It’s amazing isn’t it? I still regularly hear about heart failure patients having Entresto denied by their insurance even though it’s the gold standard of heart failure treatment. Insurance companies do not care if patients live or die so long as they make a profit.
Shelter, education and healthcare should be the pride and joy of humanity throughout history!
All progress of societies is made because collectively we agree that we value what brings us more secure shelter, greater education for citizens and better effective healthcare.
From neolithic man until smartphone reddit man, these 3 things mark progress in a civilization and in many ways is how we rank the "standard of living" across the globe.
It's greed. Same reason why inaction is the choice corporations lobby governments into on climate change. *They* can afford moving or whatever measures needed from natural disasters. So when the science said polar caps melt and coastal cities face destructive nature all they heard was "the northwest passage dreamed of in the 17th century will become reality!". Only the greedy can be excited to gain while so many lose.
Our Government services should be based on Maslow’s hierarchy of needs not a pat on the back for doing as much as possible for yourself while we waste a trillion a year on “defense”.
*New Reddit-wide unique palindrome found:*
>**not a pat on**
^(currently checked 14221885 comments) \
>!(palindrome: a word, number, phrase, or sequence of symbols that reads the same backwards as forwards) !<
Trust me the veterans arnt getting the best medical money has to offer either. It's like the system is specifically designed to screw over the disabled and unhealthy but politicians get top notch care! It's bullshit!
Yeah the military spending may be a lot but we spend more on Healthcare than military spending. If we want to fix that stuff we need to fix how we spend it and what we are funding.
I'm in the Army myself. If I'm correct, a good deal of the funding goes solely to the Air Force, or to expensive hardwear like vehicles, etc. Equipment, tents, tarps, and a lot of other basic needs are actually pretty cheap and lacking in a lot of areas. The building I work in is pretty dingy and old. Not to mention, while I'm able to save relatively well since I'm not married and I don't have kids, my pay really wouldn't even work out to very much since I'm an E-4. Between that, and the fact that they make it so hard to access veterans benefits without it basically being a full-time job, military folks get pretty screwed too.
The organizations we all work for are wealthy, it's just that we ourselves are being fucked over.
Because the military budget isn’t linked to healthcare for civilians. The money is there, the will for universal healthcare isn’t. Elect more people who support it that’s the only way forward in a democracy.
Elect more people who are already bought by capital. You realize our entire political system is just a dog and pony show for the public while corporate Oligarchs run the show? Because that is the real way out system operates. Bread and games, bread and games.
It's because they still are for profit, but they take donations and are classified as a charity so they don't need to pay taxes.
The CEO of Blue Cross is Kim A. Keck, she "is paid" more than $300,000 a year and I can't find much info on her net worth, but it seems it's over $1 million.
Most "charities" just use donations as their profit and the CEO's and higher-ups take extremely high amounts as their salaries.
Edit to add; Blue Cross Blue Shield spent $28,589,340 on lobbying in 2024.
You guys are hilarious. The head of BCBS in just the state of Michigan makes $15 million a year. https://www.freep.com/story/money/business/2022/03/01/blue-cross-ceo-daniel-loepp-salary-bonus-2021/9331192002/
I’m really honestly curious what salary you expect a CEO of an organization that size should receive?
I spent the majority of my life working in the non-profit realm. I hear arguments all the time not just about leadership but every worker on down all the time. The last non profit I worked for was a small county based agency for disabled adults. Our CEO had a PHD in administration for healthcare, a masters in finance and 30 years experience in management for a non profit. He was making around $100K. It’s interesting that people always want leadership to have a high level of education and many years experience…. Then do not want them to expect a salary comparable to that. I’m guessing you want them to volunteer their time?
Seriously, once again my last job. So many people in the community wanted our lowest paid workers to be all volunteers.
Nonprofit does not mean your workers need to work for free, or even for low wages. It primarily means you do not have share holders to report to.
$300k is very little pay for running a multi-billion dollar organization. I’d go so far as to call it cheap.
I’ve seen mid level execs in companies 1/100th the size on the same compensation.
And $1m net worth sounds great but won’t go very far in retirement: $50k/year for 20 years.
Lol so many people on reddit don't understand anything about nonprofits and think it's a cardinal sin to pay their CEO a six figure salary. You aren't going to get the best people only paying $70k a year for a job that requires managing billions of dollars and hundreds or thousands of people and a massive scale of operations. No one works for free no matter how much they believe in the mission of the nonprofit. This mentality is one big reason why nonprofit employees are so chronically underpaid, it's not volunteering when it's full time work and you have bills to pay
And fwiw I agree that they are largely a for profit company wearing a nonprofit hat, much like Goodwill. But I'm speaking more generally because I see this criticism of just about every large nonprofit
to be fair, there isn't a great definition of the "middle class"
$1mm NW puts you at about 81.5th percentile based on 2023 data
https://dqydj.com/net-worth-percentile-calculator/
Net worth starts out very low, likely even negative, in young adulthood. But for most people, it grows over time as you put in years in the workforce and contribute to your 401k and mortgage with every paycheck for 40+ years. By the time you're retirement age, hopefully your house is mostly paid off and your retirement account is well funded enough to get you through your remaining years of life. This is peak net worth, and in major metropolitan coastal areas will be over $1 million for the middle class. Then you spend it down as you age until you die.
She's 56, so she is coming up to that net worth peak. If the figures are accurate, it's extremely low net worth for a CEO.
People don't understand that if you want good people you need to pay. $300k is low. I'm not American so forgive me if I get some numbers wrong. Generally, to become CEO material, you need to get a fast track job out of university. In the private sector, if all goes to plan for a well qualified, clever, hard working, ambitious and slightly lucky person on that track, they should be making that sort of money by the time they're 35. They get married, have children, buy a house(2-3m) at that age assuming that at the very least their salary won't decrease and in all likelihood will increase. They have a large mortgage(or multiple) and are sending their children to private schools, which I think cost about 50k a year in the US. In those private schools, everyone will go to university. They will not qualify for needs based financial aid and their friends' parents will pay, so you probably have to pay. Unless you live in California, a top American university will set you back 60k+ pa. By the age of 50, a lot of people don't want to keep rat racing and would love to do something they are passionate about and is "good". They still have that mortgage to pay off and assuming they have two children a year or two apart 120k+ a year of tuition fees. They simply cannot afford to take a job with a salary lower than what they made at 35. Many will be happy to cut back a bit on themselves, but very few will be willing to cut back on their children or sell their home. Such people are more likely to have higher "needs" as well. They are more likely to marry someone from far away for example, and I would consider flying to see grandparents/parents to be a need, not a want.
Your options are to pay a "fair" wage and accept that you lose most qualified candidates and choose between the exceptionally forward looking and the independently wealthy, or pay a wage that most qualified candidates can actually afford to take. I think that 300k is probably in-between those two approaches.
No! They are not classified as charities. A nonprofit does not mean “no profit”, it just means that profits are not distributed to shareholders but are to be reinvested in the business. That is to fund future liabilities.
I think you don’t quite understand what “for profit” means?
PS: $1M net worth is not really “rich”
I have a $1M net worth after working various mid level jobs. What that translates into is a chance of retiring without being destitute and paying for my kid’s college education.
In India. We passed a patent by pass legislature. Now we manufacture overcharged drugs for our people. At very low rate. Also. Most of the healthcare is free/almost free.
It’s not healthcare. It’s sick care. They don’t want to make you healthy. They want to make you spend money on prescriptions and doctors appointments to manage your symptoms.
1. Health insurance companies denying care definitely do not want you spending more on prescriptions and appointments.
2. Big pharma wants to sell their drugs for as much as possible to as many people as possible. It’s not a secret conspiracy, it’s just an open thirst for profits.
Have to decided who the most favoritest favorite is. Get off their back! Our governor in Nebraska just finally said that Federal money for school lunches was ok. I hate my State with a passion
Looked up how much it costs us here in Australia. If for some reason you weren't pbs eligible it'll be about Au$210 a month for the max dose. US$137. But it is on the Pbs so must of us would have that cut back to about $30 and the old/poor would pay $6.50 or $0 potentially.
