health care reform – Citizens Report https://citizensreport.org a digital channel commited to health & medical rights. Wed, 17 Jan 2024 09:06:12 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.24 https://citizensreport.org/wp-content/uploads/2016/12/cropped-cr-icon-1-32x32.png health care reform – Citizens Report https://citizensreport.org 32 32 Will Federal Regulators Take Action Against Pharmaceutical Price-Gouging? https://citizensreport.org/2015/11/06/regulating-pharmaceutical-price-gouging/ https://citizensreport.org/2015/11/06/regulating-pharmaceutical-price-gouging/#respond Fri, 06 Nov 2015 18:26:22 +0000 http://www.citizensreport.org/?p=9480 Pharmaceutical companies have been notoriously price-gouging. The recent scandal centered around the ridiculously inflated cost of Daraprim showed how carelessly pricing is regulated. Many have been left wondering if federal lawmakers will take action against the high price of life-preserving medications. Putting Price-Gouging In the Spotlight Drug prices have been steadily increasing throughout the past […]

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Big Pharma Will Keep Making Big Bucks If Federal Regulators Don't Step In

Federal regulators may finally step in an take a real stance against the pharmaceutical industry’s rampant price-gouging.

Pharmaceutical companies have been notoriously price-gouging. The recent scandal centered around the ridiculously inflated cost of Daraprim showed how carelessly pricing is regulated.

Many have been left wondering if federal lawmakers will take action against the high price of life-preserving medications.

Putting Price-Gouging In the Spotlight

Pharmaceutical companies have created a pattern of acquiring the rights to certain drugs and then raising the cost.
Image: Buzzsaw Mag

Drug prices have been steadily increasing throughout the past decade. The first big hit was when Gilead Sciences priced the hepatitis C treatment Sovaldi at $84,000.

The high price of prescription medication received a renewed wave of attention when Turing Pharmaceuticals raised the price of Daraprim, an antiparasitic drug that protects seriously ill patients with weakened immune systems.  CEO Martin Shkreli made the decision to raise the toxoplasmosis treatment from $13.50 to $750 a pill.

Although he rescinded his original announcement, media broadcasters publicized widespread outrage from politicians, health professionals and patients.

Canadian drugmaker Valeant Pharmaceuticals International added fuel to the fire by raising the price of two heart medications, Nitropress and Isuprel, by 525% and 212% respectively. Many of these companies have started a pattern of acquiring the rights to sell a certain drug before raising the price a few hundred times.

On top of that, Citron Research accused Valeant of conspiring with specialty pharmacies Philidor Rx Services and R&O Pharmacy in a plan to generate phony sales.

The report sheds light on a stark jump in drug costs for both new breakthrough medications and older generics.

How To Combat The Increase

Patients protest Congress to fight Big Pharma’s standard of high pricing.
Image: US News

John Rother, CEO of the National Coalition on Health Care, has been working on a campaign to lower drug prices.

After the high price of Sovaldi and others brought attention to price-gouging, many politicians have begun to highlight the problem in their political campaigns.

“For lawmakers who are concerned about our fiscal standing, this is going to be an ever-more central issue,” Rother said.

According to a Health Affairs article, drug costs had increased 12.6% in 2014. While some are calling on regulators to step in, others believe that government interventions could have additional consequences.

“I’m very worried that on the pricing side, policymakers could be clumsy in trying to fix something and maybe make other problems,” Chip Kahn, Federation of American Hospitals CEO, said.

Both Democrats and Republicans have planned to address the issue in their platforms. Presidential candidates Hillary Rodham Clinton, Bernie Sanders and Marco Rubio are condemning the current system that allows drug companies to set their own prices.

Under Sanders and Clinton’s health care reform, Medicare would be given the ability to negotiate with drug companies to set prices. Patients would also be allowed to access to cheaper drugs from foreign providers.

Independent Health’s director of pharmacy services Sheila Arquette believes regulators will take action upon realizing that the current price of drugs makes health maintenance unsustainable.

Arquette recommends that drugmakers and insurers work together to find solutions, in addition to being more transparent about research and development costs.

“We have to be transparent, because I don’t think any of us really understand the whole picture,” Arquette said. “We need the manufacturers to come to the table and just be honest with us.”

