The cost of medicines in the USA and here

[rscott]

The Moose said:

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!

I think we're in agreement about the costs..
I only mentioned it because AJL308 was comparing the co-pay cost with the UK non-prescription cost and trying to say the US wasn't that expensive..

[Electro1980]

pavarotti1980 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.

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

Ok, so even bigger (and presumably that is the one off price rather than the bulk price the NHS pay) if the US price is correct. Unfortunately I have no idea what the correct US price is, and how accurate the NY times is. The main point being, however, is that there is no such thing as one single asthma inhaler, and the best known is also the cheapest.

[The Moose]

Electro1980 said:

Ok, so even bigger (and presumably that is the one off price rather than the bulk price the NHS pay) if the US price is correct. Unfortunately I have no idea what the correct US price is, and how accurate the NY times is. The main point being, however, is that there is no such thing as one single asthma inhaler, and the best known is also the cheapest.

I don't believe Fostair is available in the USA - I couldn't find a reference to it when I looked briefly earlier.

[Derek Smith]

The Moose said:

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!

The American version of Which? states in the current magazine that it is illegal to have them shipped into the USA without the necessary authorisation, which is not awared to users. So Tracy, who might well be importing drugs from Canada because she could not afford the charges, is committing an offence. Whether she gets prosecuted is not stated. But an offence it is.

[RDMcG]

(1)US healthcare is complex but it is important to know that it is for profit in general. Medicaid shows up at 65 and covers basic care.
(2) medical bills are the leading cause of bankruptcy
(3) quality of medical coverage is essential in taking a job
(4) If you are poor and uninsured you are done
(5) never visit without good insurance

Many people try to stay employed to 66 to qualify for Medicaid.

The real crunch comes later...elder care. Good retirement places maybe $5k a month...often much more. Otherwise back with the family.

It is a system I would never want to live in..
If you are wealthy OTOH it is amazing. Best premium car anywhere if you can afford mega dollars.

[Sheepshanks]

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.

That's exactly the angle an American colleague told me they're looking at.

I had to get eye drops (Maxidex I think) while in the US a few years ago and they were $90. Pharmacist here said they cost a fiver.


That said, he thinks their health care system is far better than ours, and I've heard that a few times from Americans who think our health care system is pretty backward.

[Sheepshanks]

RDMcG said:

Good retirement places maybe $5k a month...often much more. Otherwise back with the family.

Similar in UK.

[The Moose]

Derek Smith said:

The Moose said:

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!

The American version of Which? states in the current magazine that it is illegal to have them shipped into the USA without the necessary authorisation, which is not awared to users. So Tracy, who might well be importing drugs from Canada because she could not afford the charges, is committing an offence. Whether she gets prosecuted is not stated. But an offence it is.

Link? I know several people who regularly send their scripts North of the border and then the pharmacy mails them their drugs.

[Electro1980]

Sheepshanks said:

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.

That's exactly the angle an American colleague told me they're looking at.

I had to get eye drops (Maxidex I think) while in the US a few years ago and they were $90. Pharmacist here said they cost a fiver.


That said, he thinks their health care system is far better than ours, and I've heard that a few times from Americans who think our health care system is pretty backward.

The question is, why and how informed are they? The US media, especially the right wing media, is somewhat untrustworthy. For example they talk about “death panels” in the UK controlling access to medicine. What they are talking about is bodies that decide on the clinical value of treatments.

We also have a very different view. Americans like to medicalise things. For example most US births are in hospital, and they have a doctor. Midwifes are rare and in many places illegal. Yet the US system has better success rates and lower interventions, but because it involves less medical settings it may be considered “backwards” by those without the facts.

[popegregory]

So why would we be doing a deal with US pharmaceutical companies to pay more for drugs?

[Cantaloupe]

Sheepshanks said:

That said, he thinks their health care system is far better than ours, and I've heard that a few times from Americans who think our health care system is pretty backward.

Most countries health care systems are better than the pisspoor NHS, Ireland has double the number of GPs per head of population than we do.
Portugal 3 times.

[Zirconia]

popegregory said:

So why would we be doing a deal with US pharmaceutical companies to pay more for drugs?

Boris wants deals or he is seen to fail. US want the NHS to buy their drugs in deals with patents extended. They also want to sell more drugs claiming the nhs does not use all that is available.

[jamoor]

emperorburger said:

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.

