Importing Drugs from Canada (1 Viewer)

[MarvinTScamper]

doing some basic research, it appears all of Canada's pharm totals about $25B in revs, less than a billion on R&D.   US top 10 pharma (list, not by revs) shows over $400B in revs.  Mind you, these are global sales.  I don't think Canada is manufacturing the drugs you all are hoping to import, I just think they're sold to Canada for less.  This report seems to suggest that pharma is 1.9% of GDP, and about 10% of healthcare costs in the US.

That certainly wouldn't indicate we are going to solve the problems by cutting pharma prices.  You cut them in half and you only drop overall healthcare costs by 5%.

 

[massraider]

That certainly wouldn't indicate we are going to solve the problems by cutting pharma prices.  You cut them in half and you only drop overall healthcare costs by 5%.

It won't solve the problem all by itself, so why bother lowering prices?  Is that your position?

 

[Baloney Sandwich]

doing some basic research, it appears all of Canada's pharm totals about $25B in revs, less than a billion on R&D.   US top 10 pharma (list, not by revs) shows over $400B in revs.  Mind you, these are global sales.  I don't think Canada is manufacturing the drugs you all are hoping to import, I just think they're sold to Canada for less.  This report seems to suggest that pharma is 1.9% of GDP, and about 10% of healthcare costs in the US.

That certainly wouldn't indicate we are going to solve the problems by cutting pharma prices.  You cut them in half and you only drop overall healthcare costs by 5%.

We are talking about importing drugs from licenced Canadian pharmacies, not from Canadian manufacturing. They will mostly be produced by US pharma and sold to Canada at a much lower price than we buy them here in the states.

 

[MarvinTScamper]

It won't solve the problem all by itself, so why bother lowering prices?  Is that your position?

no....not my position at all.  I already stated that I think they should negotiate more...even cut off some of these suppliers who are raising prices on a drug with no change in the drug itself.   I also think they should make it easier for generics to be copied by allowing more manufacturers to come online.   But when one company spends more on R&D than Canada spends as a whole, I don't think the government should be in the price fixing game.   People don't HAVE to take the top rated drug when a generic will suffice.  There are very few drugs out there without options.

 

[MarvinTScamper]

We are talking about importing drugs from licenced Canadian pharmacies, not from Canadian manufacturing. They will mostly be produced by US pharma and sold to Canada at a much lower price than we buy them here in the states.

yes, and I'm saying the pharma company will figure that out, and stop supplying the Canadian pharmacies.  

 

[Baloney Sandwich]

yes, and I'm saying the pharma company will figure that out, and stop supplying the Canadian pharmacies.  

Canada is their second best market in terms of high pricing so not sure about that. They have many of the same problems related to drug costs as us but are still by and large cheaper. Opening up this option is really a band aid. 

 

[massraider]

https://www.bloomberg.com/graphics/2015-drug-prices/

Of the eight drugs analyzed, seven cost more in the U.S. after estimated discounts than in most other high-income countries. Discounts for the eighth drug, the cancer treatment Gleevec, couldn't be obtained, but its list price in the U.S. is far higher than in the rest of the world.

The list price of Merck & Co.'s diabetes pill Januvia is cut in half on average by estimated discounts, according to the SSR Health data. Even so, Merck gets more than twice as much in the U.S. for a monthly supply of the same drug as in Canada, the next most costly place to buy it, Bloomberg found. Humira, AbbVie Inc.'s best-selling rheumatoid arthritis treatment, costs an estimated $2,500 a month in the U.S. after discounts, compared with about $1,750 in Germany, Bloomberg found. In other nations, the drug's price drops even lower.

Have any of these pharma companies stopped selling drugs in other countries because it wasn't worth it, because of price fixing?  

Assuming the answer is NO, then why would anyone be concerned about a pharma company going out of business?

They are making plenty of money off their drugs in other countries, but in this country, they have their best customers, but are charging trhem the most.  In that way, they are different than most drug dealers I know. j 

 

[cincredfan]

The US is extremely good with near 100% certainty that the medication you are getting is truly the medication.  This is a major issue with importation as drug pedigree can't be guaranteed.  That being said costs of medication are far too high.  Tons and tons of medications are generic and pricing is very good.  There really is little reason why brand names are prescribed as much as they are.

