[HN Gopher] The Mafia of Pharma Pricing
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       The Mafia of Pharma Pricing
        
       Author : foolswisdom
       Score  : 37 points
       Date   : 2024-07-15 21:20 UTC (1 hours ago)
        
 (HTM) web link (www.thebignewsletter.com)
 (TXT) w3m dump (www.thebignewsletter.com)
        
       | WarOnPrivacy wrote:
       | just three PBMs [Pharmacy Benefit Manager] are now in control of
       | pricing of pharmaceuticals, and are redirecting vast amounts of
       | money to themselves. And they are why the price of generic
       | Gleevec didn't drop as it should have.
        
       | drewda wrote:
       | While I have mixed feelings about The New York Times's coverage
       | of certain topics these days, this is one topic where their
       | reporting has (positively) shaped events. They had a big
       | investigative piece earlier in the summer about pharmacy benefit
       | managers:
       | https://www.nytimes.com/2024/06/21/business/prescription-dru...
       | And that likely led to the recent FTC announcements.
        
       | its_ethan wrote:
       | Setting aside what happens for the uninsured (which is important,
       | I'm just trying to simplify for my own understanding), isn't this
       | mostly the levying of costs of _very_ expensive drugs onto the
       | insurance providers, rather than the patient? Meaning the
       | "victim" of the price gouging is the insurance company?
       | 
       | If you have insurance with a yearly out of pocket max of say
       | $8,000 and the drug you're taking has a very veiled and seemingly
       | dubious cost of $80,000 - does that effect the patient?
       | 
       | I assume it does somewhat directly in the form of higher monthly
       | payments (for the patient and other customers of the insurance)?
       | Can the insurance company deny access due to the high cost?
       | 
       | If this is somewhat the case, I would sort of expect insurance
       | companies to be lobbying for the system to be changed, and they
       | seem to have the capital to actually make a difference in that
       | "fight"?
       | 
       | Maybe I'm misunderstanding something though.. it was an
       | interesting article but it really just gave me even more insight
       | into how confusing the US healthcare system is, even beyond what
       | patients actually interact with.
        
         | dahinds wrote:
         | The PBMs have mostly been captured by the insurance companies,
         | so they're charging themselves and pocketing the profits
         | themselves. Insurance companies just pass on the costs by
         | charging higher premiums.
        
       | BenFranklin100 wrote:
       | I work in biotech. It's a long, difficult, and expensive process
       | to develop a new therapeutic. It is immensely discouraging to see
       | middlemen riding on the back of biomedical innovation and
       | enriching themselves at the expense of the scientist toiling in
       | the lab all the way to the patient in the hospital.
        
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