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Discussion How do you feel? Big Pharma drug costs $20000 a year in US vs costing $60 a year overseas

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Who is right about Big Pharmaceutical companies price gouging?

  • AOC is right.. the price gouging by pharmaceutical companies needs to be brought under control.

  • GOP Rep. Glieb is correct. The Pharmaceutical companies deserve to make as much profit as they can

  • I only care about wearing my Trump/ MAGA hat!


Results are only viewable after voting.

JSt0rm

Lifer
Sep 5, 2000
27,402
3,941
126
In a way, single payer systems are also built on a denying-coverage model. The ability to keep drug prices low requires that they payer be able to say no to the drug company, especially when there are equivalently efficacious treatment options available.
Yes both have issues but one of them say if you have money you live and if you don’t you die. That’s not the right system. But don’t worry concierge healthcare is already a thing and it could expand to cover what single payer doesn’t. There are doctors right now that only accept cash payments. They aren’t going anywhere.
 
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interchange

Diamond Member
Oct 10, 1999
7,340
2,034
136
You called Obamacare evil but it wasn't. It didn't focus on care but it's time to do that now. As far as "absolute input"? What does that even mean? They may request treatment but no system on the planet that I am aware of allows providers carte blanche. You might become better informed with "limiting doctors" because that's not the problem at all. No, it's getting residencies that is at issue and that is not controlled by medical schools and much of that is public underfunding. It's not that your desire to provide care is bad, quite the reverse, but a lot of people have strong opinions they haven't the slightest idea about.

Here's one. What is the most cost effective thing which could be done that would lower medical costs in the long run, improve patient outcomes, and mitigate or cure some illnesses before the patient even knows they are there?

Let's see if anyone here knows.
I'm going to go with banning tobacco.
 
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Hayabusa Rider

Admin Emeritus & Elite Member
Jan 26, 2000
50,880
4,212
126
I'm going to go with banning tobacco.
The answer that the single most important thing is to regularly have a patient spend an hour or more (not a minute less) with a person who is highly trained talking to that patient. Obviously there's a purpose here where crafted conversation and observation are a means to an end. What does the patient think he has? What treatments are being given and what do they know about them? Are your other conditions why you are here? I went to a seminar on pain and the specialist was part of a team working with the VA to treat chronic pain and he is a psychologist who specializes in pain management. Often a significant other comes with the patient to be treated and on more than one occassion the pain could not be managed because of a domestic situation. No one gets better who is in active litigation in this guys 20 years on the job. Once it's over? Then progress can be made. Same with a nasty divorce and the like and I think to you at least this comes as no surprise.

So "how's the family/wife/job etc going" is not a pointless type of thing to ascertain, far from it. Oh, then there's that particular rash that's not part of the complaint, or maybe there's some physical sign like edema, but hey the guy has a sinus infection and so all of this is a time sink not related to the chief complaint so that melanoma or strange growth, or blood in the urine or the history of hepatitis not given before because hey it wasn't important to his sinus and he went to a different specialist, but there's signs of ascites. Oh, we're seeing signs of depression, and on and on, things that warrant a followup on a dozen or two observed things of that medical prudence dictates a practitioner look into now rather than waiting until there's a full blown case of FUBAR. This isn't a standard nurses job, not part of regular physician practice. That hour? That's likely not enough, with an hour and a half producing average greatest benefit.

To a practitioner as you are the benefits ought to be obvious because we are having a formal and well defined process of observation and patient participation for the purpose of preventative medicine that reduces long term costs and provides an upfront basis for assessment of the health of the patient. But that's not what any existing form of insurance exists as a standard of care anywhere in the world, single payor or not.

Get them in and get them out. Assess the complaint, take up further action in that regard and treat with surgery or medication or occasionally mental health assessment. Get em in and get em out. Just think of the money it saves! and yes money is the metric of medical productivity and has been for at least 3 decades.

Care an inch wide without patient health, that is the person as (insert name here), not a disease state is what people are really asking for whether they realize it or not.

I'm not a fan. We need new paradigms and support structures and no one is talking about that, at least not so they can make themselves heard in "reform".
 
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hal2kilo

Lifer
Feb 24, 2009
16,468
4,386
136
I’ll say it for our righty members.


but...but...we need to pay extra to fund drug development.

edit:
Holy fuck I posted that before watching the video and essentially that’s what the first dude said.


I think like a deplorable
You mean the drugs that we developed by our government, already paid for in taxes?
 

interchange

Diamond Member
Oct 10, 1999
7,340
2,034
136
The answer that the single most important thing is to regularly have a patient spend an hour or more (not a minute less) with a person who is highly trained talking to that patient. Obviously there's a purpose here where crafted conversation and observation are a means to an end. What does the patient think he has? What treatments are being given and what do they know about them? Are your other conditions why you are here? I went to a seminar on pain and the specialist was part of a team working with the VA to treat chronic pain and he is a psychologist who specializes in pain management. Often a significant other comes with the patient to be treated and on more than one occassion the pain could not be managed because of a domestic situation. No one gets better who is in active litigation in this guys 20 years on the job. Once it's over? Then progress can be made. Same with a nasty divorce and the like and I think to you at least this comes as no surprise.

