Medication cost rant.....

[sengsational]

I don't think it works this way. A drug company develops a drug and sets a USA price to make a profit.
The ability to sell in other markets is just a bonus in income for them. If they were to lose money selling in other countries, they wouldn't sell there.

Yes, that's how it looks based on the way the global markets operate...the US is where they make the significant money.

But if you look at worldwide demand for a drug, maybe 20% of the demand is in the US. If the drug was sold worldwide for the same price everywhere, that price could be reasonable. But other countries can't afford even a reasonable (to us here in the US) price. That means the business cases rests on setting a high price in the US, and the rest of the world sales don't amount to much.

And of course there are examples where the manufacturers realize they have a corner on a specific market, and take advantage of that position. It's a shameful practice, certainly.

 

[Fermion]

All this bashing on "big pharma" and excess profits while nobody is investing in pharma because tech is where they are really gouging people and making true excess profits (and selling your info, targeted marketing, etc.)

I would love for it to be true that you can make a lot of money in pharma but it just isn't. The regulations are stringent on bringing new drugs to market and the competition is pretty fierce.

You want to make money? Buy Microsoft, not Merck.

 

[JoeWras]

Robaxin or Methocarbamol....

Thanks. Yeah, something went wrong with your prescription request.

Like ShockWaveRider mentions, this is a cheap drug. 60 count 500mg would cost me $10.63 at my pharmacy, so about 30 cents a pill (GoodRx).

One thing I like about my PCP is he really emphasizes generics. He won't prescribe name brand unless absolutely necessary.

I wonder if your prescription got converted to some name brand by the new doc?

As for the new drugs that are expensive, well, research is expensive and time consuming. I understand why those are expensive. What I do not like is when the big boys muscle out the generics by some reformulation. I don't understand why it happens, but they manage to put the squeeze on the generic companies. My dad went through that with the Namenda reformulation. They turned the fast-acting into extended release and jacked the price. I don't understand why the generic companies couldn't sill make the old formulation.

It is called "product hopping." Here's a short story on it:
https://pharmaphorum.com/news/allergan-pays-750m-to-avoid-alzheimers-drug-lawsuit

The class-action suit claims that the company blocked access to lower-cost generics of its immediate-release Namenda (memantine) product in 2014 by forcing patients to switch to a longer-acting, more expensive version of the drug called Namenda XR – a practice known as ‘product hopping’.

 

[target2019]

Robaxin or Methocarbamol....

On GoodRx there is a link to toggle from generic Robaxin ($11.36 for 60) to brand medication ($156.05).

That might explain what's going on. In the hospital you get one Rx, and the cost becomes part of your insurance for hospital stay. You don't notice the cost of non-generic and additional markup by the hospital.

I think this is something covered way too deep for me to understand, but the 2013 special report cover says that at the time an acetaminophen tablet could be marked up 10,000%.

https://time.com/198/bitter-pill-why-medical-bills-are-killing-us/

In general I think many things have improved in ten years, but obviously consumers can still get the shaft somewhere in the process of healthcare.

 

[punkinhead]

All this bashing on "big pharma" and excess profits while nobody is investing in pharma because tech is where they are really gouging people and making true excess profits (and selling your info, targeted marketing, etc.)

Claiming big pharma isn't gouging because some other field is gouging more isn't a very compelling argument. The NIH published an article in 2020 showing that from 2000 to 2018 pharmaceutical companies had about double the profits of similarly sized non-pharmaceutical companies.

 

[USGrant1962]

All this bashing on "big pharma" and excess profits while nobody is investing in pharma because tech is where they are really gouging people and making true excess profits (and selling your info, targeted marketing, etc.)

I would love for it to be true that you can make a lot of money in pharma but it just isn't. The regulations are stringent on bringing new drugs to market and the competition is pretty fierce.

You want to make money? Buy Microsoft, not Merck.

I just checked 10-year return on a pharma ETF (IHE) vs S&P500 (VOO). S&P is up 300% and pharma is up only 140%.

 

[target2019]

Yeah, not the best year for pharma. LLY is 56.36% NAV YTD. Most of the other top names are negative this year.

But earnings growth for 5 years: https://finviz.com/map.ashx?t=sec&st=eps5y

 

[Closet_Gamer]

I'm a passionate free marketer.

Mega-companies in certain industries, however, make me put "but" at the end of the sentence.

I'm a passionate free marketer BUT there are huge companies and specific industries that have so much leverage, vertical integration, and lightweight collusion/signalling that the government really needs to take a stronger hand to protect consumers.

I'd nominate pharmacy, finance and airlines.

Of course we don't want to snuff out R&D/infrastructure incentives. Back to being a free marketer, those long term returns are necessary for the risk. I've worked in an infrastructure intensive industry. When you're talking 10+ years to get your money back in the face of evolving technology, these are very risky bets that need to come with high rewards. Society can't only focus on the money involved when the bets are paying offi.

I think what could be taken on is the capricious changes/complexity and putting some floor under behaviors for the entire industry.

Airlines: seats must be at least this big. Deal with it.
Pharmacy: Your drug prices may not be higher here than the highest of any other country.
Finance: Anyone recommending investment must be a fiduciary.

And a far higher standard on mergers. Those efficiencies that sometimes do make their way into consumer prices often come at the expense of longer-term consolidation and accidentally creating single points of failure in critical supply chains.

