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?
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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're thinking about hurting yourself please call the National Suicide Prevention Lifeline at 1-800-273-8255 or visit suicidepreventionhotline.org to live chat with someone. Help it out there and you are not alone.


Cover Image Credit: BengaliClicker

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Thinking Of Tripping On LSD? Here Are 10 Things You Need To Know

This is a harm-reduction guide for LSD strictly for educational purposes and I do not promote the sale or usage of any illegal substances, so trip at your own risk!

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LSD (lysergic acid diethylamide), or acid, is a hallucinogenic drug created by scientist Albert Hofmann in the 1940s. LSD, along with other psychedelic drugs (shrooms, DMT, ayahuasca, peyote, salvia, MDMA, etc.) produces hallucinations and alters one's perceptions of the world.

Today, much of society sees psychedelics as these dangerous, lethal substances that are as dangerous as methamphetamine or cocaine. But the truth is, LSD and other psychedelics have potential medicinal benefits for those suffering from PTSD, anxiety, and depression and often can induce spiritual, introspective and life-changing experiences.

If you are thinking of tripping on acid, it's important you do some research and know exactly what you'll be experiencing. LSD is not for the faint-hearted, nor should it be taken irresponsibly. Ultimately, only you can decide whether this is something you wish to do. Here are some things to consider.

1. Dosage

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A normal, standard tab of acid will usually have 100-200 micrograms (ug) of LSD. LSD is measured in micrograms, and 100-150ug is the usual starting dosage for beginners. DO NOT TAKE MORE THAN THAT FOR YOUR FIRST TRIP.

2. Set and setting

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Set and setting are the most important parts for a positive LSD trip. Set refers to one's state of mind before they trip, and setting refers to one's environment in which they trip. It's important to be in a good emotional state, and to be in a safe place when you're tripping.

3. Do it with friends, and have a trip-sitter

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It's definitely more fun and meaningful when you trip with a close, trusted friend or group of friends. A trip-sitter, is also recommended for first-timers – someone SOBER who can watch over you and keep you safe and comfort you if you get anxious.

4. Be smart and safe

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LSD trips usually last around 12 hours, so I would recommend tripping on a day where you absolutely have nothing to do and no responsibilities and you won't need to drive or operate any motor vehicles. You will not be able to sleep. As with alcohol and other drugs, do not drive.

5. What will I experience?

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Everyone experiences trips differently. Some people will have more intense hallucinations than others, and some people will not have any at all. Some common things you may experience are visual hallucinations (seeing patterns and shapes), and auditory hallucinations (sounds and music sounding clearer or differently). Reality will be altered, including your senses and perceptions of your environment.

6. What should I do while tripping?

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Listen/play music. Watch a movie, or a TV show. If possible, go out for a walk in nature. Have deep conversations with your friends. Paint, draw, and create art. It's all up to what you're comfortable with.

7. Is it safe to do alone?

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Yes. But it is not recommended for first-timers, tripping alone should be for more experienced users. That's why a trip-sitter or a group of friends to do it with is recommended.

8. What if I get anxious and paranoid?

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Relax and breathe. LSD brings out a lot of thoughts and emotions that you may have and amplify them greatly. When it comes to tripping, please be mindful of your mental health. Avoid triggers, and avoid visiting bad or sad memories. Remove yourself from the environment if possible, and go lie down and try and calm yourself or talk to your trip-sitter.

9. I want to know more about the science behind LSD…

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There's several studies and info guides online, as well as YouTube videos.

AsapSCIENCE: Your Brain on LSD and Acid

PsychedSubstance: LSD in 3 Minutes

10. I’m having second thoughts about doing this…

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You don't have to do it. You should never feel pressured by anyone to do something you don't feel comfortable with. Ultimately, choosing to trip on acid is your own choice, and it's important to know what you will be getting into beforehand.

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