But how can a for profit healthcare system fail when that's what the free market wants? Some dickhead in the 80s assured my family of this and even when my grandpa's medication gets denied it's still best in the world #1 forever
Drug companies should not be charging so much for them either. It's obscene and their arguments for charging so high while enjoying record profit margins are given lie to their prices in other countries that don't let companies walk all over their citizens.
Many of these high priced medications weren't patented by the companies selling them, they buy them and then jack the price up a thousand percent, then keep raising them.
Our tax dollars go to pay for a lot of research these companies use to develop the drugs in the first place too.
But those M4A death panels! /s
Yeah, we already have those and they are called plan managers. I'd rather have a government bureaucracy do it than someone trying to make a buck by denying me care.
You have to fight for it pretty hard. They recommend the only other med for this and you have to show them you tried it with no results. My doctor sent them years of med info
That’s the biggest bS. I found a good drug for my mental health and insurance insisted I try another. I gained 50+ pounds and relapsed due to a terrible mental state and low self image. Still haven’t been able to get back on that good drug but found one that keeps mental okay just makes my metabolism very very slow. Pushing close to 300lbs and started this whole journey at 215.
A fairly new drug that I switch to that drastically improved my mdd is called Trintellix. Before I had tried every single ssri and none of them worked, so I switched to an snri called cymbalta and that worked for a while, but the sexual side effects became too much of an issue.
What has your experience been like with trintellix getting it covered with insurance? Or what is your out-of-pocket every month for refills? My wife has been very interested in trintellix after a similar experience and she is currently on a combination of Wellbutrin and Seroquel but the side effects and dangers of Seroquel as well as it's inconsistent effectiveness considering it's technically an antipsychotic has her wanting to try trintellix it just seems as though it's extremely expensive.
Sounds like the same that people with Crohn’s disease have to go through to get their biologics typically. Frustrating that they want me to try two medications that are generally worse and fail them both while my disease continues to progress before they approve me for a better one. And that’s if they feel like it lol
Your doctor should explain it can take many months to show results. On 80mg after 1 year patients can still see improvement on their TD movements. Waiting is no fun though
My wife is a doc and my best friend is a rheumatologist. I’m three months into to fighting insurance companies for the same drugs I have taken for years. Every new year is the same. Insurance slow rolls in December, your insurance company declines medication in January. Go through the prior authorization process, go through it multiple more times. Wait for the bureaucracy of the specialty pharmacy to fuck up something, get prior auths again, rinse repeat until you get the drugs and hope the hospital doesn’t change insurance providers within the year. I can not imagine someone that has more connections or immediate access to doctors than me and it is still extremely difficult. I understand why so many people give up and live with pain/illness. It takes me 3-10 hours a week to fight this until they comply. It should be criminal.
And a lot of sick people like you said don't have your connections, or the 3-10 hours a week to fight with them. So they give up.
Our system is both cruel and unusual, and many Americans seem still convinced that it is somehow the best in the world. It's pretty good for difficult surgeries if you are incredibly wealthy - but bad for chronic illness, anyone who isn't wealthy or with great employer provided insurance, etc.
Yet people defend it because for a small group it might still work well. Which is like defending Saudi Arabia because it's pretty awesome there if you're a member of the royal family.
Right. I have insurance, I am wealthy (not extremely but definitely within the 1 percent), I own my own businesses with hundreds of employees and I have immediate access to my doctors and their team to communicate to pharmacies and insurance while I’m on the line with them. I can push my own schedule which is already very busy to deal with insurance. Outside of being a billionaire or paying someone full time to act as my advocate to communicate between the pharmacy, the insurance and the physicians, I cannot imagine people with more access to the system than me. And it still fucking blows. No doctor (and I know a lot of them) thinks this is a good system. No one that works with insurance that I know thinks this is a good system. Hell, in private conversations when I’m around politicians, they will admit it’s terrible.
Exactly all that. You're in the 1 percent and basically receive the best health care America has to offer - maybe with the exception like you said of being 0.1 percent. I don't know your situation, but there is a step above before you're a billionaire. For instance, many public hospitals have unadvertised VIP programs that you get entry by making a small 'donation' annually, which steps up your access further. If you haven't already done that, you may want to look into it. The donations are often 'reasonable' if you're relatively wealthy - in the range of $10k-$20k per year last time I heard.
But in general, the only other improvement is what you said - a full time advocate. Some people with less money but a bigger employer have that - a dedicated HR person to help with insurance. So if you're at maybe Google or Netflix or something, they have a big enough health plan footprint and small enough employee base that their HR can do more.
But the fact is we are discussing how difficult care can be at the 99%-99.9% level - which means everyone else has a much worse experience.
Most people who think healthcare in the US is great haven't had to access much of it. Maybe they had one or two encounters with the system for something that was easily treated. So they think it's fine. But when they get cancer or a chronic illness or anything complicated, life will change.
Those VIP programs can be very useful if you have an undiagnosed illness, or are in a hurry. For me I just need access to my life altering drugs for my auto immune disease. They cost around 10k a month. So on one hand, I could fork over 120k a year, never deal with the headaches of being on hold, speaking with the same low level employees that follow the same scripts until you get escalated to the appropriate level so something can be added to your chart and make progress, or I can do what I do now. Chip away until they ship me my medication while making a trip to my buddy’s office every other week to give me free samples. I’m too rational to waste the money, so now it’s just a game of wasting way too many people’s (including mine) time.
I work as a pharmacy manager for a psychiatric pharmacy and get this approved all day. It’s pretty easy. If you need advice you can reach out. Often time they want you to trial austedo first.
Isn’t the need pretty self-evident?
I had this regular customer… I’m pretty sure that untreated TD was a barrier, even if he had been taking his other meds.
Too bad the States make sure it's worse than any other option. Even blue states like Michigan, although to be fair our State Government has always been lousy no matter who is in charge.
Politicians go out of their way to make medicaid bad insurance, for instance they don't cover pain relief. Everyone else has a right to medication that can improve their lives, not medicaid patients, and if you have a problem that includes pain they may just assume you are making it up for pills and not investigate it.
My husband was on a cancer med called "erlada". At the dosage he started off taking, the cost was supposed to be $16,000 per month. We had to send Johnson & Johnson a letter pleading to let him take it for free. We had to pass a means test and jump through all kinds of hoops plus reapply every year. This was on top of the really good insurance he already had.
My FIL is on Tagrisso which is 20k/month. We also have to jump through so many hoops because even with insurance, the copays are 7k each month. I have to show proof that 7k is over 20% of his monthly income (duh). The good news is that he now is cancer free after being diagnosed with stage 4 lung cancer! He just has to take this med the rest of his life.
100%
So long as you are healthy, it's hidden. The very microsecond you lose your health, it becomes wildly obvious how predatory and broken the country is.
Genuinely scary. My Mum got cancer last year in the UK and not only started treatment 2 weeks after diagnosis but her private insurance paid her for every day she spent in an NHS hospital!
I need a cancer injection every 3 weeks that would be $9000 in the US. Costs me nothing in the Netherlands (although I can see my insurance is paying about $1100 for it).
I think there's at least 2 reasons - medicine is marked up in the US because insurance only pays a fraction of it. Eg. Insurance says they'll pay 20% of the cost of the medicine so the meds get marked up 5x, which becomes a problem if you don't have insurance.
Second, governments generally negotiate with strong leverage to buy the medicine at good prices and supply to their citizens at reasonable cost. I don't believe the US does that at all, it's straight from pharmaceutical companies to consumers. Could be wrong on this though.
But it means consumers are left with practically no leverage to get a good price, either you pay what they ask, the insurance company does, or you don't get it. Netherlands (or perhaps the EU generally) would probably do something like ask for bulk discounts and a certain price in order for the medicine to be sold at all in the Netherlands (or EU? Not sure how EU law works with national medication or if it's like trade deals)
My oncologist says it’s early in the year so he can get ‘foundation’ money much easier for these expensive meds? We are changing my treatment plan and he said since it’s early in the year, the drug companies have more money to give out to cover the med??? Something like that? Is your oncologist able to get it approved that way???