You can buy glaxo ones for £1-2, in fact I bought one in Myanmar for around that much and it was made in Australia IIRC!

Makes you wonder how much the NHS makes on each when they prescribe them.

[The Moose]

RDMcG said:

(1)US healthcare is complex but it is important to know that it is for profit in general. Medicaid shows up at 65 and covers basic care.
(2) medical bills are the leading cause of bankruptcy
(3) quality of medical coverage is essential in taking a job
(4) If you are poor and uninsured you are done
(5) never visit without good insurance

There’s no reason for (4) to apply.

[jamoor]

The Moose said:

RDMcG said:

(1)US healthcare is complex but it is important to know that it is for profit in general. Medicaid shows up at 65 and covers basic care.
(2) medical bills are the leading cause of bankruptcy
(3) quality of medical coverage is essential in taking a job
(4) If you are poor and uninsured you are done
(5) never visit without good insurance

There’s no reason for (4) to apply.

I once heard that freelancers et al have problems. If they have a job with insurance that has insurance that covers a chronic condition, if they want to switch to freelancing or self empoloyed or whatever, they can't insure themselves as prexisting conditions aren't covered or similar.

Is this true? If so what kind of freedom is that

[WinstonWolf]

Cantaloupe said:

Sheepshanks said:

That said, he thinks their health care system is far better than ours, and I've heard that a few times from Americans who think our health care system is pretty backward.

Most countries health care systems are better than the pisspoor NHS, Ireland has double the number of GPs per head of population than we do.
Portugal 3 times.

The NHS isn't brilliant if you want it, however it's superb if you *need* it.

[The Moose]

jamoor said:

I once heard that freelancers et al have problems. If they have a job with insurance that has insurance that covers a chronic condition, if they want to switch to freelancing or self empoloyed or whatever, they can't insure themselves as prexisting conditions aren't covered or similar.

Is this true? If so what kind of freedom is that

Not at all true. I’ll reply fully later

[Sheepshanks]

jamoor said:

You can buy glaxo ones for £1-2, in fact I bought one in Myanmar for around that much and it was made in Australia IIRC!

Makes you wonder how much the NHS makes on each when they prescribe them.

In the great scheme of things even if the NHS paid a penny for them it's neither here nor there - 90% of prescriptions are free.

[Derek Smith]

The Moose said:

Derek Smith said:

The Moose said:

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!

The American version of Which? states in the current magazine that it is illegal to have them shipped into the USA without the necessary authorisation, which is not awared to users. So Tracy, who might well be importing drugs from Canada because she could not afford the charges, is committing an offence. Whether she gets prosecuted is not stated. But an offence it is.

Link? I know several people who regularly send their scripts North of the border and then the pharmacy mails them their drugs.

I subscribe to the magazine, Consumer Reports, but there's plenty of info out there on the internet. It's the current issue. In it it states that a number of statutes (I believe the figure was 'over 50' but that's from memory. It's ballpark though) intended to limit drug price increases and to allow people to buy drugs from abroad/Canada (forgotten which) were introduced into the senate 2019 but none were passed/enacted/or not what they needed to do to make them law.

The implication, which is often in the CR, is that vested interests stop senators actually doing anything useful for the electorate.

A small point; as you know, the fact that people do it doesn't make it legal. I remember that they suggested that it is not high on the FBI's to do list. However, a lot of online drugs that are sold from Canada are sourced from those countries with a history of counterfeiting. Again the actual figure escapes me but I think they suggested 25m Americans took the risk. There are some exceptions I understand, or read online. If you've got a condition where there is no appropriate drug sold in the states, that sort of thing.

There was a strong suggestion that 'middle men' are responsible for some of the price increases. The anti-bribery legislation that applies to other businesses does not apply with regards to drugs. Anti-bribery is not the wording but that's what it seems to be.

I dig it out over the weekend and if I'm saying tosh I'll correct it. But it's more or less correct.


EDITED TO ADD: kick-back, that's the term used in the legislation.

Edited by Derek Smith on Thursday 5th December 23:01

[bloomen]

Sheepshanks said:

That said, he thinks their health care system is far better than ours, and I've heard that a few times from Americans who think our health care system is pretty backward.

Rather like guns, it's a subject that's totally pointless to discuss with Americans. It's like arguing about the colour of the sky. If they want it then best of luck to 'em. Glad I'm not one of them.