Registered: 09/27/00
Posts: 19130
Loc: Sacramento, CA, USA
I realize this could get political, and should rightly get flushed if it does...
But I'm just flabbergasted about prescription drug prices. Last year my kid's dermatologist prescribed an acne gel called EpiDuo that worked really well. I was paying about $40 for a month's supply at the local pharmacy, and didn't think much about it. But we were in the 90/10% phase of my high-deductible health plan, so the insurance company was paying $360 to my $40.
Went to get it refilled the other day. New year, new deductible. So I was taken aback then the pharmacist told me it would be $409, so I refused it and called the doctor to request a less expensive alternative.
An hour or so later I got a call from a "Choice Pharmacy," who said they had received 3 prescriptions for my kid from this dermatologist. For the drug in question, they said they could have it delivered to my house in 2 days for a total of $30. It would have been only $3 if I had not been in the deductible phase of my insurance plan.
I asked how this was possible, and they told me that they specialize in dermatological medications, so they can offer a "coupon price." That's a hell of a coupon... 93% off. When I searched for it on line, the manufacturer's site says the average US price without insurance is $280.
Seems like there must be some really shady price-fixing going on. Anyone know how this stuff works?
_________________________ "Bobby, I'm sorry you got a head like a potato. I really am."
I Have a lifelong friend who became a pharmacist. He told me they can mark up prices over a 1000%. Thats right a 1000%. They say its for R&D. Imagine the tax base on that. A patent on a drug is not very long. But the company who patents it can dictate the price. After the patent elapses a Generic brand can be put on the market. As far as I know the composition of the drug is identical. My wife's diabetic drugs are ridiculous in price. Its made in France. Canadians can get it much cheaper than the states. Someone always wants a piece of the pie. Wanna live! Pay me!!
_________________________
Want Really High Speed Internet? Go to Hong Kong! What I know,I know! Its What I dont Know Thats a Problem! Never let an electrical engineer near a telescope or an astronomy book. They may end up correcting the astronomy book!
Yes I do. Unfortunately, it's nearly impossible NOT to politicize it.
The cheat sheet for an individual is ALWAYS ask what the cost of EVERY medical treatment is, and make the decision based on whether you would pay the cash price--ignoring what your copays or deductibles might actually be.
Insurance, or at least the paradigm of "health insurance as something that pays for all of our health care needs", is the problem. The easy analogy in the US is car insurance. Do you make a claim when you get the oil changed? When you need new tires? What about when the timing belt needs to be changed?
Health insurance in America HAS to change. It's the problem--not the solution. You either go single payer socialized medicine (which would get my vote in a heartbeat)....or you move insurance to literally change to mean "if you get cancer you won't have to declare bankruptcy"....otherwise--all the kid's acne meds? And the trips to dermatologists? 100% paid for in cash by you. As a distant third, you could turn it ALL over to the "free market" (or illusion of)--but, then ,yes you run into people making a living scamming the desperate and dying--and who the fuck wants to live in that world, when it's so easily avoided?
I'm laughing at this thread....I have been receiving 100% coverage through the VA for years....until this month.
I finally got so fed up with it that for the first time in...ever...I enrolled in fully paid regular healthcare because I'm fucking done dealing with the VA.
For years now I would hear about people's random easy in and out doctors appointments and getting surgeries like it was just a thing that had to be done...but just that it was expensive.
Free isn't worth it. The lower the cost the lower the quality of service....that's how America works in case you all didn't get the memo.
Take one single trip to the Detroit VA ER....that shit will change your life. It's basically on par with a field hospital from the civil war.
You guys are worried about Politics?
Right....Obama didn't fix it and neither will Trump, so every last one of you can just get over that shit.
Registered: 06/10/99
Posts: 20876
Loc: 3rd Stone From The Sun
Originally Posted By: Xenophile
I asked how this was possible, and they told me that they specialize in dermatological medications, so they can offer a "coupon price." That's a hell of a coupon... 93% off.
And probably a generic form made in India. But if so, don't feel bad, India is a pharmaceutical powerhouse and not only do many of the generic meds in the US come from India, name brand can also. FWIW, I have dealt directly with India (that's where your "Canadian" meds are coming from too) have had nothing put very positive experiences.
