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Old 01-05-2019, 12:26 PM   #41
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Originally Posted by gstillson View Post
The CEO of Microsoft makes over 25 million per year. The CEO of Boeing makes 18.5 million per year. The CEO of Kroger makes 11.7 million per year.

What was your point again?
Point is pharma spends all it does on market8ng and R&D and still pays its CEOs more than $25 million.

Their business model is fantastically profitable despite those expenditures.

Only apologists want to cry about clinical trial costs. Pharma companies aren’t going bankrupt because of those costs or any reason.

Instead, several of them pay $30 million a year to their CEOs, after spending those sums.
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Old 01-05-2019, 12:34 PM   #42
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I'd like to know what a CEO earning $250K a week does in a week. Seriously, what can they possibly be doing that is worth that kind of money?
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Old 01-05-2019, 12:39 PM   #43
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Point is pharma spends all it does on market8ng and R&D and still pays its CEOs more than $25 million.

Their business model is fantastically profitable despite those expenditures.

Only apologists want to cry about clinical trial costs. Pharma companies aren’t going bankrupt because of those costs or any reason.

Instead, several of them pay $30 million a year to their CEOs, after spending those sums.
So their business model is profitable. Wow. That is an interesting concept to attract investors.

I can give you a list miles long of Pharma companies that HAVE gone bankrupt because of trial costs.

Here is a little chart of one. Note how happy you would have been to be an investor in this "fantastically" profitable venture. This is for Celsion, which reverse split adjusted was trading for around $1000 a share in 1999 and now trades for $1.73. Fantastic, huh?
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Old 01-05-2019, 01:10 PM   #44
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Originally Posted by gstillson View Post
So their business model is profitable. Wow. That is an interesting concept to attract investors.

I can give you a list miles long of Pharma companies that HAVE gone bankrupt because of trial costs.

Here is a little chart of one. Note how happy you would have been to be an investor in this "fantastically" profitable venture. This is for Celsion, which reverse split adjusted was trading for around $1000 a share in 1999 and now trades for $1.73. Fantastic, huh?
In 1999 just about everything traded for $1000/share. Even companies that delivered cans of beans.
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Old 01-05-2019, 01:15 PM   #45
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I'd like to know what a CEO earning $250K a week does in a week.
It might be a fair guess that during any given week, many CEO's are busy driving stock buybacks to extract capital from the corporation instead of contributing capital for corporate needs and increasing employee pay.
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Old 01-05-2019, 01:50 PM   #46
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I think you are right.... especially on the last part... the penalty of $0 will have a minimal impact on premiums as people will continue to need and buy health insurance... the penalty was so minor it was not an affective deterrent to those who did not want to buy health insurance.

The recent rise in premiums has nothing to do with ACA but is more increases in the cost of health care services which are at least 80% of premiums by law... when the cost of those health care services goes up premiums follow.
I agree. And I believe the insurance companies are getting a better handle on pricing premiums for these products.

Unless the rules are changed again abruptly (something that is less likely now with a divided Congress but may still be possible through "Executive actions"), I think this will be relatively stable for the next 2 years.
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Old 01-05-2019, 02:08 PM   #47
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So their business model is profitable. Wow. That is an interesting concept to attract investors.

I can give you a list miles long of Pharma companies that HAVE gone bankrupt because of trial costs.

Here is a little chart of one. Note how happy you would have been to be an investor in this "fantastically" profitable venture. This is for Celsion, which reverse split adjusted was trading for around $1000 a share in 1999 and now trades for $1.73. Fantastic, huh?
So what are you a shareholder or a former employee?

Most people have heard of Merck, Pfizer, etc.

They’re the ones raising prices on OLD drugs, not a damn thing to do with trial costs.

Or are you claiming there are billions in ongoing trial costs for a long-established pharma product like insulin?

If they can’t make it a go when plenty are fantastically profitable, then they should go bankrupt and out of business.

Especially at this time when they’re all raising prices on every drug out there.
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Old 01-05-2019, 02:28 PM   #48
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Originally Posted by Rianne View Post
I'd like to know what a CEO earning $250K a week does in a week. Seriously, what can they possibly be doing that is worth that kind of money?

