Health Insurers Pressing Down on Drug Prices
From article:
In dealing with health plans, drug companies are facing a new imperative — bargain or be banned.
Determined to slow the rapid rise in drug prices, more health plans are refusing to cover certain drugs unless the companies charge less for them.
The strategy appears to be getting pharmaceutical makers to compete on price. Some big-selling products, like the respiratory medicine Advair and the diabetes drug Victoza, have suffered precipitous declines in market share because Express Scripts, the biggest pharmacy benefits manager, recently stopped paying for them for many patients.
That appears to be happening to some extent. Analysts at Credit Suisse estimate that the collective discounts and rebates for 15 large drug companies amounted to 31.9 percent of gross United States sales in 2013, up from 30.2 percent in 2012 and 19.7 percent in 2007.
Over two years ago I blogged https://www.pharmaciststeve.com/?p=1053
Another MIDDLEMAN in the healthcare system -sucking off money
about a company by the name of SXC
Founded as Systems Xcellence in 1993, SXC negotiates with drugmakers for lower prescription medicine prices on behalf of health insurers, Medicare and Medicaid plans, workers’ compensation programs and long-term care facilities.
It would now appear that the insurers want to move past rebates/kickbacks into extortion to the drug companies.. after giving a 32% discount/rebate/kickback… they want more.. and we wonder why prescription prices have been accelerating greater than the CPI ?
What about the pts? It appears that the insurance companies are looking for any therapeutic response from a drug class.. is all that is needed.. lowest cost of therapy is more important than optimum therapeutic outcome for the pt..
Is this a outcome – or collateral damage – of the government paying 60%+ of all medical costs … via Medicare/Medicaid/TriCare/VA ?
I can hardly wait until we have a national/universal healthcare system with the government picking up 100% of the tab.. with the IRS overseeing that system Woo-Whoo 🙂
Filed under: General Problems
Yup, it’s all about the almighty bottom line and we patients are all a bunch of ‘redshirts’. Medicine is not ‘One size fits all’ and more people have to ‘wake up and say enough’ to the govt and 3rd parties. As someone with a family member whose bipolar is now stable, I’ve read on how insurances/PBMs are just itching to put mental health medications under the microscope. I’ve already had push to get PAs in the recent past on a couple of psych meds because of side effects of others.