I am in complete accord with your sentiments, here, as I'd said about your take on the issue, generally (with the one exception, to which this post of yours, alludes), in my prior post. My initial reaction to your suggestion, above, was only that this seemed a more problematic way of going about achieving that same goal, than limiting our legislative remediation to our own country. But, after some of @Hollyhood 's comments, I'm no longer sure if your suggestion might actually avoid some of the legal challenges posed by the desire to price-fix, prescription drugs. The things that I would be wary of, are that I don't know that ALL other countries follow this practice, so we might need narrow your, "anywhere else in the world," criterion. Also, is the idea that different countries prioritize different meds, and following this policy would not allow for the U.S. to do this (but nor does our current law). Additionally, of course, this would essentially give other nations control over our prices. But I mention this mostly because it would be a possible point of objection, for some. Legally-speaking, I don't know if tying our maximum prices to that of other nations, would put the legislation on shakier, or more solid ground. But, as long as it withstood legal challenges, I would be all for your proposal. Even though it would keep America tied, for the highest drug prices in the world, that would still cut our current costs by at least 50%.
Really ? Are Canadians dying by the thousands from their Drugs ? This ban on imports from canada is based on the the money US Pharma companies poor into political coffers to quell competition. The idea that drugs from other countries are going to kill Americans is Big Pharma propaganda.
The ban is based on the Federal Governments constitutional duty to govern weights and standards for foreign and interstate commerce and the food and drugs we intake. And as the article states it already allows private importation. And you know you don't buy them from Canada, the Canadian health system, you buy them from private companies, how long before they see the profit potential? My brother did that a few years ago and it was like buying that Balance on Nature stuff on TV where once they get your credit card number. And he little recourse over it, the federal government was not interested in his complaint. How long will the Canadian citizens watch their drug supplies being sold to Americans? Did you read my cite at all? How about we pass a law that says a pharmaceutical manufactured by and American company no matter where it is made cannot be sold to another country than the average wholesale price here. If that country is not willing to pay that price then they cannot purchase it, then their citizens can decide if they are willing to pay the same cost as we do. I think that would work out a lot better for us don't you think?
@grapeape I saw that you were, also, part of this conversation, so I'm keeping you in the loop. I think Par10's suggestion would work a lot better for us. But first, let me mention something that I think you misunderstand. You speak as if the drugs we use in the U.S. are made by certain manufacturers, and the cheaper drugs, in other countries are all made by different manufacturers. This is not correct. Yes, certainly, with generics, there are many more local suppliers. But there are only so many major players, in the pharmaceuticals market: Merck, Pfizer, SmithKline-Glaxo, Astro-Zeneca, etc. And they sell their drugs, all around the world. So that's the same drug, and same manufacturer, as bought by other countries (most of which have national healthcare systems, giving them the buying clout to negotiate)-- yet those companies charge, in our market, double or triple the price! So, rather than trying to regulate what those companies charge in other countries-- which, of course, we cannot do, anyway-- Oh, Par10, I had missed your inclusion of the word, "lowest." I must not have been paying proper attention, & just assumed you were saying that the U.S. would not pay more than everyone else, so not more than the highest price charged elsewhere. But not more than the lowest-- I like your thinking, on this. However, that might be going a bit too far, into impracticality. The costs of production, shipping, & distribution are going to vary depending both on the drug, and the country, so it might not be realistic to always expect the lowest price. How would you feel about changing that to, "not higher than the MEDIAN price, worldwide?"
We're talking mostly generics, and let's not talk these retail prices but actually consumer cost, I get huge discounts on my drug pricing either through my insurance or through private companies such as GoodRx, they can even be had through the manufacturers. And as was noted in the citied article, 20% of the American market would use ALL the drugs available in Canada, do you really think the Canadians are going to allow the US to purchase even a significant portion of their drug supplies? And the drugs purchased are NOT purchased from the Canadian government health system at some cheap price they have negotiated, they are purchased from private online retailers, you don't think as demand goes up the prices will go up accordingly. That is not some panacea everyone thinks it is.
To your point about most of the drugs being generics, so the cost of non-generics being inconsequential: I would submit that there is a definite relationship between the price of the original drug, & the generic version. There is one generic version of a drug that I had been taking daily (I now only take it on occasion) for which a 1 month prescription was still, pre-insurance, $1000 per month. And the original patent holder (whose exclusive rights had just expired) was also manufacturing one of the "generic," versions. Also, the amount spent on the brand name drugs, before generics are available, is significantly more than you seem to think. Here is that, "lucky," element, in your situation, if the best medications for your problems are all available in generics. But when there is a new drug that comes out, especially for some serious condition, and it is a notable improvement over what else is available, it is understandable that people with this medical condition, don't want to wait a dozen years, hoping that the eventual generics will be sufficiently cheaper. So, in fact, it should not be surprising that many drugs which still have patent protection ARE still covered by Medicare Part B, and private insurers; it is the only way, in fact, that most of these drugs can recoup their research costs. To your next point, of focusing only on consumer cost, & not retail price, I would suggest it a more holistic way of seeing the issue, if we were to focus on the thing that controls both of these other two, and is also the aspect of pricing which 1) the government has the best chance of controlling; 2) has the greatest fiscal effect, on the government, i.e., on the drain of our tax dollars-- contributing to both rising national debt and a dearth of monetary resources, for application to other needs/purposes/goals-- and; 3) is where the BIDEN Administration is targeting its efforts-- WHOLESALE pricing. Lastly, I'm sure that, if the generics used in Canada are also produced there, our northern neighbor would be happy for all the business we would be giving it's companies, which would, of course, EXPAND their production capabilities, in a heartbeat, if they suddenly got the U.S. as a new, steady customer.