The patent on medications is 20 years. Then, the company comes up with a variation with no generic, pedals that, often with major coupons, until people are sold on it as must have and will pay the extra money because they've been brainwashed (your doc isn't helping if he's giving you samples of such meds, he's just been bought and is part of the problem).
Originally Posted By: GAMBLE
I finally got so fed up with it that for the first time in...ever...I enrolled in fully paid regular healthcare because I'm fucking done dealing with the VA.
For years now I would hear about people's random easy in and out doctors appointments and getting surgeries like it was just a thing that had to be done...but just that it was expensive.
Free isn't worth it. The lower the cost the lower the quality of service....that's how America works in case you all didn't get the memo.
And a single payer system would be like that (that's what the VA is)....only you'd still be paying.
Who wants a monopolized, government run insurance plan? One of the big problems is not enough competition.
Originally Posted By: GAMBLE
Right....Obama didn't fix it
No, it is worse.
Originally Posted By: GAMBLE
and neither will Trump
Fix it as in great? How we want it? Agreed....it's not getting fixed.
Fixed as is repeal certain aspects of ACA, such as mandatory Major Medical or there's a penalty, which gets paid at tax time, where you pay for the people who don't pay (much) and love Obamacare?
That can been done.
But again, I think Gamble is correct.
To make it what we want, we'd probably have to ask India to teach Mexico and then allow them, together to practice and create major competition.
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MadGuitrst has left the building....but not before committing acts designed to offend the senses....
"Seek first to understand, then to be understood." - Dr. Stephen R. Covey
While I cannot speak to the situation of the VA in Detroit, the reports that I get from clients in Oregon and Washington is that they are very happy with the service they get from the VA Hospitals in Seattle, Portland, Roseburg, Eugene, Salem. For work, I often have to review medical records and the records and treatments I see coming from the VA are absolutely on par with civilian facilities.
Indeed, I am aware of some older veterans getting treatment for HCV (Hepatitis C infection) through the VA, a course of treatment leading to cure that normally in civilian life costs about $100,000 (the drugs themselves cost about $85,000) and they are quite happy with the treatment they get.
This was not always the case. I know a lawyer who pre-Obama made a fine living suing Madigan Army Medical Center for malpractice, as they were regularly crippling, injuring or killing patients in egregious cases that would make the papers. No more. Under Obama, it was a new regime and Ted hashad to moved to another area of law.
As for Maskovitch, he is deliberately misleading you folks. His misinformation is what happens when he does a surface google search but fails to look deeper at the facts. Misinformation. It is really disrespectful to mislead readers in this way.
Sanders and Lobuchar introduced the proposal (to allow Americans to buy drugs from Canada where they are cheaper) during "vote-a-rama," a special all-night session Democrats organized to force Republicans to vote on a bunch of non-binding proposal changes to reveal which parts of the ACA/Obamacare they might keep. Do you get that --- these were not real votes on real legislation that would change laws, but for getting a read on what the GOP is planning to do to Obamacare.
Further, our senators (Murray and Cantwell) supported a proposal by Senator Ron Wyden's (D-Oregon) aimed at lowering drug prices. Both Washington Senators support lower drug prices and will be supporting future legislation that actually does that. The problem with the Sanders-Klobuchar amendment was that it had no protections against inferior foreign or counterfeit drugs. Any plan to allow importation of prescription medications also needs to include consumer and FDA-type protections that ensure foreign drugs meet American safety standards.
Senator Cantwell and Murray have both taken votes, written legislation, and cosponsored bills that are opposed by the pharmaceutical industry, including allowing the government to negotiate lower prescription drug prices for Medicare beneficiaries.
And, by the way, Americans can already get drugs from Canada by Internet ordering or by driving over the border. Folks in WA drive to Canada for cheaper drugs, folks in southern CA drive over the border to Mexico for cheaper drugs. All legal.
Anyway, anybody can call their Senators and ask about these things instead of spreading misinformation.
Funny, here in the USA it's totally illegal for a citizen to purchase any prescription drugs from another country, while it's perfectly legal for companies to purchase those same drugs from any country it wants to. We know that is a scam.
_________________________ My wife just left me. Probably because I'm so insecure... Wait, she's back. She just went for a coffee, my bad...
But don't tell Skywave that.....she's done a google search and now is an expert and thinks it's perfectly legal to purchase drugs online from foreign countries or transport drugs across borders from foreign countries.
