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Rant about the pharmaceutical companies

Switch Blayde 🚫

I always accepted that the drug companies needed to have high prices for new drugs to cover the R&D to develop those drugs. No longer.

I went to my cornea eye surgeon today. She told me about an eye drop for dry eyes that is new. Well, new in the U.S. It's been available over-the-counter in Europe. Bausch and Lomb bought the patent here (or something like that) and is selling it as a prescription in the U.S. But it's not covered by insurance and is $2,000 a bottle. And a bottle lasts about a month. So $24,000/year for something that's over-the-counter in Europe.

That's bullshit!

Rant over.

The Outsider 🚫

@Switch Blayde

Rant away! I'll add the BS the American Diabetes Association is spewing when they claim "KiDs NeeD CarbS tO gROw!"

My T1D eats less carbs in a WEEK than the ADA says kids need in one MEAL! And his A1c is so low it's not even on the endocrinologist's chart of A1c levels.

An insulin manufacturer's CEO was just quoted as calling diabetes a "growth industry…"

Replies:   ystokes  Rodeodoc
ystokes 🚫

@The Outsider

An insulin manufacturer's CEO was just quoted as calling diabetes a "growth industry…"

I am on two insulins that are capped at $35 a month each and until this year I was also taking two diabetes medications Jaidence and Januvia that were at also $35 a month, than the cost became $250 a month each. I really hope they like paying the hospital bill instead.

Replies:   Crumbly Writer
Crumbly Writer 🚫

@ystokes

Well, there's also 'Medical Tourism', where, like with Canada, you fly down to the Caribbean and get cheaper premium medical treatment with NO relation to the U.S. Medical decrees. I've known several people who've done that for VERY major conditions. And since many of the Caribbean nations are linked the European countries, they also have access to those medicines and practices too.

You'd like have trouble arranging a trip like that, yet it's worth considering IF you can manage it.

Replies:   Grey Wolf
Grey Wolf 🚫

@Crumbly Writer

Nearly all medications, except opiods and antibiotics, are over the counter in Mexico, and prices are generally (but not always) lower than non-insurance US prices. That is, if you avoid tourist-trap farmacias. For those within driving distance of the border, that makes Mexico a solid option.

On the other hand, you do need to shop around. On a recent trip to Puerto Vallarta, it amused me that we passed small farmacias just about every two or three blocks for kilometers on end. Most of those catered to tourists with inflated prices. Once you get out of tourist areas, though, things change, and that's just a few kilometers away at most (Puerto Vallarta is a fairly narrow city for the most part - there's only so much land between the coast and the mountains).

Medical work is generally half to two-thirds the price, or less (with further drops in cost as work gets more expensive - they're far less likely to have some of the absurd hospital upcharges), and dental work is 1/3 or so. The vast majority of doctors and dentists speak English and offer first-world-quality care.

Replies:   jimq2  Crumbly Writer
jimq2 🚫

@Grey Wolf

Of course those drugs in Mexico may or may not be the real drug or an accurate dosage. One of the Phoenix TV stations bought a bunch of prescription medications OTC in various places in Mexico, and less than 30% were accurately described as to the medication and dosage. One of the EXPENSIVE "cancer treatments" was merely a coated antihistamine.

Crumbly Writer 🚫

@jimq2

That's definitely true, yet a little research into the standard international practices (i.e. which drugs are sources from China, who don't give a shit whether it works or not can spare you from most disasters). But you have to know how to play those situations, as you get few 'do overs' with your health, as once it's shot, it rarely gets better, only much more expensive!

Grey Wolf 🚫

@jimq2

A lot of it depends on what it was and what pharmacies. The 'brand name' farmacias are much more likely to be selling something reliable compared to tourist pharmacies.

The most likely medicines to be inaccurate are 'under the counter' pain medication from tourist pharmacies. Buying those is a terrible idea. If you get something effective for pain, it's not unlikely that it's fentanyl-based, and that's Russian Roulette.