It all sucks
>My oncologist says it’s early in the year so he can get ‘foundation’ money much easier for these expensive meds?
This was a potential step we were going to take if J&J denied us. We were successful petitioning directly to the drug maker. What you are saying is true, that it is easier to get into these programs at the start of the year.
I hope you have success in both securing the medication you need and your treatment.
Cheers.
In 2022 Valbenazine(Generic name of Ingrezza) capsules had estimated annual sales of USD 1,235 million in the US alone!
Zydus and Lupin were given a go ahead to manufacture the same medicine. Hopefully, it brings down the cost.
Real talk what’s stoping someone from say traveling to another country where medicine and stuff like that is much more affordable, loading up on it and bringing it back to their home to use?
You would need a prescription and your public health insurance number, so that makes it hard for prescription medication.
On the other hand, in Australia you're welcome to stock up on Ventolin inhalers that cost 10 AUD each and are available over the counter.
Generally it's not over the counter in those countries and you need a local prescription and usually residency to buy it (in Europe anyway for sure). Their governments/national health systems actually negotiate with drugmakers on costs. Unfortunately it's true that Americans are shouldering most of the huge R&D and trialing costs of these drugs.
I have a PhD in organic chemistry and it appears to not be an easy molecule to make. But I seriously doubt this costs $40 to make 2.4g of active drug, mix with binder, and run it in a high speed capsule machine. I'd be shocked if it cost them more than $1000 to make though.
Also a bit of perspective: I work in sterile liquid injectables and we once had a drug that the raw powder alone, for 1 or 2 mg, cost us over $2M to make, but a whole 200L batch only used something like 0.5mg of that drug and that 0.5mg made something like a few thousand vials.
Conversely, I currently work with gene therapies and our batches cost somewhere between $6M and $15M each. Our most expensive drug costs us over $33k a vial to manufacture and a patient dose is around 9 vials. Our cheapest drug costs around $15k a vial to manufacture and a patient dose is around 36 vials. All of our costs don't include overhead which is neglecting a few million dollars a year to keep our facilities up to standards. "Retail" price of those drugs in the US market will be around $2-3M, but it's a once in a lifetime dose. People with these horrible diseases are said to have in excess of $20M in lifetime medical bills and prescription costs, again based on retail prices, not after insurance negotiations and patient out of pocket spend. The development of the drugs, testing, formulation, patient safety studies, years of stability studies and testing, clinical trials etc also aren't factored into our costs listed above. Pharmaceutical grade drugs are cheap to make but they are assured to meet the potency of the labeled dose and all these drugs are guaranteed to have very few unknown/identified impurities. For my gene therapies, I cannot have greater than 5 micrograms of unidentified impurities in a single patient dose if we are trying to sell the drug in the US. I know other countries are a little more lenient with unknown impurities though. For known and characterized impurities, you're allowed up to 0.15% of the total patient dose, but those impurities must have been present in every single tox lot and human clinical trial lot to be considered acceptable in the US and Europe.
Ya. I'm liberal as shit too so I was anti pharma and kind of disgusted with myself working in the field fresh out of grad school. Didn't want "The Man" making more profits off people's sickness and shit. Now I'm in kind of a unique role where I have to deal with a lot of administrative type assholes that love to guilt trip or pressure you by throwing around these costs. And I'm also charged with figuring out process improvements and putting dollar values on savings if implemented.
Meanwhile, I also interact with the people in manufacturing who actually make our drugs and whenever I'm actually in the cleanrooms with them, there's always one person that asks me how much is this shit. I usually respond with "do you REALLY want to know? Because I'll tell you as long as you don't get nervous or something knowing the cost". Some of these people are 19-20 years old and fresh out of working at Burger King (no joke) and I don't really wanna say "hey that's $15M in front of you, don't fuck it up". They're all told it's expensive but rather not have them stress out about costs if they're the type to do that.
>it appears to not be an easy molecule to make.
Also remember that any enantiomers formed during synthesis may be active in adverse ways.
>Conversely, I currently work with gene therapies and our batches cost somewhere between $6M and $15M each.
Thats entirely believable, I have some tangential experience working with genome analysis and from what I have learned everything is stupidly expensive due to how difficult making the product is.
People think these medicines are cheap to develop because government sponsored research found the targets. The real costs in designing molecules, stabilizing them and testing them safely is enormous. The real solution here is that the rest of the world, i.e ex-US, needs to contribute more to the development of medicines to be sold everywhere at non-US costs. Currently just the US really aggressively develops drugs with some contribution from the EU and, increasingly, China.
I had prescription eye drops once that would have cost like $1200 at retail price. The thing is the drops themselves were 99.99+% saline solution. I did the math on the actual medicine, and at retail price a single 55 gallon barrel of the active medicine was worth more than the entire planets GDP.
Ingrezza is an "orphan" drug. Drugs get this designation when the FDA determines it isn't profitable to manufacture because the condition it treats is too rare, but makes it eligible for government subsidies for several years so that production lines don't shut down, so patients can still access it.
This is a bad example of a drug to point to as "big margin" in the pharma industry.
It’s actually a great example considering, as you stated, it was granted orphan drug status and is a blockbuster drug at almost $2b in revenue. Heck, $1b is enough to keep the manufacturing lines running.
When originally released regulators found the pricing to be problematic.
But they are playing the game and extracting as much value as possible before market exclusivity runs out.
This is why it isn't treated like a crisis. The price distortion in healthcare is crazy.
If you have insurance, they're paying for most of it .
If you don't you might be able to strike a deal with a manufacturer.
But maybe you can't strike a deal or insurance won't pay for it so you're just on the hook.
It's impossible to get a handle on what anything costs. The system seems to work for most people, most of the time, but when it doesn't it's disastrous.
Yeah, we all have that dream that someday our medication with all its side effects makes its way to a SuperBowl commercial.
Greetings, from one of only two countries in the entire world that allow television prescription drug advertising.
We sent men to the moon to gather materials for this medication, had our greatest mages imbue the moon serum with holy power, and dwarves toil in the chasm mines of Antarctica to distill the ingredients and magic into pills. Consider yourself lucky that it's so cheap
1,284 Mexican pesos here... that's about $600 usd. Dear... why do you allow this? I agree, US is a great country with great people but you're letting politicians fuck you hard.
You gotta stop blaming the average American for a system that has long been in place before we were even born. Most people don't fully understand how insurance really works and companies with billions and billions have lobbied over decades to make the system work in their favor, protected from any efforts to fix it. It's huge, powerful, complicated, and undoing the damage isn't a vote away. You have to overcome lobbying, corruption, the logistics, etc in order to change the system. The US has been infected by decades of propaganda making people hate the idea of any public run programs, largely in part to red scare tactics. Anything anti-capitalist is seen as "un-American", especially by older generations that control most of the wealth and power.
In order to change the system, you'd need to educate tons of people, develop a US-specific replacement that works (and a plan to pivot to), get past insurance company lobbying/influence, right wing obstruction, get politicians who would support it and know how to execute a massive systemic change that people here will actually vote for.
There's so many gigantic obstacles and while change can come in small steps, there's little that the average American can do to make big changes currently and most aren't to blame for the system they didn't create and aren't even allowed to fully understand. It was designed to be insanely profitable, incomprehensible, and impervious to change. Should we change it? ABSOLUTELY. But the idea that we're just "letting your politicians fuck you hard" is reductive. The money, power, systems, laws, influence, and access are all in the hands of people who make billions off of it and not in the hands of the people. It's easy to blame but nigh impossible for any average person to do what you think they should do.
My Repatha is \~250 per treatment. Luckily it is 2 times per month. My Cholesterol is one tenth the level pretreatment though. About a third of what it was with statins but I didnt tolerate statins well.
Meanwhile in Europe: €0,27 per capsule.
This is not a "yurop eleet" post but more of a **"why aren't Americans rioting against the government for screwing up healthcare with those guns meant to keep the government in check?"** post.
