The cost of medicines in the USA and here

[emperorburger]

pavarotti1980 said:

So its a PGD which is sensible Not an over the counter sale.

This process is replicated in A&E departments with the hand out meds you might get

There is a control framework around the sale, which is good (It's not Russia, where you pop in to the Pharmacy to buy Interferon's for a cold). However, a drug such as Salbutamol, which was first marketed in the late 60's and has been off patent for years now is still subject to price gouging both in the States and to a lesser extent here with the NHS.

Yes, there are generics available at lower cost but in the case of salbutamol inhalers it's not so much about the active ingredients (which are the same), but the delivery of the drug itself via the inhaler, which has caused many patients to insist on being given a Ventolin rather than a generic equivalent.

[AJL308]

geeman237 said:

rscott said:

In the US the cost can vary massively, depending on whether you have the brand name drug prescribed or a generic equivalent.

Albuterol (US name for salbutamol) can be anything from $0.40 to $12.10 for 10 nebuliser doses, depending on the brand name ( https://health.costhelper.com/albuterol-inhaler.ht... ).

Some pharmacists will dispense a generic when a branded version is prescribed, some won't.

I recently got a new Salbutamol brand inhaler here in the US. I’d had the US equivalent before. With my insurance deduction, a 200(?) dose inhaler (UK size I remember) it cost me about $40 I think.

So, essentially, its nowhere even close to $250.

Edit: this is the one which is currently being bunged on every social media platform going http://huffp.st/SjRVVbc

Edited by AJL308 on Thursday 5th December 10:15

[pavarotti1980]

emperorburger said:

There is a control framework around the sale, which is good (It's not Russia, where you pop in to the Pharmacy to buy Interferon's for a cold). However, a drug such as Salbutamol, which was first marketed in the late 60's and has been off patent for years now is still subject to price gouging both in the States and to a lesser extent here with the NHS.

Yes, there are generics available at lower cost but in the case of salbutamol inhalers it's not so much about the active ingredients (which are the same), but the delivery of the drug itself via the inhaler, which has caused many patients to insist on being given a Ventolin rather than a generic equivalent.

yeah I know. 20 years hospital pharmacy experience here including writing the PGD policy review for our A&E department.

The salbutamol argument is irrelevant as the generic versions in widespread use are the same as Ventolin (MDI). Anecdotally the taste isnt as nice in generics such as Salamol but the delivery is identical

Edited by pavarotti1980 on Thursday 5th December 10:15

Edited by pavarotti1980 on Thursday 5th December 10:16

[emperorburger]

pavarotti1980 said:

yeah I know. 20 years hospital pharmacy experience here including writing the PGD policy review for our A&E department.

The salbutamol argument is irrelevant as the generic versions in widespread use are the same as Ventolin (MDI). Anecdotally the taste isnt as nice in generics such as Salamol but the delivery is identical

Edited by pavarotti1980 on Thursday 5th December 10:15

Edited by pavarotti1980 on Thursday 5th December 10:16

It's true, the generics do taste rank and the canister of a generic is often around a half or a third of the size compared to a Ventolin, so either the propellant used or pressure of the canister is different vs a Ventolin, which in my own anecdotal experience does seem to affect the delivery of the drug. I suspect this is going a wee bit off topic.

[rscott]

AJL308 said:

geeman237 said:

rscott said:

In the US the cost can vary massively, depending on whether you have the brand name drug prescribed or a generic equivalent.

Albuterol (US name for salbutamol) can be anything from $0.40 to $12.10 for 10 nebuliser doses, depending on the brand name ( https://health.costhelper.com/albuterol-inhaler.ht... ).

Some pharmacists will dispense a generic when a branded version is prescribed, some won't.

I recently got a new Salbutamol brand inhaler here in the US. I’d had the US equivalent before. With my insurance deduction, a 200(?) dose inhaler (UK size I remember) it cost me about $40 I think.

So, essentially, its nowhere even close to $250.

Edit: this is the one which is currently being bunged on every social media platform going http://huffp.st/SjRVVbc

Edited by AJL308 on Thursday 5th December 10:15

Nope, he quoted $40 as his cost AFTER the insurance contribution. So they key question is how much the insurance contribution actually is, so then we know how much the drug is actually costing over there.

[deadtom]

can someone explain in simple terms to a simple person what the risk is with trade deals? What does it mean for the NHS to be for sale?

What are Labour threatening will happen if Tory gets in, and what is bad about this? Is the risk that in return for the USA making it's products available it will impose high tariffs, taxes etc on us? If so surely we can just keep buying from our current suppliers if we don't want to pay US prices?

