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eskmd ~ why are prescription drugs less expensive outside the states? Oh,,,thanks for the information on kickbacks. I owe you a dinner and drink now.
There are several factors at play here. Countries with nationalized health care are in a better bargaining position. They can say to the drug company "you have to lower your price, or this drug will not be available for sale to this entire country". Plus, buying in such bulk always lowers the price. Also, on an international level, the drug companies price their drugs on a sliding scale. Most of the powders (chemicals) to make the drugs are very cheap. 30 cents worth of ingredients can make 100 dollars worth of a drug, so there is a lot of "leeway" in how much they can charge for the drug. The big expense for them is research and development, but that is paid for many times over. So if they know that a certain population can only afford 50 dollars for the drug, they will sell it to them at that price. After all, a 49 dollar profit may not be as good as a 100 dollar profit, but it is better than NO profit.
To sum it up, when US citizens buy their drugs from Canada at half the price of the same drug in the USA, it is because Canada said to the drug company "we will buy "X" million units of your drug, we will make your drug available to "X" million people, but at half the price you charge the individual. If you don't meet our price, we will just not have your drug available under our national health care plan." Of course the drug company will accept the offer.
In the US, there is no system of collective bargaining. Politicians occasionally mention it, but it is just lip service. The Pharmaceutical lobby is way to strong to let this happen here IMHO.
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Originally Posted by eskmd
There are several factors at play here. Countries with nationalized health care are in a better bargaining position. They can say to the drug company "you have to lower your price, or this drug will not be available for sale to this entire country". Plus, buying in such bulk always lowers the price. Also, on an international level, the drug companies price their drugs on a sliding scale. Most of the powders (chemicals) to make the drugs are very cheap. 30 cents worth of ingredients can make 100 dollars worth of a drug, so there is a lot of "leeway" in how much they can charge for the drug. The big expense for them is research and development, but that is paid for many times over. So if they know that a certain population can only afford 50 dollars for the drug, they will sell it to them at that price. After all, a 49 dollar profit may not be as good as a 100 dollar profit, but it is better than NO profit.
To sum it up, when US citizens buy their drugs from Canada at half the price of the same drug in the USA, it is because Canada said to the drug company "we will buy "X" million units of your drug, we will make your drug available to "X" million people, but at half the price you charge the individual. If you don't meet our price, we will just not have your drug available under our national health care plan." Of course the drug company will accept the offer.
In the US, there is no system of collective bargaining. Politicians occasionally mention it, but it is just lip service. The Pharmaceutical lobby is way to strong to let this happen here IMHO.
And isn't it a shame that the IRS won't let you include any Canadian or Mexico bought drug expenses on your return (towards your medical expenses) itemization.
Why not? If we let everybody buy their meds where they can be bought for significantly less, and we can take it towards our deductions, that would have a great impact in the pharm companies' pockets. Maybe they could lower their US prices too and keep everyone in affordable business.
Location: Lots of sun and palm trees with occasional hurricane :)
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Originally Posted by eskmd
Back when I first got out of residency, some drug companies would send the doctors on expensive golf outings, box seats at sporting events, Broadway shows, etc. It is actually a lot different now. The Pharm companies have actually been policing themselves pretty well. They have a set of guidelines they follow now. I occasionally get a free dinner at a nice restaurant, but we have to sit through boring lectures just to get the free grub. Other than that, we get pens and free samples to give the more needy patients (a very good thing, IMHO), but nothing of any substantial financial value to the doctors anymore.
When I do see someone getting something that one might consider a bribe, it is usually a device company giving it, not a drug company. Some of my orthopedic friends get some pretty nice handouts from the companies that make artificial joints.
There are ways around the Pharmaceuticals' compliance plan - they now fund investigational studies and a lot of the doctor's research. They also provide many "scientific" lectures to the outgoing residents and fellows.
There are ways around the Pharmaceuticals' compliance plan - they now fund investigational studies and a lot of the doctor's research. They also provide many "scientific" lectures to the outgoing residents and fellows.
Yes, but investigational studies are for drugs that aren't even on the market yet. A small percentage of doctors are doing investigational studies. AND the one investigational study in which I took part, was actually a lot of work. In fact, it was enough work that I don't particularly want to do any more investigational studies.
Thanks eskmd for the information. It’s an eye opener ~ but how to fix the problems?
I avoid prescription drugs whenever possible and go to health food stores and pickup vitamins, herbs, and whatever else can help with the issue at the time. I also buy organic when I can get it, so fare I’ve been better off.
Thanks eskmd for the information. It’s an eye opener ~ but how to fix the problems?
That's the billion dollar question. People have come up with solutions that seem viable, but they always come up against opposition from other segments of the public or the pharmaceutical companies, or both. I think we need a leader that is truly independent from corporate lobbyists as well as some serious campaign finance reform to put the power back in the people's hands.
That would not only solve this problem, but many others as well.
Please, when talking about drug costs, keep in mind the 100's of millions of dollars spent to do research by the drug companies, in the development of new drugs.
They have every right to get that R+D money back - it has to be passed through to the consumers.
Please, when talking about drug costs, keep in mind the 100's of millions of dollars spent to do research by the drug companies, in the development of new drugs.
They have every right to get that R+D money back - it has to be passed through to the consumers.
I do keep that in mind, and it is a valid point. They have every right to recoup their expenditures and make a reasonable profit. A profit that motivates them to go out and make newer an better drugs to keep us healthy. I believe in free markets.
The problem is that this market is not like other markets. By it's very nature it is not free. If someone needs a particular lifesaving cardiac drug, they don't have much of a choice. Its not like someone who's dissatisfied with Ford so they buy a Toyota. They need that particular drug, and until the patent expires they are forced to buy from 1 company. That's why it is so important to free it up from the demand side by allowing collective bargaining.
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