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Old 12-20-2019, 11:38 AM
 
3,769 posts, read 1,039,250 times
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Quote:
Originally Posted by newdixiegirl View Post
I believe one of the main reasons for the staggering costs of medication in the US is advertising.
I disagree.

The cost (not price) is mostly a result of the staggering patent royalties paid by the US entity to the foreign patent holder (usually in Switzerland, Ireland or Israel, for example).

The price (not cost) is mostly a result of Pharma companies realizing they can value price in the USA, whereas they cannot value price in most other countries. In some countries, their government determines the price, and the the pharma company can either agree to charge that reduced number, or they can go pound sand.

At the end of the day, we in the USA clearly subsidize the rest of the world. If not for we end-customers in the USA paying more, many drugs would not exist.
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Old 12-20-2019, 05:03 PM
 
9,033 posts, read 9,668,338 times
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Quote:
Originally Posted by orca17 View Post
Some countries have laws that prevent drug companies from soaking their citizens with exorbitant drug prices. America isn't one of them. If you want to do business there, you comply with the law.

America has patent laws that allow drug makers here to prevent the manufacture of generic medications, long after they are available in other countries. In the United States, drug makers get an exclusive patent for seven years. If they come up with a new indication for the drug, it can be extended almost indefinitely. Often the patents are for drugs that were developed in other countries, but American drug companies have bought the rights because they know that they san soak Americans for billions, even for drugs that they didn't develop. This is one reason that prescription drugs are advertised on television.

Example: My wife takes sumatriptan for migraine headaches. We took a trip to Cancun in 2006. At the time, only the brand name drug (Imitrex) was available in the U. S., and ten pills were about $350 without insurance. We found some in the gift shop at the Cancun airport from a generic manufacturer that I recognized (I work in the medical field), same medication, same quantity, over the counter, $20. Given that this was an airport gift shop, that probably isn't the best price that we could have found. (My note: This particular drug is an example of one developed elsewhere, but a US company bought the production rights for this country and made a killing without any R&D. Imitrex was developed in the UK.)

Another example: Medication for nail fungus, three month treatment regimen. After the second month, our insurance company took it off the formulary, and we were told that it would cost $400 if we wanted the last month of therapy. No generic was available in the U. S. I contacted a Canadian pharmacy, generic available, $35 for a one month supply paying out of pocket.
Wouldn't you like to know how much gypsum was in your wife's cheap Mexican OTC Imitrex? And what your lawsuit options would have been had the "Imitrex" killed her.
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Old 12-20-2019, 05:06 PM
 
9,033 posts, read 9,668,338 times
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Quote:
Originally Posted by RationalExpectations View Post
I disagree.

The cost (not price) is mostly a result of the staggering patent royalties paid by the US entity to the foreign patent holder (usually in Switzerland, Ireland or Israel, for example).

The price (not cost) is mostly a result of Pharma companies realizing they can value price in the USA, whereas they cannot value price in most other countries. In some countries, their government determines the price, and the the pharma company can either agree to charge that reduced number, or they can go pound sand.

At the end of the day, we in the USA clearly subsidize the rest of the world. If not for we end-customers in the USA paying more, many drugs would not exist.
Don't forget price penalty brought forth by a lawsuit happy nation.
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Old 12-20-2019, 06:18 PM
 
10,355 posts, read 6,814,899 times
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Quote:
Originally Posted by TwoByFour View Post
The law being passed by Trump is for importing drugs by pharmacies and whole-sellers, which would then be resold in the US. So this is not about personal use.

I'm a pharmacist who bought two cholesterol meds from Canada for 2 years because they were approved for generics by Health Canada before approved in US.


Yeh, I felt like a traitor for a few seconds, but a hundred dollars saved is quite an incentive
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Old 12-24-2019, 03:14 AM
 
27,058 posts, read 29,522,684 times
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Yet another band aid.

The real solution has nothing to do with cheaper drugs. It has to do with changing the lifestyle habits that lead to chronic long term illnesses and unnecessary dependence on pharmaceuticals (diabetes, heart disease, high blood pressure, some cancer, and even alzheimer's). 70% of our health care spending (over $1 Trillion) is on diseases that are largely preventable.

People like Dan Buettner are leading the way in real solutions. Of course, prevention gets little mainstream media attention:


https://www.youtube.com/watch?v=so_1etvOJiw&t=12s
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Old 12-24-2019, 07:05 AM
 
735 posts, read 311,145 times
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Quote:
Originally Posted by orca17 View Post
That's the thing - often they are not US companies. If a drug is successful overseas and was developed by a foreign company, a US drug manufacturer can buy the US production rights and all that they have to do is get it through the FDA approval process. They have done no R&D whatsoever, but they are cashing in all the same. Abilify, a widely-advertised antipsychotic drug, is an example of this. It was developed by a company in Japan. The US manufacturer also later came up with a second use, as an adjunct with antidepressants, which allowed them to extend their US market exclusivity for several years after it otherwise would have ended.
The most expense part is the phase 2 and phase 3 clinical trial costs and not the earlier stages of development. When you bring a new molecule over to the US, you still have to perform the clinical trials in order to get FDA approval. These clinical costs are also part of a company’s reported R&D expense. Secondly, if you want to expand the label for additional indications (like your example), you have to do additional clinical trials (more money). You can get extended exclusivity for a specific claim (what is listed on the product label), but a generic company can file for an ANDA on the original indication. Bringing over a new molecule gives you at least 5 years exclusivity (separate from any other IP). A new form or strength gets you 3 years. It usually takes 2.5 to 3 years post launch before a product turns profitable, so the timeframe to recoup your development costs comes in later years. There area a few unique exceptions to this. For example, there has been a critical issue around developing new antibiotics and it is tough for companies to make money in that category. Companies can now seek a QIDP designation in order to gain 10 years of exclusivity, separate from any IP.

