If prescription drug prices are very high and keep rising, if you reduce out of pocket costs for patients, premiums go up; if you reduce premiums, out of pocket costs for patients go up.

That's the truth.
You cannot have a system that relies on the generosity of Pharma to keep prices affordable. They will keep increasing drug prices to meet targets as the law allows them to set the price and prevents Medicare from negotiating.

Lowering out of pocket costs is a band aid.
You cannot give monopoly protection for >10 years and have no way of negotiating either launch prices or price increases. Particularly when the product is life saving.
This is not rocket science. Every other developed country has figured it out. Our inability to figure it out affects negotiating power for everyone else.

If we don't figure it out, from insulin to Revlimid you will see the same story play out.
So am I surprised by this story on Part B premiums? No. What else did you expect. google.com/amp/s/www.cnbc…
Regular insurance premiums will also go up.

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More from @VincentRK

14 Nov
Minnesota now has the highest number of cases per capita in the country. Florida, the lowest. But don't rush to conclusions. Florida paid a price with a high loss of life in its recent wave, the highest since the start of vaccinations. #GetVaccinated ImageImage
Vaccines are highly effective. Deaths are mainly in unvaccinated. health.state.mn.us/diseases/coron… Image
Breakthrough cases are occurring and people who are eligible need to get boosters. But once again, the vaccines are highly effective in preventing serious disease and deaths. Image
Read 4 tweets
12 Nov
Breaking: I am thrilled that Yelak Biru @NorthTxMSG has been appointed the CEO of the International Myeloma Foundation. @IMFmyeloma

Yelak is a visionary leader who will provide inspirational leadership in our pursuit to cure myeloma. @BrianDurieMD @jmikhaelmd Image
Susie Durie, who has led the organization for 31 years will assume the role of Founder and Director of Global Patient Initiatives.
Read 4 tweets
11 Nov
Singapore 85% vaccinated.

92,132 cases in last 28 days

98.7% mild symptoms or asymptomatic

0.7% needed oxygen
0.3 % ICU
0.2 % died

"Seniors 60 years old and above, especially if unvaccinated, continue to be more adversely affected by COVID-19."

channelnewsasia.com/singapore/covi…
As I look at these data, and what's going on in Europe, vaccinated younger people after vaccines and most elderly people are very well protected. But some elderly and immunocompromised may not mount a durable immune response after vaccines.
Boosters are therefore important for elderly and immunocompromised people. Early use of monoclonal antibodies are also important and should be used if available.
Read 4 tweets
3 Nov
Medicare Part D covers >3500 prescription drugs. Over 2400 of these are made by only one manufacturer (monopolies).

The prescription drug plan to let Medicare negotiate covers 10 drugs starting 2025. 20 drugs per year after.

Yet Pharma protests. Let's keep things in context.
New drugs are protected for 9 years from time on market from negotiation. Biologics for 12 years. Price increases capped to inflation.

Which means expect Pharma to "front load" prices. That means make the launch price much higher to cover all of this loss of revenue. @DavidP4AD
Out of pocket for seniors capped. Good. Important.

But it also means someone still pays Pharma. That's Medicare. Which is back to us, the public. So it's not like Pharma is losing money that way either.
Read 4 tweets
1 Nov
COVID vaccines greatly reduce severe disease and deaths.

6 countries with delta waves. In each instance despite a rise in cases, deaths have stayed low this time around thanks to vaccines.
Note that even in countries like UK and Israel, one third of the population is not fully vaccinated. In absolute terms the numbers are high and allows virus to circulate.

Some vaccinated people are unable to mount an immune response due advanced age or cancer or other illnesses
To overcome these problems we need higher vaccination rates, booster doses at least for those at high risk, and continuation of preventive measures (masks and distancing) for some more time.
Read 4 tweets
31 Oct
Headlines about a study in @TheLancetInfDis stating that vaccinated people are just as likely to spread Covid as unvaccinated are misleading. Here's why.

1) Vaccination has lower risk of transmission even in this study (see table) & severe disease.
2) This study is primarily on household contacts. Household contacts live with each other. So the exposure is prolonged and sustained. So differences between vaccinated and unvaccinated groups will narrow in household settings.
3) What the study shows is that transmission from vaccinated people to household contacts can occur but at lower rate than unvaccinated. It also basically explains why the delta wave has occurred in even in some well vaccinated countries.
Read 10 tweets

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