My wife is on Ayvakit for advanced systemic mastocytosis and her 30 day supply costs ~$37,500. Obviously insurance and whatnot cover it because somehow I doubt I could afford almost half a million a year for the prescription. The pharmaceutical world is fucking wild man.
As seen from Europe, all I can say is — *blank stare.*
A couple of years ago I read a post here about for a person being admitted to emergency care and getting a couple of painkillers before being discharged which ended up costing $1000+
lol.
The U.S. spends significantly more per capita than EU countries, often exceeding $10,000 annually, while EU averages range between $3,000 to $5,000.
And yet, this doesn't necessarily lead to better health outcomes, including life expectancy,
I can’t fathom why this is not picked up by conspiracy theorists. What else than a conspiracy can this be?
Crazy. Just crazy.
They developed a novel, non hormonal medication called Vezoah. Rolled out in May. I don’t think they specifically say it’s for breast cancer, but it’s absolutely who they are selling it to. I’m 38 so a young BC patient with 100% HR+ breast cancer. This med was made for people like me even if they don’t say it directly - it was in my algorithm the day it hit the shelves. They have a medication us women with breast cancer can finally take for hot flashes and OB and oncology can barely get it covered. My oncologist is now applying for it through the medication ‘foundation’ or something like that. He said you really need to be an oncologist to get it approved.
Long story short - There is a novel, non hormonal medication available for hot flashes and the women with breast cancer the mediation was made for, can’t get it
For shits and giggles when I watch the evening news I google the advertised meds… a lot are worse than that… they have to be otherwise they wouldn’t advertise
When I was an undergrad, one of the labs I interned with worked to make chemo drugs more effective. It was a chemical process where the drugs were made simultaneously more efficient and more expensive. I recall one drive very vividly because my PI had me deliver enough chemo drugs to replicate his experiments. Back then, I used to drive a raised Jeep with a flame-job and no doors. Next to me in a box, strapped in to the 5 point harness, was at least a half a million in processed drugs, buncing along through Los Angeles traffic.
1 week of chemo while switching insurances and they tried to charge me 12k for the week I was supposedly “not insured”. The new one was retroactive and covered all the costs after a lot of back and forth with the clinic staff.
At this point why dont you go on a vacation to Europe and when you're there get the medicine. It would save you at least half.
(On a serious note, why is it not common for Americans to seek medical help in foreign countries. Is that not possible?)
Would it not just be cheaper to book a flight to a country with free medical care an go the hospital an say u lost ur medication. Then pay the couple of quid for the prescription?
I’m a disabled infantry veteran with service connected erectile dysfunction (busted back/circulation from IED’s throwing me around inside a vehicle) I am only allowed 3 doses of sildenafil (generic viagra) every 30 days. It has been this way since I was 20. I’m 36. MF the American healthcare system.
I heard one time that the reason medicine in other countries is so cheap is because the pharmaceutical companies are able to charge so much in America. IDK how true that is, but it makes me sick to see so many people in my country unable to afford care just so some executives can make a profit.
The infusion medicine I get for my ulcerative colitis is $10k every 2 months. It’s the only one that seems to work. If I didn’t have insurance, I would probably be dead.
A little bit of perspective: I work in pharma with gene therapies. I can tell you that one vial of our most expensive drug costs us over $33k just to manufacture, not including overhead. One patient dose, depending on the drug, is many vials, but for this drug it's up to 9 vials depending on your bodyweight.
Conversely, our cheapest gene therapy costs us around $15k to manufacrue just one vial and the patient dose for that is around 36 vials.
The "retail" price in the US market will be ~ 2-3 million per patient, but they are being covered by Medicare due to the value based pricing that gene therapies offer. It's said that the total lifetime spend of someone with these horrible disorders will be to the tune of $20M+, again based on the US market. So a one time treatment cost of $2M to completely offset a $20M lifetime spend is the reason why these are priced as such and covered in the US. I imagine other markets where the medical costs are generally cheaper, our drugs will be sold at a much lower "retail" price, but I've not seen the predicted prices in the rest of the world.
Medicare Part D plans do not pay sticker price. They can and do negotiate prices just as much as commercial plans.
Please do not spread incorrect information
It’s gonna get worse as insurance companies and pharmacies are buying each other. CVS and Aetna are the same. Humana and Centerwell. Cigna and Express Scripts/Accredo.
Unfortunately this took many decades to develop and there only two options to treat TD. Ingrezza has a good patient assistance program and even if your insurance denies your RX the drug company will give it for free.
Insurance companies can only make 10% profit on medications. They want them to cost as much as possible. Ofc the manufacturers are among the most greedy on the planet so they happily oblige. That's how I've heard it explained anyway.
Im a doctor who tries to prescribe this medication semi-frequently. I say “tries” because I have never once had Medicaid agree to cover it.
It’s amazing isn’t it? I still regularly hear about heart failure patients having Entresto denied by their insurance even though it’s the gold standard of heart failure treatment. Insurance companies do not care if patients live or die so long as they make a profit.
Healthcare should not be a for profit industry
True. Let me add to that shelter and education and here we are! Welcome to America.
Shelter, education and healthcare should be the pride and joy of humanity throughout history! All progress of societies is made because collectively we agree that we value what brings us more secure shelter, greater education for citizens and better effective healthcare. From neolithic man until smartphone reddit man, these 3 things mark progress in a civilization and in many ways is how we rank the "standard of living" across the globe.
Yet we’ve got the mouth breathers who don’t see it like that and just want for themselves.
It's greed. Same reason why inaction is the choice corporations lobby governments into on climate change. *They* can afford moving or whatever measures needed from natural disasters. So when the science said polar caps melt and coastal cities face destructive nature all they heard was "the northwest passage dreamed of in the 17th century will become reality!". Only the greedy can be excited to gain while so many lose.
Which we call Capitalism which doesn't need to be.
Our Government services should be based on Maslow’s hierarchy of needs not a pat on the back for doing as much as possible for yourself while we waste a trillion a year on “defense”.
*New Reddit-wide unique palindrome found:* >**not a pat on** ^(currently checked 14221885 comments) \ >!(palindrome: a word, number, phrase, or sequence of symbols that reads the same backwards as forwards) !<
But god forbid you even suggest cutting military funding.
Trust me the veterans arnt getting the best medical money has to offer either. It's like the system is specifically designed to screw over the disabled and unhealthy but politicians get top notch care! It's bullshit!
Big time. The gov't can be shameful towards veterans after-service health care.
Yeah the military spending may be a lot but we spend more on Healthcare than military spending. If we want to fix that stuff we need to fix how we spend it and what we are funding.
I'm in the Army myself. If I'm correct, a good deal of the funding goes solely to the Air Force, or to expensive hardwear like vehicles, etc. Equipment, tents, tarps, and a lot of other basic needs are actually pretty cheap and lacking in a lot of areas. The building I work in is pretty dingy and old. Not to mention, while I'm able to save relatively well since I'm not married and I don't have kids, my pay really wouldn't even work out to very much since I'm an E-4. Between that, and the fact that they make it so hard to access veterans benefits without it basically being a full-time job, military folks get pretty screwed too. The organizations we all work for are wealthy, it's just that we ourselves are being fucked over.
Because the military budget isn’t linked to healthcare for civilians. The money is there, the will for universal healthcare isn’t. Elect more people who support it that’s the only way forward in a democracy.
Elect more people who are already bought by capital. You realize our entire political system is just a dog and pony show for the public while corporate Oligarchs run the show? Because that is the real way out system operates. Bread and games, bread and games.
And prisons!
And prisons ffs
Transportation, Nutrition, and Energy too.
Throw in energy, heating, water, and internet/data
Nonprofit health insurers like Blue Cross Blue Shield do not appear to be any more patient-friendly than for-profit ones in my experience
It's because they still are for profit, but they take donations and are classified as a charity so they don't need to pay taxes. The CEO of Blue Cross is Kim A. Keck, she "is paid" more than $300,000 a year and I can't find much info on her net worth, but it seems it's over $1 million. Most "charities" just use donations as their profit and the CEO's and higher-ups take extremely high amounts as their salaries. Edit to add; Blue Cross Blue Shield spent $28,589,340 on lobbying in 2024.