That's great Arthur, unfortunately we have people in charge congressional, if it doesn't get too political, that are just taking the people for whatever they can, and get huge kickbacks from the pharmaceutical companies. Both sides of the isle appear to be involved. It's a fleecing of America so to speak.
_________________________ My wife just left me. Probably because I'm so insecure... Wait, she's back. She just went for a coffee, my bad...
Registered: 04/22/99
Posts: 9877
Loc: a Mac of some kind
I get that, and it makes me sad. Let's just say, we live in different worlds.... there are things I envy Americans of, on the other hand, there are things I find better here... the ideal world I guess, would be a combination of both... utopia??
But I'm just flabbergasted about prescription drug prices.
you are just now figuring this out?
don't you know that's why obama kick started the whole thing with the affordable care act? trying to reign this in? if the republicans repeal the ACA without something BETTER, this will get so much worse.
But I'm just flabbergasted about prescription drug prices.
you are just now figuring this out?
don't you know that's why obama kick started the whole thing with the affordable care act? trying to reign this in? if the republicans repeal the ACA without something BETTER, this will get so much worse.
Sorry, but I must dissagree. What was done, was one fifth of our economy was taken over by our government. We are paying much more for insurance now. There is nothing affordable about it. Just a government grab for more power and control over the people.
_________________________ My wife just left me. Probably because I'm so insecure... Wait, she's back. She just went for a coffee, my bad...
The lower the cost the lower the quality of service....that's how America works in case you all didn't get the memo.
This is about the cost of drugs not medical services! Too many people want a piece of the drug trade. Drug companys are like any other company too. They sit in their boardrooms trying to maximize profits. Which is another one of my pet peeves. No one person should be allowed to be worth more than 1 billion. Period!! Yet we have 100 multi billionaires who control almost a Trillion dollars. Thats not free enterprise thats just plain greed.
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Want Really High Speed Internet? Go to Hong Kong! What I know,I know! Its What I dont Know Thats a Problem! Never let an electrical engineer near a telescope or an astronomy book. They may end up correcting the astronomy book!
obama has done more about the state of healthcare in america than anyone before.. and apparently anyone to follow.
at least he tried to get something happening, but lobbyists push politics.
why are drugs so expensive here?
government-protected “monopoly” rights for drug manufacturers is the reason drugs are so expensive.
drug companies set their own prices. it's not like that anywhere else in the world.
the patent system keeps generics from coming to market. the FDA is totally slack in approving generics. stupid slack. states make pharmacists have to get patient consent before switching to generics.
R&D, folks like to roll that out as an excuse, but it's an empty excuse... companies only pay about 10-20% of revenue for R&D, so it's not that.
But don't tell Skywave that.....she's done a google search and now is an expert and thinks it's perfectly legal to purchase drugs online from foreign countries or transport drugs across borders from foreign countries.
The reality is that lots of people from Washington state simply cross the border into Canada to buy things there that are a better bargain, including medications. I have done it myself. And folks I know in San Diego drive to Mexico to buy medication. Because Canada and most other civilized nations impose price restrictions and limit what pharmacies can charge for drugs, the cost of a brand-name medication sold in Canada can be as much as 60% less than what the same costs in the USA.
As for legality, it is a bit of a gray area. The FDA does not like it and BigPharm likes BigProfits. Yet, when US customs has found medicine bought in Canada, they did not seize it, you just tell them it is for personal use and all is well. And when I am travelling in Europe or elsewhere, I buy drugs there, not illegal. Duh.
It is illegal to REIMPORT into the U.S. prescription drugs that have been manufactured here and exported to other countries, or to bring in substances that are banned under U.S. law ----except when you've got a prescription. Customs looks the other way, nobody wants to be busting old folks for getting medicine.
And by the way, the US House of Representatives has passed three versions of bills that allow consumers to import legal drugs for personal use. A similar measure died in the Senate. Congress really needs to deal with the drug price situation.
By the way, it was also what Ron Woodruff, the subject of The Dallas Buyers Club would do --- go to Mexico to get anti-AIDS drugs.
Registered: 09/27/00
Posts: 19130
Loc: Sacramento, CA, USA
Originally Posted By: MadGuitrst
Originally Posted By: Xenophile
I asked how this was possible, and they told me that they specialize in dermatological medications, so they can offer a "coupon price." That's a hell of a coupon... 93% off.