Well there is a fixed cost to manufacture, but then someone who just gets the formula and sets of machines to formulate and package didn't put at risk and spend all that capital developing them did they. And if they are manufactured in another country and then shipped in through Canada what does that do for future drug developments. Canada doesn't produce a lot and they are limited as to what can go through their system and when the demand of the US customers starts to deplete their supplies and drive up their cost how long will they put up with it? If anyone thinks letting people import drugs from Canada, which as I showed they can already do, will drive down cost here should read the cites and link I provided. And what has the best chance of controlling cost and providing with the supplies and create and produce the new ones we need, the free market. There are plenty of ways to lower your cost now in that market if you just put forth a little effort. So as I said let's make our markets more competitive with the government subsidized markets in foreign countries.
Your claim is demonstrably false: ours is one of the exceptional countries in which the FREE MARKET has been the basis of our drug prices. And, your Good Rx discounts and all your online coupons notwithstanding, the FACT is that U.S. drug prices-- even for IDENTICAL drugs, produced by the same company-- are the HIGHEST in the World. IOW, EVERYWHERE that the free market is not permitted to fully control drug prices, they have much lower prices for the exact same drugs. Unless your theoretical rationale can account for this real-life phenomenon, it is a meritless and discredited contention. And, BTW, allowing our access to more generic drug makers, since that is the part of the argument that you keep harping on, actually IS allowing the FREE MARKET to play a GREATER role, than restricting the competition, as our current system apparently does. So even your free market advocacy is self-contradicting. If the demand for Canadian generics rises, so may the price, but not by 100%, to match our current prices. And with a new, American market, open to them, the suppliers' will undoubtedly increase their manufacturing capacities. You keep alluding to articles, but I have yet to hear the basic logic, from you, that refutes any of what is in this reply.
You cannot know this ahead of time, so you cannot claim it as a given. Solyndra and 1,000 other failed boondoggles prove otherwise. Know why? Because the people doling out OUR money don't give a rat's behind. It's not their money. They get their cut, and their lives move on while they stick the rest of us with the bill.
It's OUR free market that must compete with the other countries government subsidized market. I thought I was clear on that. It is our free market that has brought about the drugs we now enjoy and that save our lives so let/s make the rest of the world pay their fair share of the investment into those, the loses that occur when their are failures, all the testing and approval and then marking and logistics. Canada cannot supply our drug use without depleting their own and driving up their cost as ours come down. And how do we restrict the generics, most of mine are generics. How do we get all these new drugs if we do not allow the people who put their money and at risk cannot make the return they need by protecting THEIR product at least for a certain amount of time? Why Importing Drugs From Canada Won't Fix High Drug Costs "We’ve all been in situations where, instead of trying to fix an underlying problem, we find workarounds within current systems. But workarounds can get ridiculous and overelaborate. That’s happening here. And ultimately, drug importation from Canada likely wouldn’t even work as a scalable method of cost savings. A coalition of 15 Canadian clinician advocacy groups wrote to their government that importing drugs to the United States would put Canadian patients at risk. It makes sense when you think about the negotiations as the reason Canada can keep its drug prices down: Increase the demand for medications, and those prices will rise. Would Canadian government officials even go along with this proposition? We’ve endangered our northern neighbors with our mismanagement of the COVID-19 response. Americans can’t even enter Canada at the moment. Why would Trump think that Canada will compromise their own citizens’ hard-won access to affordable prescription medications, especially right now? https://www.wbur.org/cognoscenti/2020/09/02/prescription-drugs-import-canada-trump-sarah-ruth-bates Even The New Republic Buying Drugs From Canada Won’t Solve America’s Obscene Health Care Costs Proposals to lower drug prices through importation are wildly popular but also completely inadequate. ...But drug importation has never actually been as promising as it sounds. Even the most optimistic estimates offered by its loudest proponents amount to a barely perceptible dip in overall spending, and its ability to deliver even that depends on the willing participation of stakeholders who have already expressed extreme distaste for the measure. Even more, the plan’s drawbacks mirror those of other drug pricing reforms: They ultimately may not do much to help the people who need it. ... ....But larger-scale importation is a heavier lift than individual trips across the border. Not only do rules allowing importation bar biologic drugs like insulin, they demand complicated administrative moves, like contracting with private wholesalers to negotiate with Canadian counterparts. Even more of a problem is the fact that importation depends on the consensual participation of two players who hate the idea: drug manufacturers and Canadian officials. The former are unlikely to agree to ship a much larger supply to Canada that they know will be sold southward for cheap to undercut profits in their most lucrative market, and the latter have already publicly stated they won’t compromise their own supply by overpromising exports to a nation 10 times Canada’s size. ... https://newrepublic.com/article/162...-wont-solve-americas-obscene-healthcare-costs
The record of government medical research is a much better & different one from, and one that's incomparable to, picking individual companies for business investment.
