Drug prices

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Forty Two
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Re: Drug prices

Post by Forty Two » Wed Aug 02, 2017 7:00 pm

Rum wrote:Like so much else about American health care - exploitation seems to be the name of the game.
Fairness is a matter of degree. Surely there is room to accept the concept here that for an enterprise to research, develop, and produce a product, it stands to reason that they will want to make money on it. Otherwise, the risk plus fixed and variable costs associated with running any enterprise is not worth it in the end. Further, by allowing someone to produce a product which they can then sell at a profit, it provides an incentive for people to produce products and make new developments.

While the name of the game is "exploitation" in the sense of making and selling a product, there is another name to the game, which is that the overwhelming majority of medical breakthroughs and developments are taking place in the United States. So, there are two sides to the coin. At some point there must be balance. Doctors and drug manufacturers are not public servants, who are obliged to provide their services and products for free.

By the same token, the regime in which we operate now has medical devices being sold so cheaply in some markets around the world that they can be "reimported" into the US and still sold for less than the price of product originally aimed at the US market. Johnson and Johnson, for example, sells diabetes test strips over in Asia at cut-rate prices. So, there is a thriving reimportation business in the US, where importers here in the states make deals with J&J distributors to sell product directed to Kazakhstan or some such place back into the US. It winds up on drug store shelves. There are little notations on the boxes "not for retail sale" or "not for sale in the US", but independent drug stores get them for such good prices, that they sell them anyway. Check it out - generally if you go to a lesser known drug store, the smaller chains or an independent. You'll find those kinds of products.

The manufacturer tries to control where there products can be sold. They try to designate the market, or that it's not for retail sale, or that it's not for re-sale, etc. However, the law is that once they sell it, they have no right to control what happens downstream.

So, there definitely is some effort on the part of the big drug companies to sell at high prices here in the first world, and then low in the third world. But, I'd think lefties would think that made great sense....
“When I was in college, I took a terrorism class. ... The thing that was interesting in the class was every time the professor said ‘Al Qaeda’ his shoulders went up, But you know, it is that you don’t say ‘America’ with an intensity, you don’t say ‘England’ with the intensity. You don’t say ‘the army’ with the intensity,” she continued. “... But you say these names [Al Qaeda] because you want that word to carry weight. You want it to be something.” - Ilhan Omar

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Re: Drug prices

Post by JimC » Wed Aug 02, 2017 9:07 pm

mistermack wrote:I've never bought weed or hash in my life.
Smoked a lot of it though.
Used to grow it, and do swaps.

Got no interest in it at all now though. Which is just as well. I hear it's a lot stronger now.
I stopped when I started to develop mini epileptic fits...

Still remember the sensation of being stoned with great fondness...
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Re: Drug prices

Post by rainbow » Thu Aug 03, 2017 11:13 am

Forty Two wrote: So, there definitely is some effort on the part of the big drug companies to sell at high prices here in the first world, and then low in the third world. But, I'd think lefties would think that made great sense....
A perfect example of how Capitalism distorts free markets.

:hehe: Shot yourself in the foot again :hilarious:
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Re: Drug prices

Post by Forty Two » Thu Aug 03, 2017 12:37 pm

rainbow wrote:
Forty Two wrote: So, there definitely is some effort on the part of the big drug companies to sell at high prices here in the first world, and then low in the third world. But, I'd think lefties would think that made great sense....
A perfect example of how Capitalism distorts free markets.

:hehe: Shot yourself in the foot again :hilarious:
O.k., I'll bite. How does a drug company selling at high prices in one market and low prices in another market "distort free markets?" Explain that, if you can.

And... something to the effect of "if you don't know, I'm not going to explain it to you..." or "go research it..." coming in 3...2...1...
“When I was in college, I took a terrorism class. ... The thing that was interesting in the class was every time the professor said ‘Al Qaeda’ his shoulders went up, But you know, it is that you don’t say ‘America’ with an intensity, you don’t say ‘England’ with the intensity. You don’t say ‘the army’ with the intensity,” she continued. “... But you say these names [Al Qaeda] because you want that word to carry weight. You want it to be something.” - Ilhan Omar

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Re: Drug prices

Post by Tero » Thu Aug 03, 2017 9:13 pm

Teva, generic giant, suffering from taking too big a slice of generic all at once.
http://fortune.com/2017/08/03/teva-face ... nges-cuts/

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Re: Drug prices

Post by rainbow » Fri Aug 04, 2017 7:25 am

Forty Two wrote:
rainbow wrote:
Forty Two wrote: So, there definitely is some effort on the part of the big drug companies to sell at high prices here in the first world, and then low in the third world. But, I'd think lefties would think that made great sense....
A perfect example of how Capitalism distorts free markets.