And probably a generic form made in India. But if so, don't feel bad, India is a pharmaceutical powerhouse and not only do many of the generic meds in the US come from India, name brand can also.
Well, the pharmacy rep on the phone assured me that it is the name-brand medication. I talked with the dermatologist's PA the other day, and she gave me the same explanation about how this pharmacy specializes in dermatology. It still sounds fishy to me.
Many of my co-workers are from India, and they all go back home for medical procedures whenever they can. Even though it is covered as "out-of-network" by our company-sponsored insurance, the savings far out-weigh the co-pay. Plus, they feel strongly that the quality of care is better than we can get here in the US. They only take treatment here if it is an emergency or they can't afford the time to travel. My manager's manager recently had some serious knee surgery done for less than 10% of what it would have cost here.
_________________________ "Bobby, I'm sorry you got a head like a potato. I really am."
They will do anything to stop you from going back to the doc for a cheaper and likely just as effective alternative. It's not like they're losing money on YOU....you're not going to pay the inflated price, thus--if they just get you using it--and more importantly not making waves with the prescribing doc....they "win".
Think about it--most people have insurance that isn't high deductible....so if 9/10 of those RXs that doc writes are filled at that original price....and they have to sell one at what is likely the price of the older mature therapy....they are better off than if you call back and potentially other call back....and that doctor writes 10 scripts for the inexpensive option that works fine.
Now take that principle and spread it over a whole nation of doctors and kids with acne.
Registered: 09/27/00
Posts: 19130
Loc: Sacramento, CA, USA
That makes sense. Also explains the "coincidence" that the inexpensive pharmacy called me shortly after I had called the doc to request a cheaper alternative. The prescription was written a couple of weeks ago, and at that time the doctor did not steer me to the inexpensive pharmacy that apparently received the prescription at the same time that my expensive pharmacy did. If I hadn't had the high-deductible plan, I likely wouldn't have questioned it, and $400 would have changed hands instead of $30.
This system stinks.
_________________________ "Bobby, I'm sorry you got a head like a potato. I really am."
More than stinks. Its along the lines of being criminal!!
_________________________
Want Really High Speed Internet? Go to Hong Kong! What I know,I know! Its What I dont Know Thats a Problem! Never let an electrical engineer near a telescope or an astronomy book. They may end up correcting the astronomy book!
Registered: 07/11/01
Posts: 29784
Loc: Westborough, MA, USA
Originally Posted By: Xenophile
Originally Posted By: MadGuitrst
Originally Posted By: Xenophile
I asked how this was possible, and they told me that they specialize in dermatological medications, so they can offer a "coupon price." That's a hell of a coupon... 93% off.
And probably a generic form made in India. But if so, don't feel bad, India is a pharmaceutical powerhouse and not only do many of the generic meds in the US come from India, name brand can also.
Well, the pharmacy rep on the phone assured me that it is the name-brand medication. I talked with the dermatologist's PA the other day, and she gave me the same explanation about how this pharmacy specializes in dermatology. It still sounds fishy to me.
Many of my co-workers are from India, and they all go back home for medical procedures whenever they can. Even though it is covered as "out-of-network" by our company-sponsored insurance, the savings far out-weigh the co-pay. Plus, they feel strongly that the quality of care is better than we can get here in the US. They only take treatment here if it is an emergency or they can't afford the time to travel. My manager's manager recently had some serious knee surgery done for less than 10% of what it would have cost here.
This really depends on where you're going. I have some seen some incredibly bad hospitals out there in the wide world. That said, medical tourism is definitely a thing. Southeast Asia is a very popular spot for getting things done for not a lot of money, Thailand in particular, that I remember.
_________________________ The internet, and the whole technology sector on which it floats, feels like a giant organ for bullshittery—for upscaling human access to speech and for amplifying lies. - Ian Bogost
Professor Truth T. Sweetness says,"Mind your manners!"
The medical tourism thing is growing, India is where people go for cardiac surgery, Thailand for plastic surgery and sex-reassignment surgery, cancer treatment in Singapore, Brazil for plastic surgery, Malaysia for in vitro and fertility issues.
I personally would be reluctant to have medical care somewhere that I did not speak the language. Like flatcat, I have seen some pretty horrible facilities in some countries. If I was going to travel for medical procedures, I would pick Germany, France or Britain.
