U.S. lawmakers demand information on EpiPen price increase

This whole thing reminds me of an episode of House MD. Season 2, I think, where Vogler wants house to introduce a new cholesterol product. House basically gives a brochure read speech that lasts all of 10 seconds. Vogler insists house say more. So house says the new drug was merely an expensive alternative to a cheap medication to which Vogler had added nothing more than an antacid. Instead of giving Vogler's impressive speech, House explained to the audience and a stunned Vogler that they should continue to use the old cheap drug, because it was just as good.

Any fans of house knows what Im talking about.

Cliffy6745 said:

mace1229 said:

How many important drugs were only funded, tested and created because of the hopes of making millions? I don't know the answer, but I'm guessing it is at least several if not many. It sucks they get that greedy to this point, but I assume it pushes development as well. Who's going to risk tens of millions in research to just make a few hundred thousand?

Every single one. I once worked on a drug that impacted 20k people in the united states that is now well over a $500 million drug because of how important it is over the entire course of a lifetime.

Penicillin was an accident. Didn't cost anything to research, other than a lab mistake. Add that to the strange facts thread. But other than that, probably all.

Cliffy6745 said:

mace1229 said:

Cliffy6745 said:

mace1229 said:

There needs to be a balance. Without the potential of making a big profit, I bet we wouldn't have half the drugs we do. But who really needs a $19m salary?
From my experience health insurance was just as bad. My employer switched health coverage. My wife takes medication which is about 3 grand a prescription without insurance. So no way we can afford it if insurance doesn't approve. The new insurance threw us so many loop holes before they would cover it, she ended up going without it for 3 months.
Aside from the prescription, they required a doctor authorization (isn't that what a prescription is?). They gave us a number to provide to our doctor to call. We would call our insurance regularly to make sure it went through and all they would say is "it can take 2 weeks to process, so its not in the computer yet."
After the 2 weeks it changed to "no we don't have anything from your doctor. We gave you the wrong number last time, give him this number."
Another 2-3 weeks went by and same thing, but this time they said to fax it instead. Same thing, another 2-3 weeks went by before giving us a third and different number.
A few days later I called in to check on the status when I got the normal "it can take 2-3 weeks to process, so its not in our computer yet."
I unloaded on them on the phone, explaining how we kept getting the runaround and my wife and gone without her medication for 3 months now as a result, medication needed to control otherwise very debilitating arthritis, and ended the conversation with "if it isn't here tomorrow, you will be hearing from an attorney on my behalf." After than comment I was put on hold for about 30 seconds and she came back and said "it's on the way."
Ridiculous it had to come down to a threat. Our doctor said unfortunately they get that all the time, they drag their feet so they don't have to pay for expensive medication.
How do those people sleep too?

Insurance companies regularly abuse the prior authorization system, but in general, it is a very important step/requirement for consumers

I don't see the difference between prior authorization and a prescription. Isn't that essentially what a prescription is? How is it an important step, especially if it is regularly abused?

A prescription does not mean your insurance covers the product, a plan with prior authorization means the doctor needs to submit and verify with insurance that it will be covered prior to the prescription being granted. The goal of it is to ensure that doctors only prescribe drugs that are covered by a patient's insurance to minimizes costs

The abuse happens in what you saw with the insurance companies dragging the process out.

That said, it is better for the consumer to only be prescribed drugs that are approved by insurance prior to going to the pharmacist.

Then why does pre authorizations need to be done 2 or 3 times a year as the case with my wife's ambient?

That whole process is a fucking joke.

Cliffy6745 said:

mace1229 said:

Cliffy6745 said:

mace1229 said:

There needs to be a balance. Without the potential of making a big profit, I bet we wouldn't have half the drugs we do. But who really needs a $19m salary?
From my experience health insurance was just as bad. My employer switched health coverage. My wife takes medication which is about 3 grand a prescription without insurance. So no way we can afford it if insurance doesn't approve. The new insurance threw us so many loop holes before they would cover it, she ended up going without it for 3 months.
Aside from the prescription, they required a doctor authorization (isn't that what a prescription is?). They gave us a number to provide to our doctor to call. We would call our insurance regularly to make sure it went through and all they would say is "it can take 2 weeks to process, so its not in the computer yet."
After the 2 weeks it changed to "no we don't have anything from your doctor. We gave you the wrong number last time, give him this number."
Another 2-3 weeks went by and same thing, but this time they said to fax it instead. Same thing, another 2-3 weeks went by before giving us a third and different number.
A few days later I called in to check on the status when I got the normal "it can take 2-3 weeks to process, so its not in our computer yet."
I unloaded on them on the phone, explaining how we kept getting the runaround and my wife and gone without her medication for 3 months now as a result, medication needed to control otherwise very debilitating arthritis, and ended the conversation with "if it isn't here tomorrow, you will be hearing from an attorney on my behalf." After than comment I was put on hold for about 30 seconds and she came back and said "it's on the way."
Ridiculous it had to come down to a threat. Our doctor said unfortunately they get that all the time, they drag their feet so they don't have to pay for expensive medication.
How do those people sleep too?

Insurance companies regularly abuse the prior authorization system, but in general, it is a very important step/requirement for consumers

I don't see the difference between prior authorization and a prescription. Isn't that essentially what a prescription is? How is it an important step, especially if it is regularly abused?

A prescription does not mean your insurance covers the product, a plan with prior authorization means the doctor needs to submit and verify with insurance that it will be covered prior to the prescription being granted. The goal of it is to ensure that doctors only prescribe drugs that are covered by a patient's insurance to minimizes costs

The abuse happens in what you saw with the insurance companies dragging the process out.

That said, it is better for the consumer to only be prescribed drugs that are approved by insurance prior to going to the pharmacist.

That process makes sense and would be helpful. But for that to be the case wouldn't the doctor be the one needing authorization from insurance so he knows what to prescribe, not the other way around?

But it was our insurance who required it, and they already knew the medication was covered since its their own business that covers it and is listed in my medications covered. They said they would not cover it until they got confirmation from the doctor himself. And when asked, they said it was so the doctor could verify that we needed the medication (and that is what the prescription is for). Seems to me to be 100% designed to delay the delivery of medication, and nothing else.

People who are in the medical field, be it doctor, nurse, health librarian, pharmacy employee, etc. who do it because the care about others are some of our finest. People who do it simply to get rich off others misery or illness are some of the most evil.