Once Medicare can negotiate, how much would I cut the list price of Top 10 drugs that Medicare spends a lot of money on?

90%.

Even if you slash prices by 90%, these drugs will still be far more expensive than in India (for same drug or generic).
Forget India.

Take Europe. For #1 drug on the list Eliquis look at cost difference below. You could cut the price by half and the drug will still be twice as expensive in the US. Why Medicare should negotiate. statista.com/statistics/113…
What about Revlimid the #2 drug we spend the most money on?

Well it’s about $18,000 a month in the US. $115 in India and you choose from ~18 generics.

But it’s not just India. See below. statista.com/statistics/123…
Need I talk about insulin? Two of the drugs on the list are insulins. Lists 10 times more in the US than other countries. The Senate bill caps the price to $35 for Medicare. But the proposal to do the same for private insurance was blocked. #Insulin4All rand.org/blog/rand-revi…
So am I glad Medicare can now negotiate. Yes.

We are starting slow. Starting 2026, 10 drugs that have been on the market for a long time and cost Medicare a lot. And then add 15-20 each year.

Other developed countries do it at launch for all new drugs.
Medicare negotiation is important for many reasons. It will help the public get affordable meds.

It doesn’t matter how good your drug is if it is not affordable.
So when you hear Pharma protest that Medicare negotiation will hurt innovation they mean it will hurt profits.

If you can make a lot of $$ as long as your drugs squeaks past the competition & that’s the bar you have to cross, it’s easy to see why negotiation will cause concern.
It’s not only important to negotiate prices once. Then they can increase the price year after year like they have done so far. This phenomenon is unique to the US.

So I welcome capping price increases that is part of the new bill.

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More from @VincentRK

Aug 12
Revised CDC guidance on COVID does not make sense. We are still losing 500 people a day to COVID. It’s a big risk. It’s like we are giving up.

As a cancer doctor I am also worried for my vulnerable patients.
#CovidIsNotOver Image
The measures we had in place so far were quite lenient. There no mask mandates or lockdowns. Just simple common sense measures to prevent transmission given the continued rise of new variants that are vaccine evasive.

Why dismantle them? And based on what data?
And seems exactly opposite of what the FDA is recommending with more testing urging more care in regards to COVID.
Read 6 tweets
Aug 9
Patients with cancers such as myeloma and CLL will benefit greatly from new changes:

Out of pocket costs will be capped at $2000 starting 2025. A game changer. kff.org/medicare/issue…
Patients will start seeing benefit even in 2024. Patients pay 5% of the cost of the drug once they’ve spent about $7000 a year (the catastrophic threshold).

It’s not hard to hit catastrophic threshold quickly when drugs cost $15,000 a month.

This 5% cost sharing ends in 2024
But if copays are capped and Medicare cannot negotiate it will allow Pharma to hike prices even more rapidly. Why?

Coz it will effectively silence the most important voice against unreasonably high drug prices: the voice of patients. Since their cost will stay constant.
Read 5 tweets
Aug 8
While patients with diabetes may feel let down and disappointed there are some reasons for hope for lower priced modern analog insulins.

1) @CivicaRx a non profit drug manufacturer is working to manufacture insulin.
2) California announced it will manufacture insulin. @reoxoo cnbc.com/amp/2022/07/08…
3) The US plan to keep insulin price to $35 for Medicare beneficiaries is still intact. It is part of the historic healthcare reforms passed yesterday.
Read 9 tweets
Aug 7
Breaking: Finally it has happened. Senate has passed a bill that is almost certain to become law. What it does:

1) Allows Medicare to negotiate drug prices
2) Prevents price increases on drugs Medicare buys..
3) Caps out-of-pocket drug costs for seniors to max of $2000 per year
1) Medicare negotiation is critical. It is what all other developed countries do. I welcome this even though it s more modest than I wanted.
2) Preventing the ability of drug companies to increase prices on the same drug year after year is huge. This is something that will greatly benefit seniors and the public. What happened in the last decade, see below, will be slowed down.
Read 10 tweets
Aug 7
Insulin. Moments ago. US Senate #Insulin4All
57 votes is more than I thought. But unfortunately it did not pass for those with private insurance. Needed 60 votes because of the point of order. Capping insulin to $35 is not going to happen for those with insurance.
Still hoping for a miracle. @DemFromCT — your comment gives me some hope.

Watching. More on insulin here.
Read 5 tweets
Aug 7
If you want to know how powerful Pharma lobbying is, look no further than insulin.#Insulin4All

Though insulin costs 10 times more than in other countries, is needed for survival in diabetes, despite countless articles written, let’s see how many oppose capping the price to $35.
Insulin prices compared to prices of other things we use as well illustrated by @lollydaggle years ago.

Some states have acted. have introduced the oxymoronic idea of “authorized generics”. But we need a national solution.
Insulin is the Achilles heel of Pharma and PBMs. There is absolutely no justification.

mayoclinicproceedings.org/article/S0025-…
Read 10 tweets

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