This is a completely non-sensical argument. We CANNOT LEGISLATE the PRICE that even an AMERICAN COMPANY MUST CHARGE for its PRODUCT, IN OTHER COUNTRIES. Even if we could, your "solution," seems directed towards making more money for our Pharma Industry, not towards saving the citizens and government of the U.S., money from exorbitant over-pricing. Lastly, I don't think ANYONE would greet your suggestion positively, even Big Pharma. The reason that they charge less in other countries, is because those countries refuse to pay more (but the Pharm industry still makes a reasonable profit, at those prices). So your plan gives pharmaceutical concerns the unenviable choice of losing vast amounts of their markets, or voluntarily lowering U.S. prices by over 50%, overall (far more, in particular cases), so that enough of the rest of the world will buy them. A further complication in your system is that, though it seems you designed it from the perspective that drug companies were in the position to set prices, worldwide, the fact is that-- other than in the U.S.-- the reverse is true: prices are effectively set by how much countries are willing to pay. That is the fundamental problem with our current system, in the U.S. What I predict would happen, in the unrealistic scenario in which we could stop U.S. companies from selling their products at discounted prices, around the world, is that, rather than drastically cutting U.S. prices, they would dramatically raise our price, citing your hypothetical law, restricting their business, as precipitating their need to recoup their losses from America, & Americans. P.S.-- BTW, all major pharmaceutical companies, are not U.S.-based. One of the long-time, big players has been Merck, for example, which is a German company. Our laws, then, could not even hypothetically control what they charge anywhere but in our own country. Let me guess-- we "get even," with them by not allowing their medicines in our markets. If those Americans who benefit from them are truly patriotic, they won't mind, right?
False, lol. The government shouldn't be picking individual companies for investment, lol. That's not the government's purpose.
Sure you can. You can implement an export tax on drug prices which equals the price of the drug here less the price cap in the foreign country. You could end compulsory licensing of drugs in other countries. Put price caps on drugs here, and see the pace of new drug development plummet. Simple fact.
Probably, but putting my "greater good" hat on, which is more important: Affordable drugs to help more people now or new drugs to help people in the future?
That does not contradict my quote, lol. Serious question-- are you, by chance, dyslexic? Our government has a health service-- that is not going to change. They sometimes make scientific discoveries that are applicable to medicine-- that is not going to change. Currently, when this occurs, they use whatever process they use, which may be fairly (or unfairly) arbitrary, & pick a Pharm company to give it to, no strings attached. My points are 2. First, we SHOULD get something back from the corporate beneficiary of taxpayer-funded, government research, whether that is a share of the profits, or written guarantees, limiting what they can charge for this drug, which we are giving them, for free. My second point is supplemental, & it's not worth arguing over, because I have no problem w/ anyone having the opinion of wanting to wait, to see how this policy works, at current levels of staffing & funding, before increasing our investment. If, however, it was working so that the government was generating, or saving, a hefty chunk of change, due to the new policy of not giving away our discoveries to companies, without some form of compensation, would you still not support, at least a gradual expansion of this, as a specific goal of our health services, provided that any additional funds we invest, return even more, to government coffers?
When "government" "researches" something, who do you think they pay to research it? It's not always a federal bureaucrat. In fact, most times it's not. So the government then IS picking and choosing which companies to invest in. Why pick and choose winners? If the NIH, for example, comes up with a discovery, it should be public knowledge available to all companies. Then, every company that wants to produce the drug, for instance, is producing it without the intellectual property rights that can lead to higher costs. The government has no profit motive, and should not engage in businesses providing private goods for a profit motive.
Government will waste the money more than private businesses will. More dead-end research. In fact, government can run up the federal credit card on all sorts of wasteful research because they have no profit motive to keep them honest. So, no.
Even at low pricing, pharma will have to put money into R&D in order to survive, just like most other companies. The change will be the rate at which they do it or maybe they will cut some other, non-value, things like commercials that target hypochondriacs or bribing congress critters.
Europe has caps and they get meds. Canada as well, let's test it. We could cap some of the crap at half what we all pay today and big pharma would still be as rich as the cartels.
