47 replies to this topic

[chriskuo]

Sue, 

 

Your $285 monthly cost in catastrophic phase implies that your insurance company is paying about $5,700 per month (using 5% max copay).  Based on this, the drug company is making a significant concession from the list price so the meaning of list price in the US is very elusive.  Also note that the government pays a significant chunk of the cost in catastrophic phase but the insurance plan picks up part of the cost.

 

In most countries, the government negotiates prices for the drug and usually sets low costs for the patient.  For people under 65,that means that the government is paying much more of the drug cost than in the US.  In the US, the subsidies come mostly in the form of tax deductions for employers and employees and now the ACA offers tax credits for middle or lower income people.  For people under 65, the majority of the costs are paid for by employers and individuals, except for the poor who are eligible for Medicaid.

[Buzzm1]

The title "price gouging" implies that the drug companies are over-charging US patients.  What the chart shows mostly is that other governments are negotiating lower prices.  Some of the difference may be related to lower incomes in the other countries, but if our representatives allowed the government to negotiate prices, the prices in the US would be much lower.

 

Chris,

 

All I know is:

Imatinib was priced at $30,000/yr. in 2001 when it was first introduced

Imatinib was priced at $47,000/yr. in Oct., 2009 when I was first diagnosed

and that, Imatinib is now priced at around $120,000/yr.

Call it what you will.

 

Buzz

[chriskuo]

Imatinib will be generic next year.

[SUE]

Chris,

 

It seems to me that regardless of the way that who pays what is described, the economy as a whole suffers, and the ordinary middle class citizen winds up bearing a great deal of the cost.  The employer who pays more will presumably hire fewer people and/or raise his or her prices.  The insurance company that pays more will presumably raise its rates.  The government that pays more will presumably cut back on important services.  The person with cml worries that life-saving medication will soon be priced beyond his or her ability to pay.

 

Others have described the price increases that have occurred.  They truly boggle the mind.

 

There is just no excuse.

 

Sue

[chriskuo]

The American health care system is a crazy patch work of plans and policies. I agree that the system needs further reform.

Citing list prices doesn't mean much because i doubt there is any patient who pays list price. Most patients with good insurance have copays that range from several hundred to several thousand dollars per year. Patients without good insurance have various charity sources and programs from drug manufacturers. Patients on Medicare Part D can be in the most difficult position because their copays could be relatively expensive for somebody on limited income and the government forbids drug companies from helping people on Medicare.

The main point I would like to make is that there is a lot of unwarranted bashing of drug companies. They are playing by the rules that the legislators have enacted. Americans have been very slow to push for changes in the health care system.. Look at the backlash to modest changes implemented in the ACA.

[snowbear]

I'm pretty lucky in that I have fantastic insurance through my work (court system) and my supplemental cancer policy pays my co-pays so my out-of-pocket expense for Gleevec is a big fat $0.  As long as I maintain my cancer policy (which I can keep should I stop working or retire), I will never have to pay for my CML meds.   So glad I got it !!  

[AllTheseYears]

Call it what you will?  It's called profiteering.  Novartis made a fantastic return on its less-than-usual investment in Gleevec in the first few years it was on the market.  The constant jacking up of the price is due to what the company cavalierly has described as "demand," i.e. it keeps people alive so we deserve to make more profits for our investors.  Novartis has aggressively fought for its patents and profits in courts all over the world and has been particularly successful in America, where the current political climate favors big corporations at over the little guy at every turn. (India's Supreme Court has ruled against the company.)  In the USA  meanwhile, Novartis reps direct treatment away from Gleevec to more expensive TKIs - even for patients for whom Gleevec works well (like me) - before the drug goes generic. Novaratis also was successful in stalling Gleevec's going generic in USA courts until the current, pushed-back date.  Novartis labors tirelessly to restrict Gleevec's availability and discredit generic brands.  Novartis' history of Gleevec sales manipulation and pricing is well documented online, if anyone wants to check it out. 

 

So, while I have no problem with big pharma making a profit (it should),  we all should have a problem with profiteering at the expense of cancer survivors -  and the American public.  

 

How does Novartis get away with it? Americans generally don't know what's going on, we trust our leaders to look out for us (big mistake since they have refused to let government negotiate drug prices, among other things), and we remain silent. 

[Buzzm1]

Call it what you will?  It's called profiteering.  Novartis made a fantastic return on its less-than-usual investment in Gleevec in the first few years it was on the market.  The constant jacking up of the price is due to what the company cavalierly has described as "demand," i.e. it keeps people alive so we deserve to make more profits for our investors.  Novartis has aggressively fought for its patents and profits in courts all over the world and has been particularly successful in America, where the current political climate favors big corporations at over the little guy at every turn. (India's Supreme Court has ruled against the company.)  In the USA  meanwhile, Novartis reps direct treatment away from Gleevec to more expensive TKIs - even for patients for whom Gleevec works well (like me) - before the drug goes generic. Novaratis also was successful in stalling Gleevec's going generic in USA courts until the current, pushed-back date.  Novartis labors tirelessly to restrict Gleevec's availability and discredit generic brands.  Novartis' history of Gleevec sales manipulation and pricing is well documented online, if anyone wants to check it out. 

 

So, while I have no problem with big pharma making a profit (it should),  we all should have a problem with profiteering at the expense of cancer survivors -  and the American public.  

 

How does Novartis get away with it? Americans generally don't know what's going on, we trust our leaders to look out for us (big mistake since they have refused to let government negotiate drug prices, among other things), and we remain silent. 

