Why does insulin in the United States cost 10x what it costs in Canada?

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What bothers me is that US consumers subsidise the world so that everyone gets new drugs. If US cut prices, the pharma companies will either push the prices in other developed countries or stop investing in R&D.

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I agree with you on the innovative side, except many drug companies just expand existing lines rather than pushing innovative therapies. On the other hand no one needs to pay $1,000 for insulin (a Canadian invention that wasn't patented orignally). I understand new ways etc, but it is clearly exploitative.

There should be maybe a longer initial patent window and a concerted effort to simplify the regulatory processes across key countries to improve their returns. Introduce more population health outcomes based arrangements like the NHS and Novartis which really change the paradigm. At least in places with single payor systems.

And ultimately the US should adopt a ceiling like most of the other countries so they aren't subsidizing the globe. But this only works if we can drop the costs of developing and introducing therapies a similar amount.

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Because 10 different entities need to get paid throughout the distribution channel.

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Is there a book, PDF, youtube video that illustrates this? Asking for a friend

Canada is an HTA market

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I believe the biggest driver is considered to be lack of bargaining power due to fragmented market - any individual insurance company doesn’t have the same power as a consolidated federal government would. In fact, right now, the federal government (e.g., Medicare) is not allowed to negotiate drug prices. If you want to talk sides, a proposal legalizing this was recently pulled from the big spending bill because no republican supports it.

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D1

Glad you are knowledgeable enough to accept the shortcomings. That’s step 1. I agree w/ your premise. I agree Canada does score well in basic research. Some really bright spots.

However I am not as enthusiastic as you about Canada govt doing anything to advance innovation in future. I expect same old. It comes with certain political ramifications which Canada is honestly never going to be ready for.

This was in the democratic bill I think, but republicans are staunchly against this plus democrats Manchin and Sinema I believe.

My SO is a type 1 diabetic and our costs would plunge so much if republicans stopped their games of cuddling with big pharma. The biggest joke is that the drug companies can only slightly change their formulation and renew their patents to keep the prices high. Hasan Minhaj did an episode on this on his Netflix show, Patriot Act.

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The bill has way more than Medicare negotiation power in it. There are other items in it, like childcare, tax increases, and other stuff.

If Medicare negotiating power was that important, the party in power could have a single bill and have people vote on it. They could also get rid of the filibuster for that specific vote if they wanted to pass it with 50 votes. We all know they won’t and will tell you all the political reasons they won’t do it.

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Because profit

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Ever hear of Joe Biden? Also known as Brandon

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You’re joking right? The guy’s been president for <1 year, and you think this is on him?

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because competition

From what I understand, the US could in theory start paying much less for drugs starting today. But the downside would be less innovation worldwide!

I have a family member with a rare disease so I am conflicted with asking for lower prices. I think the solution is that all the countries should pay more for drugs and spread the burden.

If there was no price play everyone would be focused on diabetes and hypertension

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