 

[Fermion]

A few bad players also should not taint the whole industry. I am tired of hearing about pharma bro.

Why don't we bash Tesla and the entire EV industry because of some problem with batteries in a LEAF?

 

[brett]

I do not know anything about pharma.

One thing I do know is that medications are more expensive in the US than they are in Canada.

The other thing I know from experience is medication is less expensive in Europe, SE Asia and South America than it is in Canada. Same for same. And often more accessible without an Rx.

 

[ShokWaveRider]

Don't forget the price hospitals charge for these and some other cheap drugs. Remember the $1,000 Tylenol. So, the hospitals are just as much to blame for buying a drug for pennies and selling them for ~$1,000.

 

[Car-Guy]

I do not know anything about pharma.

One thing I do know is that medications are more expensive in the US than they are in Canada.

The other thing I know from experience is medication is less expensive in Europe, SE Asia and South America than it is in Canada. Same for same. And often more accessible without an Rx.

I know very little about pharma, but I have my suspicions. Specific suspicions! I think I'm also pretty good at spotting it when something is fundamentally "wrong".

 

[Cayman]

It is a shame that Big Pharma writes our laws instead of people with common sense working for the people.

It's big corps, special interests including Pharma and we the people allow it.
It's out of control and shameful.
So sorry Old Medic.

 

[Cayman]

All this bashing on "big pharma" and excess profits while nobody is investing in pharma because tech is where they are really gouging people and making true excess profits (and selling your info, targeted marketing, etc.)

I would love for it to be true that you can make a lot of money in pharma but it just isn't. The regulations are stringent on bringing new drugs to market and the competition is pretty fierce.

You want to make money? Buy Microsoft, not Merck.

There are many profitable Pharma examples.
Here's a recent one: LLY

 

[Fermion]

There are many profitable Pharma examples.
Here's a recent one: LLY

Over the past 20 years, LLY has gone from $68 to $572.

Over the past 20 years Microsoft has gone from $26 to $370.

Both pay a dividend, Microsoft pays a bit higher.

 

[isisdave]

In many states, you have to be offered the generic version if there is one.

In some, you must be given the generic unless the doctor checks the box that says "dispense as written" or "do not substitute".

And everywhere, there are many kinds of equivalent meds that do nearly the same thing. You can ask the pharmacist for suggestions and take them to the doctor.

In my experience, many doctors have NO idea what meds cost.

 

[plsprius]

You can get a 90 day supply of the largest dose from CostPlusDrugs with no insurance required (or accepted).

Methocarbamol (Generic for Robaxin)

Methocarbamol
Tablet • 750mg • 90 count

$10.40

 

[JoeWras]

In many states, you have to be offered the generic version if there is one.

In some, you must be given the generic unless the doctor checks the box that says "dispense as written" or "do not substitute".

And everywhere, there are many kinds of equivalent meds that do nearly the same thing. You can ask the pharmacist for suggestions and take them to the doctor.

In my experience, many doctors have NO idea what meds cost.

My doc is very sensitive to drug costs and has been recommending GoodRx for a decade, when they first came into existence.

That's why I keep him despite his incompetence in other areas. (Long story) Everyone has their strengths and weaknesses.

 

[Fermion]

Here is your greedy, insanely profitable drug company!

Now you too can benefit from the massive drug profits!

They were about $100 a share a few years ago:

 

[Koolau]

Here is your greedy, insanely profitable drug company!

Now you too can benefit from the massive drug profits!

They were about $100 a share a few years ago:

Yep, Pharma has typically been high risk - high reward model. Smaller Pharma can basically only hope to bring in one winner or be bought up by the big guys. Otherwise...

Big Pharma bets a couple of $billion on a potential block buster. If it IS a block buster, they look like real heroes. If not, they are punished in the markets. So shall it ever be - unless the gummint decides to take over the industry. Probably not a good idea, but YMMV.

The big guys have recently had great revenue growth for the most part, but they trade at high PEs so not always a lot of room for stock price appreciation. The time to buy Pharma (like most things) is when they are beat down - when their very existence (independently) is in question. (Can you spell GSK?)

Just like oil companies, Pharma "seems" like they have a license to steal, but in reality, they have the same issues most companies have and are never always up. They are among the most regulated companies in the world and gummints love to kick them around occasionally - it makes for good stump speeches.

When Pharma does well, it's really easy to point to them as greedy. What say you when a simple regimen of antibiotics or cancer treatments or weight-loss drugs make a big difference in your life? "Those blinkity, blankety evil, greedy Pharma companies charge too much." Back in the day, my dad had half his stomach removed due to ulcers. What would he have paid for a Proton Pump Inhibitor that we now take for granted - and made the Pharma industry rich. (The phrase "Doing well by doing good" comes to mind but only you can decide if it truly applies to Big Pharma because YMMV.)

Hey, I've been PO'd at Big Pharma and I hate the oil companies too. BUT, I also love to go on living with my particular (pharma-controlled) chronic illnesses and I also like to be able to drive my car, so... Thank goodness for Big Pharma (and Big Oil.) Buy their stocks if you think they have a license to print money. My opinion: We're better off with the greedy b******s than making them another gummint dominated industry. Goose that laid the golden egg may be better than the "doing good" reference. BUT, as always, YMMV.