The most absurd drug pricing I have ever seen was just approved over last couple months.  Ingrezza is the name and it treats tardive dyskinesia.  Cost over $5k per month.  Literally absurd.

 

[massraider]

The US is extremely good with near 100% certainty that the medication you are getting is truly the medication.  This is a major issue with importation as drug pedigree can't be guaranteed.  That being said costs of medication are far too high.  Tons and tons of medications are generic and pricing is very good.  There really is little reason why brand names are prescribed as much as they are.

The most absurd drug pricing I have ever seen was just approved over last couple months.  Ingrezza is the name and it treats tardive dyskinesia.  Cost over $5k per month.  Literally absurd.

Not gonna lie, had to Google 'tardive dyskinesia'.

Tardive dyskinesias (TDs) are involuntary movements of the tongue, lips, face, trunk, and extremities that occur in patients treated with long-term dopaminergic antagonist medications. Although they are associated with the use of neuroleptics, TDs apparently existed before the development of these agents. People with schizophrenia and other neuropsychiatric disorders are especially vulnerable to the development of TDs after exposure to conventional neuroleptics, anticholinergics, toxins, substances of abuse, and other agents.

Hey, these drugs we gave you have given you this incurable condition, but don't fret, we have a drug for that.  5 grand a month, please.  I know, it seems high, but we have R+D costs.

 

[MarvinTScamper]

The US is extremely good with near 100% certainty that the medication you are getting is truly the medication.  This is a major issue with importation as drug pedigree can't be guaranteed.  That being said costs of medication are far too high.  Tons and tons of medications are generic and pricing is very good.  There really is little reason why brand names are prescribed as much as they are.

The most absurd drug pricing I have ever seen was just approved over last couple months.  Ingrezza is the name and it treats tardive dyskinesia.  Cost over $5k per month.  Literally absurd.

based on Yahoo, that company has done revs of $35 million in the last 3 years, and has spent $225 million on R&D, and lost over $300 million during that timeframe

 

[MarvinTScamper]

Not gonna lie, had to Google 'tardive dyskinesia'.

Hey, these drugs we gave you have given you this incurable condition, but don't fret, we have a drug for that.  5 grand a month, please.  I know, it seems high, but we have R+D costs.

well, no, they didn't make the drugs, but, yes, they're trying to find a solution.   This is where I agree with whomever posted that we, in the US, take WAYYYYY too many drugs.  Drugs with real side effects.   Just so we don't have to change the way we live, just change the way we feel.

 

[massraider]

well, no, they didn't make the drugs, but, yes, they're trying to find a solution.   

No, they really aren't.

They are lobbying to restrict medical marijuana, while they try and release a synthetic marijuana that has (they hope) the same affects.  

They sell drugs that treat symptoms, they don't fund any cures.  What was the last thing that was cured, freaking polio?

 

[Brony]

https://www.bloomberg.com/graphics/2015-drug-prices/

Have any of these pharma companies stopped selling drugs in other countries because it wasn't worth it, because of price fixing?  

Assuming the answer is NO, then why would anyone be concerned about a pharma company going out of business?

They are making plenty of money off their drugs in other countries, but in this country, they have their best customers, but are charging trhem the most.  In that way, they are different than most drug dealers I know. j 

There are a lot of cases where companies won't sell drugs in other countries because of price fixing.  If they know they are going to lose $, they won't bother.  See India for prime example. 

It does cut down on some innovation if the U.S. revenue is going to be less.  It's not Henny Penny going to drive R&D to zero in the U.S., but there would be a cut back on R&D jobs in the U.S. if U.S. pricing was managed/reduced.

 

[cincredfan]

Other thing with the drug is the medication is only at most moderately effective. (right about 50% improvement in symptoms don't remember

Switching meds quickly if TD starts to develop is far better option anyway.

 

[Brony]

They sell drugs that treat symptoms, they don't fund any cures.  What was the last thing that was cured, freaking polio?