Those CEO's are doing the same kind of things that other MegaCorp CEO's, entertainers and athletes that make similar compensation do........ They make money for the owners of the businesses. Whether those profits, in any of the cases, would pass muster in an ethics class is another question.
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Old 01-05-2019, 02:38 PM   #49
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I personally believe the Medicare Advantage plans will be the blueprint for Medicare for all and it's the reason the marketing for Advantage has been so aggressive.
Yep. I've been on Medicare for several years now and it seems too good to be true. Because of IRMAA, Medicare is quite expensive for DW and I but we feel it's an improvement over the employer provided policies we had while working. I don't think it would be possible to give the masses the flexibility of treatment choices and the unrestricted access to providers that we 65+ Medicare geezers enjoy today.

Aren't the national health care plans in countries like Canada and the UK more like a Medicare Advantage plan than Medicare? You know, lot's of "management" of care and provider choices made for the consumer and that sort of thing?
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Old 01-05-2019, 02:56 PM   #50
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Can a U.S. doctor prescribe a med to be purchased in a different country? I understand U.S. citizens go to Canada to get meds, but do they do it illegally or do they know the name of the drug/dosage amount and buy it?
If I told my doc to send my prescription to a Canadian pharmacy, can he do that?
Don't know how that process works. I did run out of atenonol(BP med) while in Amsterdam. A very nice gentleman came to my room with an old fashioned black bag. It was full of drugs. Gave me 6 atenolol for 100 guilders. He was a doc, gave me a receipt in Dutch to take back to my American health insurance. Guess what they did?

ETA: I don't think so. They wouldn't have a medical license in another country.
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Old 01-05-2019, 03:17 PM   #51
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Much of the disapproval or disagreement with ACA is really an issue with the high cost to insure, and that will not change. This is one reason why it is so difficult to replace. I think this is not so much kicking the can down to road as it is completely ignoring the real underlying issues.

+1 Yep, ACA is just the tip of the iceberg, the high cost of medical care is the huge submerged mass.


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Sometimes, you will hear people say just go back to the way things were before the ACA but not even the opponents of the ACA seem to be pushing this line of thinking that heavily.

The ACA may have conditioned people to think that govt. needs to try to ensure coverage is more broad or accessible to more people, rather than all individuals having to fend for themselves.

That change in mindset might be the legacy.

Personally, I see this as a good change, regardless of what the specific mechanism, ACA or "other".


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- The Texas court ruling will be overturned
- The ACA will stay pretty much as it until the next election
- Premiums will rise less than many folks anticipate

I believe we aren't supposed to discuss politics, so I'll leave it at that.

If you are right, I can live with this until Medicare...

Still the rise in premium's and increasing OOP is still a problem. For now, our ACA subsidy takes most of the edge off, and I've heard that most on ACA receive some subsidy. Can't help but think the rapidly rising premiums (rack rate) is tied actual medical costs out of control. Also, this was an issue even when I was w*rking. The company was pushing High Deductible plans hard. I suspect Cadillac PPO will become the dodo bird at many companies.
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Old 01-05-2019, 03:44 PM   #52
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Mod reminder:

As with all things healthcare, we realize it's difficult to keep politics out but want to keep these threads open - as they are so important to many members here. However, if we can't keep things non-partisan, the conversation will come to a close.

Please keep this in mind as you continue your thoughtful contributions to this discussion.
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Old 01-05-2019, 04:52 PM   #53
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They spend more on marketing than R&D and they’re hiking prices on drugs developed decades ago.

They’re not even pretending that the hikes are to recoup R&D or for future R&D.

They’re practically saying “because we can.”

The other villains are the pharmacy benefit managers taking their own cuts.

In fact, they may be breaking the antitrust laws in a massive way.

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The alleged collusion transformed a cutthroat, highly competitive business into one where sudden, coordinated price spikes on identical generic drugs became almost routine.
https://www.courant.com/nation-world...210-story.html
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Old 01-05-2019, 05:02 PM   #54
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Hard to believe anyone is defending pharma these days.

Even politicians will criticize high drug prices while taking pharma lobby money while doing nothing about the prices.

