I'm not familiar with the swiss health care system, but in Norway the government foots most of the bill for prescription drugs. The government is negotiating price with the manufacturer and as a big buyer they can get a fair price.
I was a member of a very large public sector health plan that was extremely aggressive about negotiations, to the point that for awhile any maintenance medication had to be shipped from Canada. They get good prices, but not that good -- iirc my blood pressure medication total cost was 10-15% less than the shitty small business HMO that I had previously.
Generally speaking, the US government demands most favored pricing and gets it. No way we would pay more than France.
Europe does better because they have the ability to prevent sale of a drug and the drug company can just raise the price in the US. If the US gets in the game, I would expect European prices to spike, especially in smaller countries.
Switzerland also controls the max price of drugs as part of their gov't approval process.
"Drugs must be effective, cost-effective and appropriate to be listed in the positive drug list (SL/Spezialitätenliste). The federal government sets the maximal allowable public price for drugs in the SL."
Uhm, the Netherlands does? In Dutch [1]. There are a few mechanisms. One is a maximum price based on a basket of comparable countries. Two is a maximum insured price based on comparable medicines with mandatory co-payments above the average. Three is insurers bargaining with apothecaries. Four is government bargaining for orphan medicines. Five is sometimes allowing apothecaries to create licensed medicine by themselves. Many of these are totally opposite the US-system afaik, with Medicare not being allowed to negotiate prices being the most glaring one.
>The pharmaceutical industry in Switzerland directly and indirectly employs about 135,000 people. It contributes to 5.7% of the gross domestic product of Switzerland and contributes to 30% of the country's exports."
And those Swiss (or French, or Italian, or Japanese) pharma profits are also high, in large part, because some countries' citizens pay the "gouge" rates for those drugs. That's still consistent with the parent's point[1] that America is bearing the cost of these drugs, effectively subsidizing other countries that negotiate good deals.
”The Ministry of Health, Welfare and Sport and the Healthcare Institute of the Netherlands decide what drugs fall under the standard health insurance package
[…]
The Netherlands and Belgium are going to jointly negotiate lower drug prices with pharmaceutical companies. Together, the two countries represent a larger group of patients. This will make it easier for them to negotiate lower prices with drug companies. They will especially try to negotiate lower prices for expensive medicines, including orphan drugs which are used to treat rare diseases.“
It's not a "good deal" because it's not consumption for the sake of consumption. High drug prices hit those unfortunate enough to be born with a sickness, and some of those people might have a hard time with their lives if majority of their time is spent earning enough to pay their medicine.
However, I like that he then goes on to say that there should be a system that takes care of the people who CANNOT afford the drug (government-funded or a corporate-driven solution of some sort).
The whole business take on medication and health care just seems crazy for a scandinavian citizen like myself.
One political party keeps passing laws making it illegal for Medicare/Medicaid to bargain for drug prices. So the price that taxpayers pay is far higher than it needs to be. Every other country negotiates drug prices.
The NHS manages to negotiate some of the best drug prices in the world. I bet drug companies just love the opposite of Medicare and nationalised health. As I understand it other countries have an agency that stops drugs coming into the market if their cost doesn’t justify their improvement in outcomes. America just lets all drugs that are safe come onto the market at any price. https://www.vox.com/platform/amp/science-and-health/2016/11/...
I have wondered for a while why we don't make a law saying the highest price you can sell a drug for in the US is no higher than the lowest negotiated price that drug is sold to in other rich countries.
So if Canada negotiates a drug for $10 then that is the highest price you can sell it for here etc. That way they can set the prices however they want but collective buying agreements that are a part of socialized healthcare don't end up shifting the burden of cost to the US.
Sweden also has a per-drug global cap on how much state money can be used. It prevents companies in monopoly position from draining the budget by just raising the price regardless of market demand, on the assumption that public health care will be forced by policy to pay it. It is as some has described it, a chicken race until the patent (and patients) has expired.
Don't they do a better job in lots of other countries? I'm not an expert, but my understanding is that a lot of the countries with socialized medicine such that their government is the one negotiating with drug manufacturers pay substantially less for drugs than customers in the US.
> Here, multiple generic drug manufacturers are competing to win sales contracts by offering the lowest possible price. This can be seen as an example of perfect competition, where firms are price takers and compete mainly on price, driving prices down to the point where they equal the marginal cost of production.
In Switzerland there are laws covering biddings, where the state has to accept the second to lowest offering, not the lowest, thereby circumventing this race.
> According to a 2021 study by the RAND Corporation, a non-profit global policy think tank, prices of prescription drugs in the U.S. are 2.4 times higher than the average prices of nine other nations (Austria, Australia, Belgium, Canada, Germany, Japan, Sweden, Switzerland and the United Kingdom). That higher cost is largely related to brand-name drugs, which are 4.9 times more expensive in the U.S. than in those countries. In fact, brand-name drugs are responsible for 84 percent of total drug costs in the United States despite accounting for only 8 percent of drugs dispensed.
The US is just starting to negotiate pricing, beginning with ten specific drugs. Until 2022, it was illegal for Medicare to do so.
It’s a little unrelated to opioids, but increasing medicine prices is currently undermining the public health systems of Scandinavia to the point where we have to debate where to prioritise our funding. Do we really want to spend millions of dollars on people who have 6 months to live if it means children have to wait two years for knee surgery. Terrible, and that’s with a national budget struggling after just a decade of out right immoral price hikes.
I’m typically not a “to the guillotine” guy, but I can’t wait for the EU regulations on big pharma.
Almost all wealthy countries except the US, use a single payer system where the government sets the price of drugs.
> And what is the "fair and free" price of insulin?
Free as a victim of diabetes, some marginal cost to the countries budget based on a negotiation with the pharma company.
Typically, because the country has enough scale, it is cost effective for the government to design and estimate costs for a government run facility to produce the drug and use that as a bargaining chip including if needed voiding the IP rights of that foreign entity for national defense reasons.
It is just amazing to watch people in the US defend the price gouging in healthcare in the US.
The medicine prices are MUCH lower in other parts of the world - including in places where the cost of living is much higher than in the US such as Norway and Switzerland.
The cost of Insulin is 8x higher in the US than in comparable countries around the world.
In many European countries, prices are negotiated by the publicly-funded health service or a government-appointed body.
Every country will attempt to negotiate the cheapest price they can get. Even so, drug prices across Europe vary widely by country. And there are powerful European pharmaceutical companies[1] who naturally resist price discounts or cheaper alternatives (UK example: https://www.theguardian.com/society/2017/nov/01/drug-giants-...).
[1] Large European pharmaceutical companies: GlaxoSmithKline (British), AstroZeneca (Anglo-Swedish), Novartis (Swiss), Roche (Swiss), Bayer (German), Sanofi (French)
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