The horror stories that one imagines are that the NHS will be scrapped and we will each be paying £1000 / month for health insurance and/or risk becoming destitute from unexpected medical bills as you so often hear about in the USA, but even the frothiest mouthed anti-tory seems to stop short of saying this would happen, rather they make undefined threats about trade agreements and big pharma etc.

If that realistically were the case then I'd be at the front of the queue at the polling station to vote Labour, but as far as I can tell the waters are a lot more murky than that

[The Moose]

Derek Smith said:

However, it is illegal in the US for people to cross the border and import the cheaper drugs.

I don’t know if it’s illegal for a person to physically cross the border and bring in drugs from Canada, but it’s certainly not illegal to have them shipped to you!

[AJL308]

rscott said:

AJL308 said:

geeman237 said:

rscott said:

In the US the cost can vary massively, depending on whether you have the brand name drug prescribed or a generic equivalent.

Albuterol (US name for salbutamol) can be anything from $0.40 to $12.10 for 10 nebuliser doses, depending on the brand name ( https://health.costhelper.com/albuterol-inhaler.ht... ).

Some pharmacists will dispense a generic when a branded version is prescribed, some won't.

I recently got a new Salbutamol brand inhaler here in the US. I’d had the US equivalent before. With my insurance deduction, a 200(?) dose inhaler (UK size I remember) it cost me about $40 I think.

So, essentially, its nowhere even close to $250.

Edit: this is the one which is currently being bunged on every social media platform going http://huffp.st/SjRVVbc

Edited by AJL308 on Thursday 5th December 10:15

Nope, he quoted $40 as his cost AFTER the insurance contribution. So they key question is how much the insurance contribution actually is, so then we know how much the drug is actually costing over there.

Well, it's still $40. The point being, as you say, the end result after you've paid your annual health insurance premiums. The real issue is how to compare it to here. We have the NHS but pay a fk load more tax than the yanks. Does it matter whether you pay it in the form of higher taxes or as health insurance if it ends up being essentially the same amount overall?

On a personal note, I really just don't buy the guff that Is being spouted by the left that anyone is "selling" the NHS to the US drug companies. It's a complete load of horse st. No way in my lifetime is anyone in this country going to be paying £250 for an inhaler or paying £30k to drop a kid. It's utter fantasy for the young and the gullible.

[Zirconia]

I think the problem has been overtaken by the poor wording of the NHS for sale comment. Whilst I may not pay for my inhaler, the NHS could find it is having to pay a higher cost for that inhaler. That could have knock on effects and perhaps that inhaler could suffer and be a cheaper version to allow for other higher spending drugs that are tied in by a deal with the US.

Of course there is no deal at the moment, but it would appear the US want the trade on their terms, not ours.

At least as far as I understand the concern.

[rscott]

AJL308 said:

rscott said:

AJL308 said:

geeman237 said:

rscott said:

In the US the cost can vary massively, depending on whether you have the brand name drug prescribed or a generic equivalent.

Albuterol (US name for salbutamol) can be anything from $0.40 to $12.10 for 10 nebuliser doses, depending on the brand name ( https://health.costhelper.com/albuterol-inhaler.ht... ).

Some pharmacists will dispense a generic when a branded version is prescribed, some won't.

I recently got a new Salbutamol brand inhaler here in the US. I’d had the US equivalent before. With my insurance deduction, a 200(?) dose inhaler (UK size I remember) it cost me about $40 I think.

So, essentially, its nowhere even close to $250.

Edit: this is the one which is currently being bunged on every social media platform going http://huffp.st/SjRVVbc

Edited by AJL308 on Thursday 5th December 10:15

Nope, he quoted $40 as his cost AFTER the insurance contribution. So they key question is how much the insurance contribution actually is, so then we know how much the drug is actually costing over there.

Well, it's still $40. The point being, as you say, the end result after you've paid your annual health insurance premiums. The real issue is how to compare it to here. We have the NHS but pay a fk load more tax than the yanks. Does it matter whether you pay it in the form of higher taxes or as health insurance if it ends up being essentially the same amount overall?

On a personal note, I really just don't buy the guff that Is being spouted by the left that anyone is "selling" the NHS to the US drug companies. It's a complete load of horse st. No way in my lifetime is anyone in this country going to be paying £250 for an inhaler or paying £30k to drop a kid. It's utter fantasy for the young and the gullible.

If we agree that it's $40, then it's considerably more than the cost here - £9 ( NHS prescription fee).

However, what matters is how much the healthcare provider (be it insurance or NHS) pays for the drug in the first place.

[Mrr T]

deadtom said:

can someone explain in simple terms to a simple person what the risk is with trade deals? What does it mean for the NHS to be for sale?

What are Labour threatening will happen if Tory gets in, and what is bad about this? Is the risk that in return for the USA making it's products available it will impose high tariffs, taxes etc on us? If so surely we can just keep buying from our current suppliers if we don't want to pay US prices?

