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Treasured Social Butterfly
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Re: Trump Administration Seeks To Expand Medicare’s Negotiating Power In Effort To Curb High Drug Pr

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Message 1 of 23

Gail, I consider you one of the most intelligent women in this message board, and yet, it is surprising to me that you continue to post things that at this point have not happened and who knows how they will end up in happening.

And the worse part is that you try to elevate any changes to the Trump Administration as if he in his mind would actually care on how the drug system works for anyone.

Please, provide us with the information of things when they happen andnot when they are still in the proposal stage.

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Re: Trump Administration Seeks To Expand Medicare’s Negotiating Power In Effort To Curb High Drug Pr

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Message 2 of 23

@GailL1 wrote:

@BigLib

I am not disagreeing with you but it takes some time to determine if (some) prices increases are warranted especially on older meds.  By reviewing any increase that comes in over a certain amount, the reason can be scrutinized much faster as to validity or greed - as was the case of Martin Shkreli and his price increase of a generic drug.

 

How the VA does it - https://www.commonwealthfund.org/publications/journal-article/2018/nov/whats-driving-prescription-dr...

Prescription drug costs within the VA are actually on par with what we see in really well-managed health systems like New Zealand. In a few critical ways the VA acts like those countries do. First, it has a centralized purchasing and negotiating operation, which gives it enormous leverage with manufacturers when it comes to negotiating discounts. Second, the VA has shown it can “just say no.” When expensive drugs can’t demonstrate real added value, the VA will leave them off the formulary. Their “tough but fair” negotiations result in manufacturers pricing medicines at levels that represent real value for the VA and, ultimately, for the U.S. taxpayer who foots the bill.

 

Yes, there are lots of things that can be done but we and particularly Medicare cannot be afraid of saying "no".- especially if there are alternatives and we need to encourage alternatives.


New Zealand also makes it easier to obtain some drugs OTC. Viagara is just one example. But an rx is still needed for it in America. They also treat pharmacies like pharmacies in those "socialized medicine" countries. Their pharmacists can prescribe antibiotics for UTIs and such on the spot, no doctor needed. But then, doctors still make house calls over there. You can't go to a pharmacy there and get your meds, laundry detergent and something for dinner.

 

Their government picks up the tab (through taxes and fees) for most of the health care costs in New Zealand as well. So if we're going to exalt their success, then perhaps it's time the republican party stops demonizing their method.

 

The VA must say "No" a lot, because there are still plenty of vets that need medical assistance. I'd be okay with Medicare saying "No", as long as saying no doesn't eliminate the last available option.

 

 

http://www.politifact.com/personalities/donald-trump/statements/byruling/false/ (11 pages of lies and growing)
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Re: Trump Administration Seeks To Expand Medicare’s Negotiating Power In Effort To Curb High Drug Pr

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Message 3 of 23

@BigLib

I am not disagreeing with you but it takes some time to determine if (some) prices increases are warranted especially on older meds.  By reviewing any increase that comes in over a certain amount, the reason can be scrutinized much faster as to validity or greed - as was the case of Martin Shkreli and his price increase of a generic drug.

 

How the VA does it - https://www.commonwealthfund.org/publications/journal-article/2018/nov/whats-driving-prescription-dr...

Prescription drug costs within the VA are actually on par with what we see in really well-managed health systems like New Zealand. In a few critical ways the VA acts like those countries do. First, it has a centralized purchasing and negotiating operation, which gives it enormous leverage with manufacturers when it comes to negotiating discounts. Second, the VA has shown it can “just say no.” When expensive drugs can’t demonstrate real added value, the VA will leave them off the formulary. Their “tough but fair” negotiations result in manufacturers pricing medicines at levels that represent real value for the VA and, ultimately, for the U.S. taxpayer who foots the bill.

 

Yes, there are lots of things that can be done but we and particularly Medicare cannot be afraid of saying "no".- especially if there are alternatives and we need to encourage alternatives.

