Amazing how much lifesaving meds are overpriced in the US

[DandyDon]

My Cardiologist scheduled me for another leg angiogram and sents, and I love this procedure for what it does for 750-year-old coot, restoring blood flow and removing leg pains. She wanted to replace my 81 mg aspirin with 2.5 mg Xarelto twice a day tho. She even gave me a 30-day sample supply along with a prescription I could renew for a year. "OK, doc, thanks" I started shopping...

"Rivaroxaban was patented in 2007 and approved for medical use in the United States in 2011.[9] In the United States, it will not be available as a generic medication until 2024.[10][11] It is on the World Health Organization's List of Essential Medicines.[12] In 2020, it was the 86th most commonly prescribed medication in the United States, with more than 8 million prescriptions." Great stuff I guess. It had better be for $1,000 a month!

GoodRX.com says I can buy it locally in a 90-day supply to save on costs for a little over $3,000. Healthwarehouse.com offered it to me for $1,757 which gets it down to $585 a month. My part D cost was a little lower, but not much. So I found Liferxpharmacy.com which seems to checkout fine as a respectable and fully certified mail-order pharmacy. It seems that while Rivaroxaban is patented by one owner, it licenses other firms to manufacture it under certain terms. Natco in India does, along with many other drugs shipped to US pharmacies like Tamiflu, but they have an agreement to sell it "in India only" for so much less. Liferxpharmacy buys it in India and ships it to me in a 168-count package for $188 = $67 a month!

This box was actually made by Bayer in India, marked "for sale in India only," but that was fine by me. You can pay more at Liferxpharmacy to get it made in Turkey, Canada, or the UK, but I didn't see any need.

Now I know that mail orders from India can go awry so to make sure that I had plenty, I decided to stock up. "In the United States, it will not be available as a generic medication until 2024," but in India it's available. I got 180 for $33 = $11 a month!

It's the very same lifesaving med made by a reputable company that commonly supplies US pharmacies, but I used a fully certified pharmacy to work around the contracts and rules. Help me out here, tho: $11 a month vs $585 a month = a 98% savings, right?

Now that I had spent $221 on a five-month supply, my next appointment was with a senior Cardiologist at the same office who tells me that I only needed to take the first 30-day supply I was given but could now go back to aspirin. Oh great. I'll see the first doc in April and I am tempted to ask why she gave me a 12-month prescription, but probably not. I don't want to piss off the gorgeous doc who has helped me so much in saving me from myself. I'll just keep in mind that she writes the scripts, but I do the shopping, and maybe I should ask more questions.

 

[GDHLEWIS]

Just shows what a scam the medical world can be. That price difference is nothing but greed, thankfully you were able to get the meds you need for a reasonable price.

 

[kinoons]

In defense of big pharma, it’s not entirely greed…

About 90% of pharmaceuticals don’t ever get past the research phase, because they don’t work. It can cost hundreds of millions, if not a billion dollars, to bring a drug to market if it does work.

Average cost of developing a new drug could be up to $1.5 billion less than pharmaceutical industry claims | LSHTM

Co-authored by the London School of Hygiene & Tropical Medicine and KU Leuven, led by LSE. The study estimated that the median cost of bringing a new drug to market was $985 million, and the average cost was $1.3 billion. This is in stark contrast to previous studies, which have placed the...

www.lshtm.ac.uk

Why 90% of clinical drug development fails and how to improve it?

Ninety percent of clinical drug development fails despite implementation of many successful strategies, which raised the question whether certain aspe…

www.sciencedirect.com

So there is a lot of money to make up when a new drug does get approved.

OTOH Janssen, the first company to make xalerto, appears to make money hand over fist.

