I have been meaning to write this article for several weeks but the drug Cipro and its family of Quinolones have stolen the show and importance. But now that we know how dangerous they are and hopefully everyone is aware enough to not allow it to be prescribed to them (there are many safer alternatives!), maybe now it is time to show you the real bad, the evil, and all the sins pharmaceuticals do when it comes to their brand name drugs.
Some of you may have watched 60-Minutes Sunday night on CBS a couple of weekends ago but probably not everyone. I would like to take you to a segment of that 60-Minutes, and discuss that a little bit.
http://www.cbsnews.com/news/the-cost-of-cancer-drugs/
In short, we all know that drugs are very expensive and that those of us with medical insurance pay only a deductible. We also know that seniors on Medicare also just pay a deductible—usually 20% according to this video. There is nothing new or interesting about this until you listen to the rest of the story.
The first thing that I think most of us had no idea of is that Medicare or the insurance companies are not allowed to negotiate prices by law. They must pay whatever they are charged. This also explains (to me anyway) why hospitals and healthcare centers have such insane prices where a single headache medicine may be charged at $50. I now understand that the $50 is the cost to Medicare or the insurance company even if I can get the same drug in the drugstore over the counter for $1. So the first problem we are facing is Medicare and the insurance companies and their inability of negotiating a lower price. Note to self: investigate who the heck came up with this idea?!
The second problem we are facing of course is that in the US we pay much more for the same drugs than other countries pay and that comes down to the fact that the government in other countries can negotiate with pharmaceutical companies but in the US the government cannot. Note to self: Why can other governments negotiate and not the one that approved the drugs the first place?! Whose idea was that?
The third problem comes down to illegal activity actually. It appears to be legal but I am questioning that–it is certainly unethical and while ethics and law are typically not good friends, in this case I am questioning the legality of the practice. On the 60-Minutes segment you hear that the pharmaceutical company Sanofi came out with a cancer drug (colon cancer) called Zaltrap that they originally charged the doctors, insurance, and patients for $11,000 per month. An older drug called Avastin for the same cancer, working exactly the same miracle the same way, only reducing (possibly) the life expectancy after treatment by 42 days relative to Zaltrap, cost only $5,000. So this one particular hospital decided to not carry the new drug; it was too expensive and did not provide better outcome than the old (except for the 42 days of additional extended life) and had more toxic side effects as well. The hospital doctors published their opinion in The New York Times which then amazingly turned Sanofi around and said: OK doctor, I will sell you the drug for $5,000 provided you charge the insurance company and the patient $11,000. We will send you dear doctor a check for $6,000. This is an amazingly lucrative business! I suppose for unethical cancer doctors this is a lottery win equivalent.
The doctors also receive what is called “commission” of 6% when they prescribe a particular drug. I finally understand why a private doctor’s office is usually full of free samples!
I finally also understand why a family doctor of a relative of mine kept on switching the drug from the generic cholesterol pill Simvastatin, which was cheap and worked great without liver issues, to Lipitor, which did not work, cost a lot of money to Medicare, and caused a lot of liver issues. Every time I went to pick up a refill for Simvastatin for my relative, a bottle of Lipitor was waiting for me instead! I never accepted the change for health reasons of that family member but now I finally understand the cause! That family doctor was receiving 6% each time he prescribed the brand name Lipitor but nothing when he prescribed the generic Simvastatin so his unethical choice was to switch the prescription every time!
I bet it is happening to many people only they are not as vigilant about checking what they are getting and why, as I am. I called this doctor and gave him my opinion… no need to repeat it… you know what I said. I am glad I fired him and switched my relative to another family doctor.
It is good to know that the medicine we pay $1,000 for in the US is available to other countries for $300 or less. Apparently their governments can negotiate and refuse if they do not like the prices. But our government, Medicare, insurance companies, and the ill are powerless!
Can anyone please explain why the US Government, Medicare and the insurance companies cannot negotiate? Will the people responsible for this craziness please this stand up and show your faces? I bet they won’t dare!
Your comments are welcome as always!
Angela
Clueless Doctors & Scientists 
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You are so right when you say there are many doctors who should not be doctors at all…
I was a healthy 58 year old who rarely went to doctors and rarely took any type of drug. I (24) pack of paracetamol lasted me a year, and after a group of unscrupulous doctors tricked me into a totally unnecessary radical hysterectomy, harming me irreparably and now I have to take pain killers all the time…
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I am so sorry to hear June! What on earth did they do to you? Very sorry to hear. 😦 Hope you can recover from your pain in time! ❤
Angela
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My default position in regards to the drug companies ,as well as some doctors, is that of suspicion. The question I have (concerning the info you shared ) is if there is actual evidence of this 6% kickback, or is it a theory ? My son is currently under a doctors care for Lymes treatment and was told by the doctor that he also has another disease he contracted from a tick bite. The antibiotics for the ( other ) disease cost ? $1200.00 for a 21 day supply !