But, yes, selective shopping is a big deal, and 'if it looks like too good of a deal, it probably is' remains very good advice.

That said, I know a growing number of expats who live in Mexico, depend on (name-brand) farmacies for necessary medicines, and do just fine with it. But they're not in tourist areas (or, if they are, they're not going to tourist outlets).

Crumbly Writer 🚫

@Grey Wolf

And that's often because those doing the medical care were properly trained, most likely attending reliable schools in Europe which knew what they were doing. On a personal front, I've never trusted American doctors of pharmaceutical companies, yet the European ones are generally more open to new, alternative treatments and are also open to the alternative treatments which don't have nearly the side effects most western medications so.

Plus, despite American physicians assuming they already know everything and won't stand for anyone questioning their methods—even when they haven't continued study the latest treatment protocols—the best I've found were from either Northern India or the nearby Pakistan, again with their training from the more reputable institutions.

However, since they are more willing to consider new treatments, if you can back up your requests with knowledgable answers while still playing by their rules, you'll earn their trust and develop a much stronger relationship, while most American physicians won't spend more than fifteen minutes for anyone, since the more patients they see per hour, the more their paid. So they just don't have the time to care about ANY single case.

Again, if you don't have a medical advocate, then you've got to be you own advocate! But then, most Americans buy the whole dog and pony show, unwilling to ever questions their doctors recommendations, in which case, they generally receive precisely what they paid for.

In the end, who knows your personal conditions better than you. So if you want to hand your future to someone who's only willing to give you a few spare minutes, good luck with the results. Mine have never worked out in those cases, which is why I don't stick with those quacks for long.

Replies:   The Outsider
The Outsider 🚫

@Crumbly Writer

And, sorry to barge in on your convo, but the American slang saying of "blowing smoke up your (you know where)," started because people finally questioned the validity of actually blowing smoke up people's (you know where) when their heart stopped...

Rodeodoc 🚫

@The Outsider

I recall when I lived in the US in the early 2000's the marker for being prediabetic was 120 or something like that. Then a drug manufacturer gave the ADA a million dollar gift and… surprise! The number dropped 10 points. 8 million people became prediabetic over night.

Replies:   The Outsider
The Outsider 🚫
Updated:

@Rodeodoc

Yeah, my son's A1c is so low (we do low-carb for him) it's not even on the endo's chart. And we totally ignore the American Diabetes Association's "suggestions..."

(Sorry, I just saw that I've repeated myself...)

Vincent Berg 🚫

@Switch Blayde

Try searching Canadian mail-order pharmacies. Or homeopathic treatments. No insurer will cover those costs, yet the medications are usually cheap enough you won't need the extra coverage. I've been using them for the last … forty-five years.

The bigger issue is that, currently, the pharmacological industries would rather prolong conditions than resolve them, as 'curing' anything is seen as a financial loss. That's why happens when you operate from a cost-control profitability rather than a 'first do no harm' basis.

Replies:   The Outsider  DBActive
The Outsider 🚫

@Vincent Berg

Then, there are the insurance companies here in the US that expect you to get better based on some cockamamie schedule they've dreamed up!

No guarantees in medicine…

Replies:   Crumbly Writer
Crumbly Writer 🚫

@The Outsider

Due to my multiple-overlapping conditions, I've always taken a proactive role in my medical care. And anytime I encounter a physician who won't listen to me, I'll walk out and never return.

However, there are many, most foreign-born medical experts, who aren't complete raving A-holes. But you have to know what you're talking about. But typically, I'll walk in and say "I following the proscribed treatment for the typical adjustment period, but I had the following symptoms, so I did X, Y and Z, and it's working much better." If you depend on your doctor to do everything for you, you're completely dependent on them. But when you earn their trust by actively working together, you earn their respect.

However, you have to demand that respect, of yourself and them.