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The Different Parts Of Medicare Open Enrollment https://citizensreport.org/2015/10/29/medicare-open-enrollment/ https://citizensreport.org/2015/10/29/medicare-open-enrollment/#respond Thu, 29 Oct 2015 18:14:07 +0000 http://www.citizensreport.org/?p=9180 The annual open enrollment period for Medicare allows Americans to revise their insurance plans during Oct. 15 to Dec. 7. Medicare plans have a variety of different parts. It’s important to know the basics of each one. Participating In Open Enrollment Each year, the terms and costs of Medicare plans chance drastically. Millions of beneficiaries […]

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Learning About The Different Parts Of Medicare Open Enrollment

Medicare beneficiaries should be aware that open enrollment season, a three-month period that offers options to change or add to existing health care plans, has finally begun.

The annual open enrollment period for Medicare allows Americans to revise their insurance plans during Oct. 15 to Dec. 7.

Medicare plans have a variety of different parts. It’s important to know the basics of each one.

Participating In Open Enrollment

Open enrollment begins in October and ends in December.
Image: Cusd

Each year, the terms and costs of Medicare plans chance drastically. Millions of beneficiaries could save large amounts of money with better plans that offer more coverage in the new year.

If one in five people choose to select a new Medicare plan, there would be a significant shift. Because Medicare is difficult to understand, most people don’t bother with changing plans.

For existing patients, the current plan will automatically renew… even if it’s not the best fit.

An Alphabet Of Plans

Medicare is broken up into different parts identified by a letter.
Image: Boomer Benefits

Original Medicare, or Part A, includes hospital insurance. Part B is for doctors, outpatient expenses and medical equipment. Medicare Advantage plans include both Parts A and B.
Medicare Advantage plans fall under Part C, whereas Medicare prescription drug plans are classified as Part D.
The free annual guide Medicare & You 2016 will help to clear up the difference kinds of coverage for each part. For people with private insurance, the Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents will also provide important information. Being familiar with the documents is an instrumental part of selecting a plan.

Making A Decision

The plans are split into a few basic choices. The Original Medicare beneficiaries may also purchase a Medigap policy. These supplemental policies fill the holes in the Original Medicare plans.

Because Original Medicare only covers 80 percent health expenses, patients will have to pay for the rest out of pocket. This can be very expensive for patients with serious conditions that require hospitalization, surgery or other costly treatments.

During open enrollment, beneficiaries can add Medigap “letter” plans. The coverage for each letter plan is identical, meaning that all A plans are the same, all B plans, and so on. The only difference is the premiums.

If you’ve already passed the beginning eligibility period for Medicare, the plans may be pricier because guaranteed issue rights to Medigap have expired. Private insurers no longer have to sell beneficiaries a plan regardless of health status or age. It’s possible that beneficiaries could be forced to pay higher premiums or deal with coverage limitations based on pre-existing medical conditions.

Original Medicare beneficiaries may also purchase a Medicare Advantage plan or change their current Advantage plan. For this specific plan, patients cannot be forced to pay higher premiums or face rejections because of current medical problems.

The only catch is that if you choose to switch to Medigap, you can’t keep a Medicare Advantage plan. The two plans can never overlap, so patients should be sure about making the switch because they will lose their guaranteed issue rights.

While 70 percent of patients have Original Medicare plans, and 30 percent are covered by Medicare Advantage, all beneficiaries can alter their Part D prescription plan during open enrollment.

Take the time to understand the different options during Medicare enrollment to receive better coverage for a cheaper price.

 

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Cancer Medication Is Grossly Overpriced In The U.S. https://citizensreport.org/2015/10/15/cancer-medication-overpriced-america/ https://citizensreport.org/2015/10/15/cancer-medication-overpriced-america/#respond Thu, 15 Oct 2015 16:27:07 +0000 http://www.citizensreport.org/?p=8841 Consumer surveys illustrate a serious and widespread concern, presidential candidates push health care reform in their political platforms and the media continues to publicize drug makers putting profits over people. The unreasonably high cost of pharmaceuticals in the United States has grabbed attention from politicians, advocates and consumers. Now, research exposing the actual cost of cancer drugs juxtaposed with […]

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Cancer Medications Cost Triple The Price In America

British researchers analyzed data that shed light on the rising cost of cancer drugs in the U.S., which are priced 600 times higher than the actual cost.

Consumer surveys illustrate a serious and widespread concern, presidential candidates push health care reform in their political platforms and the media continues to publicize drug makers putting profits over people.

The unreasonably high cost of pharmaceuticals in the United States has grabbed attention from politicians, advocates and consumers. Now, research exposing the actual cost of cancer drugs juxtaposed with the price charged by pharmaceutical companies will add further fuel to the fire.

