[CapmCrackaWaka]

My wife and I recently decided to do IVF. The doctor specifically told us that we needed to order the medicine (menopur, Gonal F, etc) from an American pharmacy. That alone made me suspicious, so I looked at foreign options. Altogether, the medication required would have cost us about $5000 from American pharmacies. We found out that we can just buy the exact same stuff from a German pharmacy for about $1000. So yes, Americans get wrecked by drug prices.

[viccis]

When my wife needed a rabies post-exposure shot course, it would have been around $25000 range for the shots without coverage. Our (expensive high end) insurance brought it down to "only" $2500 out of pocket for us. The alternative is to take the gamble of a possible horrible death.

In the UK? Around £150-£300 total.

[jen20]

> In the UK? Around £150-£300 total.

For whom? I can't imagine this in particular would not be free at the point of use like almost everything else. That said, the UK has famously been free of (classical) rabies since the 1920s, so it's unclear if it would be easily available if there aren't other uses.

[JumpCrisscross]

> doctor specifically told us that we needed to order the medicine (menopur, Gonal F, etc) from an American pharmacy

Why do they care? Referral bonus?

Did you report them?

[nerdsniper]

Well, for one ... it's illegal to import drugs that aren't FDA approved. You can import a few months personal supply of a prescribed drug that is FDA-approved but doesn't just mean that the active-ingredient is FDA-approved. It has to be the same exact product, manufactured in the same FDA-approved facility with the same packaging/labeling/etc to be considered "FDA-approved". The most expensive FDA-approved drugs are sold at US prices globally, so there's no geographic arbitration. Then other non-FDA approved brands are sold at lower prices - importing these is a smuggling offense, though enforcement was pretty low (but now with CBP's upcoming budget increases, who knows if this will continue to be practical or ultra-risky).

More practically - HMG is a very difficult drug to assay for purity. It's too complex to interpret with qNMR, HPLC testing is also very hard to interpret. The testing that exists evidently either has a very high margin of error or involves lots of rats and dissections.

Even testing for hCG, while it can be done reliably with HPLC, results between different labs are not comparable because the primary assay is also to test bioactivity on rodents, so they're not normalized to the same standard.

The lack of any independent testing for HMG means that some of the more accessible international manufacturers don't actually test their own product. Combined with its high price, that all makes it a very common target for counterfeit.

Yes, the American pharmaceutical system absolutely has quality-control issues. 80% of our generic pharmaceuticals come from overseas production. The pentagon wanted to independently test the drugs it was purchasing for the VA, so it worked with a company named Valisure who determined that about 10% of the drugs had issues with contamination or a lack of the active ingredient[0]. The FDA responded by shutting down Valisure's third-party testing.

But even with the problems we have here in the USA, HMG is the one drug I would particularly not trust from gray-market supply chains. It's conjecture, but I wouldn't be surprised if the doctor said that because other patients had tried it and had poor results.

0: https://archive.ph/ubLmg

[dahinds]

It is often illegal to purchase drugs from other sources?

The named drugs are injectable and require cold storage so it is not trivial to safely source them from overseas.

[WalterSear]

Fear of counterfeit/low quality drugs?

[apwell23]

what do you mean? you expect american doctors to prescribe you medicines from german pharmacies?

[hshdhdhj4444]

The only reason Americans complain about drug prices is because that’s the one they usually pay directly.

The other parts of the healthcare system are hidden behind taxes and insurance.

[bruce511]

Not to be unnecessarily sparky here, but are we limiting this discussion to legal drugs?

Drugs like Oxy are both "legal" yet also consumed illegally. Made by a perfectly legit pharma company.

And that's before we discuss the river of fentanyl apparently flowing across the Canadian border...

[duxup]

I think insurance prices are very much a part of the overall healthcare conversation too though.

[liquid_thyme]

YouTube Premium is also cheaper in Bangladesh.

[hshdhdhj4444]

Is it cheaper in the UK, Canada, Germany, etc?

[9question1]

The problem with this argument is that pharmaceutical companies are private businesses trying to make a profit, not charities. If it were truly unprofitable to sell drugs in, say, Canada or France, pharmaceutical companies would just not sell their drugs in those countries. It is _less_ profitable to sell drugs in those countries than America but still profitable, which is why they still try to capture those markets. If America fixed this imbalance by forcing a lowering of drug prices in the American market, there's no reason to believe that this would cause raising of prices elsewhere. The only way this would be possible is if it were truly unprofitable to sell the drugs elsewhere, which can't be the case since these are corporations not charities. The real impact would be to slow down new drug development, since existing drugs are already profitable to sell everywhere in the world even in countries with more regulation, but if America fixed its market by lowering drug prices for Americans, the total profitability of pharmaceuticals would decrease, decreasing the incentive to create new pharmaceuticals. That's a totally different and very plausible impact. Rising drug prices for existing drugs in other countries is not a plausible impact.

[mothballed]

You think pharma companies won't bill the rest of countries whatever the market can bear? I can't think of why they possibly would lower their prices even if the American government stops subsidizing their businesses via using their monopoly on violence to enforce our perverted IP regimes.

[gruez]

>If America prohibited such gouging, would the rest of the world accept price increases on their drugs? If the current administration is so interested in inflicting harm on the rest of the world, maybe they should be convinced to lower drug prices.

I doubt governments elsewhere are itching to increase their healthcare spending even more. Realistically speaking the actual result will be cost cutting from pharma companies, mostly in the form of lower R&D spending for new drugs.

[badosu]

Seems like an interesting hypothesis to explore.

You didn't provide any context of why you think that could be the case or the mechanism through the alleged subsidies happen.

[Der_Einzige]

The sad reality is that if Americans stopped paying inflated prices the 40% of drugs discovered here would shrink to about 10% and world wide drug discovery would be massively reduced.

You literally have to get fucked or the world get fucked harder and drags you down with them. Same reason why NATO and the farm bill are good for America.

The greatest trick from the wealthy is to not just exploit you to get it, but to destroy any possibility of resistance to them. Even trying to resist does nothing but harms the under class even more than if you simply accept it.

“If you want a picture of the future, imagine a boot stamping on a human face—forever.“ - George Orwell, a communist/socialist

Edit: To the guy who claimed Orwell wasn't a communist, the POUM who he fought for in the Spanish Civil war was communist (https://en.wikipedia.org/wiki/POUM) and according to the soviet union was specifically trotskyist. If you fight for them you are a communist, even if and especially if you claim you weren't later in life.