[Ip-health] Zoe's question

Jamie Love james.love at keionline.org
Wed Oct 22 04:43:31 PDT 2014

The following is an exchange on the facebook page, Paying Till it Hurts.
Zoe Kirsch asked a followers in a Facebook group about high drug prices,
" what do you think isn't getting enough coverage" by journalists?


Zoë Kirsch
17 hrs · New York, NY
I'm a journalist at Columbia Journalism School about to embark on a
months-long investigation of prescription drugs. Survey: what do you think
isn't getting enough coverage?
LikeLike ·  · Share
9 people like this.

Christopher Gregory Investigate and write about the tremendous disparities
in the costs of drugs in the US vs the costs for those same drugs in other
countries, like Canada or the UK.
16 hrs · Like · 12

Abigail Addington-May What the effect would be if the government were able
to negotiate drug prices.
16 hrs · Like · 8

Jeff Gottesfeld 1. recent rapid rise in price of generics 2. differences in
cost for same drug at various chains 3. steering of doctors away from
tried-and-true to new medications that may be marginally more effective.
16 hrs · Like · 9

Patti Peeples Take a look at my website HealthEconomics.Com
http://www.healtheconomics.com/ and feel free to reach out to me to find
resources. This website is FILLED with articles/resources on Rx
Pricing/Reimbursement (and we have a FB group too) HealthEconomics.Com
16 hrs · Like · 1

Ilya Valkovsky Zoë Kirsch, Christopher Gregory -I would go even further and
look at prices in India and Africa, which easily could be 100 times or more
lower than US, while their consumers in those regions are newly affluent
and well off.
9 hrs · Edited · Like · 3

Jane McGuinness Antidepressants. Different types are treated as
"equivalent" when they're not; also generic formulations screw up proper
absorption. End result is paying full price for brand label or
ineffective/useless treatment.
16 hrs · Like · 3

Gary Groeller just a suggestion: mention is deserved regarding the void
between "Spam international Rx" and "valid supply houses"
15 hrs · Like

James Packard Love The fact that Democrats no longer take on pharma, like
they did up and until the 2008 election.
15 hrs · Like · 1

Lisa Napier There's some practices we take for granted in the US that are
arbitrary with respect to drugs. For example: why are you only permitted a
30 day supply of any particular drug? Sometimes with byMail programs you
can get 90 days at a time. Some folks ...See More
15 hrs · Like · 5

Linda Lamp Why is the cost of prescription medication so high in the United
States and yet so affordable throughout the rest of the world
15 hrs · Like · 3

Deb Kleinen What Lisa Napier said. I'm only "allowed" 4 pills per refill a
month for migraines which can sometimes be 3-4 days in duration. Several
years ago, 9 pills were allowed by insurance. With my new plan, however, I
was able to get a 3 month supply (12 pills) with 1 co-pay.
15 hrs · Like

Linda Roberts Singh Cost of drugs for children (adhd drugs and asthma
inhalers) and the number of kids not taking those drugs due to limited
family budgets, and then the resulting educational disparities.
14 hrs · Like · 3

Dina Feith In the vein of why generic prices are going up - examine what it
would cost (time and money) for a new startup to try to fill the void left
by companies that got out of the business of certain "commodity" (high
volume, low margin when there's competition) drugs. Regulatory hurdles are
very expensive and widely unknown by the general public.

A sterile salt solution may cost pennies for the materials that end up
shipping to a hospital, but to start making it with a new company would
cost tens of millions of dollars.
14 hrs · Like · 2

Jonathan Michael Lloyd Cost of cancer and immunosuppressive therapy leading
to bankruptcy; the failure of gov't to force Big Pharma to bid prices; the
ridiculous waste of money the US spends on over ten thousand different Rx
plans in this nation--really? We need that many? That's ten thousand
duplications. Waste, waste, waste. And profit, profit, profit...from other
people's illness. Disgusting.
14 hrs · Like · 1

Dave Schmidt What is the cost from R&D and production to what is charged
for the prescription. How much is the mark up?
13 hrs · Like · 2

Emily Krasinsky Kullmann Please please do a story about the cost of test
strips for diabetics. We have type one diabetes and need to test up to 10xs
a day. We r fortunate in having insurance but I noticed the retail price
the other day of 169.99 for a box of 100 which means they're about 1.70 a
strip. Robbery to the max. Do private message me for more......
13 hrs · Like · 2

Emily Krasinsky Kullmann I can tell you about insulin too. Robbery!
13 hrs · Like · 2

