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[Frumple]

Why is there no outrage over it costing 13.50 in the first place? The pill costs 40 cents in the Netherlands. It's almost as if your health department / insurance negotiator / whomever it is that sets healthcare prices really hates people with hiv.

Mostly 'cause 13.50 is frankly kinda' cheap for prescriptions stateside. Insurance can bring it down lower so far as the direct consumer's cost goes, but stuff that that has a base price under 10-20 per whatever the standard bit is isn't terribly common.

Do remember, mart, that the US healthcare system is fucked up, particularly price wise. Whatever you view as sanity in your netherlands, eject it from your nethers before you attempt to apply it to the US. Its place here is as the dreaming promises of the underside of a nickel whore's skirt, the reality of which is a thing not of splendor.

[Sheb]

Captialism seeks to charge the highest price the market can bear. This leads to expensive healthcare, BY DEFINITION.

If you want affordable, easy access healthcare, you cannot use capitalism to get there.

That's a technically correct, but lazy answer. Of course companies charge as much as they can. The question is, why do some pharma companies get away with that crap but not coffee show or internet providers? There are a lot of reasons, but by and large it's about how they can abuse the regulatory environment. One trick they favor for exemple if to abuse the use instructions on drugs to prevent potential competitor to get their hand on enough of the drug to prove to the FDA their generic is equivalent. Fixing shit like that would already save tons of money at a fraction of the cose of instauring single-payer system (let alone ripping capitalism off and replacing by whatever).

[Frumple]

'Course, that trick wouldn't be nearly as effective if it wasn't healthcare, heh. Coffee show or whatev' can do that, and people can just shrug their shoulders and not buy until the price turns sane. Prescriptions (medical care in general, really), well. Lot of those you try that and you die.

When I was talking about that 10-20 base I was talking about generics, heh. There's certain ones that are cheaper, but most I've seen are still in that range or higher. Even with generics breaking a de facto or de jure monopoly over a substance that sees shit like shkreli happen, it doesn't do much to stop providers from looking at each other and going, "Heee~ey. Maybe we all agree to not go lower, eh?" Not like their consumers can wait until someone not in on it manages to break into production.

[ChairmanPoo]

Pricefixing is illegal in most places

[milo christiansen]

Why is there no outrage over it costing 13.50 in the first place? The pill costs 40 cents in the Netherlands. It's almost as if your health department / insurance negotiator / whomever it is that sets healthcare prices really hates people with hiv.

You know, there is a reason most new drugs hit US markets first. Also, isn't the Netherlands the country where they refuse you health care if you have a "terminal" illness? (At least a few of which can be treated in the US via very expensive methods)

[martinuzz]

You know, there is a reason most new drugs hit US markets first. Also, isn't the Netherlands the country where they refuse you health care if you have a "terminal" illness? (At least a few of which can be treated in the US via very expensive methods)

Uh, no? Insurance companies might refuse paying for experimental, unproven, high risk procedures though, but that's not 'refusing healthcare'. Trust me, if you have a terminal illness, in general, you're most likely better off in the Netherlands than in the US.

[Sheb]

Why is there no outrage over it costing 13.50 in the first place? The pill costs 40 cents in the Netherlands. It's almost as if your health department / insurance negotiator / whomever it is that sets healthcare prices really hates people with hiv.

You know, there is a reason most new drugs hit US markets first. Also, isn't the Netherlands the country where they refuse you health care if you have a "terminal" illness? (At least a few of which can be treated in the US via very expensive methods)

While we could discuss the impact of low prices, in this case it's a generic, so "first hit the market" isn't really relevent. I also have no idea what you're reffering to by this terminal illness thing, either.

[martinuzz]

Maybe he is confusing it with the recent case in the UK, where a terminally ill baby was forbidden to fly to the US for experimental treatment by the Child Protective Services, who argued that no quality of life could possibly be gained for the child, no matter how hard the parents hoped the experimental treatment would work.
Some alt right media turned that into 'Europe refuses terminally ill people healthcare'.

[Sheb]

Maybe he is confusing it with the recent case in the UK, where a terminally ill baby was forbidden to fly to the US for experimental treatment by the Child Protective Services, who argued that no quality of life could possibly be gained for the child, no matter how hard the parents hoped the experimental treatment would work.
Some alt right media turned that into 'Europe refuses terminally ill people healthcare'.

Yeah, which is a bit different: it had nothing to do with costs (which the parents had crowdfunded the money for), but with quality of life for the kid (And shady-looking practice by the doctor that was proposing the treatment).

[Starver]

(And shady-looking practice by the doctor that was proposing the treatment).

If he was the one that had not been treating the child, but came over to testify that he could still help then suggested that he might have been able to help, months ago, but not now and therefore it was the Hospital's fault...   Always sounded like snakeoil to me, being sold to the parents.  At best, I suspect Charlie's condition could have been prolonged (unimproved) if used as a guinea-pig, but sounded like they were trying to skip Phase I and II and go straight to Phase III.

Noting that this became a stealth news item that "everyone" was talking about while I was still wondering if the "Charlie Guard" was some sort of Sarah's Law thing (it having rattled around social media and front headlines without my noticing, and suddenly arrived, already full formed into the shortcut that was the child's name (Gard!) and that I was obviously expected to already know about), so I haven't immersed myself in the details, just left trying to separate the wheat information from the chaff hype about this case, as it became ever more prominant, and may not have done a perfect job.

[MetalSlimeHunt]

It's probably coming more from the Netherlands' euthanasia practices than from Charlie Gard. It's a source of propaganda amongst the right-wing of the healthcare debate for...pretty much everything, real or imagined. They make up so much stuff I have a hard time remembering what parts are true and what are lies, such as giving suicide drugs to minors who are mentally but not physically ill or any of the stories of "soft" coercion of the sick elderly to "stop wasting time" and die.

[wobbly]

Why is there no outrage over it costing 13.50 in the first place? The pill costs 40 cents in the Netherlands. It's almost as if your health department / insurance negotiator / whomever it is that sets healthcare prices really hates people with hiv.

I'm curious how much of this is government subsidy. It's possible the dutch are still being Price Gouged through their taxes.

[Frumple]

Honestly, probably not much. Certainly not even remotely as much as, say, the US market does. Whatever making it has good odds of still turning a profit, if that's what they're after.

Most prescription style stuff is very, very cheap so far as actual cost of production goes. If you don't factor out the R&D costs, it's still cheap, just less cheap. There's exceptions, but most of it just... isn't. The base materials for most of this stuff generally isn't exactly hard to come by or process.

The markup is about a bunch of other shit, including hitting the patient's metaphorical pound of flesh like a strip mine into a moutaintop, that doesn't really have much to do with whatever the medication itself is.

[EnigmaticHat]

They're not being price gouged, not compared to us at least.  The company making the pills is willing to sell them cheap because that's the price of doing business at all.  True, it is tax money buying the pills.  But remember, in the US our healthcare costs more in taxes per person, than any other country in the entire world.  And then private citizens pay for it again, with both insurance premiums and out of pocket expenses.

[Sheb]

It still seems low for cost. Or is it after the reimbursement from the insurance company.