Healthcare spending compared in the US and other countries

[MillCreek]

https://www.nytimes.com/2018/03/13/upshot/united-states-health-care-resembles-rest-of-world.html?hpw&rref=upshot&action=click&pgtype=Homepage&module=well-region&region=bottom-well&WT.nav=bottom-well

https://jamanetwork.com/journals/jama/fullarticle/2674671

Perhaps the US is not such an outlier after all. Two areas where the US is leading the pack include paying higher prices for medical services and higher rates of poverty and obesity.

[Angel Eyes]

Thread  necro: stumbled across this on X:



Obvious question: do we need all these administrators?

[WLJ]

Bet "education" shows a similar graph

[sumpnz]

Thread  necro: stumbled across this on X:



Obvious question: do we need all these administrators?

Yeah, MillCreek, do we really need you?

[AZRedhawk44]

Thread  necro: stumbled across this on X:



Obvious question: do we need all these administrators?

I was, and am again, one of those administrators.

Government pretty much mandates those administrators.  "Meaningful Use" meant that all practices had to get their medical records systems online.  Continued digitalizing of a nonbinary product (well being) results in diluting the product into complaint/treatment encounters.  Benefits Management alone is a nightmarish industry.

[Angel Eyes]

Government pretty much mandates those administrators.  "Meaningful Use" meant that all practices had to get their medical records systems online.  Continued digitalizing of a nonbinary product (well being) results in diluting the product into complaint/treatment encounters.  Benefits Management alone is a nightmarish industry.

"The bureaucracy is expanding to meet the needs of the expanding bureaucracy."

[Pb]

Ok, so if utilization of health care is similar between the USA and some other high income countries, how do we get the price down? 

[De Selby]

Ok, so if utilization of health care is similar between the USA and some other high income countries, how do we get the price down?

You copy what they do.

[AZRedhawk44]

You copy what they do.

One of the biggest costs is of prescription drugs, and if you unilaterally make laws outlawing profits on new drug development then you get no new drug research.  Much of the First World has done this, relying on US health care costs to give the lion's share of profits to Big Pharma so they continue researching new drugs.

With no profit, R&D budgets get slashed and medicine stagnates. 

[Ben]

Much of the First World has done this, relying on US health care costs to give the lion's share of profits to Big Pharma so they continue researching new drugs.

Are you suggesting that Australia needs to pay their fair share? 

[De Selby]

One of the biggest costs is of prescription drugs, and if you unilaterally make laws outlawing profits on new drug development then you get no new drug research.  Much of the First World has done this, relying on US health care costs to give the lion's share of profits to Big Pharma so they continue researching new drugs.

With no profit, R&D budgets get slashed and medicine stagnates.

There is no first world country with a public healthcare system that outlaws making a profit on drugs.

The suggestion that big pharma sells at a loss to most of the world is laughable - they sell at lower prices in other countries because their health authorities bargain prices, not as charity. In the US legislation doesn’t just enable profit - it enables gouging. That’s why prices are high.

[De Selby]

Are you suggesting that Australia needs to pay their fair share? 

The point is actually clownish - drug companies actively apply to get listed on the government scheme for sales here, not the other way around. Why do you think they do that? They spend money to apply for their drugs to be sold in Australia because it loses money???

[Pb]

You copy what they do.

Well, what do they do that is helpful?  Honest question. 

Some things other some countries do - severe wait times and care rationing for specialists- don't sit right with me. 

Is there something we can do that doesn't involve these things to lower prices?  Something has to limit consumption of medical care.

[WLJ]

Are you suggesting that Australia needs to pay their fair share? 

The point is actually clownish - drug companies actively apply to get listed on the government scheme for sales here, not the other way around. Why do you think they do that? They spend money to apply for their drugs to be sold in Australia because it loses money???

I think the emoji indicated he wasn't being serious

[Pb]

The point is actually clownish - drug companies actively apply to get listed on the government scheme for sales here, not the other way around. Why do you think they do that? They spend money to apply for their drugs to be sold in Australia because it loses money???

How are drugs priced in Australia?  Honest question, I have no idea.

I'm guessing once a drug is developed, manufacturing is relatively inexpensive.. so selling a drug to other non-USA countries (once the development is paid off), even at low prices can still added profit... I think you said drugs in AUS were about 1/4 the price as the USA.

The question is, how can the company make enough money to pay back the high cost of development in the first place.  I get the impression that users in the USA pay most of this, though I am uncertain of this.  If, say, the USA slaps price control laws on our drug market, and drops their prices similar to Australia, will that pay for the development of new drugs, or render them unprofitable?

[Ben]

I think the emoji indicated he wasn't being serious

 

[WLJ]

Sorry, didn't mean to step on anyone's toes

[Ben]

Sorry, didn't mean to step on anyone's toes

No, I was agreeing with you. 

[dogmush]

How are drugs priced in Australia?  Honest question, I have no idea.

I'm guessing once a drug is developed, manufacturing is relatively inexpensive.. so selling a drug to other non-USA countries (once the development is paid off), even at low prices can still added profit... I think you said drugs in AUS were about 1/4 the price as the USA.

The question is, how can the company make enough money to pay back the high cost of development in the first place.  I get the impression that users in the USA pay most of this, though I am uncertain of this.  If, say, the USA slaps price control laws on our drug market, and drops their prices similar to Australia, will that pay for the development of new drugs, or render them unprofitable?

Another salient question would be what is the cost of regulatory conformance in both countries?

De Selby says that drug companies pay some amount to sell in Australia,  and I think we all know the prices for FDA approval of a new drug (excluding vaccines for novel respiratory viruses)  is significant.   How do those costs compare?  Even outside of subsidizing R and D countries can vary widely in the cost of doing business there.

Also how different countries handle drug patents can significantly affect market price (negotiated or not).

I have no idea what that info is, but it would seem to be necessary to an informed discussion on the topic.

[De Selby]

Prices are negotiated for publicly subsidised drugs; drugs where the company doesn't want to get public funding for consumer prescriptions can be sold after they are approved. Most pharma companies go for the public benefits scheme, because people buy many more drugs from that system due to public funding.

A really detailed article on how pricing works is here, but the short version is the Government negotiates a price with the drug maker, then separately decides how much of that price it will pay for and consumers pay the difference.

This website has some details:  https://www.globallegalinsights.com/practice-areas/pricing-and-reimbursement-laws-and-regulations/australia

A succinct version of advice to private companies who come to sell a drug in Australia:

A well-planned pricing strategy must give consideration to both the clinical needs of patients and the Government’s budgetary pressures (and desire to focus upon lowest-cost comparators).  If a sponsor wishes to seek a higher price for a medicine seeking listing, this must be justifiable by reference to the available alternatives and the advantages (whether clinical or economic) of the new product seeking listing compared to alternative therapies.

Fees for getting a drug registered to be sold either privately or through the PBS are here:

https://www.tga.gov.au/sites/default/files/2023-12/fees-and-charges-summary-1-July-2023.pdf

[MillCreek]

Yeah, MillCreek, do we really need you?

I live for the day in which we no longer need people to explain to the family how we killed Grandma in the OR. And then pay off on the lawsuit.

[WLJ]

I live for the day in which we no longer need people to explain to the family how we killed Grandma died of COVID in the OR. And then pay off on the lawsuit.

A, sort of, tongue in cheek FIFY