[HN Gopher] Dubious $56,000 Alzheimer's drug spurs largest Medic...
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       Dubious $56,000 Alzheimer's drug spurs largest Medicare price hike
       ever
        
       Author : samizdis
       Score  : 52 points
       Date   : 2021-11-15 18:43 UTC (4 hours ago)
        
 (HTM) web link (arstechnica.com)
 (TXT) w3m dump (arstechnica.com)
        
       | datavirtue wrote:
       | $65k per year medications are Biogens specialty. They payup a
       | patient's full out of pocket for them when they start on this.
       | Really cools tension over the price for those receiving the drug.
        
       | samlosodesign wrote:
       | I love how a Biogen conference was responsible for one of the
       | biggest initial outbreaks of Covid, and now every senior will be
       | responsible for paying $20 more per month for a drug of theirs
       | that has no clinical efficacy whatsoever.
       | 
       | When will they ever get what's coming to them? One must wonder...
       | 
       | Things are really starting to feel like France at the turn of the
       | 18th century.
        
         | bhouston wrote:
         | > When will they ever get what's coming to them? One must
         | wonder...
         | 
         | It is probably best to accept that there is no such thing as
         | Karma in life. We don't live in a Hollywood blockbuster where
         | the good guys win all the time no matter what the odds.
        
           | djohnston wrote:
           | I am aligned with this and it pushes me towards vigilantism.
           | In the words of big Sean "if you want the crown bitch you
           | gotta take it", although here the crown is more the
           | abolishment of the new aristocracy.
        
         | andrei_says_ wrote:
         | Not sure when exactly but definitely after election financing
         | reform.
        
       | TrackerFF wrote:
       | Somewhat related: Why is it that the US needs middle-men to
       | negotiate prices - that is, why can't Medicare just negotiate the
       | prices themselves?
       | 
       | If I understand it right, that's what other countries do.
       | Countries with universal healthcare systems are basically the
       | only buyer, and can drive a hard bargain. Yet the US needs for-
       | profit middle-men, that can't seem to get a price as good other
       | countries...but yet they're supposed to perform better than
       | Medicare? Doesn't make any sense (to an outsider)
        
         | wefarrell wrote:
         | Not only that, but the middle men are permitted to receive
         | rebates from the manufacturers. Rebates like that are illegal
         | in all other industries except pharma.
        
         | quickthrowman wrote:
         | > Why is it that the US needs middle-men to negotiate prices -
         | that is, why can't Medicare just negotiate the prices
         | themselves?
         | 
         | Pharmaceutical companies bribe--sorry, lobby--members of
         | Congress so those members of Congress vote against letting
         | Medicare negotiate pricing.
         | 
         | Since money is speech, (see Citizens United v FEC) the one with
         | the most money wins.
        
         | colinmhayes wrote:
         | Congress doesn't allow it. Biden tried to get this into the
         | reconciliation bill, but Manchin rejected it.
        
           | [deleted]
        
         | vmception wrote:
         | As you form your observation, a few notes:
         | 
         | Other developed countries have a variety of systems, but they
         | typically do at least have a public option (available to all).
         | 
         | US middle men are not trying to get a good price.
         | 
         | US consensus failures on this are based on fear of the
         | government, entrenched interests, lack of inspiration on what
         | specifically to change, coincidental convenience as the status
         | quo keeps people preoccupied and risk averse, and a large very
         | sick population that really would massively increase taxpayer
         | costs in the first several years no matter how it would
         | equalize in a longer term.
        
         | ZetaZero wrote:
         | "The Medicare Prescription Drug Act expressly prohibited
         | Medicare from negotiating bulk prescription drug prices."
         | 
         | https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Im...
        
       | Gunax wrote:
       | There is rightly focus on whether this drug works, but the more
       | interesting question is "assuming it does work, what then?".
       | 
       | Now you opened up the balance of cost and effectiveness. Therein
       | lies the nest of vipers.
        
         | bradleyjg wrote:
         | That's a solved problem. The solution is called QALYS. Richer
         | or poorer countries can set the total budget differently and
         | then QALYS tells you how to spend it.
        
           | denimnerd42 wrote:
           | that does not at all sound controversial
        
       | Shadonototra wrote:
       | I don't understand how can people advocate for this kind of
       | society.. it's depressing
        
       | Ericson2314 wrote:
       | Politicians whip out the inflation boogieman to wage class
       | warfare, and of course simultaneously also do stupid things like
       | that will just make it worse.
        
       | Barrin92 wrote:
       | _" Meanwhile, Biogen had set the list price at $56,000 per year.
       | Media analyses suggested that at that price, the drug could cost
       | Medicare up to $334.5 billion per year, which is nearly half of
       | the budget for the Department of Defense[...]In November 2020, a
       | committee of independent advisers for the Food and Drug
       | Administration voted nearly unanimously against FDA approval for
       | Aduhelm. The data did not indicate the drug is effective, the
       | committee concluded. Ten of 11 committee members voted against
       | approval while one voted "uncertain." But in June of this year,
       | the FDA approved the drug anyway"_
       | 
       | That's almost twice of the entire NHS healthcare spending for one
       | drug that probably doesn't do anything for Alzheimer patients?
       | This isn't actually going through at the end of the day right?
       | The US healthcare, drug and regulatory system has lost the plot,
       | that's just nuts.
       | 
       | And what on earth is going on at the FDA to approve this? Even if
       | I was a literal pharma lobbyist I would probably skip that one
       | because it just sounds too wrong
        
         | treeman79 wrote:
         | Medical industry is about milking the government for everything
         | possible. Actually helping people is secondary.
        
         | elhudy wrote:
         | FDA doesn't approve based on the projected costs to the system.
         | That's the underlying problem. There is no political mechanism
         | to say "no, this treatment won't be covered by medicare."
         | Further, such a mechanism would be wildly unpopular with your
         | average voter. Nobody wants to deny their grandmas coverage to
         | anything, and it's a huge burden on the system and contributor
         | to inflation.
        
         | criddell wrote:
         | Can intellectual property be made public through eminent domain
         | the same way physical property can be?
        
         | missedthecue wrote:
         | Biogen had 'only' ~$13 billion in revenue in 2020, and won't do
         | much better in 2021. If this one drug is really going to 25x
         | their top line, why has the stock barely budged?
        
           | sjg007 wrote:
           | My guess is that nobody will prescribe it?
        
             | kadoban wrote:
             | That sounds like a bad bet. Pharma ads are allowed to
             | target patients directly, so people will ask their doctor
             | for it, and pharma reps are cozy with doctors, so at least
             | some doctors will go for it themselves.
             | 
             | This really requires some fix at the FDA or somewhere in
             | the government or it's going to be a disaster.
        
               | pedalpete wrote:
               | Yeah, but there is so much publicity around the efficacy
               | of the drug, people might not ask for it, and doctors
               | might advise against it, or just refuse to write a
               | script, particularly at that price.
        
               | kadoban wrote:
               | You have far too much faith in people, especially
               | scared/hurting people.
        
         | lupire wrote:
         | Comparing to NHS is mismatched units.
         | 
         | But it's 12% of all Medicare premiums
        
       | kwertyoowiyop wrote:
       | It's really annoying to watch the scare-tactic ads by the drug
       | companies against allowing Medicare to negotiate drug prices. "Oh
       | don't let them take away my precious drugs!!"
        
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       (page generated 2021-11-15 23:02 UTC)