The big objection to Pharma that I always see is differential pricing -- I recall a lecture on differential-pricing in relation to intellectual property by professor Wm Fisher, where you could tell he was "agin-it", but was careful to explain the arguments on both sides. Many people seem to think that even if the additional cost of making "a bit more" is small, then one should not sell at greatly reduced cost to people in needy countries -- or somewhat reduced cost to governments that have the legal ability to invalidate patents "for the public good" within their territory if they choose to.
If you hated poor-people, especially those in sub-saharan Africa and the less developed parts of Asia, then insisting that Pharma have the same prices for all regardless of quantity purchased and ability-to-pay might seem "fair".
Even within the US, most Pharma companies have well-publicised programs for providing cheap or free life-saving medications to people who need but cannot afford them. But for some reason, those greedy bastards want to be recoup all of the costs of developing and getting regulatory approval for a drug, as well as the manufacturing costs. So they insist upon charging what the developed world markets will bear, and continue to have scientists and researchers on their payroll investigating potential new drugs and treatments.
Donna, are you referring to PBMs? Like how things are on-formulary and off-formulary? That is always an odd mix- there's some difficulties there for employer-based coverage. A big employer can push for certain things to be covered, since they are paying for it. But a small employer can't, and doesn't have a lot of leverage. The big thing with those is that they're often tied (in my experience) to who they work with- so if Express Scripts and GSK and Pfizer work together a lot, the Pfizer/GSK meds will be on formulary, and something from Abbott won't be.
The "new" big thing is step therapy, which is a good way to force consumers to work in their own best interest. Basically, you try the generic, then the on-formulary, then can move to the off-formulary. That works great for someone who's just asking for the drug he's seen on TV. However, for someone who switches Rx plans often and has a chronic condition that they've managed to get under control, I could see that being really frustrating. You're basically having to recreate the wheel everytime.
Whenever I've seen a person using the phrase 'Big Pharma' they almost invariable seem convinced that drug companies primarily want to produce 'me too' drugs instead novel cures, or most of the hard work of drug development is done by universities/government agencies, or drug companies spend too much money on marketing and could really produce drugs at or near the cost of production if they stopped doing that, or some combination of the preceding, with complaints about immunization payout caps thrown in from time to time.
I really can't say that I've ever seen anybody complaining that marginal drug consumers are charged too little. Offering it as an explanation for why US drug costs are higher than that sub-Saharan (or maybe it's Asian) country called Canada is more typical.
for someone who switches Rx plans often and has a chronic condition that they've managed to get under control, I could see that being really frustrating.
Worse than frustrating, potentially. Consider someone who's had thyroid cancer. Or someone with at-last-mostly-controlled psychotic disorder NOS plus bipolar II. Months of the wrong medication as they go through the song-and-dance with a new prescriber can have serious consequences.
7 comments:
One can be purty dang certain the commenter is agin it.
The big objection to Pharma that I always see is differential pricing -- I recall a lecture on differential-pricing in relation to intellectual property by professor Wm Fisher, where you could tell he was "agin-it", but was careful to explain the arguments on both sides.
Many people seem to think that even if the additional cost of making "a bit more" is small, then one should not sell at greatly reduced cost to people in needy countries -- or somewhat reduced cost to governments that have the legal ability to invalidate patents "for the public good" within their territory if they choose to.
If you hated poor-people, especially those in sub-saharan Africa and the less developed parts of Asia, then insisting that Pharma have the same prices for all regardless of quantity purchased and ability-to-pay might seem "fair".
Even within the US, most Pharma companies have well-publicised programs for providing cheap or free life-saving medications to people who need but cannot afford them. But for some reason, those greedy bastards want to be recoup all of the costs of developing and getting regulatory approval for a drug, as well as the manufacturing costs. So they insist upon charging what the developed world markets will bear, and continue to have scientists and researchers on their payroll investigating potential new drugs and treatments.
Can I be agin Big Pharma Benefit Management Companies? Please?
Oh, you can even hate the companies. You just can't lump them together as Big Pharma and blame them for stuff they aren't doing.
I'll ask my son, who's in the benefit management biz, who you are allowed to hate on that one.
Donna, are you referring to PBMs? Like how things are on-formulary and off-formulary? That is always an odd mix- there's some difficulties there for employer-based coverage. A big employer can push for certain things to be covered, since they are paying for it. But a small employer can't, and doesn't have a lot of leverage. The big thing with those is that they're often tied (in my experience) to who they work with- so if Express Scripts and GSK and Pfizer work together a lot, the Pfizer/GSK meds will be on formulary, and something from Abbott won't be.
The "new" big thing is step therapy, which is a good way to force consumers to work in their own best interest. Basically, you try the generic, then the on-formulary, then can move to the off-formulary. That works great for someone who's just asking for the drug he's seen on TV. However, for someone who switches Rx plans often and has a chronic condition that they've managed to get under control, I could see that being really frustrating. You're basically having to recreate the wheel everytime.
Whenever I've seen a person using the phrase 'Big Pharma' they almost invariable seem convinced that drug companies primarily want to produce 'me too' drugs instead novel cures, or most of the hard work of drug development is done by universities/government agencies, or drug companies spend too much money on marketing and could really produce drugs at or near the cost of production if they stopped doing that, or some combination of the preceding, with complaints about immunization payout caps thrown in from time to time.
I really can't say that I've ever seen anybody complaining that marginal drug consumers are charged too little. Offering it as an explanation for why US drug costs are higher than that sub-Saharan (or maybe it's Asian) country called Canada is more typical.
for someone who switches Rx plans often and has a chronic condition that they've managed to get under control, I could see that being really frustrating.
Worse than frustrating, potentially. Consider someone who's had thyroid cancer. Or someone with at-last-mostly-controlled psychotic disorder NOS plus bipolar II. Months of the wrong medication as they go through the song-and-dance with a new prescriber can have serious consequences.
Post a Comment