Replies:   The Outsider
The Outsider 🚫

@Crumbly Writer

Advocate, advocate, advocate…

I totally agree…

DBActive 🚫

@Vincent Berg

the pharmacological industries would rather prolong conditions than resolve them, as 'curing' anything is seen as a financial loss.

That is bullshit.
Almost all the infectious diseases which took hundreds of thousands of lives in the past have been eliminated either through vaccination or treatment. What are they supposed to cure? Heart disease is largely caused by lifestyle issues and modern medical treatments deal with the intractable issues when people won't make the lifestyle changes.
Cancer? A thousand different diseases that can affect anyplace in the body in different ways. And there are "cures" for many types of cancer.
What are you looking for? A magic pill or shot that eliminates all problems from your body?

Replies:   Vincent Berg
Vincent Berg 🚫

@DBActive

I was discussing RECENT U.S.A. medical decisions, Not those when the American Medical care was still one of the best.

Yes, we once had a wonderful medical system, but now, most medications are simply for 'maintaining' the conditions. And that was specifically driven by the Pharmacological companies. But as always, you want to see the actual documentation while I tend to view 'trends'. So the pharmacological countries WON'T publicly admit the effect they're forcing on people's lives.

But the BIG diseases rely on the science, not the funding. And if the science isn't ready, then no amount of funding will make ANY difference. Yet when it is, then suddenly everything just comes together. So historically, you'll have decades of research funding (on the MAJOR conditions) and suddenly you'll get massive sweeping changes close together.

But yet again, we never seem to agree, so why bother arguing the details when they AREN'T any acknowledgments of it.

Pixy 🚫

@Switch Blayde

There is a new scam in the UK, where Investment Firms buy up veterinary practices and immediately double (at least) the cost of all treatments and medicines at that practice.

The IF also 'gamify' treatment, in that they award 'points' to all the practices in their portfolio. Giving points to the practice for treatments carried out, with certain medical interventions gaining higher points than other treatments. At the end of the month, practices with the highest points gain perks, like either financial staff bonuses or corporate away days, money towards the Christmas party, etc etc.

Totally unexpectedly, this has led to treatments being carried out that are not required, or not in the patients best interest.

Also, totally unexpectedly, this has led to an increase in otherwise healthy animals being put down because their owners can no longer afford treatment for previously affordable conditions.

Even more totally unexpectedly, is that Vet's are now pushing their clients into pre-payment and insurance policies, where if they pay monthly 'insurance', they will gain a 50% reduction in the cost of medicine/treatment at the practice. 50% off bills that increased 100% when the practice was taken over. An absolute bargain!

And the vets whose practices are being bought out? Non disclosure agreements and caveat's that if they leave the practice, they are not allowed to set up competing practices within one hundred miles.

Ahh, the joyous smell of capitalism and how it enriches all our lives.

Replies:   Bondi Beach  greenbottle
Bondi Beach 🚫

@Pixy

There is a new scam in the UK, where Investment Firms buy up veterinary practices and immediately double (at least) the cost of all treatments and medicines at that practice.

The IF also 'gamify' treatment, in that they award 'points' to all the practices in their portfolio.

Happening in the U.S. as well with hedge funds.

Replies:   Grey Wolf
Grey Wolf 🚫

@Bondi Beach

Sometimes it's nearly impossible to tell if a given vet is independent or part of one of the big companies. There's no requirement to advertise their ownership (or any change in ownership) and many don't.

Perhaps amusingly, Mars (the candy maker) is the largest operator of veterinary clinics in the US. They operate both the Banfield chain and VCA Animal Hospitals. Banfield practices are obvious (that's the brand), but only some VCA practices make it clear they're part of the chain.

greenbottle 🚫
Updated:

@Pixy

Also happening in Australia for the last couple of years exactly as Pixy has said.

My wife in her mid 70's is heart broken because she can't afford to pay the vet bills associated with a replacement for her dog who had to be put down two years ago because of cancer (he was 14).