“2020 Revenues ($USD) : $45,572,000,000
2020 R&D spend : $9,563,000,000
2020 Number of Employees : 43,000
Fiscal Year End : 1/3/2021
Key People : Alex Gorsky, chair and CEO, Johnson & Johnson; Jennifer Taubert, EVP and worldwide chair, Pharmaceuticals”

Janssen (Johnson & Johnson’s pharmaceutical segment) - Drug Discovery and Development

www.drugdiscoverytrends.com

The US, and to a lesser extent European, market is the target because of the availability of cash money. Very few people in India can afford $500-$1000 a month for an anticoagulant. But with commercial insurance products and Medicare that sweet sweet cash is available in the US. So, like any good company, they charge whatever they think the market will tolerate. Because, profit, right?

 

[boulderjohn]

A friend of mine is a long retired microbiologist who owned a company providing services for companies doing research. He said that back in the day, they considered branching out to make insulin because it was so easy and cheap to make. They eventually decided not to, and one of the reasons was that given how easy and cheap it was to make, it was also very cheap on the market, so there were then no chances for big profits.

My, how things change!

 

[boulderjohn]

When one of my sons got an eye infection while under our health care, the prescribed medication cost us a $30 copay. A few months later, the infection returned, and he got the same medication, again for our $30 copay. A few months later He got it again, this time while vacationing with us in Cozumel. He went to a local drug store and got the exact same medication over the counter for $5.

 

[boulderjohn]

Years ago I was taking an extremely expensive drug, costing many thousands of dollars a year, as a copay on my insurance. My doctor got me a coupon given out by the makers of that drug that brought the copay down to $30/month. That told me that the money I was paying without the coupon was pure profit.

Then I went on Medicare and discovered that Medicare is not allowed to take coupons, and it is not allowed to negotiate drug prices with insurance companies. The price shot back up.

 

[BlueTrin]

A friend of mine is a long retired microbiologist who owned a company providing services for companies doing research. He said that back in the day, they considered branching out to make insulin because it was so easy and cheap to make. They eventually decided not to, and one of the reasons was that given how easy and cheap it was to make, it was also very cheap on the market, so there no chances for big profits.

My, how things change!

I read about insulin prices, it seems that there is a process called evergreening that people use to extend the patent with marginal improvements.

 

[rhwestfall]

When my wife got sick (sinus infection) in Bonaire, the ER and meds were free...

Anyhow, as said above, development is risky and costly.

Lastly, if the US wasn't so litigious, I likely believe costs would be significantly lower...

(disclosure: my father worked in the pharma industry for 30 years....)

I will say however that there are "bad apples" out there too...

 

[boulderjohn]

It's not just drugs.

I was once in a bad bicycle accident that resulted in several painful surgeries and months of recovery. It was paid for by insurance, except, of course, for my significant copay. We did not pay a lot of attention to the paper work--we just paid our portion of the total charges.

The accident was clearly caused by the teenager who hit me, with the fault so clear that his family's insurance company settled quickly. When my attorney gave me the settlement check, he held back a portion until he got a quote from my health insurance on their actual costs for the surgeries, since they were eligible for reimbursement. When he heard from them, he gave me all of the money he had held back. The insurance company had not paid a dime for my surgeries. All the actual costs had been covered by my copays.

 

[Ghost95]

There is an interesting book out titled "America's Bitter Pill" that discusses the passage of the Affordable Care Act. It seemed to me, well researched and written but, as with anything, the author could be pushing an agenda. Still, there was allot of interesting info in there.

Anyway, the book discussed what was going on behind the scenes to get that bill passed. The non-negotiablity of Medicare drug prices was one of those agreements. That just seemed absurd that the largest purchaser of Rx meds in the world can't negotiate prices.

It sounds like a conspiracy theory, and maybe it is but, it's almost like the ACA was passed flawed on purpose to give politicians something to dangle in front of us come election time...over and over. Right now, Democrats who were instrumental in passing the bill that included no negotiating Rx on Medicare,are talking about requiring that Medicare be allowed to negotiate the price of Rx. It's just crazy.

It's really hard not to be a conspiracy theorist these days. Time to put my head in the sand and read a book about diving.