Why drug prices in America are so high

Re:Why drug prices in America are so high by refurb on Wednesday September 14, 2016 @10:52AM (#12497477)

Example: GSK is selling Advair Diskus for $300 in the US, and the same Seretide Diskus for 30 euros in France. Because on one side, they negotiate, and on the other, the enact laws to prevent negotiations (see Medicaid).

As others have mentioned, there can be a big difference between the list price and the actual price the insurer pays. The asthma market is highly contracted with big rebates going to payers.

Second, Medicaid does negotiate. First off, Medicaid get 23.1% off of every drug, just to start with. Then they can negotiate supplemental rebates if there is a lot of competition in a therapeutic area.

When you add it all up, Medicaid pays some of the lowest costs for drugs of any payer.

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Re:Why drug prices in America are so high by bisRepetita on Wednesday September 14, 2016 @11:07AM (#12497671)

So basically, with a high deductible plan, I am getting screwed by my insurance company, because I do pay $300 for Advair out of pocket, instead of the negotiated price.

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Re:Why drug prices in America are so high by refurb on Wednesday September 14, 2016 @11:37AM (#12498022)

Correct! You are typically responsible for the list price, not the net price the payer pays.

So, you pay $300 for the drug (list price). The insurance company uses that $300 to pay the drug company, which in turn, rebates $150 back to the payer. Pure profit!

If you are just responsible for the co-pay it works better. You pay $30, the payer pays $270 and the manufacturer rebates $150. Overall, the drug costs $150, $30 coming from you and $120 (net) coming from the payer.

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Re:Why drug prices in America are so high by alistairSH on Wednesday September 14, 2016 @12:30PM (#12498637)

I'm not sure that's true. In cases where I've had a deductible, I've always paid the lower negotiated price. The vendor (doctor or pharmacy) has always run the product through insurance first, then billed me whatever my insurer says is correct.

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Re:Why drug prices in America are so high by refurb on Wednesday September 14, 2016 @01:05PM (#12499028)

It's really up to the payer as to how much you are billed. I have heard of them passing along the negotiated discount, but it doesn't always happen.

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Re:Why drug prices in America are so high by lintiness on Wednesday September 14, 2016 @11:40AM (#12498075)

what you pay for advair should have little / nothing to do with your plan deductible. you should still get a negotiated, lower than retail price for drugs.

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Re:Why drug prices in America are so high by coldcode on Wednesday September 14, 2016 @11:54AM (#12498221)

Medicare is the problem, Medicaid is allowed to negotiate.

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Re:Why drug prices in America are so high by refurb on Wednesday September 14, 2016 @04:01PM (#12500735)

Medicare Part D (prescription drugs) is entirely run by commercial payers who are allowed to negotiate (and do). Only Part B is limited from negotiating price, but discounts do happen in competitive markets and CMS captures those savings.

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