But few if any will try to rationalize these price hikes.
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Old 01-05-2019, 05:09 PM   #55
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That will be the mother of all fights get some popcorn ready..Pharma will not go down without a fight. I've seen my DH EOBs from Medicare and if the hospitals got that little amount of money from everyone they'd go broke.

I personally believe the Medicare Advantage plans will be the blueprint for Medicare for all and it's the reason the marketing for Advantage has been so aggressive.
Had a bad experience with trying to get second opinions for my father who was on an Advantage plan.

If you have any suspicion about the providers in an Advantage plan and want to go to an outside provider for that second opinion, you’re at the mercy of that Advantage insurer. They in effect control your Medicare funds. You apparently can’t go to an outside doctor who takes Medicare and be granted of being reimbursed.

Based on that we put our mother on a Medigap (F plan) which has higher monthly premiums but no deductibles or copays.

I plan to sign on for Medigap, not Advantage.
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Old 01-05-2019, 05:56 PM   #56
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In fact, they may be breaking the antitrust laws in a massive way.



https://www.courant.com/nation-world...210-story.html
That is about generics, not drugs that are progressing through clinical trials.

I guess it would be better if we could not slap the whole industry with one label. Just because you have a few bad eggs doesn't mean you have to throw out the whole henhouse.

If you drastically reduce the incentive to make money on developing a drug to treat a needed disease, you will lose investors. This is simple simple math. Aside from charity, none of you would put your retirement money in a company who had a 99% chance of losing it all with the only upside being a small gain. None of you.
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Old 01-05-2019, 06:06 PM   #57
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That is about generics, not drugs that are progressing through clinical trials.

I guess it would be better if we could not slap the whole industry with one label. Just because you have a few bad eggs doesn't mean you have to throw out the whole henhouse.

If you drastically reduce the incentive to make money on developing a drug to treat a needed disease, you will lose investors. This is simple simple math. Aside from charity, none of you would put your retirement money in a company who had a 99% chance of losing it all with the only upside being a small gain. None of you.
Oh, the branded drug companies also do their share of acts alleged to be in violation of the antitrust laws. Google "pharmaceutical product hopping". Here is one example.

https://www.cnn.com/2016/09/23/healt...ust/index.html


P.S. -- I try not to invest in companies that deliberately violate the law. (Yes, I know that these are for the present mere allegations in a lawsuit. At the end of the day, they may not actually be found liable.)
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Old 01-05-2019, 06:08 PM   #58
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Oh, the branded drug companies also do their share of acts alleged to be in violation of the antitrust laws. Google "pharmaceutical product hopping".

https://www.cnn.com/2016/09/23/healt...ust/index.html
And Wells Fargo employees set up fake accounts using real customer information. Do you still bank?
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Old 01-05-2019, 06:13 PM   #59
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And Wells Fargo employees set up fake accounts using real customer information. Do you still bank?
Not with Wells Fargo.
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Old 01-05-2019, 10:34 PM   #60
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That's not what insurers here in New York thought when they filed their 2019 rate increases back in June. I posted this link to begin the long thread last year about 2019 rate increases.

https://www.dfs.ny.gov/about/press/pr1806011.htm

Insurers filed for a 24% increase overall, with half of that (12%) due to the repeal of the mandate and the other half (12%) separate from the repeal of the mandate.

Back in 2010-2011, before the ACA, I saw increases of 20% and 25% in those 2 years (50% overall) before I finally dropped that policy and opted for, temporarily, a bare-bones, hospital-only policy to get me to 2014 when the exchanges came in. My rate for a Silver plan dropped to less than what I was paying in 2009. The mandate surely dropped the rates because there were more healthier people like me (this was before I got sick in 2015) were back in the main insurance pool.
Sounds like NY insurers used the repeal of the mandate to take you for a ride. This link of a study by Kaiser Family Foundation suggests that most insurer adjustments for repeal of the mandate were modest... on average 6% and ranging from 0% to 14%.

https://www.kff.org/report-section/h...iums-appendix/

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Among insurers that publicly specify the effect of these legislative and policy changes, we found that 2019 premiums will be an average of 6% higher, as a direct result of individual mandate penalty repeal and expansion of more loosely regulated plans, than would otherwise be the case.
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