brori

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I am in India and came down with an URI with cough/fever/green phlegm production

Cost of Z pack in India $1.50
Cost of Z pack in US cash pay $37.00

same packaging/blister packs

Keep in mind that there are no pharmacology rep restrictions in India. Physicians here tell me they get 1st class flights and AV/media rooms from pharm industry

What is going on? Can't be $35 mark up for US R&D.
 

RxWildcat

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I think the short answer is India has much lower standards for drug quality and manufacturing than the FDA.
 

brori

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Sure, that is a small factor. Many medications that US customers consume are manufactured in India (huge Novartis plant here) Americans are paying huge mark up prices for the same medications. Drug company lobby in US is very powerful. Part of NAFTA ensured that US drug companies have lengthy patent protection and price control.

Many consumers have been brainwashed by TV commercials to ask physicians for the "latest and greatest" FP physicians and pediatricians are under extreme pressure to overprescribe.

This is a game, and the drug companies are winning. They are making billions by overcharging and brainwashing the American consumer.
 
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confettiflyer

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Are you sure it wasn't concrete?

Many countries have price controls, so big pharma must sell at those prices. US prices reflect the true market cost of these drugs AND paying for the "shortfall" these greedy countries have caused.

I mean, did you think all those scientists at GSK were working for peanuts? It's a naive position to simply say drugs should be cheaper.
 

Hels2007

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Sorry to break your bubble, but compare the price of, say, a house in India and in US. Or cost of rice. They aren't going to be the same either. The salaries are also not the same. Sheesh, I understand that the world is coming closer together, but we ain't at the point of having the common currency for the whole world with same earnings and prices... and hopefully not in my lifetime.
 

RxWildcat

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Sure, that is a small factor. Many medications that US customers consume are manufactured in India (huge Novartis plant here) Americans are paying huge mark up prices for the same medications. Drug company lobby in US is very powerful. Part of NAFTA ensured that US drug companies have lengthy patent protection and price control.

Many consumers have been brainwashed by TV commercials to ask physicians for the "latest and greatest" FP physicians and pediatricians are under extreme pressure to overprescribe.

This is a game, and the drug companies are winning. They are making billions by overcharging and brainwashing the American consumer.


Small factor? I think its more like the MAIN factor. Production is based off of 3 things: quantity, quality, and costs. You get to pick two, which do you think a lot of Indian manufacturers are missing? A quick google search will get you several articles discussing this same topic, here is a quick example:

Link
 

brori

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Appreciate this point of view. Please take a look at US pharmaceutical company profit margins, and CEO packages. Anything seem odd or disproportionate?
 

brori

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Are you sure it wasn't concrete?

Many countries have price controls, so big pharma must sell at those prices. US prices reflect the true market cost of these drugs AND paying for the "shortfall" these greedy countries have caused.

I mean, did you think all those scientists at GSK were working for peanuts? It's a naive position to simply say drugs should be cheaper.

Ahh, America and "true" market cost. Love this topic. I am a Texan American and there is nothing greater than the American spirit. However, America has prospered using the basic formula of cheap (slave labor if possible) and hype demand to sell at ridiculous prices. Brainwashed Americans and people world wide blindly purchase overpriced product.

This formula works for all products and many services.
Athletic shoes
Clothing
Medications
Home furnishings

The formula fails when manufacturing and employee costs (salary and benfits) get too high
Current example: US Automotive industry

Oh, and is it concrete? Could be, but I'm feeling much better (no more fever or productive cough) I'll save a tab and have it tested when I get back home. Will update.
 

diabeticfootdr

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I am in India and came down with an URI with cough/fever/green phlegm production

Cost of Z pack in India $1.50
Cost of Z pack in US cash pay $37.00

same packaging/blister packs

Keep in mind that there are no pharmacology rep restrictions in India. Physicians here tell me they get 1st class flights and AV/media rooms from pharm industry

What is going on? Can't be $35 mark up for US R&D.

Another factor is the US carries the R&D burden for the rest of the world. We are a rich nation that can afford markups in the drugs, where other nations can't or contract out their drugs on national formularies (UK).

I'm a consultant for several pharma/device companies. Docs don't get first class flights (unless you use your own miles to upgrade yourself).
 

Priapism321

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Moderators, why was my post deleted from this thread?
 

Priapism321

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Another factor is the US carries the R&D burden for the rest of the world. We are a rich nation that can afford markups in the drugs, where other nations can't or contract out their drugs on national formularies (UK).

I'm a consultant for several pharma/device companies. Docs don't get first class flights (unless you use your own miles to upgrade yourself).

How can you justify America being able to "afford the markups"? Please explain why my family and the american public deserves to be financially raped when it comes to paying for medications because other countries have price controls. I simply do not get it.
 

confettiflyer

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How can you justify America being able to "afford the markups"? Please explain why my family and the american public deserves to be financially raped when it comes to paying for medications because other countries have price controls. I simply do not get it.