* * * * * * It’s Always Something - Roseanne Rosannadanna
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Re: Trump Administration Seeks To Expand Medicare’s Negotiating Power In Effort To Curb High Drug Pr

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Message 4 of 23

@gordyfl wrote:

I think we all agree - it's unfair that the people of Canada pays less for drugs than we do. Every major industrialized country in the world pays less than we do.

 

 


Yes, sounds like we do all agree and the Administration is going to try to analyze this and if possible equalize them in at least Part B drugs which are some of the most expensive - we can see how this works and go from there.

 

American Patients First - ( page 31 )

 

Part B drugs are reportedly available to OECD nations at lower prices than those paid by Medicare Part B providers. HHS is interested in re ceiving data describing the diffences between the list prices and net prices paid by Medicare Part B providers, and the prices paid for these same drugs by OECD nations. Though these national health sys- tems may be demanding lower pric- es by restricting access or delaying entry, should Part B drugs sold by manufacturers ofering lower prices to OECD nations be subject to nego- tiation by Part D plans? Would this lead to lower out-of-pocket costs on behalf of people with Medicare? How could this afect access to medicines for people with Medicare?

 

A couple of points - often other countries lag behind our approval method because then do a much better job of evaluating a drug.  Not just whether or not it works but does it work better than something already on the market and they take their price of the new drug into consideration within this comparison.

 

So there are gonna be some drugs which we utilize here that may not be on other country formularies because they take the better benefit and the cost into consideration before it is put on their national formulary.

 

This is one of the reasons why our medical cost are more expensive than other countries.  Should we be more like them in this respect?  Would not having access to a new drug because of pricing or because it is not that much better than something already on the market a reason to not cover a new medication in Medicare?

 

There is lots to consider especially when there is the human equation involved among the cost and the good-better-best rating system which other countries use in establishing their national formulary.  How much is potentially keeping a cancer patient alive for an addition 3 - 4 months worth when quality of life isn't even in the measure - $10,000 , $100,000, $500,000?

 

 

 

* * * * * * It’s Always Something - Roseanne Rosannadanna
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Re: Trump Administration Seeks To Expand Medicare’s Negotiating Power In Effort To Curb High Drug Pr

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Message 5 of 23

@GailL1 wrote:

That is precisely what step therapy is - finding the best one for the patient.


That's what I just said. But when a drug's worthiness is deemed appropriate or eliminated solely by cost, then there isn't much "stepping" to done.

 

We first have to come to an understanding - do companies exist to serve people, or do people exist to serve companies. And whose interests come first.

 

Here's an idea. Since Trump is so fond of slapping penalties on industries he feels disadvantages the average American (cough), and even threatens to take away tax incentives for businesses that make him mad, here's his chance to prove how mad prescription drug price gouging makes him. Slap a tax on companies overcharging for their drugs, that is the percentage equivalent between what the rest of the industry is charging for similar drugs, and falls into the price range that Medicare would pay.

 

So when pigs like Martin Shkreli spike their drug prices from $13.50/pill to $750/pill (about a 56% price hike), then that company is taxed at 56% for each time Medicare is asked to pay for filling that prescription. And just like a larger lottery win, the government keeps the tax money before it's ever sent to the company. That's a good position to start bargaining from.

 

 

http://www.politifact.com/personalities/donald-trump/statements/byruling/false/ (11 pages of lies and growing)
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Re: Trump Administration Seeks To Expand Medicare’s Negotiating Power In Effort To Curb High Drug Pr

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Message 6 of 23

@BigLib wrote:

@GailL1 wrote:

"Step Therapy" was another one of the things mentioned in the HHS Blog - that is to say, allowing the insurers of Medicare Part D to required using the lowest cost drug 1st to see if it works before moving up the chain to other drugs for the same condition.

