[HN Gopher] Most Expensive Drugs in the U.S.
       ___________________________________________________________________
        
       Most Expensive Drugs in the U.S.
        
       Author : avonmach
       Score  : 31 points
       Date   : 2021-06-08 21:18 UTC (1 hours ago)
        
 (HTM) web link (www.goodrx.com)
 (TXT) w3m dump (www.goodrx.com)
        
       | tristanc wrote:
       | Unfortunately seems unavailable in Europe...
        
         | felixg3 wrote:
         | Fortunately, most of us Europeans do not need to compare prices
         | of prescription medication.
        
           | ryan93 wrote:
           | Comparing the prices of unavailable medicine?
        
           | 1123581321 wrote:
           | Most of these aren't available in Europe or European approval
           | lagged the US (not that the US is as fast is it should be.)
           | Europeans have had to fundraise to personally pay for such
           | niche medications.
        
           | pkaye wrote:
           | Though it still happens a few times for these expensive
           | drugs.
           | 
           | https://smanewstoday.com/news-posts/2021/04/26/danish-
           | family...
        
             | gambiting wrote:
             | I just posted above - UK's National Health Service has just
             | struck a deal with Novartis to provide Zolgensma to
             | children who need it at no charge:
             | 
             | https://www.theguardian.com/society/2021/mar/08/nhs-use-
             | worl...
        
           | wyager wrote:
           | I guarantee you can't get any of these drugs payed for by the
           | government in countries with government-run healthcare.
        
             | gambiting wrote:
             | Really? How certain of it are you? What's your source?
             | 
             | Very recently UK government has struck a deal with Novartis
             | to provide "the world's most expensive drug" to children
             | with spinal muscular atrophy - at PS1.8M a dose(the amount
             | NHS agreed to pay Novartis is confidential).
             | 
             | https://www.theguardian.com/society/2021/mar/08/nhs-use-
             | worl...
             | 
             | My own father has been treated with Glivec for over 8
             | years, all on the national health service - treatment which
             | in the US costs about $100k/year.
             | 
             | Like, I'm genuienly curious if you have a source, or is
             | this just a flex of some kind?
        
       | johntdyer wrote:
       | So fwiw I take Solaris every two weeks to treat Myasthenia Gravis
       | and it probably saved my life. It's an auto immune disease that
       | causes voluntary muscles to quickly tire, and you would be
       | surprised what actually qualifies at voluntary, eg your
       | diaphragm.... So yea, these drugs may be unaffordable and that
       | needs to change , but they do save lives.
        
         | the_svd_doctor wrote:
         | I'm glad that drug is helping you. I'm curious, do you know if
         | it is available in other countries? If yes, then we are
         | basically just subsidizing other places which can buy it, most
         | likely, for much cheaper.
        
       | akamoonknight wrote:
       | Maybe naive question, but why do _any_ insurance companies
       | provide payments for these medications?
        
         | H8crilA wrote:
         | Free market? Wouldn't you like your insurance to cover all
         | diseases? I know I would.
        
         | [deleted]
        
         | johntdyer wrote:
         | Well... Because my doctor prescribed it and said it's
         | necessary, and as it turns out it was.... I'm just thankful
         | that I have good insurance...
        
         | KMnO4 wrote:
         | Do insurance companies actually pay full price for these drugs?
         | I was under the impression that (at least in the US) it's a bit
         | of a racket where the bill will say $1000 and insurance will
         | make a deal with the supplier to pay $100 (while simultaneously
         | telling you they saved you $1000).
        
       | KMnO4 wrote:
       | What is "annual cost based on length of therapy"?
       | 
       | If you take a pill for 3 months at $10k/month does it have an
       | "annual cost" of $120k or $30k? And if it's the latter then it
       | would be less confusing if "annual" were omitted.
        
       | throwaway13337 wrote:
       | It would be nice to have a comparison to non-US costs.
       | 
       | I know the medication I take costs 5-6k a month in the US
       | (without insurance) but I am able to get it for 700-2k in
       | everywhere else.
       | 
       | I suppose it's about what you'd like to highlight.
        
         | sneak wrote:
         | It's a real shame that you're not allowed to freely transport
         | lifesaving medications across borders.
        
       | bitmover wrote:
       | All I could think about reading that list is, "damn I'm glad we
       | have a drug for that."
        
         | jumelles wrote:
         | Yep, medicine is incredible. The cost of medication is still a
         | massive issue in the world, though.
        
         | standardUser wrote:
         | All I could thing was "damn, too bad so many people who
         | desperately need these drugs can't afford them".
        
           | colechristensen wrote:
           | The max out-of-pocket for anyone insured in the US is $8,550
           | presently for an individual.
           | 
           | The big price tag is irrelevant, there's the most you can
           | spend on approved treatments in a year.
        
             | NortySpock wrote:
             | ...Plus the money you pay monthly in order to have health
             | insurance.
        
             | dillondoyle wrote:
             | And also IF you can get your insurance to cover or get it
             | on formulary. The article lists links on most of these
             | drugs the companies actively helping patients get it
             | covered.
        
             | jakeva wrote:
             | $8,550 is a lot of money to most Americans
        
         | caslon wrote:
         | Does it matter if nobody can afford it?
        
           | H8crilA wrote:
           | ~nobody pays those prices out of pocket
           | 
           | There's absolutely no way you can have a medical system
           | without insurance (either govt underwritten or private
           | corporation underwritten) beyond something trivial like a
           | village herbalist.
           | 
           | The only question is who does the underwriting and even more
           | importantly how are the premiums collected (taxes, that is
           | proportional to income, or flat fees).
        