Data Exposes Price-Gouging

The same cancer medications are priced differently all over the world, but these drugs are the most expensive in the U.S.
Image: 123rf

Pharmaceutical companies must pay various costs to bring a drug to market, including funding the active ingredient and other chemicals, developing the combination into a pill, arranging packaging and shipping and budgeting for a profit margin.

British researchers analyzed data that shows five common cancer drugs are priced 600 times higher than they actually cost. The cost of ingredients came from a public database called IndiaInfoDrive. The report is be presented at the European Cancer Conference in Vienna.

Leukemia drug Glivec, also known as imatinib, costs pharmaceutical companies $159 in total. However, it’s priced at $106,322 in the U.S. and $31,867 in the U.K. In Brazil, the generic version is around $8,000.

“We were quite surprised just how cheap a lot of these cancer drugs really are,” pharmacologist Andrew Hill of the University of Liverpool said. “There’s a lot of scope for prices to come down.”

Four other drugs in the same class, called tyrosine-kinase inhibitors (TKIs), also had shocking true cost comparisons.

These drugs treat cancer in the lung, breast, liver, pancreas and thyroid, in addition to leukemia. Tarceva (erlotinib), Nexavar (sorafenib), Tykerb (lapatinib) and Sprycel (dasatinib) cost anywhere from $236 for Tarceva to $4,022 for Tykerb. In the U.S., these drugs are priced at around $78,797 to $135,679.

According to Hill, more than a million cancer patients worldwide would benefit from TKIs but cannot access them because of the hefty price tag.

“Very few of them are being treated now,” he said.

The Preposterous Price Of Cancer Drugs

Health professionals believe that the price of these drugs is not equal to their value.
Image: John Tabita

The price-gouging of cancer drugs has continued to rise overall. Dr. Peter B. Bach of Memorial Sloan Kettering Cancer Center in New York tracked the rise. After adjusting for inflation he found an estimated 100 percent increase since 1965.

“The rate of rise exceeds the rise in benefits from these drugs,” Bach says. “This is a ginned-up pricing structure that isn’t a product of careful analysis. It’s not a bunch of guys in green eye-shades but a bit of dart-throwing and chutzpah. And if there’s a critical Op Ed piece or a Twitter avalanche [in response to a high price] they’ll lower it.”

Three years ago, Bach and two of his peers wrote a New York Times opinion-editorial about the refusal to prescribe a new colon cancer drug at Memorial Sloan Kettering that wasn’t as effective as the high price tag made it seem.

In response to the piece, the drug maker cut the price in half. A similar response from the CEO of Turing Pharmaceuticals occurred after a public outcry caused by the fact that he raised the price of Daraprim from$13.50 to $750-per-pill.

Hope For A Change

Presidential candidates such as Hilary Clinton and Bernie Sanders have both led campaigns that include health care reform.
Image: Southside Pride

While Obama’s administration continues to work on a way to lower the prices of pharmaceuticals nationwide, democratic candidates are attempting to make price-reducing proposals a part of their platform.

“We’ve spoken with Bernie Sanders’ advisers and shown him our results with HIV, hepatitis and cancer drugs,” Hill says.

Because Washington’s pharmaceutical lobbyists are extremely powerful, coming to an agreement on a policy change will be difficult. Pharmaceutical manufacturers argue that regulating prices will limit the likeliness of new drugs being brought to market.

Clinton’s proposal to regulate drug prices “would restrict patients’ access to medicines, result in fewer new treatments for patients, cost countless jobs across the country and could end our nation’s standing as the world leader in biomedical innovation,” according to the Pharmaceutical Research and Manufacturers Association.

The association is not alone. Bach critiques Clinton’s idea that companies should be required to assign a certain proportion of their revenue to research and development.

“Pharma uses the language of a regulated monopoly like utility companies, which argue that they need to be compensated for infrastructure costs,” Bach says. “Apple never says, ‘We charge $600 for an iPhone because of our research.’ Or Ford never says a Taurus costs X dollars because of its R&D.”

In addition, Bach disagrees with the idea that high drug prices are justified if they save patients money on hospitalization or transplants.

“That argument is unique to the pharmaceutical industry,” Bach says. “Can you imagine if Poland Spring priced their bottled water to include the value of avoiding cholera? Or if the price of condoms included the cost of an avoided pregnancy?”

 

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