Comments on: Reducing pharmaceutical utilization and costs

By: dblacklock

dblacklock — Sat, 05 Dec 2009 20:03:45 +0000

I saw a presentation on PBS 2 weeks ago that featureed the health delivery systems in England, Japan, Taiwan, Germany, and Switzerland. In all cases the governments have taken the profit out of healthcare. In the US, every direction the patient turns, a different provider or industry has their hand out. Socialized medicine didn’t look bad at all. A consistent question the journalist asked his interviewee in each country was, “How many people in your country have to declare bankruptcy on account of a healthcare catastrophe. In each instance the answer was zero, usually with a puzzled look.

By: JimEd

JimEd — Sat, 07 Feb 2009 15:25:42 +0000

Some accurate, some inaccurate, some advisable, some inadvisable, IMHO.

Accurate: Docs give in to patients’ requests. Inaccurate: Rx costs only dropped in 2008. Advisable: ban advertising of Rx. Inadvisable: Have govt negotiate Rx prices.

I think you’re both on the spot when you say that part of the problem is that Docs simply give in to patients’ requests. Typically, the doc has no idea what the copay is or the cost of the drug, so why not? Insurance companies & Medicare/Medicaid discourage docs from taking “too much time” with a patient, so docs are unable or unwilling to direct the patient to the RIGHT drug (i.e., the lowest cost-effective option).

Drug pricing/inflation has been ebbing along with the increasing penetration of the three-tier drug copay. As employees are forced to share in the cost of their medical decisions, generic and tier-2 drugs gain ground, tier-three drugs lose ground, and drug inflation ebbs. Patient sharing in the cost of treatment is ALWAYS helpful, providing it doesn’t reach ruinous levels.

I think it’s advisable to ban pharmaceutical ads on TV. The Rx cos are reaching the lowest common denominator with a necessarily-incomplete message. I’m not capable of deciding WHICH hypertension medicine is best for me. That’s what I have a doc for. We USED to ban Rx ads, up until some time in the 60’s or 70’s, maybe the 80’s. Drugs were then selected in a less uninformed way (not uninformed… LESS uninformed)

Not advisable, IMO, to regulate drug prices. That is how new drugs are developed — from the profits on existing drugs. The socialized countries that regulate the prices of OUR drugs in THEIR countries continue to carp that we’re not developing ENOUGH NEW DRUGS. If we shut off the flow of profits, we’ll eventually shut off the flow of new, effective, targeted drugs. With outlawing ads, even MORE money would be freed up to research new cures.

However, bureaucrats are ONLY concerned about the deaths people can see, not the deaths that MIGHT have been prevented but weren’t because new drugs weren’t developed.

By: K_pruchnik

K_pruchnik — Mon, 02 Feb 2009 21:14:31 +0000

I agree with you David, but doctors need patients and they like to please their patients, thus they often give them what they ask for. Patients request the name brands that they see advertised.

By: David

David — Mon, 19 Jan 2009 04:44:42 +0000

It is not an issue of lowering costs of pharmaceuticals, which is complicated, but rather making sure that expensive pharmaceuticals are being directed to the correct patient population. This is the goal of Personalized Medicine. The connection of a diagnostic test to a specific pharmaceutical.
There is too much of a focus on cost and not enough on value.

By: alewis

alewis — Wed, 10 Dec 2008 15:44:15 +0000

I think you are 80% of the way there. It might be a little Draconian to ban TV advertising for the entire category, though clearly it is an abused medium, where ads tell you to ask for the “purple pill” without giving you a clue of what it’s for (which would require disclaimers).

How about, Medicare negotiates a rate, as you say and as will likely happen, and then part of the deal is that the co-pay varies according to the TV advertising budget? You could come up with a formula. That would discourage TV advertising, save money for Medicare, and prevent the whole thing from having to go to Congress, I think.