If you believe that pharma companies are purposely not looking for cures and focusing on symptoms, I have a bridge you might be interested in. 

 

[cincredfan]

No, they really aren't.

They are lobbying to restrict medical marijuana, while they try and release a synthetic marijuana that has (they hope) the same affects.  

They sell drugs that treat symptoms, they don't fund any cures.  What was the last thing that was cured, freaking polio?

Hep C was cured (crazy cost for those meds but at least cure the disease - Harvoni and Solvadi may be more also)

 

[MarvinTScamper]

No, they really aren't.

They are lobbying to restrict medical marijuana, while they try and release a synthetic marijuana that has (they hope) the same affects.  

They sell drugs that treat symptoms, they don't fund any cures.  What was the last thing that was cured, freaking polio?

too many misplaced "they"s in here....the folks doing medical research...the scientists, biologists, physicians, chemists.....they want to find cures more than anyone else out there.  I know what you're getting at, but you're aiming at the wrong people, primarily.

 

[modogg]

I get all this.  This is why this issue is so dang infuriating.  This is a really complicated situation ("lotta ins, lotta outs, lotta what-have-yous").  We are dealing with principles of free market, capitalism, socialistic tendencies, health of our populace, health of our economy.  There are a TON of things to consider, and "importing drugs from Canada" seems like the laziest, most simplistic, cop out sort of thing to do.

Some things I THINK are true

1) Drug manufacturers make fantastic, amazing, life saving medication.  And boner pills.  This is good.

2) Drug manufacturers, being corporations in a capitalist system, are driven by greed and a profit motive.  This is neither good nor bad.  It just is.

3) The profit motive referenced in (2) drive the companies to research and develop more and better and effective drugs referenced in (1).  This is good.

4)  If Drug companies were limited in their pricing, would it affect R&D?  We need to think about this.

5) But hold on a second -- the US provides all sort of R&D funding to drug companies?  How much?  Should the government off-set this funding by mandating price controls on certain things?

6)  But seriously, what would be the effect of price controls on healthcare in this country?  On development of drugs?  Shouldn't someone ACTUALLY do some thought about this instead of blindly importing Canada's socialist system?  We want to encourage R&D.

7)  I get it that we don't have a purely capitalistic system -- take for example drug patents and generic drugs.  That is clearly a bastardization of capitalism.  But a lot of smart people got together and studied the issue and decided that this system would benefit americans by making lower prices, but it wouldn't completely stifle innovations.

(8)  WHY CAN'T WE PUT SOME ACTUAL THOUGHT INTO IT AND COME UP WITH A REAL SOLUTION RATHER THAN SUCKING ON CANADA'S TEAT?

@IvanKaramazov, would like to know your thoughts. I am really surprised to hear you back Warren on this. 

i'll disagree with 3. Not to sound all but some (not a majority I hope) do not seek more effective and "better" medicine. There is already a history to show of having addictive properties and creating a dependency on some drugs to create a reliance on the medication. There is also plenty of mis-information pushed out there as advertising and marketing of their product, much of which is conscientious decision making.

 

[Gawain]

too many misplaced "they"s in here....the folks doing medical research...the scientists, biologists, physicians, chemists.....they want to find cures more than anyone else out there.  I know what you're getting at, but you're aiming at the wrong people, primarily.

There's a chicken pox vaccine now. I was amazed when my daughter received it, I remember my mom wanting me to catch it when I was 3 or 4. There's an HPV vaccine. While cures are much more difficult, there have been great strides made on the vaccine front, which, like polio, is effectively a cure.

 

[AAABatteries]

Can you get boner pills from Canada? And if so, how much do they cost?  Asking for a friend.

@Limp Ditka?

 

[AAABatteries]

And that friend was Barack Obama.

 

[Sweet J]

i'll disagree with 3. Not to sound all but some (not a majority I hope) do not seek more effective and "better" medicine. There is already a history to show of having addictive properties and creating a dependency on some drugs to create a reliance on the medication. There is also plenty of mis-information pushed out there as advertising and marketing of their product, much of which is conscientious decision making.

We've reached a complete stalemate if we can't even agree that Capitalism drives innovation.

