Aller au contenu

Un hedge fund augmente de 5 000% le prix d'un medicament utilisé par les séropositifs


Bézoukhov

Messages recommandés

Oui. Et les assureurs paient aussi des PBM pour négocier les médicaments (au sens large : prix, niveau de remboursement, générique etc). L'Etat fédéral fonctionne un peu de la même façon (il ne peut pas négocier en direct).

Donc le prix peut être affiché 750, négocié 375 avec 365 payé par l'assurance et 10 par le patient.

Lien vers le commentaire

Pour les personnes non assurées dont le revenu est inférieur à 5 fois le seuil de pauvreté fédéral c'est gratuit

 

Rofl. La phrase était claire, mais j'étais déterminé à la comprendre de travers :D

 

Du coup, 5 fois le seuil fédéral ..

 

Federal Poverty Level (FPL)

A measure of income level issued annually by the Department of Health and Human Services. Federal poverty levels are used to determine your eligibility for certain programs and benefits. FPL amounts currently used by the Marketplace:

    $11,770 for individuals

    $15,930 for a family of 2

    $20,090 for a family of 3

    $24,250 for a family of 4

    $28,410 for a family of 5

    $32,570 for a family of 6

    $36,730 for a family of 7

    $40,890 for a family of 8

https://www.healthcare.gov/glossary/federal-poverty-level-FPL/

 

C'est très large en fait.

Lien vers le commentaire

Pas loin de 60.000 dollars par an donc pour une personne seule. Et les personnes au-dessus de ce seuil ont probablement une assurance santé.

Bref, il n'y a pas grand monde qui va payer le prix annoncé au départ. Beaucoup de bruit pour pas grand chose.

Lien vers le commentaire

Il y a un gros problème aux US de pénurie de médicament. Il y a eu quelques problèmes avec des médocs il y a quelques années et en 2009, la FDA a considérablement renforcé les normes et contrôle de production ce qui a évincé pas mal de monde et fragilisé les lignes de production et l'importation est excrément compliqué (notamment pour ces raisons).

Ca tire les prix à la hausse.

Lien vers le commentaire

Ah oui, je confonds toujours. Faut dire que j'ai jamais bien compris pourquoi les négociations de salaires se font à l'année alors que la plupart des dépenses qu'on a sont par mois.

13è mois, primes diverses...

Puis les dépenses annuelles sont fréquentes : Assurances, impôts...

Lien vers le commentaire

Dans un contexte français, oui, mais à l'étranger, c'est loin d'être évident. Pour les US en l’occurrence:

- Pas de système de 13e mois à ma connaissance

- Les primes ne sont pas comprises dans le salaire annuel

- Impôts prélevés à la source, donc par mois. Certes, il y a un ajustement annuel.

- Beaucoup de paiement d'assurances sont étalés au mois par mois. Les seules assurances que je paie sur des périodes plus longues sont l'assurance locataire (soit environ $100 pour un an) et l'assurance voiture (il y a possibilité de payer mois par mois pour quasiment le même prix).

Lien vers le commentaire

Pour compléter ce que je disais, on voit bien qu'il y a de fortes augmentations de prix depuis 2009 (l'année du durcissement des règles par la FDA) : http://www.sacbee.com/latest-news/article46602700.html

 

 

The paper, which involved a survey of 19 dermatology products, found they had increased an average of 401 percent between 2009 and 2015. The survey was based on prices at four national chain pharmacies: Costco, CVS, Sam's Club and Walgreens. The surveyed stores all were in Florida, though prices at the individual chains were consistent around the country.

"The majority of the drugs are bread and butter drugs that a lot of patients are on," Miranda Rosenberg said.

 

 

Lien vers le commentaire
  • 3 weeks later...
  • 1 month later...

MARTIN SHKRELI SHOWS US HOW REGULATION DRIVES INEQUALITY

BY WILL WILKINSON

Martin Shkreli, the fresh-faced founder of Turing Pharmaceuticals, recently snatched up the rights to Daraprim, a 62-year-old generic drug used to treat malaria, toxoplasmosis, and symptoms of AIDS. He then raised the price from $13.50 to $750 per dose, because he could. Shkreli’s shameless gambit has been met with outrage. Shkreli has tried to justify this banditry—not that many people pay for prescriptions of the drug anyway; the profits will finance a newer, better version—but no one is biting. It’s clear enough that this resourceful young man is a morally rudderless scoundrel.

But that’s just capitalism, right? Shkreli’s seems to thinks so.

“There’s no doubt … I’m a capitalist,” he said in an interview with CBS. “I’m trying to create a big drug company, a successful drug company, a profitable drug company. We’re trying to flourish.”

This sort of capitalism is a godsend to capitalism’s opponents. This meme, alleging that capitalism rewards sociopaths, basically sums up the reaction in my social media feeds, which are heavy with left-leaning academics:

 

CPifGgUW8AAr5Xq.jpg

Shkreli is a gift to less ideologically zealous liberals as well. Dan Diamond of Vox, who favors heavier government regulation of drug prices, says Shkreli is a “national hero” because, “[w]e don’t get health reform without a catalyzing moment like this.” Hillary Clinton, the Democratic presidential frontrunner, bounced off the springboard of Martin Shkreli’s avarice proposing a new rule that would cap the monthly out-of-pocket cost of prescription drugs to $250 for Americans with serious conditions.