The "new" age vets said there was nothing wrong with him, even though he was not eating and was supposed to have had an X-ray. Went to old style vet practice (further away from where we lived) and after the vet picked the dog up and felt his stomach, said he was a very sick dog before any further tests were done. Unfortunately nothing could be done for him. THe end result was the same but the attitude of the new age vets was all "$", while the second vet practice tried to do the best for the dog and his owner. We have moved to a new town which only has new age vet surgeries so can't use the old style vet practice.
Very sad.

awnlee jawking 🚫

@Switch Blayde

I went to my cornea eye surgeon today. She told me about an eye drop for dry eyes that is new. Well, new in the U.S. It's been available over-the-counter in Europe. Bausch and Lomb bought the patent here (or something like that) and is selling it as a prescription in the U.S. But it's not covered by insurance and is $2,000 a bottle. And a bottle lasts about a month. So $24,000/year for something that's over-the-counter in Europe.

Donald Trump is blaming Europe for inflated US pharmaceutical pricing and has implemented large tariffs as punishment :-(

AJ

Dominions Son 🚫

@awnlee jawking

Donald Trump is blaming Europe for inflated US pharmaceutical pricing and has implemented large tariffs as punishment

You wouldn't be able to order prescription drugs from Europe anyway.

A few years back people were trying that with Canada. The Canadian government quashed Canadian pharmacies selling price controlled drugs to US residents.

Replies:   awnlee jawking
awnlee jawking 🚫

@Dominions Son

I believe the Donald was railing against how much European pharmaceutical companies charged US healthcare providers.

AJ

Switch Blayde 🚫

@awnlee jawking

Donald Trump is blaming Europe for inflated US pharmaceutical pricing and has implemented large tariffs as punishment :-(

Are you sure about that? I heard the opposite. That he is trying to force U.S. prices to match the lowest price it can be found elsewhere, like from Europe or Canada.

jimq2 🚫

@Switch Blayde

You have to remember that Canada and most of Europe subsidizes all things medical.

awnlee jawking 🚫
Updated:

@Switch Blayde

Are you sure about that?

Reasonably. The papers said that some pharmaceutical companies were shifting manufacturing to the US to avoid the tariffs.

ETA AstraZeneca is building a manufacturing plant in the US, but they were going to do that anyway because the UK govt wouldn't give it a big enough bung. I vaguely remember another company moving some manufacturing from Mexico to the US too.

That doesn't mean you're wrong. In fact it would be very sensible for The Donald to adopt a multi-pronged approach.

AJ

Replies:   Dominions Son
Dominions Son 🚫

@awnlee jawking

I don't think the tariffs and the drug prices are connected.

The drug price issue includes US companies as well, who sell at higher prices in the US than in other countries due to either subsides or price controls in other countries.

Dominions Son 🚫

@Switch Blayde

Are you sure about that? I heard the opposite. That he is trying to force U.S. prices to match the lowest price it can be found elsewhere, like from Europe or Canada.

And not just the foreign pharmaceutical companies. US based pharmaceutical companies as well.

Replies:   ystokes
ystokes 🚫

@Dominions Son

And not just the foreign pharmaceutical companies. US based pharmaceutical companies as well.

I truly doubt he means it. In 2022 most Senate Republicans killed the cap on insulin costs and there is nothing about lowering costs in the Big Bill being voted on now.

DBActive 🚫
Updated:

@Switch Blayde

Are you speaking of xiidra eye drops?
They aren't sold in Europe.
If not, you are comparing Evotears Omega with the US drug Meibo. The cost of Meibo is high - $750 -$900 per month on GoodRX

But, on the general issue:
There are major differences in the drug market for many drugs in the US from Europe.
- If it is permitted to sell a drug OTC the price will always be much lower; its simply a matter of scale. The FDA has much stricter rules requiring prescriptions on numbers of drugs that are OTC elsewhere. The marketing, record keeping and distribution costs for prescription drugs are much much higher than OTC products.
- Liability. It is guaranteed that any new drug with any possible side effects will be subject to a myriad of lawsuits. That isn't true in Europe.