 

[cincredfan]

@Limp Ditka?

Sildenafil is available generically (not technically Viagra as that comes in 25,50,100 and this is same generic but 20mg)

Cost to pharmacy after rebates is less than a quarter a tablet (US obviously).

 

[IvanKaramazov]

We've reached a complete stalemate if we can't even agree that Capitalism drives innovation.

Not to be pedantic, but it's profit that drives innovation, not really capitalism.  For example, the fact that we don't allow Medicare to negotiate on drug prices definitely increases profitability to firms and definitely encourages innovation.  But that's not really capitalism -- that's just a policy choice made by legislators.  A bilateral monopoly like that used in other countries (the government negotiating with drug companies on pricing and market access) would be just as "capitalistic" as what we're currently doing.

Likewise, there's nothing intrinsic in capitalism that requires the government to write IP laws in a manner that allows some of the gamesmanship and re-patenting that has been described elsewhere in the thread.    

The point I'm trying to make is that "capitalism" shouldn't be synonymous with "the government always doing what firms would like."  I see drug re-importation as pro-capitalism, for example, but drug companies will fight it tooth and nail.  (Lots of folks in the private sector are all in favor of free enterprise, except when a particular restriction on free enterprise would increase their profits by a dollar.  Then they're all in favor of regulation).

 

[Sweet J]

Not to be pedantic, but it's profit that drives innovation, not really capitalism.  For example, the fact that we don't allow Medicare to negotiate on drug prices definitely increases profitability to firms and definitely encourages innovation.  But that's not really capitalism -- that's just a policy choice made by legislators.  A bilateral monopoly like that used in other countries (the government negotiating with drug companies on pricing and market access) would be just as "capitalistic" as what we're currently doing.

Likewise, there's nothing intrinsic in capitalism that requires the government to write IP laws in a manner that allows some of the gamesmanship and re-patenting that has been described elsewhere in the thread.    

The point I'm trying to make is that "capitalism" shouldn't be synonymous with "the government always doing what firms would like."  I see drug re-importation as pro-capitalism, for example, but drug companies will fight it tooth and nail.  (Lots of folks in the private sector are all in favor of free enterprise, except when a particular restriction on free enterprise would increase their profits by a dollar.  Then they're all in favor of regulation).

First - yes, I should have indicated that "profit" is what drives, not "capitalism" writ large.

But that just begs the next series of questions - most importantly, isn't "importing drugs" from Canada merely importing Canada's price controls on drugs? If that is the case, and you or others are ok with that, isn't that a loopy way to fix a problem?  Why not implement a system of price controls in America that is right for American businesses and consumers alike? 

 

[Sand]

I get all this.  This is why this issue is so dang infuriating.  This is a really complicated situation ("lotta ins, lotta outs, lotta what-have-yous").  We are dealing with principles of free market, capitalism, socialistic tendencies, health of our populace, health of our economy.  There are a TON of things to consider, and "importing drugs from Canada" seems like the laziest, most simplistic, cop out sort of thing to do.

Some things I THINK are true

1) Drug manufacturers make fantastic, amazing, life saving medication.  And boner pills.  This is good.

2) Drug manufacturers, being corporations in a capitalist system, are driven by greed and a profit motive.  This is neither good nor bad.  It just is.

3) The profit motive referenced in (2) drive the companies to research and develop more and better and effective drugs referenced in (1).  This is good.

4)  If Drug companies were limited in their pricing, would it affect R&D?  We need to think about this.

5) But hold on a second -- the US provides all sort of R&D funding to drug companies?  How much?  Should the government off-set this funding by mandating price controls on certain things?

6)  But seriously, what would be the effect of price controls on healthcare in this country?  On development of drugs?  Shouldn't someone ACTUALLY do some thought about this instead of blindly importing Canada's socialist system?  We want to encourage R&D.

7)  I get it that we don't have a purely capitalistic system -- take for example drug patents and generic drugs.  That is clearly a bastardization of capitalism.  But a lot of smart people got together and studied the issue and decided that this system would benefit americans by making lower prices, but it wouldn't completely stifle innovations.

