Should Medicare be allowed to negotiate drug prices?
 

Seeing a new add sponsored by PhRMA stating that allowing Medicare to negotiate drug prices will reduce availability of drugs. I think that might be a fib but wonder what others think. I know drug prices are very high for many Tier 4 and 5 drugs when on Medicare.

S.99 - Medicare Drug Price Negotiation Act
116th Congress (2019-2020)

Someone needs to!

Not likely....too big....too influential.....too much $$$$....

It is disgraceful that big pharma lobbyists are able to buy enough people in DC to make us pay the highest drug prices in the world.

Not on Medicare yet.

Something needs to be done about pricing. Doctor presribed two heart medcines to me one of which is Eliquis(can not miss their TV adds) and three months supply was $1300. Could buy it through Canada at 1/3 the cost, but had to be ordered. Shopped around and all regular US pharmacies were very close in price. Was told by my insuror that I had to pay full price since I did not match my deductible

Another drug was $1800 for 3 months. Canadian price is 1/3 of that cost. Pharmacist at Publix gave me information on coupons and saved at least 50%. Now some of us(under 65) need to clip coupons to get reasonalbe priced prescriptions.

Have always said insurance is good until you become sick.

I find it amusing that the Government is the reason on for high prices, and now people want the Government to reduce the prices.

For $ 50,000 we can buy our own Congressional rep for one 2 year term and for 100,000 for life. What can we expect when the people who supposedly work for us are bought and paid for by lobbyists.

And we stupidly keep reelecting the same people.

If there is any issue we should pay attention to regarding who votes which way this is one. You can follow those things and let your congressional representatives know you are and how you feel about it. Our form of government does require an educated public. I just don't know if in fact this would reduce availability of drugs like Eliquis. I have used a Canadian pharmacy for the first time in my life for this drug and
another called Jublia, both of which are ridiculously expensive if you're on Medicare and in the donut whole.

Another reason to do this is that Medicare is going to run out of money in a couple of years. Reduce drug cost and medicare can stay solvent longer.

You may be making a potentially costly mistake. While you are in what used to be called the donut hole you do NOT pay the retail cost of the medication. Rather:

For Eliquis, the retail cost of 3 months is about 1500. But you will only pay 25% or 375. That is likely not much different than your Canadian cost. Purchases via a Canadian pharmacy, thus outside your Medicare plan, also do not count toward getting out of the coverage gap. For that 1500 Eliquis, 1425 would be applied to your getting out (95%)

You need to look at not just the cost of the medication but the overall result of paying your 25% on the big picture. I might also add that Jublia is a not covered medication in some Medicare plans as it has a very low complete cure rate, only about 10 to 15% better than placebo when using it every day for an entire year on nails where only a maximum of 50% of the nail was involved, the easier cases to cure. [see also table 2 in the link from the package insert] It did slightly better [additional 5%] if you define cure as mostly better. So if you are self paying, you may want to balance the cost against the likelihood of benefit. Photo from the manufacturer's website:

Canadian cost was $163 for 168 tablets, slightly less than a 90 day supply of 180. I think I will save some money using the Canadian Pharmacy. Let's just shed some light on these drug pricing practices. It seems the issue is as convoluted as they come by BIG PHARMA.

OP, Can you ask your doctor if there is a less expensive, but as effective, alternative?

It's not convoluted to me. The drug companies are ripping off the taxpayers to make a lot of money. It seems pretty simple.

So you don't think it would help if Medicare started negotiating what they can charge? Why is a drug like Eliquis available for so much less in other countries?

I support Medicare being allowed to negotiate prices. But the proposals being suggested which despite overwhelming public support, may still not have enough Congressional support are weak tea. They are only suggesting negotiating for a very narrow number of medications.

I did try to find out my Senator's opinions on Medicare negotiating drug costs.

I will remove the names to avoid the prohibition about political postings

From 2016 [last time I can find something from this Senator]
I cannot find a statement from my other Senator on Medicare negotiating drug prices. There must be one as this is a very commonly discussed topic in Florida. His opposition when he ran did in one of their releases say that candidate [redacted] opposed allowing Medicare negotiations but no link to that position.

I'm in favor of anything that will reduce the prices. But, anytime the Federal Government pays for anything, they pay too much.

Eliquis is not available for a lot less. The difference is that other countries do not follow US patent law and make generic drugs available much sooner. He is getting generic Eliquis which is very likely totally fine. Big Pharma has gotten very good at getting its US patents extended over and over.

Generic Eliquis was actually approved by our FDA, but because of the patent it cannot be sold here. The patent on the medication expires in 2026, that is the actual ingredient. But the patent on the manufacture of the drug lasts until 2031 in the US

It does say Eliquis on the packaging and the drug companies name is on the package. I get what your saying though. Seems we have multiple Federal agencies who can be influenced. No wonder drugs are so expensive. :)

According to H.R. 3, the Sec. of HHS would be allowed to negotiate rates on at least 50 brand name drugs per year without generic competitors. These rates would then also be available to commercial insurers.

