Insurance and the price of drugs

@TiaG That is a frightening prospect. The government has no business " negotiating" the price of anything they don’t pay for, and the last time I checked, we don’t have a government run single payer system (thank the Lord).

What the government needs to do ( and can do) is disallow any rebates or payoffs made by drug companies to anybody other than the final consumer. This will streamline and make transparent drug pricing in this country. And likely cause prices to come down.

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They negotiate the price of $400 toilet seats rather ineffectively

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I don’t believe (but I may be mistaken) that she literally meant the “US Federal Government”…I believe she meant the US…as in, the nation as a whole (whatever components need adjusted), work to lower the prices.

But I could be wrong!

She means Medicare/aid. All insurers negotiate for drug prices except Medicare/aid which is prohibited from doing so to “protect” drug manufacturers. All other states in the world allow it but us.

yet Canada clearly is negotiating drug prices and getting a much better outcome (in terms of price) than the US.

So what’s the difference in your opinion? Is it that the Canadian government is competent and well run and ours is not?


When they sell to Canada, insurance is not in the picture. That’s why it’s cheaper.

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well, so I’m not sure, but this highly technical article seems to suggest that some of Canada’s drugs are federally purchased (those used inpatient in hospitals) but that the majority are purchased by either private employer insurance plans or provincial-level entities. Kind of confusing but it does seem like there’s an insurance middle man in some of these situations:

Actually, the price in Canada is authorized by the Canadian government, as is the case in most countries. That is probably why it is cheaper:

Pharmaceutical pricing in Canada

[EDIT] Double post, same link :slight_smile:

Please tell me you guys don’t believe that insurance has no bearing on the cost we pay here!

Certainly you know it does.

@Eric, I do believe that any time you add a middleman, you’re going to increase the cost somewhat, because that middleman needs to profit. But my guess is that middlemen increase the cost about 10 to 15%. I don’t think all (or even most) of the price differential can be accounted for by simply having insurance companies between us and the drugs.

Insurance exists as a middleman in every country. Our system is just worse than others in some ways.

Many ways…where healthcare is concerned.

If band aids were covered by insurance, they’d be about $10 each.

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Insurance isn’t just a middleman though when it comes to pharmaceuticals… they’re negotiating secret rebates which just continuously raise the list prices higher and higher with no bearing to what the drugs actually cost or how much is actually (and secretly) being paid for them (which has become a trade secret of the PBMs because the rebates they receive are confidential)… they are a driving force in the upward price escalation not merely an added layer of expense


Having lived in several other countries, I have seen first hand that other systems are cheaper (sometimes much cheaper), but also less able to deliver best-quality care. We have best-quality care in most ways, but we pay more. So not everything about it is bad, far from it. Let’s not forget that people come from all over the world to get the best care they can get – when they can pay.

I know Western Europe well. Every system in Western Europe is cheaper, but none of them gives the quality of care we have, particularly for “hard” cases.

For instance, I don’t think there is a country in Europe where the Dex is authorized for insurance (I could be wrong). For sure it is not authorized in most European countries for insurance.

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That is true.

A post was merged into an existing topic: Foreign drug import is now legal: new SCOTUS decision

well, but the outcome measures suggest that at least some of our “best care” is unnecessary. As far as I know Dex is paid for by insurance certainly in Norway. But that doesn’t mean every country pays for them.

i do think there are often worse outcomes when you come to the more serious or rare conditions (certainly UK’s NHS has been dinged for forcing breast cancer patients to take outdated, cheaper drugs when newer ones would be more efficacious). And I know that in the realm of premature babies, they certainly work less hard to save the smallest ones, for instance.

But my guess is that by improving standard care for the population, they’re reducing the incidence many serious conditions. And that when you have fewer unhealthy people in the population, that also allows you a little bit more leeway to pay for the sicker patients.

This is written by one of my old teachers. Not sure I agree with all the conclusions, but I think the charts he included are quite interesting. My takeaway is that we have more health inequality than other countries, but that people who are in some groups are getting quite good care. Good health care or bad though, no question it’s way more expensive than in other countries.

I’ve lived in quite a few countries myself, but didn’t experience the healthcare myself directly (as far as the billing/payments go) as I was in the Army; however, my daughter lives in Germany and I’m certain the Dexcom is available there (as it is in 44 other countries - which you can see here.). Although it wasn’t covered by insurance in previous years, it is now (as of one year ago.)

Concerning how cheap HC is in other countries…lots’ of other countries (including Germany) have FREE* healthcare for all…(* - the trade-off is a much higher tax rate…my daughter and x-wife pay nearly 50% in taxes from each of their paychecks.)

As far as Western Europe goes, I can really only speak to Germany…I LOVED their gesundheitsbereich (healthcare system) and had many experiences with various Krankenhäuser (hospitals - including having my daughter in one of them)), and I had nothing but the best, highest care I could have ever asked for. I’m sure you’re correct with regards to the ‘hard’ cases; however, because all of the global “smart” people flock to America because they know this is where they can make the most money.

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When I lived in Kalifornia I paid about 50% of my gross income in taxes, and healthcare wasn’t free. If it included healthcare, I’m sure it would be over 75% in this country.