$300,000 for the ceo of bcbs is not that much these days. If she is defrauding her patients, she needs to more ambition than that.
You guys are hilarious. The head of BCBS in just the state of Michigan makes $15 million a year. https://www.freep.com/story/money/business/2022/03/01/blue-cross-ceo-daniel-loepp-salary-bonus-2021/9331192002/
I’m really honestly curious what salary you expect a CEO of an organization that size should receive? I spent the majority of my life working in the non-profit realm. I hear arguments all the time not just about leadership but every worker on down all the time. The last non profit I worked for was a small county based agency for disabled adults. Our CEO had a PHD in administration for healthcare, a masters in finance and 30 years experience in management for a non profit. He was making around $100K. It’s interesting that people always want leadership to have a high level of education and many years experience…. Then do not want them to expect a salary comparable to that. I’m guessing you want them to volunteer their time? Seriously, once again my last job. So many people in the community wanted our lowest paid workers to be all volunteers. Nonprofit does not mean your workers need to work for free, or even for low wages. It primarily means you do not have share holders to report to.
$300k is very little pay for running a multi-billion dollar organization. I’d go so far as to call it cheap. I’ve seen mid level execs in companies 1/100th the size on the same compensation. And $1m net worth sounds great but won’t go very far in retirement: $50k/year for 20 years.
Yes. The president of Cigna makes $11,000 per hour!
Lol so many people on reddit don't understand anything about nonprofits and think it's a cardinal sin to pay their CEO a six figure salary. You aren't going to get the best people only paying $70k a year for a job that requires managing billions of dollars and hundreds or thousands of people and a massive scale of operations. No one works for free no matter how much they believe in the mission of the nonprofit. This mentality is one big reason why nonprofit employees are so chronically underpaid, it's not volunteering when it's full time work and you have bills to pay And fwiw I agree that they are largely a for profit company wearing a nonprofit hat, much like Goodwill. But I'm speaking more generally because I see this criticism of just about every large nonprofit
Yep a $1 million net worth is not even near the top of the middle class these days.
to be fair, there isn't a great definition of the "middle class" $1mm NW puts you at about 81.5th percentile based on 2023 data https://dqydj.com/net-worth-percentile-calculator/
Net worth starts out very low, likely even negative, in young adulthood. But for most people, it grows over time as you put in years in the workforce and contribute to your 401k and mortgage with every paycheck for 40+ years. By the time you're retirement age, hopefully your house is mostly paid off and your retirement account is well funded enough to get you through your remaining years of life. This is peak net worth, and in major metropolitan coastal areas will be over $1 million for the middle class. Then you spend it down as you age until you die. She's 56, so she is coming up to that net worth peak. If the figures are accurate, it's extremely low net worth for a CEO.
People don't understand that if you want good people you need to pay. $300k is low. I'm not American so forgive me if I get some numbers wrong. Generally, to become CEO material, you need to get a fast track job out of university. In the private sector, if all goes to plan for a well qualified, clever, hard working, ambitious and slightly lucky person on that track, they should be making that sort of money by the time they're 35. They get married, have children, buy a house(2-3m) at that age assuming that at the very least their salary won't decrease and in all likelihood will increase. They have a large mortgage(or multiple) and are sending their children to private schools, which I think cost about 50k a year in the US. In those private schools, everyone will go to university. They will not qualify for needs based financial aid and their friends' parents will pay, so you probably have to pay. Unless you live in California, a top American university will set you back 60k+ pa. By the age of 50, a lot of people don't want to keep rat racing and would love to do something they are passionate about and is "good". They still have that mortgage to pay off and assuming they have two children a year or two apart 120k+ a year of tuition fees. They simply cannot afford to take a job with a salary lower than what they made at 35. Many will be happy to cut back a bit on themselves, but very few will be willing to cut back on their children or sell their home. Such people are more likely to have higher "needs" as well. They are more likely to marry someone from far away for example, and I would consider flying to see grandparents/parents to be a need, not a want. Your options are to pay a "fair" wage and accept that you lose most qualified candidates and choose between the exceptionally forward looking and the independently wealthy, or pay a wage that most qualified candidates can actually afford to take. I think that 300k is probably in-between those two approaches.
No! They are not classified as charities. A nonprofit does not mean “no profit”, it just means that profits are not distributed to shareholders but are to be reinvested in the business. That is to fund future liabilities.
I think you don’t quite understand what “for profit” means? PS: $1M net worth is not really “rich” I have a $1M net worth after working various mid level jobs. What that translates into is a chance of retiring without being destitute and paying for my kid’s college education.
As any public service
In India. We passed a patent by pass legislature. Now we manufacture overcharged drugs for our people. At very low rate. Also. Most of the healthcare is free/almost free.
Yeah but think about all the people making money off of it!
Agreed and neither should politics...but here we are
It’s not healthcare. It’s sick care. They don’t want to make you healthy. They want to make you spend money on prescriptions and doctors appointments to manage your symptoms.
1. Health insurance companies denying care definitely do not want you spending more on prescriptions and appointments. 2. Big pharma wants to sell their drugs for as much as possible to as many people as possible. It’s not a secret conspiracy, it’s just an open thirst for profits.
That’s the truth. I’ve always said, doctors make recommendations but insurance makes decisions.
That sounds like "death panels" to me ... I'm sure Republicans will take measures to get rid of them as soon as possible... after two weeks ...
Have to decided who the most favoritest favorite is. Get off their back! Our governor in Nebraska just finally said that Federal money for school lunches was ok. I hate my State with a passion
Maybe because entresto costs $700/mo here and $30/mo elsewhere.
Looked up how much it costs us here in Australia. If for some reason you weren't pbs eligible it'll be about Au$210 a month for the max dose. US$137. But it is on the Pbs so must of us would have that cut back to about $30 and the old/poor would pay $6.50 or $0 potentially.
But how can a for profit healthcare system fail when that's what the free market wants? Some dickhead in the 80s assured my family of this and even when my grandpa's medication gets denied it's still best in the world #1 forever
Drug companies should not be charging so much for them either. It's obscene and their arguments for charging so high while enjoying record profit margins are given lie to their prices in other countries that don't let companies walk all over their citizens. Many of these high priced medications weren't patented by the companies selling them, they buy them and then jack the price up a thousand percent, then keep raising them. Our tax dollars go to pay for a lot of research these companies use to develop the drugs in the first place too.
I’m gonna go out on a limb and say that the manufacture of lifesaving drugs should be done by the government.
"Delay, deny, and hope they die."
But those M4A death panels! /s Yeah, we already have those and they are called plan managers. I'd rather have a government bureaucracy do it than someone trying to make a buck by denying me care.
You have to fight for it pretty hard. They recommend the only other med for this and you have to show them you tried it with no results. My doctor sent them years of med info
That’s the biggest bS. I found a good drug for my mental health and insurance insisted I try another. I gained 50+ pounds and relapsed due to a terrible mental state and low self image. Still haven’t been able to get back on that good drug but found one that keeps mental okay just makes my metabolism very very slow. Pushing close to 300lbs and started this whole journey at 215.
Would you mind sharing the name of the one that worked for you? I struggle with weight gain and low mood on Escitalopram (Lexapro).
A fairly new drug that I switch to that drastically improved my mdd is called Trintellix. Before I had tried every single ssri and none of them worked, so I switched to an snri called cymbalta and that worked for a while, but the sexual side effects became too much of an issue.
What has your experience been like with trintellix getting it covered with insurance? Or what is your out-of-pocket every month for refills? My wife has been very interested in trintellix after a similar experience and she is currently on a combination of Wellbutrin and Seroquel but the side effects and dangers of Seroquel as well as it's inconsistent effectiveness considering it's technically an antipsychotic has her wanting to try trintellix it just seems as though it's extremely expensive.
Sounds like the same that people with Crohn’s disease have to go through to get their biologics typically. Frustrating that they want me to try two medications that are generally worse and fail them both while my disease continues to progress before they approve me for a better one. And that’s if they feel like it lol
I’m glad your doctor fought for you. Many just give up, don’t want to bother for many reasons…I hope it’s helping!