Americans drive cars and live in houses/apartments larger than 800 square feet. That automatically puts us in the top 10% of the world's standard of living.

But you're right, the world should be sharing in the burden. I'm tired of giving sh-t away to the rest of the world for cheap/free. You want to do price controls? Well, f--k you then, we'll keep this medicine thank-you-very-much.

(i think the forums have been having problems so i don't think your post was deleted)
 
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Moderators, why was my post deleted from this thread?

Yeah...where did it go? I was going to respond to it when I had a chance re: much of R&D going to me-too drugs...

I went out the other night to a really nice restaurant downtown with a good friend. We happened to be sitting next to two drug reps schmoozing with a physician. All I heard of their conversation was "FDA approved" towards the beginning...and "well, you're our favorite doctor" at the end of dinner. I so wish I had heard what drug they were pushing though...

Made me wonder how things would be different in the US if we had something similar to Australia's PBAC requiring solid pharmacoeconomic numbers for drug approval...i.e. drug companies would need to show not only safety and efficacy, but cost effectiveness too. Would be a neat way to weed out some of the Regadenosons, Levalbuterols, Desvenlafaxines, etc.
 
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diabeticfootdr

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Made me wonder how things would be different in the US if we had something similar to Australia's PBAC requiring solid pharmacoeconomic numbers for drug approval...i.e. drug companies would need to show not only safety and efficacy, but cost effectiveness too. Would be a neat way to weed out some of the Regadenosons, Levalbuterols, Desvenlafaxines, etc.

I agree that it can get out of hand with pharma reps "courting" doctors and some have "encouraged" off label prescribing, which is against regulations. Like your situation you describe above.

I usually ask them to go to dinner instead of disrupting my busy clinic day. I hate it when a rep comes in and expects me to give them time during clinic. Why should I make my patients wait longer so this guy can give me his sales pitch.

I'm not familiar with the PBAC, but I think I get the gist of what your saying.

The real question is, if the US doesn't pay for the extra costs with R&D, who else will. And if the answer is no one, or who cares - then what if R&D drops? That's not good for patients either.

One area pharma could save a lot of money is on their direct patient advertising. We've all seen the TV adverts. I've seen a big effect on patients asking me for Cymbalta or Lyrica, as opposed to beginning a cheaper generic drug for painful DPN.
 

ItsOverZyvox

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The real question is, if the US doesn't pay for the extra costs with R&D, who else will. And if the answer is no one, or who cares - then what if R&D drops? That's not good for patients either.

Nations in the G8 and affluent contries around the world should share the burden of pharmaceutical R&D, not the US alone. We all know we subsidize the rest of the world pharma and to an extent, it's the right thing to do, ie AIDS in Africa.

Going off on a tangent, Generic patent can be a significant factor in our healthcare cost. But we waited 19 years for Rocephin to go generic. But introduction of generic ceftriaxone 1 gram meant $45 per gram brand down to $2 per gram generic and the nationwide impact on pharmaceutical cost was tremendous. (somebody write a paper on it)

Yet, without patent protection and potential for revenue, pharmaceutical R&D will certainly wane. But 19 years patent protection for a drug was out of line. Pip/Tazo has enjoyed 16 years of patent protection so far and we're teased with the pending generic everyday. Yet FDA has not ruled.

Make it a 7 year patent no exceptions. Let pharma make the money and keep up the R&D. But prevent raping of our healthcare economy with a legal red tape that denies healthcare to hard working US citizens.
 

ItsOverZyvox

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I am in India and came down with an URI with cough/fever/green phlegm production

Cost of Z pack in India $1.50
Cost of Z pack in US cash pay $37.00

same packaging/blister packs

Keep in mind that there are no pharmacology rep restrictions in India. Physicians here tell me they get 1st class flights and AV/media rooms from pharm industry

What is going on? Can't be $35 mark up for US R&D.

Well, Zpak sux.. but you shouldn't pay that much for 5 tabs of generic azithromycin 250 mg in the US.
 

ItsOverZyvox

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I'm not an economist nor will I claim to understand the economic implications of banning of pharmaceutical marketing representation. What will an unemployment of tens of thousands good looking and semi-well educated pharmaceutical reps do to our already fragile economy? I don't know.

But as a healthcare professional, if you're relying on drug reps for pharmaceutical information and education, put up your diploma on Craigs List Free section and sell your license on Ebay.
 

ItsOverZyvox

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I agree completely.

And, BTW, your screen name and avatar are hilarious.

Let's face it. Healthcare is a serious business. And most of the time, we take ourselves too seriously. You have to have an outlet or two. This is one of many for me.
 

ItsOverZyvox

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In this day and age? Spawn a reality show on VH-1 or MTV. :smuggrin::smuggrin:


Fantastic idea! The plot has to thicken. I would like to pretend to be a laid off Pharma Exec and mix in with the group only to let them know towards the end that I was responsible for them getting laid off...

On 2nd thought...never mind.
 
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