One of the major reasons why drugs are so expensive is R&D. The drug sector is second only to the tech sector in R&D costs as a percentage of revenue. Restricting that revenue can stifle innovation if the drug makers know they won't get their money back which can, in fact, result in shortages if the drug maker restricts the amount they produce in response to losing money. I'm not defending the drug makers, just pointing out that, like any other business, they could scale back in response to decreased revenue.

As I understand it, the Medicare Part D law was deliberately designed to prohibit the Medicare administrators from negotiating directly with the drug companies on drug prices. So, it was Congress (and the drug lobbyists) that didn't want Medicare to save money on drugs, not the agency that executes the Medicare Part D law.

That's the big joke, really. The Pharmaceutical industry has enough money to buy legislation, to keep their prices high.

But if they'd just stop spending all that money lobbying, they'd profit AND be able to keep their prices down, at the same time.

Also, I am against medicare being able to negotiate prices. The lower the price to medicare recipients, the higher the price for everyone else. MOST Americans don't qualify for Medicare, because MOST Americans are under 65 years of age.

The prices for drugs are through the roof in all sectors, people are rationing their meds, not taking as many, or taking lower doses than their doctor says they need, just to make their prescription last until they can afford a refill.

This phenomenon isn't exclusive to senior citizens. But if seniors get a break on the price, you can BET those Rx companies will make up that loss by raising the prices to everyone else.

What we need to do is - yup - that really bad evil horrible concept - socialized medicine. Which is what Medicare is anyway, but the word creates a knee-jerk reaction and trigger to some folks I guess.

The COUNTRY needs to negotiate prices with the pharmaceutical companies. The COUNTRY needs to mandate that insurance companies allow their insured members to get their meds from Canada, Mexico, and India (where many of their generics are manufactured). This needs to be done on a national level, not just from one company to another, or one segment of the population to another.

I agree ! The Wrong people are making all the money in this world right now. It's not the people devoting their lives to developing cures or even the doctors working 80 hours a week. Greed is such a powerful force. I digress. :pray: One solution at a time?

Eliquis in the USA will cost you about $1400 for 180 (2.5 mg) tablets. It’s manufactured by Pfizer

In Canada the Eliquis will cost you $481 for 180 (2.5 mg) tablets. This is Eliquis marketed by Bristol Myers and is NOT a generic. Bristol Myers and Pfizer have a comarketing agreement in Canada for Eliquis and is marketing Pfizer’s Eliquis.

So the nongeneric prescription for Eliquis that cost you $1400 in the USA will cost you only $481 in Canada.

US consumers are paying for the drug development costs … and the rest of the world is getting a free ride. Why should Medicare or any US consumer not be able to access Canadian pricing for Pfizer’s Eliquis?

Some of the rest of the world has no access to some of these meds at all. Other parts of the world have cheaper prices because they have fully socialized medicine, and the government negotiates the prices with the pharmaceutical companies. The industry is profitable here, because this country (the USA) chooses to allow the market to determine its own prices, AND because we rely primarily on private insurance for the general public. Even with Medicare, you have to choose which profit-making company will provide your coverage. This just isn't really the case in many other first-world countries.

When selling drugs to consumers via medicare the drug companies set the price. Only in America would the govt allow the fox to control the henhouse.

Medicare isn't a singular thing. It's a collection of insurance companies that have agreed to specific benefits for their older insured members with specific guidelines and assorted options and fees. It is a collaboration between government and insurance companies.

The Rx industry is no different from any other profit-making industry when it comes to pricing. They set the MSRP for their product. They can negotiate lower prices, they can run specials and deals, they can offer coupons and discounts, but their MSRP is their MSRP, take it or leave it.

Just like the MSRP for your car is what it is, it's set by the manufacturer. The dealer you buy your car from might have incentives to lower their asking price, but if they don't, then the price on the sticker is the price dictated by the manufacturer.

Same as the can of beans on the shelf. If the store has a BOGO price, it's because the store has worked out a deal with Bush Beans for that week. The store isn't just being generous, or got too much and trying to get rid of overstock.

Rx is no different. They set their MSRP, and if you have insurance, you might get a discounted price. Or you can try GoodRx or any of the other discount programs. Or - you can write to the pharmaceutical company and ask for a discount. You can usually get coupons if you ask them.

This is just how it is when you live in a country that promotes capitalism above all else. It has its benefits - to those who can afford to enjoy those benefits. For everyone else, not so much.

Politicians are corrupt
 

Why are lobbyists legal? It seems politicians are out for themselves- they are all rich, power hungry and NOT for the people. Social media is allowed to cancel FREE SPEECH AND NOTHING IS DONE ABOUT IT. People need to wake up stop complaining and DO SOMETHING.

Half the money they take in on sales goes goes straight back to MSM….. talk about a vicious cycle….

