2/ Already starts off with a bang where @VPrasadMDMPH Points to a study identifying 71 modern cancer drugs that yield a net benefit of 2.1 months.
3/ Wow. Some of these drugs “are 12, 14, $16,000 a month”?!?
4/ Really great discussion that follows this at around 3:30 where they’re discussing quality of life for dollars spent. How to assess that cost/benefit, what are the trade-offs?...
5/ Granted, I am only just a few minutes in – but I really do recommend this portion I’m listening to now given I rarely hear such a well articulated case on the powerful trade-offs involved with provider care.
6/ At around 14 minutes, @EconTalker says it would be great if these drug companies simply developed patents and then could make money off what the market would bear, but it’s really what the political system will bear.
7/ @VPrasadMDMPH: Medicare has to pay for any approved cancer drug from the food and drug Administration And they cannot negotiate the price. Nothing stops a drug from tomorrow coming with a price that’s $2 million a pill, save that it would end up on 60 minutes.
8/ This tweet is just for you to pause and reflect on the prior tweet.
9/ @VPrasadMDMPH There’s another policy many people don’t know, which is that many years ago we allowed for groups of experts who are often in financially conflicted relationships with drug companies to create registries of off label drug use...
10/ ... and we have wedded Medicare to pay for off label drug use as recommended by experts at certain levels of evidence. And Medicare here too cannot say no, cannot negotiate price, they must pay for this off label use of drugs.
11/ At around 19:00 @EconTalker makes the important point that all countries outside the US can and do negotiate with the drug companies directly in the way we don't. Thus about half (HALF!) of the phrama revenue comes from inside the United States...
12/ Thus, the US is footing a giant part of the bill for this innovation given we don't have the latitude in these contexts to say, "well, it's not worth it" to drive market forces for better pricing.
13/ -- Well, I'm sad to say I have to pause and come back to this thread on the next walk as there's some work I have to take care of. To be continued...
