America's large hospital chains will start manufacturing generic drugs in order to beat shkrelic price-gouging

Originally published at: https://boingboing.net/2018/01/18/intermountain-healthcare.html

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Great; the hospitals will get cheaper drugs.

Will these for-profit organisations be slashing the prices they charge their customers?

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At a guess, I’d be inclined to think that being closer to the coalface would discourage the more rampant strains of evil displayed by the likes of big pharma…

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I love the new adjective “shkrelic”, implying a particularly obnoxious and sociopathic expression of greed.

The sense I get is that they don’t want to be held hostage to the pharmatrolls when trying to get re-imbursed by the insurers for claims. Even if they’re still charging a premium for a generic they manufacture it’ll be far less that what a shkrelic company would charge, so the negotiation between hospital and insurer will be a little easier. It’s a small step, but anything that eliminates (or at least reduces the income of) one of the parasitic middlemen who thrive off the broken American system is a good step.

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Okay, do that then it’s just one small step further to collectively order things in bulk from a national health service with the size to add weight to negotiations, rather than a million smaller units competing.
You can get there America, absurd corporate profit as a focus is not the only way to do healthcare…

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In large part the “price” they can charge will be the billing rates dictated by medicaid/care and insurance companies. That price will need to be lower than hedge fund owned biotech companies that seem to be driving the price gouging. Those parties aren’t going to agree to cover any drug that’s more expensive. But what a lot of them increasingly do is require cheaper generics in some way. Whether only covering generics or charging a much higher copay for name brand. Or even requiring you to get scrips from a mail order source.

That means competition. Which can only create downward pressure. Remember a hell of a lot of the drugs that are going up in price are out of patent. And the price drive is coming from the fact that only one company in the market is still manufacturing them.

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I can tell you from personal experience that the hospitals are getting killed on drugs prescribed by the doc but are not covered by the insurance formulary so the hospital doesn’t get reimbursed. Might also solve some of the issues with shortages of some drugs.

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OT but related to the gif… Lazytown is a bizarre thing to stumble across when you’re sick and flipping through channels…

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I for one welcome the hospital ceramic smart dosing cup foundry and walk (gurney, whatever) over to the stylist and formularist. Smart microbusses all over Cleveland that take care pay and roll ubiquitous generics-level care too. (So the CES2018 coverage I saw was Red Bird, Red Bird level…and tbh VW and Intel.)

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My friend, please, slow down on the caffeine. You’re starting to type like a bipolar pounding red bulls after a jog.

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image

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Why isn’t someone already taking advantage of this?

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Color me cynical but I bet this will mean it costs a mere $30k per year.

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“Slashing” is such a strong, vengeful, hopeful word. “Somewhat discounting” would be a far more truthful, far more profitable way of describing things.

Great money-saving strategy for the hospital systems and their shareholders…not the patients.

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On one hand, yay to them for working to get around the actions of big-pharma.
On the other hand, they’re still hospitals and not without a lot of blame themselves for the high cost of healthcare in the US.

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Shkreli’s sentencing hearing was scheduled for 01/16/18 - I don’t see any follow up in a quick search.

Wonder if he’s enjoying prison as much as he thought he would?

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A few are. Compounding pharmacies have become a bigger thing. And have started manufacturing generics to some extent. The compounders can make generics without neccisarily going through the same fda approval process normally needed. And I think they can even make/prepare drugs that are still in patent.

But there a big hurdles for starting to manufacturing generics. You have to have or build out a really precise, expensive manufacturing capability. Or find some one to contract to. New generics have to get approved by the fda as equivalent of just as effective and safe as the name brand. You have to have a slaes/marketing operation so docs, insurers and pharmacists know it’s an option.

And then there are the weirder situations. Some of these drugs that are crazy expensive are still under patent. Or like the epipen, The drug itself isn’t. And is in fact widely manufactured. But the delivery system is patented, And can be kept in patent by the usual improvement refilings. Generic epinephrine auto-injectors have been held up by problems of getting a new auto-injector that doesn’t infringe on the epipen patents through the fda. There’s been reliability issues.

There a just a lot of high hurtles. But hospitals have some of this built in already. They don’t need sales reps or marketing. They are the docs and pharmacists. They have direct connections to insurers. And existing relationships with drug manufacturers who can produce the drugs for them.

It’s a smaller move though. Unless they open to eventually sell them on the open market, it’s a relatively limited impact.

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It’s this kind of idea that I wish would take off for consumers where people buy into a cooperative that can makes orders to pharma manufacturers for off-brand drugs since it would pass the savings directly to them and not just hospitals. Basically, it would be a mutual aid society for prescriptions.

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I’m soooo sorry no one with small kids warned you about this creepy trip into the Uncanny Valley.