:hehe: Shot yourself in the foot again :hilarious:
O.k., I'll bite. How does a drug company selling at high prices in one market and low prices in another market "distort free markets?" Explain that, if you can.

And... something to the effect of "if you don't know, I'm not going to explain it to you..." or "go research it..." coming in 3...2...1...
Holy Shiite.

Free trade means that you can buy in one country and sell in another without restrictions and duties.
:fp:
...or does your "Free Market Capitalism" allow for such restrictions?
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Re: Drug prices

Post by Tero » Sat Aug 05, 2017 12:25 pm

Actually it is no trick at all to price differently, as all the national "FDA" departments have packaging rules so the product has to be packaged and sold in a language in Europe. Sometimes it is just a package insert in a couple of languages. You cannot sell a drug in a package that is in a language the patient does not understand. A pharmacist will explain the details if a country has multiple languages.

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Re: Drug prices

Post by rainbow » Sun Aug 06, 2017 11:13 am

Tero wrote:Actually it is no trick at all to price differently, as all the national "FDA" departments have packaging rules so the product has to be packaged and sold in a language in Europe. Sometimes it is just a package insert in a couple of languages. You cannot sell a drug in a package that is in a language the patient does not understand. A pharmacist will explain the details if a country has multiple languages.
Fluoxetine was discovered by Eli Lilly and Company in 1972, and entered medical use in 1986.[6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] It is available as a generic medication.[2] The wholesale cost in the developing world is between 0.01 and 0.04 USD per day as of 2014.[8] In the United States it costs about 0.85 USD per day.[2]
https://en.wikipedia.org/wiki/Fluoxetine

How can it be justified to charge 80 times the amount in the US?
Are package inserts that expensive?
I call bullshit - Alfred E Einstein
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Re: Drug prices

Post by Tero » Sun Aug 06, 2017 11:27 am

Insurance! "I got dizzy on fluoxetine" and drove into a telephone pole" will cost $5 million to the seller in the US.

"I fell off my bicycle" will not get you anything in the developing country.

Also, every hand touching the drug, middlemen, gets a cut in the US.

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Re: Drug prices

Post by laklak » Sun Aug 06, 2017 3:23 pm

Lawsuits are a huge factor. There are TV commercials every night touting one class action suit or another. Did you ever take {insert drug name}? You may be eligible for a HUGE financial reward!!!!

The first thing we do, let's kill all the lawyers.
Yeah well that's just, like, your opinion, man.

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Re: Drug prices

Post by Sean Hayden » Sun Aug 06, 2017 3:41 pm

:cheer:

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Re: Drug prices

Post by Brian Peacock » Mon Aug 07, 2017 1:15 pm

We can get the accoutants to beat the lawyer to death and then shoot the accountants. Saves on ammo - the accountants will appreciate that. :tea:
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Re: Drug prices

Post by Forty Two » Mon Aug 07, 2017 1:39 pm

rainbow wrote:
Forty Two wrote:
rainbow wrote:
Forty Two wrote: So, there definitely is some effort on the part of the big drug companies to sell at high prices here in the first world, and then low in the third world. But, I'd think lefties would think that made great sense....
A perfect example of how Capitalism distorts free markets.

:hehe: Shot yourself in the foot again :hilarious:
O.k., I'll bite. How does a drug company selling at high prices in one market and low prices in another market "distort free markets?" Explain that, if you can.

And... something to the effect of "if you don't know, I'm not going to explain it to you..." or "go research it..." coming in 3...2...1...
Holy Shiite.

Free trade means that you can buy in one country and sell in another without restrictions and duties.
:fp:
...or does your "Free Market Capitalism" allow for such restrictions?
Capitalism allows such restrictions, yes. Not all capitalism is free market capitalism. And, even where a country desires to maximize the freedom in its own market, we live in the real world, where there are 192, give or take, different countries, with different economies (some wholly unfree, some more or less free, and others very free), and different legal regimes, etc. In other words, having a free market does not mean having absolute freedom or anarcho-capitalism in one country, even though other countries do things like allow nearly slave labor, have no legal regulations on product manufacture, and have high tariffs, etc.

