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Conversation has been slow here. I feel like the standards have increased to the point where people are afraid to post (except of course for bad faith posters who don't care).
So, let me try a post that's more of a conversation starter and less of a PhD thesis.
According to Bernie Sanders, it costs about $5 to make a monthly dose of Ozempic, the blockbuster-weight loss drug. Americans pay about $1000/month. Canadians pay $155. Germans pay $59.
The stock of the company which makes the drug, Novo Nordisk, has doubled since the beginning of 2023. (I considered buying in 2022 but didn't because I thought I was already too late 💀) It now has a market cap of nearly $600 billion, making it the most valuable company in Europe.
I assume that if companies were forced to charge the same price in U.S. as they do in Europe, the global pharma industry would become insolvent.
So why is the United States paying for > 100% of global pharma research? And how can we fix the glitch?
A: You can't just look at the marginal cost, you have to consider the fixed costs that go into making the first dose. Drug development has a lot of candidate drugs that don't pan out and so they need big hits to pay for failed drugs.
B: For the past two years there have been and continue to be pretty severe GLP-1 supply shortages in the US, availability for those prescriptions in centralized health care systems ration access to GLP-1 meds much more strictly on top of similar supply shortages. Good luck getting Ozempic in Canada/Germany without a T2D diagnosis, and most US insurance does cover Ozempic at reasonable rates if you have a T2D diagnosis and can jump through some hoops with a prior authorization. If you just want a weight loss drug, then you're looking at $900+ every four weeks here.
C: To a large extent, the 'system' is working. US citizens are getting earlier access to these drugs. Companies are churning out new and better versions, Mounjaro/Zepbound is a big step up from semaglutide and there are even more and better drugs in development. High prices mean should help supply issues get sorted out sooner and more weight drugs means that US insurers should be able to force drug companies to compete and lower prices over time.
Yes. Bernie Sanders is quite dumb and honeymooned in the USSR. His understanding of economics is at the /r/antiwork tier.
Cool. Why don't they just cut off all supplies to Europe and sell exclusively to the US at 20x the price.
Where can I sign up to wait in line 12 months like a German and get drugs for 95% off?
$12,000/year is immense. Americans are being uniquely screwed here.
Edit: Apologies for unnecessary antagonism. No hard feelings I really just want more posts on this frickin' forum already!
If you have a T2D diagnosis, you can get the drug for 95% off tomorrow after going through a prior authorization on most insurance (mine quotes me $30).
If you don't have T2D, the more accurate comparison is more like 340$ in germany for Wegovy (so ~400 after you adjust for purchasing power parity) and you can get a Zepbound prescription with coupon for $550, which is a much better drug: fewer side effects, higher average weight loss. That's an extra $2k a year (13 four week boxes*150) but it's hardly $12k.
I'd guess politics, these companies do have to play the long game and I'm certain that the supply is much more limited in other countries.
You'll get a better quality discussion if you present the stronger version of an argument. If that's such a dumb argument and missing context, why didn't you add that in your top level post? ಠ_ಠ
Good point. Set aside Bernie's worthless statement about Wegovy costing only $5 to make, which ignores the immense cost of research and regulatory compliance.
Let's say that Americans paid the same price for medication as Germans do. The pharma industry would no longer be profitable and drug development would slow to a crawl. Why must the entire global pharma industry be dependent on a single country with less than 5% of the world's population? How do we make Germans pay their fair share?
Because America by being willing to pay 1000 more is showing they value it at that price. And they can value it at that price because they are richer.
In theory the best pricing practice for companies is to sell their product at 100 bucks to people who will pay that, then 60 to whover will pay that and then 40 and so on, down to where the price still creates profit per unit. In practice that is tricky because fluctuating prices is something direct consumers don't like. But when selling to different countries you can set your prices depending on what the local market will bear in each one.
So the US pays more because it is richer and therefore is willing to pay more. That is the market signal the companies are following. And arguably the US is richer because it interferes in market signals less than other countries.
In that case asking about paying their fair share is looking at the question the wrong way round. How do you get Germany to be richer so that they too value the product equally is the more accurate question. And the answer would seem to be, promote more free market principles.
Of course if Germany gets richer that may have other knock on effects on the US economy. No free lunches here unfortunately.
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