There’s no point denying that Shkreli is a sort of capitalist practicing capitalism as it actually exists in the United States. All market institutions are built around a political superstructure of law and regulation. The problem is that American pharmaceutical markets are so badly regulated that normal market mechanisms can’t function, creating opportunities for knaves.

Daraprim is a generic, which means that the patent on the drug—a government-granted monopoly meant to encourage innovation—has expired and the relevant chemical structure (it’s called “pyrimethamine”) is in the public domain. Anyone could in principle come to market with a pyrimethamine drug identical to Daraprim. So what is it that Shkreli bought when he spent $55 million for the right to sell Daraprim? Easy question. He bought Daraprim’s Food and Drug Administration (FDA) approval. But why is that so valuable?

Bringing a copy of Daraprim to market would require filing an Abbreviated New Drug Approval with the FDA. The new formulation would be tested to make sure it’s really the same, and as safe, as the previously approved generic. The FDA is notoriously slow and the process is expensive. Probably not $55 million expensive, however. Shkreli was willing to pay such a huge sum because he could see that no Daraprim copies were in the regulatory pipeline, meaning that, for a time, he would have a monopoly and could reap monopoly profits by callously demanding exorbitant prices from patients who have no alternative to the drug. The scandal of Martin Shkreli’s profiteering tells us very little about capitalism, per se, but it does tell us a lot about the perverse market incentives that overzealous regulation can create.

“It’s easy to see that this issue is almost entirely about the difficulty of obtaining generic drug approval in the United States,” writes Alex Tabarrok, an economist at George Mason University who specializes in the political economy of drug approval. “[T]here are many suppliers in India and prices are incredibly cheap. The prices in this list are in India rupees. 7 rupees is about 10 cents so the list is telling us that a single pill costs about 5 cents in India compared to $750 in the United States!”

But $.05 Indian pills aren’t a problem for Shkreli’s bottom line because it’s illegal to sell imported generic versions of the drug that have not been independently approved by the FDA. Some of these generic brands have been blessed by European countries with perfectly sane and safe drug approval processes, but the U.S. won’t recognize foreign vetting, and insists on wasting resources, time, and lives with redundant oversight. On the global market, a dose of generic pyrimethamine costs a few pennies. If “capitalism” is a system of competitive markets in which prices adjust with supply and demand, then it definitely wasn’t capitalism, in that sense, that led Shkreli to charge $750 for something that costs pocket change on a free market. The culprit is a regulation—a restriction on capitalist acts between consenting adults—that makes it illegal for Americans to buy well-tested, imported generics on the open market. Shkreli’s cashing in precisely because the American pharmaceutical market is so far from free.

Gaming the regulatory system for profit is not unusual. What’s less well-recognized is that so-called “rent-seeking“—the pursuit of economic gain through primarily political means, more or less—is one of the main engines of growing economic inequality.

In an important new essay in National Affairs, Steven Teles, a political scientist at Johns Hopkins, points out that a fair number of the top 1% of earners owe a sizable part of their incomes to regulatory barriers to entry. Doctors, dentists, and lawyers all profit from licensing schemes that limit competition. Car-dealerships are, more or less, politically-granted concessions protected from competition. Government contractors and consulting firms that specialize in regulatory compliance reap outsized gains from heavily politicized markets. “[R]ents are pervasive in the fields of finance, entertainment, and technology,” Teles observes. Disney’s successful political efforts to keep Mickey Mouse out of the public domain are infamous. The titanic fortunes of tech billionaires such as Bill Gates and Mark Zuckerberg depend on legal definitions of intellectual property rights that may hamper innovation as much as they incentivize it. There are companies that do nothing but hoard pre-existing tech patents and then sue everyone who comes a country mile of infringing on one of them. Martin Shkreli’s Turing Pharmaceuticals is in a similar line of business. Just buy up little state-sanctioned monopolies then make a mint destroying rather than creating economic value.

Anyway, if Teles is right, regulation-loving progressives will need to reconcile themselves to the fact that the economic inequality and injustice they deplore may be driven in no small measure by regulations they might otherwise favor. This suggests that fighting inequality requires more than taxing America’s Martin Shkrelis more heavily—though it may require that, too. Pushing for a more equitable economy also means pushing for reforms like ending the ban on the importation of prescription drugs that have been deemed safe by, say, Canada or Germany. Which is to say, well-targeted “deregulation” is the egalitarian’s friend.

It may be true that we can’t risk unfettered markets on which anything can be bought or sold without government oversight of health and safety. But it’s incredibly important to recognize that Martin Shkreli’s brazen legal fleecing would be impossible in an unfettered market. He bought himself a monopoly made entirely of health-and-safety red tape. This profit-seeking ploy is outrageous for all the reasons everyone is already outraged at Martin Shkreli. It’s exploitative. It’s heartless. It hurts vulnerable people, producing nothing of value in return. But we ought to be outraged also because Shrkeli’s racket is a straightforward consequence of stupid over-regulation and symptomatic of the way badly fettered markets generate injustice.

 

 

https://niskanencenter.org/blog/martin-shkreli-show-us-how-regulation-drives-inequality/

Lien vers le commentaire
  • 2 weeks later...
  • 3 months later...
  • 6 months later...

Créer un compte ou se connecter pour commenter

Vous devez être membre afin de pouvoir déposer un commentaire

Créer un compte

Créez un compte sur notre communauté. C’est facile !

Créer un nouveau compte

Se connecter

Vous avez déjà un compte ? Connectez-vous ici.

Connectez-vous maintenant
×
×
  • Créer...