             | the_svd_doctor wrote:
             | That's true, but everything also seems so much more
             | expensive here, even after negotiations between private
             | insurances and healthcare providers.
        
       | eplanit wrote:
       | I notice how the prices are not rationalized beyond "because
       | that's what Pharma charges" because of rarity of the illnesses,
       | etc. But there's no concrete 'why' the prices are what they are.
       | It seems they charge what they can get away with charging (it is
       | a market economy, after all).
       | 
       | It's not goodrx's fault in their reporting (bravo to them, in
       | fact), it's that there is no transparency into that industry that
       | would provide such a breakdown (that I know of -- surely never
       | see it reported).
        
       | CobaltFire wrote:
       | My son as diagnosed with B-ALL (Leukemia) last year, and one of
       | the drugs on this list was on the table. His genetic screening
       | came back as it not being required/appropriate, but it really
       | opened my eyes. I have health coverage that means I wouldn't have
       | paid a cent, but I didn't know that at first, and the feeling
       | that price tag left me with was something I won't forget.
       | 
       | A cancer diagnosis is hard. The fact that not only may you lose a
       | loved one, but then to confront the cost of treatment during the
       | phase when you are just trying to accept that diagnosis is
       | something else.
       | 
       | Even without that drug I would be bankrupt if I had chosen a
       | different career that afforded my family less coverage.
        
         | grecy wrote:
         | > _Even without that drug I would be bankrupt if I had chosen a
         | different career that afforded my family less coverage_
         | 
         | The knowledge that hundreds of millions of people in the
         | richest country that has ever existed live like that sickens
         | me.
         | 
         | My Mum was diagnosed with stage four lung cancer. She had
         | radiation, chemo, 4 different trail drugs and more pills and
         | doctor visits than I ever want to remember over two and half
         | years. Multiple multi-day stays in hospital and of course all
         | the at-home care towards the end.
         | 
         | It was horrible, and I wouldn't wish it on the worst person in
         | the world.
         | 
         | None of it cost a cent out of pocket, and my parents are both
         | retired teachers (average middle class) with just normal public
         | healthcare.
         | 
         | Australia can figure this out but the USA can't? Feels more
         | like doesn't want to.
        
           | mnouquet wrote:
           | > Australia can figure this out but the USA can't? Feels more
           | like doesn't want to.
           | 
           | I went through the cost/revenue data from public Big Pharma
           | companies a few years ago, long story short, the US prices
           | are subsidizing the rest of the world's (ie. really only
           | first world countries) "free" healthcare.
        
       | enahs-sf wrote:
       | All of the drugs on this list seem to treat some pretty nasty
       | conditions. I wonder what the payback time for the research is
       | and the target market looks like for each one. I also wonder what
       | the landscape of medicine will look like when generic versions of
       | these become available. How many awesome treatments are out there
       | but uncovered by insurance and thus, out of reach for all but the
       | most rich individuals.
        
         | philjohn wrote:
         | On the flipside, a treatment for Wilson's disease that was
         | first authorised for use in 1985, Syprine, is now well over
         | $200 per tablet - the problem here, it's probably not worth
         | making a generic as the market is pretty small.
        
         | H8crilA wrote:
         | If you have $300/month you can afford those drugs. That's
         | barely ultra rich.
        
       | LatteLazy wrote:
       | The most expensive drug on the list costs 2m, but then you're
       | done. Cured.
       | 
       | The second most expensive costs 1m. But that's per year.
       | 
       | 1m/year > 2m/lifetime
        
         | yepthatsreality wrote:
         | From the same site:
         | 
         | > ABOUT ZOLGENSMA
         | 
         | > ONASEMNOGENE ABEPARVOVEC is used to treat patients with
         | spinal muscular atrophy (SMA). It is not a cure. Compare gene
         | therapy drugs.
        
         | johntdyer wrote:
         | Yep, I can't testify personally that Solaris is a treatment ,
         | not a cure
        
         | woleium wrote:
         | Sadly though, even with the drug lifetime in this case is only
         | 15-19 years.
        
           | johntdyer wrote:
           | Yea, well Myasthenia Gravis is not terminal, so I'll likely
           | be on Solaris for the next 30-40 years... so $28,000,000 USD
           | :(
        
       | tamaharbor wrote:
       | I do a GoodRx price check of every drug I see advertised on TV.
       | There is typically no drug that costs less than $5k a month. Is
       | there a problem here?
        
         | sonofhans wrote:
         | Yes. The problem is allowing pharmaceutical products to be
         | advertised directly to consumers. That's only legal in 2
         | countries -- https://en.wikipedia.org/wiki/Direct-to-
         | consumer_advertising
         | 
         | As a consequence, many large drug companies spend more money
         | marketing drugs than developing them --
         | https://www.raps.org/news-and-articles/news-articles/2019/7/...
        
         | LeegleechN wrote:
         | Most prescribed drugs are generics that will cost you a couple
         | bucks. The drugs advertised on TV are precisely the ones with
         | high margins that support expensive customer acquisition
         | efforts.
        
           | to11mtm wrote:
           | Yeah. New Drugs are 'new', have probably just gone through
           | expensive R&D and Trial periods, so there is a need to recoup
           | investment.
           | 
           | Of course, there's the problem of when companies make a 'new'
           | drug that is very similar to an existing drug/generic that
           | already exists. A great example of that in my head is how
           | Cymbalta is not that much different than Effexor.
        
             | willcipriano wrote:
             | The most egregious was when the CFC ban went into place and
             | the non-CFC inhalers were all under patent again.
        
       ___________________________________________________________________
       (page generated 2021-06-08 23:02 UTC)