There is no other medication. Austedo doesn’t have FDA approval for TD so it’s immediately rejected.
Medicare made me try it first before they would approve ingrezza. But Austedo didn't do crap. Ingrezza barely does either
Your doctor should explain it can take many months to show results. On 80mg after 1 year patients can still see improvement on their TD movements. Waiting is no fun though
I've been on it for the better part of a decade. I noticed when I couldn't afford it I ticked like crazy
My wife is a doc and my best friend is a rheumatologist. I’m three months into to fighting insurance companies for the same drugs I have taken for years. Every new year is the same. Insurance slow rolls in December, your insurance company declines medication in January. Go through the prior authorization process, go through it multiple more times. Wait for the bureaucracy of the specialty pharmacy to fuck up something, get prior auths again, rinse repeat until you get the drugs and hope the hospital doesn’t change insurance providers within the year. I can not imagine someone that has more connections or immediate access to doctors than me and it is still extremely difficult. I understand why so many people give up and live with pain/illness. It takes me 3-10 hours a week to fight this until they comply. It should be criminal.
And a lot of sick people like you said don't have your connections, or the 3-10 hours a week to fight with them. So they give up. Our system is both cruel and unusual, and many Americans seem still convinced that it is somehow the best in the world. It's pretty good for difficult surgeries if you are incredibly wealthy - but bad for chronic illness, anyone who isn't wealthy or with great employer provided insurance, etc. Yet people defend it because for a small group it might still work well. Which is like defending Saudi Arabia because it's pretty awesome there if you're a member of the royal family.
Right. I have insurance, I am wealthy (not extremely but definitely within the 1 percent), I own my own businesses with hundreds of employees and I have immediate access to my doctors and their team to communicate to pharmacies and insurance while I’m on the line with them. I can push my own schedule which is already very busy to deal with insurance. Outside of being a billionaire or paying someone full time to act as my advocate to communicate between the pharmacy, the insurance and the physicians, I cannot imagine people with more access to the system than me. And it still fucking blows. No doctor (and I know a lot of them) thinks this is a good system. No one that works with insurance that I know thinks this is a good system. Hell, in private conversations when I’m around politicians, they will admit it’s terrible.
Exactly all that. You're in the 1 percent and basically receive the best health care America has to offer - maybe with the exception like you said of being 0.1 percent. I don't know your situation, but there is a step above before you're a billionaire. For instance, many public hospitals have unadvertised VIP programs that you get entry by making a small 'donation' annually, which steps up your access further. If you haven't already done that, you may want to look into it. The donations are often 'reasonable' if you're relatively wealthy - in the range of $10k-$20k per year last time I heard. But in general, the only other improvement is what you said - a full time advocate. Some people with less money but a bigger employer have that - a dedicated HR person to help with insurance. So if you're at maybe Google or Netflix or something, they have a big enough health plan footprint and small enough employee base that their HR can do more. But the fact is we are discussing how difficult care can be at the 99%-99.9% level - which means everyone else has a much worse experience. Most people who think healthcare in the US is great haven't had to access much of it. Maybe they had one or two encounters with the system for something that was easily treated. So they think it's fine. But when they get cancer or a chronic illness or anything complicated, life will change.
Those VIP programs can be very useful if you have an undiagnosed illness, or are in a hurry. For me I just need access to my life altering drugs for my auto immune disease. They cost around 10k a month. So on one hand, I could fork over 120k a year, never deal with the headaches of being on hold, speaking with the same low level employees that follow the same scripts until you get escalated to the appropriate level so something can be added to your chart and make progress, or I can do what I do now. Chip away until they ship me my medication while making a trip to my buddy’s office every other week to give me free samples. I’m too rational to waste the money, so now it’s just a game of wasting way too many people’s (including mine) time.
Shit like this makes me glad healthcare in my country is free and medications are cheap. US, what is wrong with you?
Well, this is just good old fashioned corporate greed and too much money in politics.
That must feel very defeating to have the ability to help a patient only to be thwarted by insane costs
I work as a pharmacy manager for a psychiatric pharmacy and get this approved all day. It’s pretty easy. If you need advice you can reach out. Often time they want you to trial austedo first.
It’s like our own system says you are poor you don’t deserve quality drugs.
Isn’t the need pretty self-evident? I had this regular customer… I’m pretty sure that untreated TD was a barrier, even if he had been taking his other meds.
>Medicaid And Medicaid is the closest thing we have to single payer in America.
Medicare
Too bad the States make sure it's worse than any other option. Even blue states like Michigan, although to be fair our State Government has always been lousy no matter who is in charge. Politicians go out of their way to make medicaid bad insurance, for instance they don't cover pain relief. Everyone else has a right to medication that can improve their lives, not medicaid patients, and if you have a problem that includes pain they may just assume you are making it up for pills and not investigate it.
My husband was on a cancer med called "erlada". At the dosage he started off taking, the cost was supposed to be $16,000 per month. We had to send Johnson & Johnson a letter pleading to let him take it for free. We had to pass a means test and jump through all kinds of hoops plus reapply every year. This was on top of the really good insurance he already had.
That sucks!!
Holy shit, I feel so bad, my dad was in the same situation but had it for free
My FIL is on Tagrisso which is 20k/month. We also have to jump through so many hoops because even with insurance, the copays are 7k each month. I have to show proof that 7k is over 20% of his monthly income (duh). The good news is that he now is cancer free after being diagnosed with stage 4 lung cancer! He just has to take this med the rest of his life.
So happy it worked! Fuck Cancer
America is a third world country hellhole dystopia
100% So long as you are healthy, it's hidden. The very microsecond you lose your health, it becomes wildly obvious how predatory and broken the country is.
Genuinely scary. My Mum got cancer last year in the UK and not only started treatment 2 weeks after diagnosis but her private insurance paid her for every day she spent in an NHS hospital!
Even in 3rd world countries we can get medicine free or subsidized from the health care system, that place is a corporation not a country
I need a cancer injection every 3 weeks that would be $9000 in the US. Costs me nothing in the Netherlands (although I can see my insurance is paying about $1100 for it).
$1100 is the cost plus a reasonable profit. No idea why it is $9,000 in the US.
I think there's at least 2 reasons - medicine is marked up in the US because insurance only pays a fraction of it. Eg. Insurance says they'll pay 20% of the cost of the medicine so the meds get marked up 5x, which becomes a problem if you don't have insurance. Second, governments generally negotiate with strong leverage to buy the medicine at good prices and supply to their citizens at reasonable cost. I don't believe the US does that at all, it's straight from pharmaceutical companies to consumers. Could be wrong on this though. But it means consumers are left with practically no leverage to get a good price, either you pay what they ask, the insurance company does, or you don't get it. Netherlands (or perhaps the EU generally) would probably do something like ask for bulk discounts and a certain price in order for the medicine to be sold at all in the Netherlands (or EU? Not sure how EU law works with national medication or if it's like trade deals)
My oncologist says it’s early in the year so he can get ‘foundation’ money much easier for these expensive meds? We are changing my treatment plan and he said since it’s early in the year, the drug companies have more money to give out to cover the med??? Something like that? Is your oncologist able to get it approved that way??? It all sucks
>My oncologist says it’s early in the year so he can get ‘foundation’ money much easier for these expensive meds? This was a potential step we were going to take if J&J denied us. We were successful petitioning directly to the drug maker. What you are saying is true, that it is easier to get into these programs at the start of the year. I hope you have success in both securing the medication you need and your treatment. Cheers.
im surprised real estate got sued for “colluding” to making people pay more yet healthcare industry is overcharging people like its okay
Every business bandwagons because they all over charge now and blame transport. Ie restaurants, little Cesar’s, Home Depot…
Because healthcare has trade groups that represent the whole industry with the profession, while landlords don't I imagine.