So "how's the family/wife/job etc going" is not a pointless type of thing to ascertain, far from it. Oh, then there's that particular rash that's not part of the complaint, or maybe there's some physical sign like edema, but hey the guy has a sinus infection and so all of this is a time sink not related to the chief complaint so that melanoma or strange growth, or blood in the urine or the history of hepatitis not given before because hey it wasn't important to his sinus and he went to a different specialist, but there's signs of ascites. Oh, we're seeing signs of depression, and on and on, things that warrant a followup on a dozen or two observed things of that medical prudence dictates a practitioner look into now rather than waiting until there's a full blown case of FUBAR. This isn't a standard nurses job, not part of regular physician practice. That hour? That's likely not enough, with an hour and a half producing average greatest benefit.

To a practitioner as you are the benefits ought to be obvious because we are having a formal and well defined process of observation and patient participation for the purpose of preventative medicine that reduces long term costs and provides an upfront basis for assessment of the health of the patient. But that's not what any existing form of insurance exists as a standard of care anywhere in the world, single payor or not.

Get them in and get them out. Assess the complaint, take up further action in that regard and treat with surgery or medication or occasionally mental health assessment. Get em in and get em out. Just think of the money it saves! and yes money is the metric of medical productivity and has been for at least 3 decades.

Care an inch wide without patient health, that is the person as (insert name here), not a disease state is what people are really asking for whether they realize it or not.

I'm not a fan. We need new paradigms and support structures and no one is talking about that, at least not so they can make themselves heard in "reform".
Might you cite a study? There is no doubt quality of provider relationship is paramount to success in medicine, no differently in psychiatry. The non-specific buzzword there is "therapeutic alliance". Time is not the ultimate determining factor here, but it might be the easiest way to study things.

I doubt you could find a study that would trump the health effects of banning tobacco for the nation, though.

As far as effecting change, I think whatever system which is designed to have the greatest alignment with patient care is best. If the provider has relative isolation from economic benefits to themselves, pressures from administration for business reasons, and fears of liability, their interest in doing the best for patients will naturally produce better treatment relationships and therefore better outcomes.
 

Hayabusa Rider

Admin Emeritus & Elite Member
Jan 26, 2000
50,880
4,212
126
Might you cite a study? There is no doubt quality of provider relationship is paramount to success in medicine, no differently in psychiatry. The non-specific buzzword there is "therapeutic alliance". Time is not the ultimate determining factor here, but it might be the easiest way to study things.

I doubt you could find a study that would trump the health effects of banning tobacco for the nation, though.

As far as effecting change, I think whatever system which is designed to have the greatest alignment with patient care is best. If the provider has relative isolation from economic benefits to themselves, pressures from administration for business reasons, and fears of liability, their interest in doing the best for patients will naturally produce better treatment relationships and therefore better outcomes.

This was from a seminar and finding the original material may be tricky as this was a few years back but I'll try to see. What I think you will find from other practitioners is that they are under pressure to produce. If they see half the patients that a more "efficient" MD does then the latter will be the kind that the bean counters are cutting staff because of reimbursments with specialist nurses in cardiac units working 16 hours a day and the docs also perpetually shortstaffed. The result is all insurances reimburse at a rate that requires those to practice quickly or leave people unseen and guess how long they last if they practice as prudence demands? Not long at all except in limited circumstances. No insurance scheme actively encourages a proper patient/provider relationship with more than lip service. Saying "Do that" isn't anything rational to insist upon when there's no material means, the proper resources at the right place at the right time. I've gotten the rush before and quashed that right away. As a great many people don't even know exactly what is wrong or understand treatment there's a disconnect between care and real world practice and an absolutely abysmal understanding of what basic care entails.
 

senseamp

Lifer
Feb 5, 2006
34,807
4,714
126
We tried it the Republican way, it didn't work. Time to learn the lesson and move on to other approaches.
 

Sunburn74

Diamond Member
Oct 5, 2009
4,223
1,589
136
Here is the problem. Company A does R&D to develop a drug, and then also puts forth the money to produce the drug. Company B doesn't do R&D, just produces generics. Considering the price to produce a drug is typically orders of magnitude less than the cost to develop a drug, how could company A compete with company B? They couldn't. Company B could always undercut company A on prices. This is why we have patents, to encourage investment in intellectual assets. Patents expire so that companies can't hold a monopoly on a product long after the cost of the intellectual investment has been recuperated. There is definitely a balance that needs to be achieved, but we can't just throw out patents in medicine without another method of protecting IP in place.
I think you underestimate the profit margins of big pharma, their actual contribution to drug development. 2x as many dollars are spent by big pharma on ads than on research. Even more so, many big pharma companies simply buy promising drugs from smaller companies (who have done all the research and development BTW) and then use their market share to then sell the drug en masse.