Your assertion was that "capitalism" distorts the market in the example where a medical device company manufactures a product and sells it at different prices in different markets. In that situation, please explain how "capitalism" distorted the market?

Also, are you equating capitalism with "free trade?" It's not the same thing. Capitalism is an economic system wherein property, business and industry are largely held in the hands of private individuals and groups.

So, the question is, how does "capitalism" (the economic system where property/business/industry are largely held in the hands of private individuals and groups) distort the free market in the example we're discussing?

Capitalism is a necessary feature of a free market, but a free market is not a necessary feature of capitalism. For example, you can have a bunch of capitalist countries, but since they all use different currency, and have different domestic economies such as pricing of goods and services, they would have certain kinds of tariffs and regulations and such to smooth out the differences. In other words, you can still have capitalism even if the market between or among countries is not free of all tariffs. You can recognize that country X might be using slave labor to produce products to sell into a market that has very high wages.

So, you were saying?
“When I was in college, I took a terrorism class. ... The thing that was interesting in the class was every time the professor said ‘Al Qaeda’ his shoulders went up, But you know, it is that you don’t say ‘America’ with an intensity, you don’t say ‘England’ with the intensity. You don’t say ‘the army’ with the intensity,” she continued. “... But you say these names [Al Qaeda] because you want that word to carry weight. You want it to be something.” - Ilhan Omar

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Re: Drug prices

Post by Forty Two » Mon Aug 07, 2017 1:53 pm

rainbow wrote:
Tero wrote:Actually it is no trick at all to price differently, as all the national "FDA" departments have packaging rules so the product has to be packaged and sold in a language in Europe. Sometimes it is just a package insert in a couple of languages. You cannot sell a drug in a package that is in a language the patient does not understand. A pharmacist will explain the details if a country has multiple languages.
Fluoxetine was discovered by Eli Lilly and Company in 1972, and entered medical use in 1986.[6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] It is available as a generic medication.[2] The wholesale cost in the developing world is between 0.01 and 0.04 USD per day as of 2014.[8] In the United States it costs about 0.85 USD per day.[2]
https://en.wikipedia.org/wiki/Fluoxetine

How can it be justified to charge 80 times the amount in the US?
Are package inserts that expensive?
That's a complicated question. A big part of it is the fact that the other countries in question do not have a free market in such products, whereas the US does. So, for a manufacturer to sell in the UK, for example, it must adhere to the formulary pricing for the UK. If it doesn't, it doesn't sell there. If it doesn't sell there, some other company will sell to it. So, it sells to the UK at the formulary price, and then it makes up by pricing it higher in the US where government regulations prohibit Medicare from negotiating on price. It's a weird system overall.

More research and development, moreover, is done in the US than anywhere else in the world, by far. So, it's American companies in the US that are spending the $2.6 billion over 10 years that is necessary to research, develop and bring to market a new pharmaceutical. The payments have to come from somewhere. Our government has not taken action necessary to address these issues.

In the case of pharmaceuticals, it's like a relatively free(r) market (the US market is certainly not entirely free, not by a long stretch) competing with dozens of relatively unfree markets where large government buyers can act as one customer with the power to dictate prices.
“When I was in college, I took a terrorism class. ... The thing that was interesting in the class was every time the professor said ‘Al Qaeda’ his shoulders went up, But you know, it is that you don’t say ‘America’ with an intensity, you don’t say ‘England’ with the intensity. You don’t say ‘the army’ with the intensity,” she continued. “... But you say these names [Al Qaeda] because you want that word to carry weight. You want it to be something.” - Ilhan Omar

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Re: Drug prices

Post by Tero » Mon Aug 07, 2017 2:34 pm

If it doesn't sell there, some other company will sell to it. So, it sells to the UK at the formulary price....
They never sell below cost. The only thing they are selling is the brand, Prozac. If the customer thinks Prozac cures them but the generic fluoxetine does not, then you sell Prozac.

The generic maker usually has figured out a cheaper cost, as the innovator moves onto a new product. The innovator can even buy generic fluoxetine and sell it as formulated Prozac.

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