#copayment

How #Big_Pharma Uses Charity Programs to Cover for Drug Price Hikes
▻http://www.bloomberg.com/news/articles/2016-05-19/the-real-reason-big-pharma-wants-to-help-pay-for-your-prescription

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PSI is a patient-assistance charitable organization, commonly known as a copay charity. It’s one of seven large charities (among many smaller ones) offering assistance to some of the 40 million Americans covered through the government-funded Medicare drug program. Those who meet income guidelines can get much or all of their out-of-pocket drug costs covered by a charity: a large initial copay for a prescription, another sum known as the coverage gap or the donut hole, and more-modest ongoing costs. It adds up fast. After Turing raised Daraprim’s price, some toxoplasmosis patients on #Medicare had initial out-of-pocket costs of as much as $3,000.

That’s just a fraction of the total cost. Turing’s new price for an initial six-week course of Daraprim is $60,000 to $90,000. Who pays the difference? For Medicare patients, U.S. taxpayers shoulder the burden. Medicare doesn’t release complete data on what it pays pharmaceutical companies each year, but this much is clear: A million-dollar contribution from a pharmaceutical company to a copay charity can keep hundreds of patients from abandoning a newly pricey drug, enabling the donor to collect many millions from Medicare.

#complicité #vicié #vicieux

Drug Industry Launches Ad Campaign Aimed at Lawmakers
▻http://www.wsj.com/articles/drug-industry-launches-ad-campaign-aimed-at-lawmakers-1454885145

The sector’s largest trade group, the Pharmaceutical Research and Manufacturers of America, or PhRMA, says it intends to spend several million dollars this year, and 10% more than in 2015, on digital, radio and print ads that emphasize the industry’s role in developing new drugs and advancing medical science.

[...]

In 2015, PhRMA spent $18.45 million lobbying federal officials, up 11% from 2014, and the ninth-largest sum of any organization, according to data from the Center for Responsive Politics.

[...]

“We’ve identified 7,000 Americans who matter,” Mr. Hugin said during a lunch with reporters in January at the J.P. Morgan Healthcare Conference in San Francisco. “We’re focusing on [people] in policy positions, talking to patient groups, to fight structural issues.”

The industry is also focusing its discussions with doctors, think tanks and other stakeholders, a Celgene spokesman said.

At the January lunch, Mr. Hugin said many in the public took a dim view of drugmakers because of high prescription copays. The industry can’t change the minds of more than 300 million Americans, he said, so was instead focusing on policy makers.

#pharma

The best health care system in the world? Nonsense!
▻http://www.publicintegrity.org/2015/06/01/17426/best-health-care-system-world-nonsense

To understand how foolish we are, let’s consider the war of words that recently erupted between health insurers and drug companies.

First, though, let’s take a look at a new study that compares how much Americans pay for prescription medication compared to what folks in a few other industrialized countries pay.

The study, released last week by the Kaiser Permanente Institute for Health Policy, showed that pharmaceutical spending in the U.S. per capita had reached $1,010 in 2012. The next highest spender was Germany at $668 per capita. Australia came in at $558.

Am I the only one who finds it more than a little upsetting that the Germans spend 66 percent of what we spend for drugs and the Aussies spend just 55 percent?

As the Kaiser researchers point out, those countries’ citizens get a much better deal on their meds because their federal governments have policies in place to regulate drug prices. And those nations are not alone. Every other country in the developed world has instituted some kind of price control mechanism. Except, of course, the United States.

Kaiser’s numbers are consistent with those from a 2013 analysis by the 34-member Organization for Economic Cooperation and Development (OECD), which showed that Americans spend 40 percent more on drugs than the next highest spender, Canada.

As PBS pointed out last year in a report on drug prices around the world, government agencies in other countries set limits on how much they (and their citizens) will pay drug makers for their various products.

“By contrast,” as PBS further pointed out, “in the U.S., insurers typically accept the price set by the makers for each drug, especially when there is no competition in a therapeutic area, and then cover the cost with high copayments.” (Emphasis mine.)

PBS nailed it. American insurance companies are essentially powerless when it comes to negotiating prices with Big Pharma, just as they are becoming increasingly powerless in controlling the cost of hospital care and physician services. The way insurers continue to make money is not by doing a good job for their customers but by constantly shifting more of the cost of care to those customers.

If we were paying close enough attention to what insurers were saying during the health care reform debate, we would have realized that they are, for all practical purposes, impotent when it comes to holding down costs. All we had to do was read between the lines.

#santé #etats-Unis #

What the U.S. Can Learn About Health Care from Other Countries
▻http://www.sanders.senate.gov/newsroom/recent-business/us-can-learn-other-countries-health-care

Other major countries offer better health care at less cost than the United States, according to witnesses who testified on Tuesday at a Senate hearing chaired by Sen. Bernie Sanders. “What this hearing is really about is two fundamental issues. First, the U.S., the wealthiest country on the planet, is the only major industrialized country in the world that does not guarantee health care as a right to its citizens. Should we consider joining the rest of the world? I’d argue we should,” Sanders said. “Second, the U.S. spends twice as much as other countries that have much better health outcomes. What can we learn from these countries?” asked Sanders, chairman of the Senate Subcommittee on Primary Health and Aging.

Citing World Health Organization data, Sanders said the U.S. spends as much as three times more on health care than other industrialized countries. Health care outlays in the U.S. account for about 18 percent of our Gross Domestic Product, significantly more than in France, Germany, Denmark, Canada, Great Britain, Australia, Norway, Taiwan and Israel.

In Denmark, “all citizens have access to care; no one may be denied services on the basis of income, age, health or employment status,” according to Jakob Kjellberg, an economist from Copenhagen. Victor Rodwin, an expert on the French health care system, said “the French have easy access to primary health care, as well as specialty services, at half the per capita costs of what we spend in the U.S.”

Other witnesses said the money Americans sink into their expensive health care system does not buy better care. “Canada achieved health outcomes that are at least equal to those in the U.S. at two-thirds the cost,” according to one witness at the hearing, Dr. Danielle Martin of Women’s College Hospital in Toronto.

The United States ranks 26th in life expectancy compared to other countries ranked by the Paris-based Organization for Economic Cooperation and Development. People who live in Italy, Spain, France, Australia, Israel, Norway and other countries live 2 to 3 years longer than Americans.

The Affordable Care Act has improved access to insurance, but millions of Americans still lack insurance or have plans with such high deductibles and copayments that they cannot afford the care they need. As a result, some 45,000 uninsured Americans die each year because they didn’t go to a doctor in time.

A major factor driving up health care costs in the U.S. is the high cost of prescription drugs. Hospital stays also cost more. While hospitals in Germany and France charge $3,000 for an appendectomy, for example, the average price for the same procedure in American hospitals is $13,000. Some U.S. hospitals charge $28,000.

“It is time for the U.S. to join the rest of the industrialized world and guarantee access to health care as a right of all people, not just a privilege for those who can afford it,” Sanders said.

#Système_de_soins_de_santé