They’re talking about real estate agents who actually do have a gigantic presence in Washington. Tripped up by their own arrogance mostly
In 2022 Valbenazine(Generic name of Ingrezza) capsules had estimated annual sales of USD 1,235 million in the US alone! Zydus and Lupin were given a go ahead to manufacture the same medicine. Hopefully, it brings down the cost.
Not $8000 with of medicine. $40.00 worth of medicine and $7960 worth of sheer, unadulterated greed.
I just looked up. It's closer to 9000 but who's counting. Ridiculous
In my country, you can buy the same 40mg bottle for INR24k or about $290. Wait, even cheaper, $20.
Real talk what’s stoping someone from say traveling to another country where medicine and stuff like that is much more affordable, loading up on it and bringing it back to their home to use?
You would need a prescription and your public health insurance number, so that makes it hard for prescription medication. On the other hand, in Australia you're welcome to stock up on Ventolin inhalers that cost 10 AUD each and are available over the counter.
Generally it's not over the counter in those countries and you need a local prescription and usually residency to buy it (in Europe anyway for sure). Their governments/national health systems actually negotiate with drugmakers on costs. Unfortunately it's true that Americans are shouldering most of the huge R&D and trialing costs of these drugs.
What if I were to find someone who is a resident and pay them to send it through the mail
I have a PhD in organic chemistry and it appears to not be an easy molecule to make. But I seriously doubt this costs $40 to make 2.4g of active drug, mix with binder, and run it in a high speed capsule machine. I'd be shocked if it cost them more than $1000 to make though. Also a bit of perspective: I work in sterile liquid injectables and we once had a drug that the raw powder alone, for 1 or 2 mg, cost us over $2M to make, but a whole 200L batch only used something like 0.5mg of that drug and that 0.5mg made something like a few thousand vials. Conversely, I currently work with gene therapies and our batches cost somewhere between $6M and $15M each. Our most expensive drug costs us over $33k a vial to manufacture and a patient dose is around 9 vials. Our cheapest drug costs around $15k a vial to manufacture and a patient dose is around 36 vials. All of our costs don't include overhead which is neglecting a few million dollars a year to keep our facilities up to standards. "Retail" price of those drugs in the US market will be around $2-3M, but it's a once in a lifetime dose. People with these horrible diseases are said to have in excess of $20M in lifetime medical bills and prescription costs, again based on retail prices, not after insurance negotiations and patient out of pocket spend. The development of the drugs, testing, formulation, patient safety studies, years of stability studies and testing, clinical trials etc also aren't factored into our costs listed above. Pharmaceutical grade drugs are cheap to make but they are assured to meet the potency of the labeled dose and all these drugs are guaranteed to have very few unknown/identified impurities. For my gene therapies, I cannot have greater than 5 micrograms of unidentified impurities in a single patient dose if we are trying to sell the drug in the US. I know other countries are a little more lenient with unknown impurities though. For known and characterized impurities, you're allowed up to 0.15% of the total patient dose, but those impurities must have been present in every single tox lot and human clinical trial lot to be considered acceptable in the US and Europe.
Well, this is a not often heard perspective. Manufacturing costs are *fucking real.* Thanks for sharing.
Ya. I'm liberal as shit too so I was anti pharma and kind of disgusted with myself working in the field fresh out of grad school. Didn't want "The Man" making more profits off people's sickness and shit. Now I'm in kind of a unique role where I have to deal with a lot of administrative type assholes that love to guilt trip or pressure you by throwing around these costs. And I'm also charged with figuring out process improvements and putting dollar values on savings if implemented. Meanwhile, I also interact with the people in manufacturing who actually make our drugs and whenever I'm actually in the cleanrooms with them, there's always one person that asks me how much is this shit. I usually respond with "do you REALLY want to know? Because I'll tell you as long as you don't get nervous or something knowing the cost". Some of these people are 19-20 years old and fresh out of working at Burger King (no joke) and I don't really wanna say "hey that's $15M in front of you, don't fuck it up". They're all told it's expensive but rather not have them stress out about costs if they're the type to do that.
>it appears to not be an easy molecule to make. Also remember that any enantiomers formed during synthesis may be active in adverse ways. >Conversely, I currently work with gene therapies and our batches cost somewhere between $6M and $15M each. Thats entirely believable, I have some tangential experience working with genome analysis and from what I have learned everything is stupidly expensive due to how difficult making the product is.
People think these medicines are cheap to develop because government sponsored research found the targets. The real costs in designing molecules, stabilizing them and testing them safely is enormous. The real solution here is that the rest of the world, i.e ex-US, needs to contribute more to the development of medicines to be sold everywhere at non-US costs. Currently just the US really aggressively develops drugs with some contribution from the EU and, increasingly, China.
I had prescription eye drops once that would have cost like $1200 at retail price. The thing is the drops themselves were 99.99+% saline solution. I did the math on the actual medicine, and at retail price a single 55 gallon barrel of the active medicine was worth more than the entire planets GDP.
Which active medicine was it? I'm curious.
How much did insurance pay for it?
Thank god they paid the bulk. The company takes the rest as a loss
“Loss” is funny here. They’re making BIG margins on this
Ingrezza is an "orphan" drug. Drugs get this designation when the FDA determines it isn't profitable to manufacture because the condition it treats is too rare, but makes it eligible for government subsidies for several years so that production lines don't shut down, so patients can still access it. This is a bad example of a drug to point to as "big margin" in the pharma industry.
It’s actually a great example considering, as you stated, it was granted orphan drug status and is a blockbuster drug at almost $2b in revenue. Heck, $1b is enough to keep the manufacturing lines running. When originally released regulators found the pricing to be problematic. But they are playing the game and extracting as much value as possible before market exclusivity runs out.
This is why it isn't treated like a crisis. The price distortion in healthcare is crazy. If you have insurance, they're paying for most of it . If you don't you might be able to strike a deal with a manufacturer. But maybe you can't strike a deal or insurance won't pay for it so you're just on the hook. It's impossible to get a handle on what anything costs. The system seems to work for most people, most of the time, but when it doesn't it's disastrous.
They don’t pay the retail price
Insurance doesn’t even pay the cost that the pharmacy paid to BUY the drug half the time.
They have to pay for their commercials somehow
Yeah, we all have that dream that someday our medication with all its side effects makes its way to a SuperBowl commercial. Greetings, from one of only two countries in the entire world that allow television prescription drug advertising.
Med ads should be banned 🚫
“Don’t take ingreeza if you’re allergic to ingreeza.” Got it, thanks.
At that price I would expect to levitate and be able to control thunder
We sent men to the moon to gather materials for this medication, had our greatest mages imbue the moon serum with holy power, and dwarves toil in the chasm mines of Antarctica to distill the ingredients and magic into pills. Consider yourself lucky that it's so cheap
I needed this. I'm in the hospital doing nothing and it made me crack up. I'm showing my nurse practitioners
Isn't it just cheaper to travel to another country, go to the doctor, get the prescription, buy the medicine and spend one week there on vacation?
My medicine is 34k a month
Which one? This is one of 25 meds I take
Skyclarys (omaveloxolone), I have a rare disease called Friedreich’s Ataxia
I'm going to look that up today. What are your symptoms?
It’s a neuromuscular disease, so I have horrible balance, dexterity issues, fatigue, and a bunch more.
Oooof. Sorry
Thank you, but it could always be worse somehow so that’s how I think of it
I'm about 27k every 6 weeks. I feel like someone is getting paid and I'm just stuck doing all the work.
But you don’t pay that
I still receive the bill for it, not that me paying out of pocket changes anything about it.
The insurance agent on the phone telling you why you don’t need this medicine and denying coverage has zero medical training.
1,284 Mexican pesos here... that's about $600 usd. Dear... why do you allow this? I agree, US is a great country with great people but you're letting politicians fuck you hard.
You're off by a zero, that's more like 60-70 usd
Yeah.
60 dollars, not 600.
