pay. No reason canada pays $100 for asacol when it is $1,200 here.

Make the approval process easy for generics. Bar generic producers from lawsuit from the original patent holders, once the 1st and only first patent has expired.

I'd take the profit out of healthcare as a rule. I find it immoral to charge a profit to sick people (leave the profits on fancy coffee, designer clothes, luxury cars, etc etc). I'd make the majority of hospitals and doctors practices government-run (with the exception of a few like Cleveland clinic, mayo, etc etc). No multi-million dollar CEO pay for hospitals, add some common sense to it all. Leave some private for those, like in the UK, who want to may more for private insurance and private facilities. The majority would be government, and available to all for a low cost.

No prohibition of pre-existing conditions, illegal.
Posted 5/16/2019 6:53 PM (GMT 0)
The average cost to bring a drug to market in the United States is $2.6 billion dollars.That's nuts. From what I understand, even drugs used safely in other countries for decades are not exempt from that. True that this doesn't affect generic prices, but overall generics are already super cheap and not in need of price controls. Going after price-fixers is better than price controls for generics IMO, although I am not against price controls. And the $30 billion spent on advertising!!?? We all pay for that in the end through inflated prices.
Posted 5/16/2019 7:07 PM (GMT 0)

iPoop said...

I'd take the profit out of healthcare as a rule.

It's tricky.

Most hospitals are already non-profit. Less than 20% of hospitals are for-profit.

If you take the profit motivation out of drug research, then what motivation will there be to attract the best and brightest into the field? We already have a diversion problem in this country where a lot of STEM graduates end up selling real-estate or working on Wall street, because they can make more money.
Posted 5/16/2019 9:09 PM (GMT 0)
I have some experience of the UK healthcare system, it is vastly under resourced, and the quality of treatment you receive ends up being a lottery. People then end up paying to go private because of the long waiting times on the NHS. For example someone in my family had endometriosis and was told she'd have to wait 7 months for an appointment on the NHS to get it treated. She had so much pain she paid to go to a private hospital instead.
As far as I'm aware the EU puts price caps on all medicines, generic or otherwise. So for example entyvio costs around 1000 euros per infusion. I'm guessing it would be more in the US?
Posted 5/20/2019 1:07 PM (GMT 0)
If 20 years of exclusive patent rights granting the ability to be the sole seller at whatever price the market will bear isn't incentive enough, I don't know what would be.
Posted 5/20/2019 1:12 PM (GMT 0)

C_G_K said...

If you take the profit motivation out of drug research, then what motivation will there be to attract the best and brightest into the field? We already have a diversion problem in this country where a lot of STEM graduates end up selling real-estate or working on Wall street, because they can make more money.

This is just trickle-down thinking....how much of the sky-high price we pay for drugs actually trickles down into STEM research? For a generic, that number is zero or very close to it. For a brand drug, it's still a small fraction of some number that doesn't even bear much relationship to the value of the advance in the first place.

For example, a drug that merely "maintains" patients can bring in far more money than one that cures them, because people have to keep buying it. If you want to promote STEM research in medicine, the current system is an extremely inefficient, even counterproductive, way of doing that. It would be better to just give cash awards directly for the quality of the discovery, if that's what you want to pay for.

If you just throw a bunch of money around, thinking that profit, riches, greed, etc will motivate people to "treat the sick", you will get a system exactly like the one we have. A system that LOVES sickness and keeping people sick and HATES health and everything to do with healthiness. But because you attracted the best, brightest, and greediest to it, they will be very good at lying to you and even to themselves, telling you how much they want you to be healthy, while doing everything in their power to keep you sick.
Posted 5/21/2019 5:52 AM (GMT 0)

fredflats said...

For example, a drug that merely "maintains" patients can bring in far more money than one that cures them, because people have to keep buying it. If you want to promote STEM research in medicine, the current system is an extremely inefficient, even counterproductive, way of doing that. It would be better to just give cash awards directly for the quality of the discovery, if that's what you want to pay for.

That is a problem, but limited to chronic conditions like what we suffer from (U.C.). I do think the current research model is not that helpful for us, or for people with similar conditions for the reasons you have mentioned, but not all health issues are chronic (examples: cancer, injuries, infections, etc.). For acute issues the system actually works pretty well.
Posted 5/24/2019 9:43 PM (GMT 0)
Apparently, because prices are controlled and negotiated in other countries, the U.S. "free market" is the only place that can really fund major drug research. So essentially, Americans are subsidizing the cost of drug development for the rest of the world.

I don't fully buy this argument because you can find many exceptions, such as generics being taken off the market and then re-branded under newer formulations at high price. But it does make you think.
Posted 5/25/2019 5:10 PM (GMT 0)
Colorado just capped the price of insulin, that could be a heads up to Big Pharma that people are flexing their state legislative powers while Pharma buys off federal legislators. For diabetics insulin is life or death. We UC'ers have less drama (rarely die but can be financially broken) and this movement by states could happen for us too.

But don't expect this in Florida where I live. Medicare people (majority here) don't care how much other people have to pay for RX or insurance. The 65+ I've met are fairly self-ish, don't you touch their "earned" medical coverage and RX. They are a very powerful voting bloc here and on the national level. Why? Because they do vote. I hit Medicare age this December but I do care about other people, I don't see it as my loss when they can afford their RX meds and insurance. We are all in this together.
Posted 5/26/2019 2:56 AM (GMT 0)
You've got the mob, and then you've got big pharmaceutical companies. Both are organized crime IMO. Insulin is a classic example of the games big pharma plays to rip people off. Price fixing, patent "evergreening", colluding with competitors to stay out of the market... etc..
The cost of insulin is a global problem though, not just in the United States. It's technically a biologic, so making a generic is difficult.
Posted 5/26/2019 1:28 PM (GMT 0)
I know bipartisan legislation is being talked about for passage this summer. See if anyything cones out of it.

"Pelosi’s office has been developing a plan that involves Medicare negotiating drug prices. It would allow an outside independent expert to set the price of a drug if Medicare and the manufacturer cannot find middle ground, followed by a 50 percent tax on a drug’s revenue if the drug company still does not reach an agreement.

The plan would not call for negotiating all drug prices, but instead would require talks for a minimum of 25 high-priced drugs. Some Republicans say that limitation could make the plan more amenable to the White House."

Election talk in the air, both sides feel something needs to be done. Only thing to pass (if anything) will be a baby step at most. So each side can claim something was done at least.
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