Drug Prices Are Higher In The United States Than Any Other Country, It's Time For The Trump Administration To Do Something About It

Drug Prices Are Higher In The United States Than Any Other Country, It's Time For The Trump Administration To Do Something About It

Where are these costs coming from?
Jake VP.
Jake VP.
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If you have ever needed to go to the pharmacy, you may have noticed that drug prices are a big problem. If you have, you wouldn't be the only one. An analysis from Bloomberg shows that 7 of 8 top-selling drugs are more expensive in the US than in other countries, even after you take discounts into account.

So the obvious question is "where do these costs come from?" Well, many will point to the research and development of these drugs, but a quick look into that shows that idea doesn't really pan out. Looking at below chart, put together by the BBC using data from GlobalData, you can see that for many companies their profits are comparable, or even larger than their R&D spending.

World's largest pharmaceutical firms
Company Total revenue ($bn) R&D spend ($bn) Sales and marketing spend($bn) Profit ($bn) Profit margin (%)
Johnson & Johnson (US) 71.3 8.2 17.5 13.8 19
Novartis (Swiss) 58.8 9.9 14.6 9.2 16
Pfizer (US) 51.6 6.6 11.4 22.0 43
Hoffmann-La Roche (Swiss) 50.3 9.3 9.0 12.0 24
Sanofi (France) 44.4 6.3 9.1 8.5 11
Merck (US) 44.0 7.5 9.5 4.4 10
GSK (UK) 41.4 5.3 9.9 8.5 21
AstraZeneca (UK) 25.7 4.3 7.3 2.6 10
Eli Lilly (US) 23.1 5.5 5.7 4.7 20
AbbVie (US) 18.8 2.9 4.3 4.1 22
Source: GlobalData

Another contender, PBMs, or pharmacy benefits managers, never heard of them? Neither had I until I read this Washington Post article which said:

"PBMs are for-profit companies that negotiate drug price discounts on behalf of insurers and employers. They include giant companies like Express Scripts Holding and CVS Health. They make money from fees paid by insurers and employers and by taking a cut of the rebates they negotiate. Drug companies have argued that the need to give larger and larger rebates to PBMs is what’s driving up the list prices of drugs. "

The article continues with "PBMs say they typically pass along 90 percent of the savings they negotiate to customers " but then they provide this paper to show that the rebates PBMs argue for have 0 effects on drug prices.

So essentially, PBMs are middlemen, that do nothing more than bog down an already complex system, and take in money that could be passed on to the consumer, or go to making better drugs.

The Washington Post article goes on to say how the whole debate gets skewed since two people could spend very different prices on the same drug depending on their insurance plans.

And by-and-large, it is a mess, but that shouldn't stop us from trying to fix it. What it really comes down to is the fact that America's way of getting medicine to people is not as efficient as it is in other countries. In other countries, the government can negotiate with pharmaceutical companies, and if the country doesn't get a good deal, the company loses out on selling to that entire nation. But that isn't true in the US. Let alone all of the various PBMs and insurance companies, Medicare is bound by law not to negotiate with pharmaceutical companies. This, along with the all of the other players such as PBMs and all of the different insurance companies, which makes it so hard for Americans to get good drug prices.

That is without even mentioning the power pharmaceutical companies have to get consumers to spend money on their most expensive drugs. Since generic brand rugs are cheaper and equally effective, many people would prefer to use them, but of course, many people just use whatever their doctor rights in the prescription. This is why it is a big deal that pharmaceutical companies give doctors "gifts, educational grants and sponsor[ed] lectures" which the BBC describes as still "commonplace in the US". They then point to this research paper to show that "doctors in the US receiving payments from pharma companies were twice as likely to prescribe their drugs."

This would be another problem that could vanish if the government was a bigger player in buying drugs for the US.

Other solutions could be having US-made drugs which are exported to other countries (where they are sold much cheaper) be bought by Americans (something that is currently outlawed). Or have a price-cap on certain drugs. Ideas both presented in this Los Angeles Times article.

Either way, we need a solution, and since this is something that Trump has said he is going to tackle then now seems like a perfect time for something to be done.

Cover Image Credit: rawpixel.com on Unsplash

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To The Person Who Feels Suicidal But Doesn't Want To Die

Suicidal thoughts are not black and white.
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Everyone assumes that if you have suicidal thoughts that means you want to die.

Suicidal thoughts are thought of in such black-and-white terms. Either you have suicidal thoughts and you want to die, or you don't have suicidal thoughts and you want to live. What most people don't understand is there are some stuck in the gray area of those two statements, I for one am one of them.

I've had suicidal thoughts since I was a kid.

My first recollection of it was when I came home after school one day and got in trouble, and while I was just sitting in the dining room I kept thinking, “I wonder what it would be like to take a knife from the kitchen and just shove it into my stomach." I didn't want to die, or even hurt myself for that matter. But those thoughts haven't stopped since.

I've thought about going into the bathroom and taking every single pill I could find and just drifting to sleep and never waking back up, I've thought about hurting myself to take the pain away, just a few days ago on my way to work I thought about driving my car straight into a tree. But I didn't. Why? Because even though that urge was so strong, I didn't want to die. I still don't, I don't want my life to end.

