Posts Tagged price control

Asthma Inhaler Costs — ripoff alert

ripoffAsthmatic abuse:  (definition)  The systematic and intentional market manipulation of asthma medication prices resulting in large corporate profits and financial ruin for people with asthma (see also: racketeering, theft, extortion, corruption, complicity and congress).

Price gouging of people with asthma by U.S. pharmaceutical companies is legendary (New York Times).   Now some of those same companies want to move their corporate offices to other countries to avoid U.S. taxes.  RIPOFF is the technical term.

mdisprayAn inhaler is a pressurized gadget to make a mist of a medication so a person can inhale the mist  (see the picture at the right).   It should have never been patented:  it is useful, but it is trivial and certainly not novel.   Now, through patent manipulations and suits there are NO GENERIC INHALERS FOR ASTHMATICS; there are only high priced brand name products — despite the fact this type of sprayer and medication has been available for 40 years.

Albuterol is the most common anti-asthma inhaler.  The drug is easy to manufacture (costs a few cents) and the inhaler is trivial (costs less than a dollar).  The US price listed below is from  Costco (considered the lowest price source in the US).  The Indian price quoted below is from allmedsdeal.com (this is not an endorsement,  just an example).

  • The US price:  PROAIR HFA 90 MCG INHALER (TEV)       $55.46
  • The Indian price:  Ventorlin CFC Free Inhaler / Salbutamol 100mcg  (GSK)    $4.40

These are the same drugs:   US price $55, Indian price $4.   GSK is a reputable UK company that  manufactures albuterol, sells it worldwide, but not in the US.  Without the unreasonable market restrictions and nearly insane FDA rules asthmatics would be able to purchase albuterol for about $4 per inhaler.

THE SOLUTION:

Patents should be allowed to exist, but consumer prices  must be limited.  Countries other than the US exercise this control.   Citizens fight price-gouging companies — why not fight price-gouging drug companies?  Medicare insists doctors accept payment at the lowest rate offered, so why should Medicare  fail to insist on the lowest price drug companies offer elsewhere in the world?

The current laws for pharmaceuticals are so complicated it defies understanding.  If you like complexity, like laws and like legal suits then continue the current system.  Instead, consider the following:

What part of this simple rule would be difficult to understand:

 THE RETAIL PRICE OF ALBUTEROL INHALER SHALL BE $4.

That’s the kind of pharmaceutical control the US needs.

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The $9,000 Colonoscopy — lighting the way for profit

TheScopesOnYou (4)

$3,500 is the amount US insurance companies pay  for a screening colonoscopy that takes 30 minutes.   In some states a $9,000 charge is routine.  In the country of  Switzerland the cost is $655 using the same techniques and the same scope from Japan.  This sad story of price gouging was reported in detail by the New York Times on Sunday June 2, 2013.

Key points about high charges from the Times’ article include:

  • Adding charges for an unnecessary anesthesiologist
  • Adding facility fees by calling colonoscopy a surgery
  • Adding huge fees for biopsies that take only minutes
  • Repeating colonoscopy too frequently

If it was just colonoscopy that was the cause of the problems with high cost in the US  it would be an easy fix.  But, the pattern of prices having no basis in actual cost is a systemic problem of huge proportions.

In other walks of life people would not tolerate the abuse.  We would complain bitterly if a garage mechanic charged for someone to hold his light, or added a fee to use the garage space,  or tacked on a charge to check tire pressure  or wanted to recheck the muffler every 3 months.

Why do people tolerate unreasonably high medical prices?  Because people do not understand health care.  Because insurance shields them from the need to understand.  And, because we think 10 years of training is needed to do many procedures, which is absolutely not true.

Surgeons and gastroenterologists study many things but if colonoscopy was separated out, the total training time for that procedure itself  is probably only a few months.  A trained physician assistant or nurse practitioner could easily do a screening colonoscopy at much lower cost and with equal safety.  The manpower drain from gastroenterology to do screening colonoscopy  is astounding and the only reason they do it is the high reimbursement.

Keep in mind, it is not people causing the problem.  The fault is with the warped system of care and reimbursement we have devised.

To fix the problem the US system of payment must change to be more like other advanced countries.  That means  either the prices for procedures are set nationally (the French way) or large conglomerates of doctors and hospitals are paid to provide all necessary care to people on a per capita basis (the ACO way).

Numerous publications are reporting on the problems in our health care system.  The New York Times, The Wall Street Journal and Time Magazine have had lead articles on the subject.

The problem of high cost will need government action to make a significant change since no business is large enough to force the issue alone.   It is easy to be pessimistic — but, there is a tipping point coming.  When consumers realize lower-cost  higher-quality health care is possible they will want it.

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