(8)  WHY CAN'T WE PUT SOME ACTUAL THOUGHT INTO IT AND COME UP WITH A REAL SOLUTION RATHER THAN SUCKING ON CANADA'S TEAT?

@IvanKaramazov

We do want to encourage R&D, but the fact is we currently subsidize almost everyone else in the world.  With the Prez philosophy we need to stop those giveaways.  Always gets me when folks crow about single payer elsewhere and don't realize we're helping pay for some of that.

Best i can see is to allow reimportation, but delay it for two years for the express purpose of allowing drug companies to renegotiate with foreign powers.  That would help a lot in getting true price discovery here.

 

[IvanKaramazov]

First - yes, I should have indicated that "profit" is what drives, not "capitalism" writ large.

But that just begs the next series of questions - most importantly, isn't "importing drugs" from Canada merely importing Canada's price controls on drugs? If that is the case, and you or others are ok with that, isn't that a loopy way to fix a problem?  Why not implement a system of price controls in America that is right for American businesses and consumers alike? 

I have to be honest and admit that I'm not overly familiar with Canada's pricing system.  Is this something that's negotiated between Canadian authorities and drug companies, or is it just fiat?  If the latter, then things might need to change if we do re-importation.  

I see re-importation as a way around some of crony capitalism that the US has in place in this market at the moment, and also as an end-run around the FDA.  My aim is not simply to replicate somebody else's price control system.

 

[modogg]

We've reached a complete stalemate if we can't even agree that Capitalism drives innovation.

that is fine in the finance and food marketing areas, but when we are talking about quality of life do we want capitalism/profit to be the driving factor? i honestly don't know, and don't care to argue either side, simply stating that capitalism/profit-driven shouldn't be the driving force behind things like quality of life or educating youth. I am sure there are tons of examples where it has benefited all. But in my work experience, i can say confidently that this has not created a better education system overall in my little world, might be different across the nation. 

 

[Sheriff Bart]

Can you get boner pills from Canada? And if so, how much do they cost?  Asking for a friend.

Thanks, man.  I was way too nervous to ask.

About 10 years ago somebody, think it was @Wingnut, posted about ordering Cialis from a Canadian pharmacy. I was curious so ordered some. The good news is that I could drink an almost lethal amount of whiskey and still get a boner. The bad news is that they STILL MOTHER####ING CALL ME to order more. ONE ORDER TEN YEARS AGO. I have at least 30 phone numbers blocked in my phone. I swear to ####### god I'm close hiring a hitman to hunt them all down and murder them, their families and their pets. 

 

[OrtonToOlsen]

About 10 years ago somebody, think it was @Wingnut, posted about ordering Cialis from a Canadian pharmacy. I was curious so ordered some. The good news is that I could drink an almost lethal amount of whiskey and still get a boner. The bad news is that they STILL MOTHER####ING CALL ME to order more. ONE ORDER TEN YEARS AGO. I have at least 30 phone numbers blocked in my phone. I swear to ####### god I'm close hiring a hitman to hunt them all down and murder them, their families and their pets. 

My friend wants to know how much it was.

 

[Sheriff Bart]

My friend wants to know how much it was.

I forget because IT WAS TEN YEARS AGO!!!!!  THEY CALLED ME FROM THREE DIFFERENT NUMBERS ON SATURDAY!!!!! I STARTED ANSWERING THE PHONE "HELLO THIS IS FRANK!" AND THEY DON'T CARE!! HEY FRANK, WANT SOME BONER PILLS?  DIE!!!!!!!!!!!!!! 

 

[OrtonToOlsen]

I forget because IT WAS TEN YEARS AGO!!!!!  THEY CALLED ME FROM THREE DIFFERENT NUMBERS ON SATURDAY!!!!! I STARTED ANSWERING THE PHONE "HELLO THIS IS FRANK!" AND THEY DON'T CARE!! HEY FRANK, WANT SOME BONER PILLS?  DIE!!!!!!!!!!!!!! 

Can I order them and use your number? I mean you're already hosed so..