Replies:   Switch Blayde
Switch Blayde 🚫

@DBActive

Are you speaking of xiidra eye drops?

No.

My eye doc said Miebo. She will give me a sample on my next visit (next week).

ystokes 🚫

@Switch Blayde

The best piece of advice I ever got about drugs was "You don't know what's in the drug until the drug is in you."

DeeGee 🚫

@Switch Blayde

My old doctor used to tell me, "There are no such things as drug side effects. Drugs have effects, period. The manufacturers call the things they like 'effects' and the things they don't like 'side effects', which has the effect of minimizing bad effects and allowing them to be ignored."

Replies:   Cheshire_Writer
Cheshire_Writer 🚫

@DeeGee

thats how all things are.

and i saw a commercial for these eye drops today. id be embarressed to be using them

Replies:   Switch Blayde
Switch Blayde 🚫

@Cheshire_Writer

and i saw a commercial for these eye drops today. id be embarressed to be using them

Miebo?

I've been trying a sample bottle of it my eye surgeon gave me. It's the first time in years my left eye is not in pain.

The thing is, it's not covered by my insurance. So far the best price I can find is $966 a bottle (which should last one month).

Replies:   DBActive
DBActive 🚫
Updated:

@Switch Blayde

Try goodrx. It is around $650 there.If you are not on Medicare/Medicaid there are other avenues.

Replies:   Switch Blayde
Switch Blayde 🚫

@DBActive

If you are not on Medicare

I am. I have a GoodRX card.
Thanks.

Replies:   DBActive
DBActive 🚫

@Switch Blayde

I probably spoke too fast. Since I checked last week on there the price went from around $650 -700 to $750 to $850.
Sorry.

Replies:   Switch Blayde
Switch Blayde 🚫
Updated:

@DBActive

Since I checked last week on there the price went from around $650 -700 to $750 to $850.

The GoodRX price varies from where you live. If I remember, GoodRX gives you different places near your zip code with the price at each place. It varies.

I think I'm going to write RFK Jr. What the FDA did was completely wrong. It just proves they're in bed with the drug companies.

Replies:   Grey Wolf  DBActive
Grey Wolf 🚫

@Switch Blayde

It occurs to me that, at some price points, it's cheaper to fly to Europe, buy a supply, and fly back than buy it in the US.

Which is, of course, completely ridiculous, but that's the world we live in.

Replies:   Switch Blayde
Switch Blayde 🚫

@Grey Wolf

it's cheaper to fly to Europe

I bought two bottles of the OTC version from Amazon Germany the other day. Two bottles for around $63 U.S. The price includes shipping.

Replies:   awnlee jawking
awnlee jawking 🚫

@Switch Blayde

Good for you!

AJ

DBActive 🚫

@Switch Blayde

The drug companies don't want these to be prescription drugs. The would always prefer to sell them as OTC products.
For 70 years the ghost of Thalidomide, OTC in Europe and banned in the US, has governed the US drug approval process.

Replies:   Switch Blayde
Switch Blayde 🚫

@DBActive

The drug companies don't want these to be prescription drugs. The would always prefer to sell them as OTC products.

Just the opposite. This was an OTC product. Bausch and Lomb bought it and got the FDA to approve it as a prescription drug. That's how they can charge so much for it.

Replies:   DBActive
DBActive 🚫
Updated:

@Switch Blayde

No. Under the law, every drug that is new to the US market must undergo the same approval process. It doesn't matter if it is used elsewhere or is OTC elsewhere. That's been the law since the 1930s. If approved, it must initially be only offered on a prescription basis so that the actually efficacy and safety can be monitored in the real world as opposed to simple test data.

There is much, much more money to be made in the OTC market.

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