The horror stories that one imagines are that the NHS will be scrapped and we will each be paying £1000 / month for health insurance and/or risk becoming destitute from unexpected medical bills as you so often hear about in the USA, but even the frothiest mouthed anti-tory seems to stop short of saying this would happen, rather they make undefined threats about trade agreements and big pharma etc.

If that realistically were the case then I'd be at the front of the queue at the polling station to vote Labour, but as far as I can tell the waters are a lot more murky than that

I know its the Guardian but this explains what the US are looking for in any FTA with the UK.

https://www.theguardian.com/commentisfree/2019/nov...

[The Moose]

rscott said:

If we agree that it's $40, then it's considerably more than the cost here - £9 ( NHS prescription fee).

However, what matters is how much the healthcare provider (be it insurance or NHS) pays for the drug in the first place.

The cost to the user could be as little as $0.

[sparkythecat]

Carl_Manchester said:

The short answer is that drug prices in the USA are astronomical and they are astronomical, ironically because the USA market is rigged internally. If Trump can open a path to foreign companies selling their drugs internally within the US market, it will be a big win for him.

The Trump administration has been trying to do this since election however, the big pharma lobby in the USA is strong.

In the UK market, the drug purchasing industry is not rigged and so, even if US drug companies had full access to the UK NHS market to sell their wares, like-for-like they would not get many contracts if they are in direct competition with the EU manufacturers.

The EU manufacturers also have volume in their favour, they constitute 50%+ of global capacity, the USA companies are around 10% and so if the USA market was straightened out, it is likely that the profits of the US drug companies would tank and this is why the lobby is so strong.

The irony of all this is that in a trade deal, including medicines, it would be the U.K based drug manufacturers that would benefit the most. The USA manufacturers are sitting ducks for competition.

Have you got any corroboration for this Carl?
It's a long way from the picture painted in MrrT's Guardian link above.

[Electro1980]

rscott said:

AJL308 said:

rscott said:

AJL308 said:

geeman237 said:

rscott said:

In the US the cost can vary massively, depending on whether you have the brand name drug prescribed or a generic equivalent.

Albuterol (US name for salbutamol) can be anything from $0.40 to $12.10 for 10 nebuliser doses, depending on the brand name ( https://health.costhelper.com/albuterol-inhaler.ht... ).

Some pharmacists will dispense a generic when a branded version is prescribed, some won't.

I recently got a new Salbutamol brand inhaler here in the US. I’d had the US equivalent before. With my insurance deduction, a 200(?) dose inhaler (UK size I remember) it cost me about $40 I think.

So, essentially, its nowhere even close to $250.

Edit: this is the one which is currently being bunged on every social media platform going http://huffp.st/SjRVVbc

Edited by AJL308 on Thursday 5th December 10:15

Nope, he quoted $40 as his cost AFTER the insurance contribution. So they key question is how much the insurance contribution actually is, so then we know how much the drug is actually costing over there.

Well, it's still $40. The point being, as you say, the end result after you've paid your annual health insurance premiums. The real issue is how to compare it to here. We have the NHS but pay a fk load more tax than the yanks. Does it matter whether you pay it in the form of higher taxes or as health insurance if it ends up being essentially the same amount overall?

On a personal note, I really just don't buy the guff that Is being spouted by the left that anyone is "selling" the NHS to the US drug companies. It's a complete load of horse st. No way in my lifetime is anyone in this country going to be paying £250 for an inhaler or paying £30k to drop a kid. It's utter fantasy for the young and the gullible.

If we agree that it's $40, then it's considerably more than the cost here - £9 ( NHS prescription fee).

However, what matters is how much the healthcare provider (be it insurance or NHS) pays for the drug in the first place.

That’s a Salbutamol inhaler though. They are by far the cheapest but are only relive current symptoms. There are many other types of inhaler, which are more expensive. A Forsair preventative inhaler is about £60 in the UK, and digging around this seems to be what is being referred to (the only reference I can find is an NY Times article talking about Forstair inhalers being $250-$350)

[The Moose]

Electro1980 said:

rscott said:

AJL308 said:

rscott said:

AJL308 said:

geeman237 said:

rscott said:

In the US the cost can vary massively, depending on whether you have the brand name drug prescribed or a generic equivalent.

Albuterol (US name for salbutamol) can be anything from $0.40 to $12.10 for 10 nebuliser doses, depending on the brand name ( https://health.costhelper.com/albuterol-inhaler.ht... ).

Some pharmacists will dispense a generic when a branded version is prescribed, some won't.

I recently got a new Salbutamol brand inhaler here in the US. I’d had the US equivalent before. With my insurance deduction, a 200(?) dose inhaler (UK size I remember) it cost me about $40 I think.