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Hi Steven,
Your question is very valid. The 6% is not a rumor at all though things may have changed now that we have the “open database” that released all payments received by doctors from all pharmaceuticals for the years 2013, 2014, and 2015–perhaps the 2016 data will be completed soon and uploaded. When you type in your doctor’s name, just type the last name (they often modify how they enter the first name so they cannot be found), and the state! Not even the city or zip. It will find many doctors with that name so click on yours. When you find your doctor, click on his/her name. A new screen will appear with the name, the amount and also the number of transactions. I am trying to include a screen capture of a doctor I “used to know” but no longer, obviously. The picture insert didn’t work but here is the picture. And this doctor is small change compared to some who I found receiving hundreds of thousands of dollars. I even found some that earn millions. This is not fake data but provided to us by our own government–something good our tax money is going towards.
It may not be 6% that they receive–that is something the pharma rep said and she probably knows better. The database just shows to totals and the number of transactions. They changed the database a bit since last year you could see what the transactions were! Now you cannot but you can download the entire data-set and that may help you find the answer in full. Visit here and click on “Download Data”. It saves it is MS Excel .cvs format.
Best,
Angela
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I’m going to go out on a limb here, Angela, and say that the root problem isn’t who can and cannot negotiate drug prices with big pharma. Rather, the root problem IS big pharma, their deceptive practices, and their choke-hold on the public at large. They inflate the statistics regarding the cost of research & development; they lie about the number and results of clinical trials implemented and instead use the public as guinea pigs; they reap billions per year and stash it offshore to avoid paying taxes; and the list goes on. Pharmaceutical companies have to be reined in, criminally charged, and brought to justice. They’re monopolies and need to be broken up, just like the big banks and so many other big corporations. Passing legislation to allow insurance companies to negotiate with them is band aid treatment and won’t stop their heinous practices.
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Thanks Tina for “going out on the limb” becuase I think you are completely correct! I know very little of their practices of course but I agree with everything you wrote! ❤
Angela
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I do not understand the 6 percent per prescription written and filled by an independent pharmacy or do you mean when the prescription is filled by doctor in his office?
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The 6% commission goes to the doctor for prescribing the medicine regardless where the prescription is filled. The sales representative from the pharmaceutical company receives a commission based on which pharmacy filled the prescription. Everyone gets paid off but the 6% goes to the doctors. This has changed by the open payment database because many doctors so took advantage of this that when the open payments database first opened, their red faces changes their tactic and now the payments are hidden under “lunches”, “meals”, “dinners”, “education”, “research”, “travel” you name it… the pharmaceuticals are very creative these days.
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A truly thought provoking post, Angela–and many thanks for the clip.
It is a most frightening situation we find ourselves in as consumers, and an even more frightening situation if we are consumers who are ill and must rely upon those we put our trust into when urgency doesn’t allow us the opportunity to research what’s best for ourselves or the family members we’re in charge of.
I fear we’re in for much more of the same, at least for the foreseeable future. That almighty dollar is surely one difficult piece of paper to push aside.
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Indeed! Money talks in more ways than one! I think we can change it for each one of us! When the doctor kept on changing my mom’s prescription from Simvastatin to Lipitor I refused every time and the drugstore had to call for permission to switch it back. I finally called the doctor and gave him hell. I just calculated. The average Lipitor price without insurance for a one-month supply is about $200 so that is what Medicare or the insurance company gets charged. Since it is a brand name, the doctor gets 6% kickback on that, which is $12. If he does this with this one drug alone with 100 of his patients, that is $1,200 a month extra income! And that is on one drug! Imagine the amount of money they can take home on such kickbacks! I bet it is more per month than their salaries! Shame on the pharmaceutical industry for the kickback! Shame on our government for letting this happen!
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“Can anyone please explain………” From what I know, a guy going by the name of Tommy Thompson, a former governor of Wisconsin, and G.W. Bush’s secretary of health and human services, orchestrated this magnificent law.
Um…… free market anyone? 😛
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Grrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
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Some doctors are doing similar things to people who do NOT even have cancer. Those doctors make up excuses to give very dangerous cancer drugs to people who do not have cancer. They get it for one price then charge the patients huge prices for it. So they can easily make lots of money. There have been some articles about that. A doctor here was convicted of it several yrs ago and there is a law firm currently looking into this very serious problem.
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That is an amazingly scary information! There are many doctors who should not be doctors at all. I too have heard of horror stories and seen some before on 60-Minutes. It is time we put our heads together and try to force a change.
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