 

[Sweet J]

that is fine in the finance and food marketing areas, but when we are talking about quality of life do we want capitalism/profit to be the driving factor? i honestly don't know, and don't care to argue either side, simply stating that capitalism/profit-driven shouldn't be the driving force behind things like quality of life or educating youth. I am sure there are tons of examples where it has benefited all. But in my work experience, i can say confidently that this has not created a better education system overall in my little world, might be different across the nation. 

It's not a "want" or "should" sort of thing.  The profit motive is an incentive that drives people and corporations. It's not a "good" or "bad" judgement.  It just is. The most clear example of that I can think of is what happened to the internet.  Once it as opened up so that the pornographers and gamblers could profit, it just exploded (particularly the video streaming capabilities) in a way that it wouldn't have if it was an exclusive providence of the government. 

Some things, this concept of the profit motive driving innovation simply does not work, for a variety of reasons (like environment, prisons, or maybe schools), because you have to measure public benefit in weird ways that the profit drivers don't really account for.  And the State must treat citizens in certain ways that would go against some decisions that would be driven by the profit motive in these situations. 

I'm somewhat on the fence with pharmaceuticals.  If companies believe they can make money be developing new and better drugs, than I would think that the profit motive is an exceptional driver to innovate these drugs.  Ivan is right that this is not a pure Capitalism sort of scenario (I'm not sure if anywhere is left in America that is pure capitalism; the state is involved in all sort of industry in all sort of ways).  But yes, I do think that profit motive is an exceptionally strong driver for lots of things. 

 

[MarvinTScamper]

It's not a "want" or "should" sort of thing.  The profit motive is an incentive that drives people and corporations.

along these lines...I think all the SJWs out there, that want to "cut prices" or "limit profits" don't realize just how little innovation, progress, or success comes from worlds where the government does these things.   Show me where the Russians or the Chinese are blowing the lid off innovation, idea creation or streamlining.

 

[The Commish]

Instead, drugs in Canada are cheaper because of the price controls that Canadian government mandates for drugs manufactured/sold in Canada.  The Canadian government, as a policy, limits the amount that companies can charge.

So, IF THE ABOVE IS TRUE (and please correct me if I've gotten something wrong), then isn't a "Congressional Solution" to allow the US to import drugs really, really, really disingenuous?  What I mean is this:  If Congress wants to mandate the VERY SAME price controls for drugs sold by US manufacturers, it can.  It doesn't need to go through the farce of allowing for Canadian drugs to be imported to the US, when what is really happening is that they would be allowing for Canadian price controls to be imported into the US.

This is it.

The pharma companies are allowed to make up their perceived "lost profits" in other areas of the world here in the US.  This isn't an economic issue.  It's a relationship issue.  The relationship between these companies and our politicians is stronger than the one between our politicians and us.  Of course the politicians hide behind the innovation rock that these companies seem to be trying to hold over their heads, but anyone with a brain knows that excuse is pure BS.  All it does is help the politicians sleep at night.

 

[Wingnut]

About 10 years ago somebody, think it was @Wingnut, posted about ordering Cialis from a Canadian pharmacy. I was curious so ordered some. The good news is that I could drink an almost lethal amount of whiskey and still get a boner. The bad news is that they STILL MOTHER####ING CALL ME to order more. ONE ORDER TEN YEARS AGO. I have at least 30 phone numbers blocked in my phone. I swear to ####### god I'm close hiring a hitman to hunt them all down and murder them, their families and their pets. 

Lol...I still get a call every month or so...I ignore or reject calls from strange area codes, and they never leave a message

 

[modogg]

cooking dinner and have the HBO show Vice on in the background. Hear how the 1st gene therapy for cancer has been approved and can be used to treat childhood Leukemia. the company who owns it charges 1 treatment for............450K. Yup, $450,000 for one treatment. Guess we hope it works the first time around for the 15-20 people who can afford that

 

[Homer J Simpson]

along these lines...I think all the SJWs out there, that want to "cut prices" or "limit profits" don't realize just how little innovation, progress, or success comes from worlds where the government does these things.   Show me where the Russians or the Chinese are blowing the lid off innovation, idea creation or streamlining.

Yes, I'm sure they'll all fold up their tents and call it a day if their profits go from obscene to just ridiculous.