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by refurb 2437 days ago
Two things:

1) The largest private insurers in the US cover more people than many single payer countries, like Canada for example. They don’t get better prices.

2) As someone who works in the drug industry, Trump is actually the first President in recent history that is freaking out the pharma companies. His “international price referencing” proposal is being taken very seriously as it would have very negative consequences.
3 comments
dhshahsndeisjwn 2437 days ago
They don't get better prices because they are operating in a system where access to key drugs is a key differentiator. Penny pinching on access drugs (as does NICE in the UK on behalf of the NHS) wouldn't be a good look for an insurance company as they pitch for your business. The only way negotiations with Pharma companies will work is is you actually refuse to pay over-inflated prices, again as-does NICE. And the only way this can be justified is to have a centrally mandated $ per unit 'utility' (aka QALY) beyond which you won't pay.

Private insurers aren't motivated to do any of this because high drug prices don't hurt their bottom line.

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refurb 2437 days ago
I agree with your first point. Having talked to a number of pharmacy directors at private insurers, there is a huge amount of pressure to cover all drugs, regardless of the price.

Insurers who say “no” (Aetna) is a good example, quickly lose customers to insurers who say “yes”.

He’ll, even Medicaid and Medicare at home flack for not having a drug on their formulary.

Very unlike other countries.

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Ididntdothis 2437 days ago
”The largest private insurers in the US cover more people than many single payer countries, like Canada for example. They don’t get better prices.”

I don’t think they really care about prices as long as they can pass them on through higher premiums.

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opless 2437 days ago
Just to add to the other comments to your reply.

Dealing with a nation's major provider is very different to insurance companies. As I said, if you try to price gouge then they governing body will take what they need as a matter of national security/public health safety.

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