 

The only drugs that could be eliminated would be the ones that are more expensive than another one that does the same or better at a cheaper cost


So much for "Step Therapy" then. Not everyone is going to tolerate the same drug identically, regardless of what it costs. Statins are a great example of that. I can't help but think of how much Medicare could have been saving all this time, had republicans not made it illegal for it to negotiate drug prices over a decade ago.

 

 


That is precisely what step therapy is - finding the best one for the patient.  When 1st ordered, the doc does not know which is best - the patient doesn't know either - so by trying them, one by one, beginning with the most economical , the doc can figure out which one works the best for the patient.  If there are some medical extenuating circumstances with the patient all of that is also taken into the prescribing - some allergy to an ingredient, some genetic marker, etc.

Happens everyday in the normal course of treatment.  It is all about finding what works the best for the patient but also determining what works the best for the patient considering the cost especially since our drug approval method does not rank new medicine approval as better than something already on the market.

 

How would Medicare ever negotiate the cost of a medicine if all medicines have to be covered by mandate ?  Where is their power to get the lowest price in that case?  Really, I would really like to know how you see that the process would work especially since our drug approval process does not compare a new medication to one already on the market - Especially since we don't take price into consideration in this approval process.

 

 

* * * * * * It’s Always Something - Roseanne Rosannadanna
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Re: Trump Administration Seeks To Expand Medicare’s Negotiating Power In Effort To Curb High Drug Pr

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Message 7 of 23

@GailL1 wrote:

"Step Therapy" was another one of the things mentioned in the HHS Blog - that is to say, allowing the insurers of Medicare Part D to required using the lowest cost drug 1st to see if it works before moving up the chain to other drugs for the same condition.

 

The only drugs that could be eliminated would be the ones that are more expensive than another one that does the same or better at a cheaper cost


So much for "Step Therapy" then. Not everyone is going to tolerate the same drug identically, regardless of what it costs. Statins are a great example of that. I can't help but think of how much Medicare could have been saving all this time, had republicans not made it illegal for it to negotiate drug prices over a decade ago.

 

 

http://www.politifact.com/personalities/donald-trump/statements/byruling/false/ (11 pages of lies and growing)
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Re: Trump Administration Seeks To Expand Medicare’s Negotiating Power In Effort To Curb High Drug Pr

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Message 8 of 23

I think we all agree - it's unfair that the people of Canada pays less for drugs than we do. Every major industrialized country in the world pays less than we do.

 

 

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Re: Trump Administration Seeks To Expand Medicare’s Negotiating Power In Effort To Curb High Drug Pr

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Message 9 of 23

There is Nothing New Here - More Grandstanding & Empty Promises

 

“It’s hard to take the Trump administration and Republicans seriously about reducing health care costs for seniors when they have repeatedly advocated for and implemented policies that strip away protections for people with pre-existing conditions and lead to increased health care costs for millions of Americans,” said Senator Chuck Schumer of New York, the Democratic leader.

 

While Democrats have long pushed for such negotiations, Republicans in this country have blocked them, fearing Medicare could eventually dictate prices or restrict access to drugs deemed to be too expensive.

 

More Empty Promises - Get Back to Us When he signs any of this into Law

 

Source - https://www.nytimes.com/2018/10/25/us/politics/medicare-prescription-drug-costs-trump.html

 

 

 

 

( " China if You're Listening - Get Trumps Tax Returns " )

" )
" - Anonymous

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Re: Trump Administration Seeks To Expand Medicare’s Negotiating Power In Effort To Curb High Drug Pr

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Message 10 of 23

@mandm84 wrote:

Republicans are interested in calling out Drug Companies on price gouging ? Yeah sure !!


This is only price gouging in those (6) classes of drugs in the Medicare Part D program which have a legal mandate to cover ALL drugs in those classifications.

Because of that legal mandate, Medicare and beneficiaries are paying some very high prices for these drugs.

 

Read the links -

* * * * * * It’s Always Something - Roseanne Rosannadanna
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