Emily Krasinsky Kullmann They're not doing much research they're paying
their shareholders.
13 hrs · Like

Doug Hirsch Let us know if GoodRx can help...
13 hrs · Like

Leesa Dean The studies big pharma does that are used to justify use of
their own drugs but somehow ends up being viewed as independent research.
Also, the outrageous costs of some meds.
13 hrs · Like · 2

Ken Parmer Here is a suggestion....compare Medicare part D DRUG coverage
after the " donut hole "...and buying same prescriptions from Dr. Solve.
Com from Canada....Before part Medicare part d coverage one could Save many
times 50% or more there... it seems many times seniors are just being hit
with with more premiums,co-pays and donut hole....their out pocket seems to
increase each year .....
10 hrs · Edited · Like

James Packard Love There are 100 members of the US Senate, 435 members of
the House of Representatives, a President, a Vice President, 15
Secretaries, and lots of heads of relevant health or budget agencies. How
many of them are ever heard on the issues presented in this thread or this
13 hrs · Like · 5

Marcia Lynch Coverage isn't necessarily the concern but the overall cost
13 hrs · Like · 1

Susan Olsonoski The problems involved with fluoroquinolones.
13 hrs · Like

Mary Urech Stallings Even with insurance no one can afford them? And once a
previously prescription drug becomes OTC it isn't as effective.
12 hrs · Edited · Like · 1

Debbie Abbott-Brown I think the mystery of what drug products make an
insurers formulary, how the tier of the drug is established, and how much
variability there is across insurers formularies would help with consumer
transparency. Also, how similar are the copays for each tier across various
12 hrs · Like · 1

Susan Gillespie "Pre-authorization" - all of a sudden the pharmacy can't
fill the rx you've been depending on for years, without getting the dr to
write to the insurance company, who then "rules" on whether you can atill
take it. And in the meantime, you either go without or pay full retail,
hundreds of dollars. And this can go for weeks...even months...and they
make you do it again next year.
11 hrs · Like · 2

Jeff Gottesfeld There are plenty of scare stories about medications from
India mailed to the USA. But know what? At least some of them are legit,
and can save consumers 90% or more. Why not find out who is legit there, or
what drugs there actually are what they're supposed to be, and publicize
those online pharmacies? Now, that's something that consumers will thank
you for.
11 hrs · Like · 3

Gary Groeller a thought occurs: make note of the amount of money 'Big
Pharma' sinks into advertising budgets producing and presenting the
tri-fold septo-color info-mercials that we are continually being golden
showered with from every media source [...] and how that amount of money
could be well used elsewhere actually delivering real health care
11 hrs · Edited · Like · 3

Barbara Heller Compare the stock price increases of pharm companies with
their recent drug price increases...Follow the money and figure out who is
getting richer!
11 hrs · Like · 2

Juliette Caminade High price of generic drugs in the US.
11 hrs · Like

Eric Caplan Compare the top 10 best selling drugs (in terms of revenue) for
each of the past five decades. Note the shift away from small molecules to
biologics and other so-called specialty-drugs. Why has this transformation
taken place? Twenty years ago, a so-called blockbuster was a
relatively-speaking modestly priced drug (e.g., Lipitor, Prozac, Prilosec,
etc) taken by millions of people to control a chronic disease. Today's
blockbusters are biologics like humira, avastin, and the new HEP C drugs,
which are extraordinarily expensive but used only by hundreds of thousands
rather than millions.
10 hrs · Like · 1

Melissa Schober The DME vs RX confusion. My kid needs a spacer for asthma.
It is prescribed by her doctor and issued by a pharmacy. But it isn't a
prescription. Nope, it is a durable medical good, subject to entirely
different rules. Never mind that you can't use the RX -- way overpriced
albuterol -- without it. So you pick up your RX and your DME device. But
then you need a second spacer and inhaler for school. That sends you down
the rabbit hole of prescription and DME preauth and fights over limits and
you wind up paying $75 for a stupid plastic tube because you've wasted
hours of your time on the phone.
10 hrs · Like · 1

Mary Beck Metzger There isn't an inexpensive generic rescue inhaler
(Proventil, ProAir) for asthma on the market.
10 hrs · Unlike · 4