Last edited by Jim1921; 12-24-2019 at 07:17 AM..
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Old 01-03-2020, 07:36 PM
 
442 posts, read 200,890 times
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There are other laws about pharmaceutical sales. Out of concern about counterfeit drugs, the pedigree law was passed. In short, the movement of every single bottle of drugs is tracked. The FDA can demand this information and it must be produced within 72 hours.

Wholesaler's aren't going to touch foreign drugs because they won't meet those requirements. A wholesaler which does purchase those drugs will loose their certification. Pharmacies aren't going to buy from an uncertified wholesaler because they can loose insurance contracts.
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Old 01-04-2020, 03:13 PM
 
Location: Fort Payne Alabama
1,428 posts, read 1,695,497 times
Reputation: 2663
Quote:
Originally Posted by RationalExpectations View Post
I disagree.

The cost (not price) is mostly a result of the staggering patent royalties paid by the US entity to the foreign patent holder (usually in Switzerland, Ireland or Israel, for example).

The price (not cost) is mostly a result of Pharma companies realizing they can value price in the USA, whereas they cannot value price in most other countries. In some countries, their government determines the price, and the the pharma company can either agree to charge that reduced number, or they can go pound sand.

At the end of the day, we in the USA clearly subsidize the rest of the world. If not for we end-customers in the USA paying more, many drugs would not exist.
You probably have some valid points but.......
https://www.washingtonpost.com/news/...than-research/
I believe the difference is even more today. Keep in mind a significant portion of the R&D is to slightly modify drug they already produce to defeat the patent restrictions.
Strange to me drug companies can import their drugs from India, China, Mexico, etc. but it is not safe for individual to do the same.
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Old 01-05-2020, 01:52 PM
 
9,033 posts, read 9,668,338 times
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Quote:
Originally Posted by GreggT View Post
You probably have some valid points but.......
https://www.washingtonpost.com/news/...than-research/
I believe the difference is even more today. Keep in mind a significant portion of the R&D is to slightly modify drug they already produce to defeat the patent restrictions.
Strange to me drug companies can import their drugs from India, China, Mexico, etc. but it is not safe for individual to do the same.
The last part of that is very weak.

It's not remotely possible for John-Q buying Chinese meds over the 'net to test and qualify what he buys.
We know for certain that many Chinese drugs in particular are either fake, fraudulent or out of spec. sometimes spectacularly so - 60 Minutes ran a great piece about this topic maybe two years ago.

Drug companies via federal mandate must have cradle to sale QC or if say a Chinese drug or intermediate product is purchased as an ingredient the drug company must test and analyze the inbound product to statistical satisfaction.
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Old 01-08-2020, 01:51 AM
 
31,339 posts, read 48,685,881 times
Reputation: 17053
Quote:
Originally Posted by TwoByFour View Post
Trump is going to allow some (but not all) prescription drugs to be imported from Canada. I am wondering if this is going to work out in the long run as intended.

Currently the main players in all drugs, Canadian or American are:
- The patent owner of the drug. Most of those are US Big Pharma companies at this point.
- The manufacturer. This may be the patent owner but most US drugs are manufactured in India.
- The pharmacy or whole-seller

In the US, drugs are expensive because the patent owner licenses that patent to the manufacturer at a very expensive rate. That same license to a Canadian manufacturer is much cheaper.

So if Americans will be buying their drugs from the Canadian manufacturer, the patent owner is going to make less money and will respond by charging more for the license to the Canadian manufacturer. Both Canadians and Americans will then pay more. This is going to anger Canadian citizens and Canada will respond by not allowing the export of Canadian drugs to the US. So we are back where we started.

The other situation that can occur is that the Canadian whole-seller just decides to charge a much higher price to an American drug importer than it would do a Canadian pharmacy. That whole-seller is not subject to US laws so can do whatever it wants. I would charge just about the same as a US whole-seller would charge, which means US citizens will not be paying much less for imported Canadian drugs.

In any event, it seems to me that the dynamics of the market will change pricing of Canadian drugs and end up washing away the advantage we will get.

What do others think?
it is cheaper because Canada negotiates as a united front and all the insurance providers in the US plus the government which provided Medicare and Medicaid doesn’t negotiate for drug pricing as one entity......
So WE (American consumers) are where drug companies and mfg make most of their profits
We SUBSIDIZE Canadian and other socialized medical plans in other countries by not having a one-payer system ourselves...
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