Late in the Clinton administration (1999), the government passed legislation prohibiting itself from negotiating prescription drug prices for Medicare. An obvious kowtow to the drug industry. This explains why up until recently I’ve been paying $255 for a vial of insulin under Medicare but chose to buy it in Canada for $35. Buying outside of the Medicare system saved me $4,500 a year. HR 4680 Medicare RX 2000 Act, Section 201.

We don't vote for competence, we vote to hear our opinions parroted.
.

This link is to an article about part D. VERY interesting reading. According to the article, big pharma spends 19 times more on advertising than R&D. Why are they allowed to advertise drugs to consumers
who may not understand all the implications. I really wonder about that when I see adds for drugs
like Humira or Eliquis.

Access Denied

No one can "lower drug prices". But it is possible to change who pays the most and the least. I have an idea, let's require drug companies to sell to US consumers at their lowest world wide price. So if a drug is $1 a dose in Canada, that's what they have to sell it for here. Of course, someone else has already thought of that and tried...

The pharmaceutical industry's argument against allowing negotiation is that lower prices will lead to less research and development and therefore fewer breakthrough, life saving drugs.

The truth is that we Americans are paying for the full cost of R&D and most other countries are only paying the marginal costs of actually producing the drug.

The best and simplest answer is for the US to allow re importation of medications creating a "world price" and spreading R&D costs to all customers.

????

OrangeBlossomBaby,
Insurance companies are not restricting importation of drugs, the FDA does not allow it.

I started this thread to get peoples opinions on Medicare being allowed to negotiate drug prices and the current legislation. I don't care who is responsible for "why not".. I just want to watch carefully if it continues with this current bill in congress and WHO and WHY. Maybe one of those representatives will not continue to be because they vote against it.

Ohiobuckeye
 

Guess we’ll just have to suck it up, 🤪!

This is incorrect. Medicare is a government program. They determine the benefits and rates, both for the beneficiary and provider reimbursement rates. Instead of creating a government claims processing system they contract in each state for a third party to process claims. This is often the Blue Cross plan in that state.

Big Pharma desperately wants YOU, through your health insurance, to keep being their Cash Cows. (Bear in mind that a huge percentage of us have mutual funds that are making us money by investing in drug companies, so if the government cuts what is paid, that will hurt us some because there will be less profit, but do you want to make you retirement income by gouging other Americans, as well as yourself?)

I remember a few years ago when the price of generic Doxycycline went up from $20 a month to $260. In a week. Is that because it got more expensive to produce? No, it’s because there had been several generic drug companies making it, but when some stopped, the sole remaining maker took advantage of us by raising the prices.

If the drugs are only 1/3 the price in Canada, that’s because that is the nationwide price negotiated by the Canadian government. It’s not being sold for less than the cost of making it or less than a healthy profit margin. If our legislators on both sides of the aisle refuse to do the same for us because they have been purchased by Big Pharma, they are giving a giant middle finger to all voters. They are saying, “We don’t care if you are paying $1300 a month for this medication that costs $100 to make. You don’t really matter to us. Our job is to keep drug companies happy.”

As for hospitals and pharmacies, remember that they mark up the price of drugs they sell. A 20% markup on a drug costing us $100 a month makes them $20 profit, while if it costs $10 a month, they make only $2. So of course they want the cost high, whether or not they admit it. Their profits are more important to them than your pockets.

Remember, this proposal came from President Trump a couple years ago, and President Biden is simply carrying on the good fight that couldn’t be won in a year. We should ALL get on board and pressure Congress to put WE THE PEOPLE above the drug companies.

Like most pharmacies, Medicare has a “formulary” of drugs approved because they work well and don’t cost much. They urge that these be prescribed and prefer that doctors not prescribe drugs that cost much more but don’t work any better. For example, my blood pressure is normal because I take two generic drugs that together cost about $5 a month. If I insisted on taking the latest blood pressure med advertised on TV that costs $500 a month (maybe with a big co-payment I have to pay), maybe my doctor will prescribe it after telling me it’s a waste of money for me, but my blood pressure will still be normal. So yes, maybe Medicare will point you toward cheaper drugs that work just as well. That saves you money and saves all of us money as we pay for the cost of health insurance. So don’t be swayed by the arguments of drug companies. They only care for your money, not for you.

Makes perfect sense to me. Prior admins (all of them) rolled over to pressure from industry vs pressure from the general population - big talk, no action, then "gee, I tried" is the usual pattern. We (the people) need to keep a closer eye on this attempt and make sure the politicians know that big pharma is not their client, we are. I am modestly hopeful this time, but not holding my breath.

Years ago the owner of a pharmacy that was delivering oxygen to my father said that he would sell it at a lower price but Medicare set the price (much higher) he had to sell it for.

My assumption is higher prices in the US do help fund research but why should a citizen in the US have to pay more than a citizen in another country? And that foreign country citizen could have better financial resources the US citizen.

I did have contracts with the US government and they required that I sold to them at the lowest price I offered to all customers.