There is plenty of room for both protecting patents and profit margins whilst preventing what is essentially price gouging.
 

mect

Platinum Member
Jan 5, 2004
2,176
1,117
136
I think you underestimate the profit margins of big pharma, their actual contribution to drug development. 2x as many dollars are spent by big pharma on ads than on research. Even more so, many big pharma companies simply buy promising drugs from smaller companies (who have done all the research and development BTW) and then use their market share to then sell the drug en masse.

There is plenty of room for both protecting patents and profit margins whilst preventing what is essentially price gouging.
I never argued that there wasn't. However, the idea that we can simply allow generics to manufacture drugs from day 1 is equally flawed. Instead, we need to do things like allow medicare to negotiate drug prices, put restrictions on advertising by drug companies, and look into patent reform.
 

senseamp

Lifer
Feb 5, 2006
34,807
4,714
126
Patent is a government granted monopoly. It should have a lot more strings attached.
 

brandonbull

Diamond Member
May 3, 2005
5,711
661
126
if your job hinges on the fact that you are making a profit off of someones inability to choose or die then you dont need a job. You are a fuckign lich for wanting to go into that industry to begin with. Im talking about executive types here not care givers or researchers.
And whom do you think will be out on the street once the private healthcare industry is eliminated as it currently stands? The executive or the regular 9-5er?
 

SMOGZINN

Lifer
Jun 17, 2005
13,156
2,732
136
And whom do you think will be out on the street once the private healthcare industry is eliminated as it currently stands? The executive or the regular 9-5er?
Does it matter? Industries move on, and they will both find other jobs. Most of the jobs of both of them will still exist, they will just change some. We can't keep a broken system that is literally costing people their lives because we are afraid that some people will lose their jobs.
 

Sunburn74

Diamond Member
Oct 5, 2009
4,223
1,589
136
The answer that the single most important thing is to regularly have a patient spend an hour or more (not a minute less) with a person who is highly trained talking to that patient. Obviously there's a purpose here where crafted conversation and observation are a means to an end. What does the patient think he has? What treatments are being given and what do they know about them? Are your other conditions why you are here? I went to a seminar on pain and the specialist was part of a team working with the VA to treat chronic pain and he is a psychologist who specializes in pain management. Often a significant other comes with the patient to be treated and on more than one occassion the pain could not be managed because of a domestic situation. No one gets better who is in active litigation in this guys 20 years on the job. Once it's over? Then progress can be made. Same with a nasty divorce and the like and I think to you at least this comes as no surprise.

So "how's the family/wife/job etc going" is not a pointless type of thing to ascertain, far from it. Oh, then there's that particular rash that's not part of the complaint, or maybe there's some physical sign like edema, but hey the guy has a sinus infection and so all of this is a time sink not related to the chief complaint so that melanoma or strange growth, or blood in the urine or the history of hepatitis not given before because hey it wasn't important to his sinus and he went to a different specialist, but there's signs of ascites. Oh, we're seeing signs of depression, and on and on, things that warrant a followup on a dozen or two observed things of that medical prudence dictates a practitioner look into now rather than waiting until there's a full blown case of FUBAR. This isn't a standard nurses job, not part of regular physician practice. That hour? That's likely not enough, with an hour and a half producing average greatest benefit.

To a practitioner as you are the benefits ought to be obvious because we are having a formal and well defined process of observation and patient participation for the purpose of preventative medicine that reduces long term costs and provides an upfront basis for assessment of the health of the patient. But that's not what any existing form of insurance exists as a standard of care anywhere in the world, single payor or not.

Get them in and get them out. Assess the complaint, take up further action in that regard and treat with surgery or medication or occasionally mental health assessment. Get em in and get em out. Just think of the money it saves! and yes money is the metric of medical productivity and has been for at least 3 decades.

Care an inch wide without patient health, that is the person as (insert name here), not a disease state is what people are really asking for whether they realize it or not.

I'm not a fan. We need new paradigms and support structures and no one is talking about that, at least not so they can make themselves heard in "reform".
Yeah this is total non sense.
You realize that the US actually has relatively high time per clinic visit as compared many countries with universal health care.

https://bmjopen.bmj.com/content/bmjopen/7/10/e017902/F2.large.jpg?width=800&height=600&carousel=1

In japan a visit is 5 minutes and is extremely focused. A Korean doctor the other day told me she sees like 60 patients a day easily.

US doctors are basically fine. 90% of the time, a doctor knows what needs to be done before you even come in the room. If a doctor didn't have to listen to people blab about meaningless things (how they are unhappy with their job or their wife or how their knee hurts -the doctor is like a brain surgeon or something-) they'd have you out of there in like 5 minutes flat. It has nothing to do with money or reimbursement. It has to do with the same reason at work you work efficiently. No on is ragging on you at work for getting something done in 10 minutes when you see allocated 30 as long as it gets done well. And there is minimal correlation between how much time is spent flapping lips and ultimately the right decision getting made. It's like when you take your car to the mechanic. Does he take 30 minutes talking to you about all sorts of random stuff or does he look at the car, give you the diagnosis on like 3 mins and tell you the next steps?
 

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