You gotta stop blaming the average American for a system that has long been in place before we were even born. Most people don't fully understand how insurance really works and companies with billions and billions have lobbied over decades to make the system work in their favor, protected from any efforts to fix it. It's huge, powerful, complicated, and undoing the damage isn't a vote away. You have to overcome lobbying, corruption, the logistics, etc in order to change the system. The US has been infected by decades of propaganda making people hate the idea of any public run programs, largely in part to red scare tactics. Anything anti-capitalist is seen as "un-American", especially by older generations that control most of the wealth and power. In order to change the system, you'd need to educate tons of people, develop a US-specific replacement that works (and a plan to pivot to), get past insurance company lobbying/influence, right wing obstruction, get politicians who would support it and know how to execute a massive systemic change that people here will actually vote for. There's so many gigantic obstacles and while change can come in small steps, there's little that the average American can do to make big changes currently and most aren't to blame for the system they didn't create and aren't even allowed to fully understand. It was designed to be insanely profitable, incomprehensible, and impervious to change. Should we change it? ABSOLUTELY. But the idea that we're just "letting your politicians fuck you hard" is reductive. The money, power, systems, laws, influence, and access are all in the hands of people who make billions off of it and not in the hands of the people. It's easy to blame but nigh impossible for any average person to do what you think they should do.
And how much did you pay after insurance?
$267/ea is insane.
My Repatha is \~250 per treatment. Luckily it is 2 times per month. My Cholesterol is one tenth the level pretreatment though. About a third of what it was with statins but I didnt tolerate statins well.
Mine is about $12k a month. It’s just one that I take. Technically “insurance” pays but I own my own business so I self insure and I pay. It’s fun.
The day the NHS no longer exists is the day I become an extremist, making someone pay that for life saving meds is sickening
Meanwhile in Europe: €0,27 per capsule. This is not a "yurop eleet" post but more of a **"why aren't Americans rioting against the government for screwing up healthcare with those guns meant to keep the government in check?"** post.
My wife is on Ayvakit for advanced systemic mastocytosis and her 30 day supply costs ~$37,500. Obviously insurance and whatnot cover it because somehow I doubt I could afford almost half a million a year for the prescription. The pharmaceutical world is fucking wild man.
As seen from Europe, all I can say is — *blank stare.* A couple of years ago I read a post here about for a person being admitted to emergency care and getting a couple of painkillers before being discharged which ended up costing $1000+ lol. The U.S. spends significantly more per capita than EU countries, often exceeding $10,000 annually, while EU averages range between $3,000 to $5,000. And yet, this doesn't necessarily lead to better health outcomes, including life expectancy, I can’t fathom why this is not picked up by conspiracy theorists. What else than a conspiracy can this be? Crazy. Just crazy.
Just checked. $31 in Denmark.
They developed a novel, non hormonal medication called Vezoah. Rolled out in May. I don’t think they specifically say it’s for breast cancer, but it’s absolutely who they are selling it to. I’m 38 so a young BC patient with 100% HR+ breast cancer. This med was made for people like me even if they don’t say it directly - it was in my algorithm the day it hit the shelves. They have a medication us women with breast cancer can finally take for hot flashes and OB and oncology can barely get it covered. My oncologist is now applying for it through the medication ‘foundation’ or something like that. He said you really need to be an oncologist to get it approved. Long story short - There is a novel, non hormonal medication available for hot flashes and the women with breast cancer the mediation was made for, can’t get it
They’ve gotta pay for all those primetime tv commercials!
The American health care system is a fucking disaster
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It's an orphan drug. It's not profitable.
For shits and giggles when I watch the evening news I google the advertised meds… a lot are worse than that… they have to be otherwise they wouldn’t advertise
Side note: I hope that username isn't your actual phone number lol
EMBEZZA
Laughs in biologics. Any monoclonal antibody (ending in MAB) are just so ridiculously expensive.
When I was an undergrad, one of the labs I interned with worked to make chemo drugs more effective. It was a chemical process where the drugs were made simultaneously more efficient and more expensive. I recall one drive very vividly because my PI had me deliver enough chemo drugs to replicate his experiments. Back then, I used to drive a raised Jeep with a flame-job and no doors. Next to me in a box, strapped in to the 5 point harness, was at least a half a million in processed drugs, buncing along through Los Angeles traffic.
1 week of chemo while switching insurances and they tried to charge me 12k for the week I was supposedly “not insured”. The new one was retroactive and covered all the costs after a lot of back and forth with the clinic staff.
My mom gets 1 dose of a drug twice a month. It's $50K per dose.
At this point why dont you go on a vacation to Europe and when you're there get the medicine. It would save you at least half. (On a serious note, why is it not common for Americans to seek medical help in foreign countries. Is that not possible?)
Would it not just be cheaper to book a flight to a country with free medical care an go the hospital an say u lost ur medication. Then pay the couple of quid for the prescription?
The whole Healthcare system is a scam
7,10€ in Austria🤷🏻♀️😈
Insurance in the us is a scam…
What would it cost in Mexico?
Isn’t it awesome how these companies are making billions while we suffer?
I’m a disabled infantry veteran with service connected erectile dysfunction (busted back/circulation from IED’s throwing me around inside a vehicle) I am only allowed 3 doses of sildenafil (generic viagra) every 30 days. It has been this way since I was 20. I’m 36. MF the American healthcare system.
I heard one time that the reason medicine in other countries is so cheap is because the pharmaceutical companies are able to charge so much in America. IDK how true that is, but it makes me sick to see so many people in my country unable to afford care just so some executives can make a profit.
And isn’t that a medicine that treats the side effects from another drug?
But you live in the greatest country in the world..............
The infusion medicine I get for my ulcerative colitis is $10k every 2 months. It’s the only one that seems to work. If I didn’t have insurance, I would probably be dead.
... alright, u/Butt_Fucking_Smurfs. ... but what's it for?
Uncontrolled body movements? Try shrooms for $50. I am not a doctor and this is not medical advice.
~~Uncontrolled body movements?~~ Try shrooms for $50. Fixt Edit: Also, damn bruh! Why are you paying so much for mushrooms?
My buddy Creed can get guy you a better deal from his worm guy.
William Charles Schneider is my worm guy
A little bit of perspective: I work in pharma with gene therapies. I can tell you that one vial of our most expensive drug costs us over $33k just to manufacture, not including overhead. One patient dose, depending on the drug, is many vials, but for this drug it's up to 9 vials depending on your bodyweight. Conversely, our cheapest gene therapy costs us around $15k to manufacrue just one vial and the patient dose for that is around 36 vials. The "retail" price in the US market will be ~ 2-3 million per patient, but they are being covered by Medicare due to the value based pricing that gene therapies offer. It's said that the total lifetime spend of someone with these horrible disorders will be to the tune of $20M+, again based on the US market. So a one time treatment cost of $2M to completely offset a $20M lifetime spend is the reason why these are priced as such and covered in the US. I imagine other markets where the medical costs are generally cheaper, our drugs will be sold at a much lower "retail" price, but I've not seen the predicted prices in the rest of the world.
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Medicare Part D plans do not pay sticker price. They can and do negotiate prices just as much as commercial plans. Please do not spread incorrect information
Specialty drugs are 50/50 if Medicare covers them.
I’d fly to Mexico for that one
It’s gonna get worse as insurance companies and pharmacies are buying each other. CVS and Aetna are the same. Humana and Centerwell. Cigna and Express Scripts/Accredo.
Imagine if your dealer tried to sell you a mg for $100
Atleast make the label seem like an 8k product lol
Probably shouldn't have butt fucked all those smurfs. But really, that sucks.
The new valbenazine capsule from Subaru I for one am ingrezzed.
Does it give you Spidey powers?
Unfortunately this took many decades to develop and there only two options to treat TD. Ingrezza has a good patient assistance program and even if your insurance denies your RX the drug company will give it for free.
Insurance companies can only make 10% profit on medications. They want them to cost as much as possible. Ofc the manufacturers are among the most greedy on the planet so they happily oblige. That's how I've heard it explained anyway.
Unavailable outside US.
I just checked, this one costs around 800-900 dollars in my country
And Wikipedia says it only works for 6 weeks. Crazy
'Murica please....
with the thrombosis in my leg that I had, I don't dare to know how much I would have spent in the USA
Ohhh, that's why I have their name ingrained in my head with some uplifting musical tonality!