I don't think I've ever told anyone about these feelings. I don't want others to worry because the first thing anyone thinks when you tell them you have thoughts about hurting or killing yourself is that you're absolutely going to do it and they begin to panic. Yes, I have suicidal thoughts, but I don't want to die.

It's a confusing feeling, it's a scary feeling.

When the depression takes over you feel like you aren't in control. It's like you're drowning.

Every bad memory, every single thing that hurt you, every bad thing you've ever done comes back and grabs you by the ankle and drags you back under the water just as you're about the reach the surface. It's suffocating and not being able to do anything about it.

The hardest part is you never know when these thoughts are going to come. Some days you're just so happy and can't believe how good your life is, and the very next day you could be alone in a dark room unable to see because of the tears welling up in your eyes and thinking you'd be better off dead. You feel alone, you feel like a burden to everyone around you, you feel like the world would be better off without you. I wish it was something I could just turn off but I can't, no matter how hard I try.

These feelings come in waves.

It feels like you're swimming and the sun is shining and you're having a great time until a wave comes and sucks you under into the darkness of the water. No matter how hard you try to reach the surface again a new wave comes and hits you back under again, and again, and again.

And then it just stops.

But you never know when the next wave is going to come. You never know when you're going to be sucked back under.

I always wondered if I was the only one like this.

It didn't make any sense to me, how did I think about suicide so often but not want to die? But I was thinking about it in black and white, I thought I wasn't allowed to have those feelings since I wasn't going to act on them. But then I read articles much like this one and I realized I'm not the only one. Suicidal thoughts aren't black and white, and my feelings are valid.

To everyone who feels this way, you aren't alone.

I thought I was for the longest time, I thought I was the only one who felt this way and I didn't understand how I could feel this way. But please, I implore you to talk to someone, anyone, about the way you're feeling, whether it be a family member, significant other, a friend, a therapist.

My biggest mistake all these years was never telling anyone how I feel in fear that they would either brush me off because “who could be suicidal but not want to die?" or panic and try to commit me to a hospital or something. Writing this article has been the greatest feeling of relief I've felt in a long time, talking about it helps. I know it's scary to tell people how you're feeling, but you're not alone and you don't have to go through this alone.

Suicidal thoughts aren't black and white, your feelings are valid, and there are people here for you. You are not alone.

If you or someone you know is experiencing suicidal thoughts, call the National Suicide Prevention Hotline — 1-800-273-8255


Cover Image Credit: BengaliClicker

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Stop Demonizing CBD Just Because You Associate It With THC

CBD doesn't get you high, do your research.

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I'm sure you've heard about CBD already, but if not, then let me break it down for you. Cannabidiol, CBD, is one of the hundreds of cannabinoids identified in the cannabis plant, but unlike the THC in the marijuana plant, it doesn't have any psychoactive properties.

CBD doesn't get you high.

When extracted from the plant, CBD has proven to be effective in the medical field. It has shown to be effective in the treatment of epilepsy, in the management of pain, in reducing depression and anxiety, and relieving cancer symptoms, among a host of other uses. New research from Mount Sinai Hospital in New York has revealed that CBD may be beneficial for society as a whole, too.

Researchers at Mount Sinai Hospital conducted the study to understand how we can fight the opioid epidemic through the discovery of alternative treatment options by assessing the potential effects of CBD on craving and anxiety in heroin users.

42 drug abstinent men and women between the ages of 21 and 65, who had recently stopped using heroin, were recruited for the study. Two groups were formed out of the participants: a control group that received a placebo and a test group that received CBD doses ranging from 400 mg to 800 mg per day. After administration, participants were exposed to neutral environmental cues and cues that would be considered drug-use inducing over three sessions. The cues in the environment were tested because an addict's environment and the cues it gives are the strongest triggers for relapse and continued drug use.

The results of the research hold great promise for the future of CBD.

Participants who were in the test group and given CBD had significantly reduced cravings for heroin, and noted feeling less anxiety when exposed to drug-use inducing cues. Moreover, the CBD had a lasting effect on this group as it continued to reduce cravings and relieve anxiety for seven days after the last dose was administered. In essence, this is the most important takeaway from the research: CBD had lasting effects well after it was present in the body. Numerous vital signs like heart rate, skin temperature, blood pressure, and oxygen saturation were taken to ensure only objective results were obtained since cravings and anxiety are subjective feelings. Another finding was a reduction in participants' heart rate and salivary cortisol levels, which would have both increased in the presence of anxiety-provoking images.

I think the evidence points to a logical conclusion: CBD is safe, it is effective in treating opioid addictions, and it is beneficial for those who experience a host of issues from pain, to anxiety, to epilepsy or to illnesses. Now is the time to keep pushing for legalization to continue larger scale studies and introduce CBD as a valid treatment option.

"A successful non-opioid medication would add significantly to the existing addiction medication toolbox to help reduce the growing death toll and enormous health care costs." - Yasmin Hurd, director of the Addiction Institute at Mount Sinai Hospital in New York.

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