Sunday, April 6, 2014

For pharma and medical device makers, U.S. is The Big Rock Candy Mountain | xpostfactoid

Andrew Sprung is a too little known gem of an analyst.  A "media consultant" (for whom he doesn't say).  He is a brilliant analyst of presidential rhetoric and strategy.  But he has been concentrating on his work as a rigorous analyst of the ACA - what works, what doesn't, who benefits (everyone up to 4x poverty level, who doesn't [almost no one but it's tricky for self-employed and individual market people above the subsidy line].

The big missing piece here?  No government-imposed price discipline.  Government-imposed is of course the current GOP bad of all baddies.  Those of us of more than tender years remember that in 1971 President Nixon imposed wage and price controls. - GWC

For pharma and medical device makers, U.S. is The Big Rock Candy Mountain | xpostfactoid:

by Andrew Sprung

The New York Times' Elisabeth Rosenthal is out with another front-page chapter in her incomparable epic detailing the dysfunction of the U.S. healthcare system. She's spotlighted (123) price-gouging by various physician specialties, hospitals, and now medical device makers and pharma.

Rosenthal focuses mainly on diabetes treatment. It really has improved radically over the past two decades, with ever-more sophisticated insulin pumps and accouterments, and synthetic human insulin.  But near-monopoly pricing power -- unmitigated, in the U.S. alone, by strong government pushback -- forces many patients to buy more sophisticated treatment than they need, at astronomical markups. As is de rigeur in Rosenthal's pieces, the contrast with other wealthy countries hurts most. The contrast with the U.K. highlights strengths and, to a lesser extent, weaknesses of that system that contrast starkly with our own:

In Britain, each hospital negotiates for pumps for its patients, getting prices that are typically less than half those in the United States, Dr. Pickup said. The vial of insulin analogue that Ms. Hayley gets for $200 at an American pharmacy is typically bought by British pharmacists for under $30 and dispensed free....

Even when governments negotiate prices and foot the bill, patients may feel the rising price of diabetes care in other ways: While about one-third of Type 1 diabetics use pumps in the United States, that number is under 10 percent in Britain. What is the right number? Since pumps are complicated to operate, young children cannot use them, and some patients prefer syringes that operate like pens because they do not like having pumps attached.

The British government will not dispense these costly items unless a patient’s diabetes has proved uncontrollable using other methods, but many doctors feel the devices are underutilized in Britain.*********

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