Els Torreele The non-alignment between pharma's R&D priorities and the
population's health needs (how many statins, and more in the pipeline while
no new antibiotics?) and the related fact that the (large) majority of new
medicines have no therapeutic benefit compared to what already exists (if
you look at clinical evidence and ignore the marketing). The current
incentives for pharmaceutical R&D, including FDA rules, favor Rx with huge
market opportunities instead of Rx to address health needs
10 hrs · Like

Jordan Levin There is a law in NY that prevents doctors from distributing
(selling) prescription meds to patients. The govt. called it a co flirt of
interest. As a result for the last 20+ years pharmacies have made billions
marking up the prices. And now they are allowed to have medical clinics in
the pharmacy but nobody mentioned the conflict of interest for them. It's
hypocrisy especially since I know for a fact I can order many common
genetics for very low prices but cannot give them to patients unless it is
for free and I lose the money. The system is rigged.
10 hrs · Like

Els Torreele the lack of transparency and accountability around medicines
prices, and their total arbitrariness: non-evidence based price setting
("what the market can bear", except that there is no real consumer market
since you have a producer monopoly, a prescriber who doesn't foot the bill
and doesnt know or care about the price, and a third party payer for most
of the cost), secret price negotiations for some and not others (VA versus
medicare, certain hospitals vs others, US vs other countries), but the real
questions is: who decides, who pays, and who's responsible for the
consequences for the fact that many people have no access because they
cannot afford (and see their health deteriorate, or even die)
10 hrs · Like · 2

Gregg Kravatz The differential of drugs prices sold in America versus the
rest of the world.
9 hrs · Like · 2

France Andrews Zeve Psychiatric drug coverage/ cost. My bi-polar son's
medications run about $2000 a month and we have had to fight with the
insurance almost three times as often to get them filled than our BP and
other mAintanence RX's.
9 hrs · Like

Jodi Brown The stratodpheric cost of Tier 5 Drugs like Remicade used to
treat chronic illness such as Chron's disease and Rheumatoid Arthritis. One
treatment for a 4 hour infusion starts at $35,000.00 depending on the
dosage of which disabled medicare patients are liable for 33%. How is that
one for a start. And please include the bill lanquishing in congressional
committee for the past 6 years that has been drafted to deal with this
terrible problem and the refusal of Speaker Boehner to bring it up for a
8 hrs · Like · 1

Donna Hannan Why it costs so darn much to purchase a pill or two when
you've forgotten your medicine at home whilst on a trip! True story.
8 hrs · Like

Jodi Brown Investigate the discriminatory practice of drug tiering
8 hrs · Like

Daniel Ginsberg As a practicing physician, I suggest looking at the affect
of coupons on the cost of medications. It's complicated in that it may save
patients money on a prescription, sometimes making a brand name less
expensive than a generic, but hides the true cost as the insurer or
government pays much of the cost. Ultimately the costs get passed to the
consumers. With high deductible plans sometimes a medication starts out
free, then ends up being expensive if one exceeds the value of the card.
Also most coupon cards cannot be used for those on Medicare.
8 hrs · Like · 1

Donna Hannan The cost of prophylactic drugs that may never get used. How
many dozens of epipens are sitting in nurse's offices in elementary schools
nationwide because EVERY allergic child needs one? They expire in about a
year if unused. While its great that many go unused, what a giant waste!
8 hrs · Like

Karen Yuen Maybe how ACA has affected coverage of mental health drugs? In
theory, the companies should be more generous now. But a friend's insurer
panicked. They now make him see a psychiatrist before every refill (3 or 4
weeks supply) of the stimulants he'd been taking for many years to control
his ADHD.
8 hrs · Like

Tali Arik Coupons are not what they seem...read this...
8 hrs · Like

Julie Foulkes King The most basic topic within this subject: the fact that
naturally occurring substances (remedies) cannot be patented, resulting in
minimal profit potential, and how this contributes to the R&D, patent, big
pharma circus. Surely, American medical R&D is in many ways exemplary, but,
IMO, when drugs become cash cows, patients and corporations alike become
dependent - regardless of other viable, effective, cheaper options.
7 hrs · Like · 1

Therese Meuel Karen I don't think the ACA is what has caused the problem
with ADHA meds. It's about the reclassification of those meds from what I
7 hrs · Like · 1

Roshan Venugopal Some important drugs have very limited suppliers. If any
goes burst, many important drugs will be inaccessible.
6 hrs · Like · 2

James Love.  Knowledge Ecology International
KEI DC tel: +1.202.332.2670, US Mobile: +1.202.361.3040, Geneva Mobile:
+41.76.413.6584, twitter.com/jamie_love

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