So, essentially, its nowhere even close to $250.

Edit: this is the one which is currently being bunged on every social media platform going http://huffp.st/SjRVVbc

Edited by AJL308 on Thursday 5th December 10:15

Nope, he quoted $40 as his cost AFTER the insurance contribution. So they key question is how much the insurance contribution actually is, so then we know how much the drug is actually costing over there.

Well, it's still $40. The point being, as you say, the end result after you've paid your annual health insurance premiums. The real issue is how to compare it to here. We have the NHS but pay a fk load more tax than the yanks. Does it matter whether you pay it in the form of higher taxes or as health insurance if it ends up being essentially the same amount overall?

On a personal note, I really just don't buy the guff that Is being spouted by the left that anyone is "selling" the NHS to the US drug companies. It's a complete load of horse st. No way in my lifetime is anyone in this country going to be paying £250 for an inhaler or paying £30k to drop a kid. It's utter fantasy for the young and the gullible.

If we agree that it's $40, then it's considerably more than the cost here - £9 ( NHS prescription fee).

However, what matters is how much the healthcare provider (be it insurance or NHS) pays for the drug in the first place.

That’s a Salbutamol inhaler though. They are by far the cheapest but are only relive current symptoms. There are many other types of inhaler, which are more expensive. A Forsair preventative inhaler is about £60 in the UK, and digging around this seems to be what is being referred to (the only reference I can find is an NY Times article talking about Forstair inhalers being $250-$350)

I just took a quick look and Fostair appears to be £100 for 1 off 100/6 inhaler from Superdrug. Is this what you're talking about?

[AJL308]

The Moose said:

rscott said:

If we agree that it's $40, then it's considerably more than the cost here - £9 ( NHS prescription fee).

However, what matters is how much the healthcare provider (be it insurance or NHS) pays for the drug in the first place.

The cost to the user could be as little as $0.

It can't as it has to be paid for by someone and that someone is the user who pays for it via their taxes.

[pavarotti1980]

rscott said:

If we agree that it's $40, then it's considerably more than the cost here - £9 ( NHS prescription fee).

However, what matters is how much the healthcare provider (be it insurance or NHS) pays for the drug in the first place.

Drug tariff price for salbutamol 100micrograms/dose inhaler CFC free (the price paid by NHS to the contractor i.e. community pharmacy) is £1.60

Electro1980 said:

That’s a Salbutamol inhaler though. They are by far the cheapest but are only relive current symptoms. There are many other types of inhaler, which are more expensive. A Forsair preventative inhaler is about £60 in the UK, and digging around this seems to be what is being referred to (the only reference I can find is an NY Times article talking about Forstair inhalers being $250-$350)

Fostair (beclometasone dipropionate/formeterol) 100/6 is £29.32

Edited by pavarotti1980 on Thursday 5th December 13:53

[The Moose]

AJL308 said:

The Moose said:

rscott said:

If we agree that it's $40, then it's considerably more than the cost here - £9 ( NHS prescription fee).

However, what matters is how much the healthcare provider (be it insurance or NHS) pays for the drug in the first place.

The cost to the user could be as little as $0.

It can't as it has to be paid for by someone and that someone is the user who pays for it via their taxes.

A drug co-pay can be as little as $0.00. This means at the point of dispensing, the cost to the user is $0.

[rscott]

The Moose said:

AJL308 said:

The Moose said:

rscott said:

If we agree that it's $40, then it's considerably more than the cost here - £9 ( NHS prescription fee).

However, what matters is how much the healthcare provider (be it insurance or NHS) pays for the drug in the first place.

The cost to the user could be as little as $0.

It can't as it has to be paid for by someone and that someone is the user who pays for it via their taxes.

A drug co-pay can be as little as $0.00. This means at the point of dispensing, the cost to the user is $0.

And prescriptions are free to many UK patients.

The end user cost is pretty irrelevant really - it's what the healthcare provider (be it NHS or private insurance) is having to pay for the drug.

[The Moose]

rscott said:

The Moose said:

AJL308 said:

The Moose said:

rscott said:

If we agree that it's $40, then it's considerably more than the cost here - £9 ( NHS prescription fee).

However, what matters is how much the healthcare provider (be it insurance or NHS) pays for the drug in the first place.

The cost to the user could be as little as $0.

It can't as it has to be paid for by someone and that someone is the user who pays for it via their taxes.

A drug co-pay can be as little as $0.00. This means at the point of dispensing, the cost to the user is $0.

And prescriptions are free to many UK patients.

The end user cost is pretty irrelevant really - it's what the healthcare provider (be it NHS or private insurance) is having to pay for the drug.

I know! You were comparing $40 to £9!