Lobbying Spending Database http://bit.ly/1M1K7Qf

 

EZ Contact Congress http://bit.ly/1a2QiUB

 

Lobbyists http://bit.ly/kjcTzs

 

BIG PhRMA http://bit.ly/msN6D4

 

fixing healthcare, first things first http://bit.ly/176OIxM

[chriskuo]

AllTheseYears,

I don't think you or I know the legal definition of profiteering in this context.

Most of us have relatively modest co pays.

You are right that many Americans (who do not require expensive drugs and/or have employer insurance) were quite satisfied with the status quo until ACA starting rocking their boat.

It is going to take a concerted effort to push politicians toward a more society-based solution to health care.
The drug companies will not be a match for an educated electorate. The criticism of drug companies drives away supporters.
If you read the comments on this topic on WSJ.com, there are many who consider these attacks on drug companies as the work of wild-eyed socialists.

[Buzzm1]

Drug Companies Are Gouging Cancer Patients, Top Doctor Says http://thkpr.gs/3664581

[chriskuo]

When people are done bashing drug companies, they could do something useful, like pushing their representatives to allow the government to negotiate drug prices with the manufacturers, which is what happens in almost all other developed countries.

 

Blasting drug companies may make some people feel better, but it is completely useless as a strategy for making drugs more affordable.

What exactly does blasting drug companies accomplish?

 

In another article, the Dr who made the speed quoted in the article said one of the most effective things that could be done is to allow the government to negotiate prices.  That is quite a bit different from the impression left by the headline on this article.

[Gail's]

I just talked with the pharmacist at kaiser today. He verified that it's 9k a month for my 30 day 400 mg supply. When I brought up that kaiser negotiates for better prices, he said that's true of generics when many companies produce the generic form. But as long as a drug is still under patent, the company producing it can charge whatever they want. He told me about another cancer med that was $500 per dose (not per month!) and when it went off patent the price dropped to $15 per dose. He's hoping the same thing will happen with gleevec. I wonder if there will be much reason for other companies to manufacture it. What would the incentive be to produce it if the price drops so much?

[Buzzm1]

Gleevec pricing at Kaiser

 

Gleevec 400mg X 30 = $9,871 =  $329/tablet

Gleevec 100mg X 90 = 300mg X 30 = $8,221 = $274

 

surprised at the cost disparity between 100mg and 400mg on a per mg basis

 

if a person was going to take 200mg, and concerned about cost,

breaking a 400mg in half would amount to a considerable savings

[stearnsdeb]

If u need help with the cost of the med's checkout PSI.com they have assistance for qualified people it is based on ur income that u claim on ur taxes. They have been help me for 9 years along with my Humana I haven't had to pay anything out of pocket. If I didn't have there help I couldn't get the gleevec I live on social security disability.

[chriskuo]

Gail,

 

In a recent presentation, Dr Shah said he guessed (only a guess) that generic imatinib would be 30-40% the cost of Gleevec.

[Buzzm1]

Novartis has been increasing the price of Gleevec twice a year, at least since I was first diagnosed in October, 2009.

In that Novartis last increased the price in February of this year, another price increase is likely in August.

 

Novartis Gleevec

$30K/yr. 2001 intro

$47K/yr. 10/2009

$120K/yr. 02/2015

is there yet another price increase close at hand?

Generic 02/2016 at 30-40% retail? 

 

The best health care system in the world? Nonsense! http://www.publicint...-world-nonsense via @PublicI

And we are still buying the pharmaceutical industry's argument that if Americans don't keep paying more for prescriptions than anyone else on the planet, drug companies—which have gargantuan profit margins­­—won't be able to keep developing the drugs we need.

To understand how foolish we are, let's consider the war of words that recently erupted between health insurers and drug companies.

First, though, let's take a look at a new study that compares how much Americans pay for prescription medication compared to what folks in a few other industrialized countries pay.

[chriskuo]

I think all of us on this board understand that Americans pay more for patented drugs than anybody else in the world.

 

The key factor is that the political party to which most Federal representatives belong is dead set against allowing the Federal government to negotiate drug prices with manufacturers, which is standard in almost all developed countries.

 

Change will result from political action, not by tarring drug manufacturers (which have a strong lobby, but are not a match for a motivated citizenry).  

[MACELPatient]

Massachusetts has a law the requires Oral Chemotherapies to be covered similar to older, less expensive IV therapies.  As such, most of those therapies are covered in this State and I have had a $0 copay in about 2 years now.  It's been nice.  If I had no coverage it would run about $10k/mo based on the statements I receive from my Provider.

[Buzzm1]

The issue is not about how much our copays are, or aren't.  The issue is about the outright greed of Big PhRMA, Novartis, in this case, continually increasing the price of Gleevec in the U.S., driving our healthcare costs ever higher, raising insurance costs and increasing the burden on U.S. taxpayers.  

[chriskuo]

Buzzm1,

 

You are missing the point.  

 

Our lives are worth more than $100,000 / year.  Almost nobody in the US is paying anything close to that for the drug.

 

Ranting against so-called profiteering does absolutely nothing to reduce drug prices.  It makes no sense to complain about how evil drug companies are and then expect them to lower drug prices out of the goodness of their heart.  I understand that ranting makes you feel better, but I am interested in a practical way to attain lower drug prices.

 

 What will reduce drug costs is letting the government negotiate prices with the drug companies.  However, I don't think you want the government to negotiate them too low because we want research to continue for treatments and cures for CML and other cancers.

How much should society be willing to pay for a year of our lives?  That is the question.  I don't see any scenario in which the patient will be paying most of the cost of these drugs.