About prescriptions...access, costs, emergency supplies

[Handlebars]

With the lockdowns and transport issues looking to be a permanent for many parts of the now not free world, there are some things to consider regarding possible emergency needs that didn't really enter into plans, before.
Meanwhile, in the much less free world, even previously, you couldn't buy tropical fish meds without a vet prescription ( e.g. UK sent out investigators to look at customer records in pet shops).
Americans were given some relief a while back by being allowed to legally buy meds from Canada - that was a major relief for the less affluent with long-term needs.

What about prescriptions do you want changed?
I want all my dog's needs met without spending $500 every time at the vet's office. I want Bayer worm meds. I want stomach meds for coating and antibiotic action to be on-hand just in case - because those problems can be lethal in 24 hrs.
I don't even want to take my pet to the vet unless necessary, just like I don't want to be in a doctors office where all the sick people go.

 

[theemartymac]

Americans were given some relief a while back by being allowed to legally buy meds from Canada - that was a major relief for the less affluent with long-term needs.

As a Canadian, I can tell you this move pissed us off more than a little. To the end that we had to place emergency parliamentary orders to limit exports to the US. We are a tiny market for pharmaceuticals, and we don't produce many here in-country. Most actually come from the US and abroad.

To use us as a discount drug center instead of fixing your own supply and pricing issues at the source (With legislation) is insulting. We price fix drugs, and take other measures to subsidize and secure the supply chain as a part of our universal healthcare system that is funded by all Canadian Taxpayers. So by default, Americans ordering drugs from Canada are benefitting from Canadian taxpayer dollars, as well as placing a massive burden on our tiny supply chain. The US is 10x our size after all.

I appreciate the potential help this can provide to US Seniors and others hampered by the exorbitant prices, but it is a manipulation of the system to your neighbors detriment, not a solution IMHO!

 

[Handlebars]

As a Canadian, I can tell you this move pissed us off more than a little. To the end that we had to place emergency parliamentary orders to limit exports to the US. We are a tiny market for pharmaceuticals, and we don't produce many here in-country. Most actually come from the US and abroad.

To use us as a discount drug center instead of fixing your own supply and pricing issues at the source (With legislation) is insulting. We price fix drugs, and take other measures to subsidize and secure the supply chain as a part of our universal healthcare system that is funded by all Canadian Taxpayers. So by default, Americans ordering drugs from Canada are benefitting from Canadian taxpayer dollars, as well as placing a massive burden on our tiny supply chain. The US is 10x our size after all.

I appreciate the potential help this can provide to US Seniors and others hampered by the exorbitant prices, but it is a manipulation of the system to your neighbors detriment, not a solution IMHO!

I'm Canadian. Americans shoulder the bigger burden in the FDA and the world runs with that. If Canada doesn't want to sell internationally, then Canada just needs to stop doing it, eh? ...and not blame the customer.

 

[Handlebars]

As a Canadian, I can tell you this move pissed us off more than a little. To the end that we had to place emergency parliamentary orders to limit exports to the US. We are a tiny market for pharmaceuticals, and we don't produce many here in-country. Most actually come from the US and abroad.

To use us as a discount drug center instead of fixing your own supply and pricing issues at the source (With legislation) is insulting. We price fix drugs, and take other measures to subsidize and secure the supply chain as a part of our universal healthcare system that is funded by all Canadian Taxpayers. So by default, Americans ordering drugs from Canada are benefitting from Canadian taxpayer dollars, as well as placing a massive burden on our tiny supply chain. The US is 10x our size after all.

I appreciate the potential help this can provide to US Seniors and others hampered by the exorbitant prices, but it is a manipulation of the system to your neighbors detriment, not a solution IMHO!

Why would Canada purposefully lose money so that pharmacies can sell to other countries on the taxpayer dime? Guess who would be to blame for cheating its taxpayers?

 

[mschwett]

With the lockdowns and transport issues looking to be a permanent for many parts of the now not free world, there are some things to consider regarding possible emergency needs that didn't really enter into plans, before.
Meanwhile, in the much less free world, even previously, you couldn't buy tropical fish meds without a vet prescription ( e.g. UK sent out investigators to look at customer records in pet shops).
Americans were given some relief a while back by being allowed to legally buy meds from Canada - that was a major relief for the less affluent with long-term needs.

What about prescriptions do you want changed?
I want all my dog's needs met without spending $500 every time at the vet's office. I want Bayer worm meds. I want stomach meds for coating and antibiotic action to be on-hand just in case - because those problems can be lethal in 24 hrs.
I don't even want to take my pet to the vet unless necessary, just like I don't want to be in a doctors office where all the sick people go.

i'm not sure what you're getting at here. obviously the situation is somewhat different in canada, but other than a few days right at the beginning of the pandemic when nobody knew what was going on and there was a broad shelter-in-place order, it's hardly been any kind of challenge to get prescription medication. there are pharmacies in every direction (cvs, walgreens, duane reed, target, etc) in most american cities and i don't recall any of them being closed. what transport issues are you referring to? transport of meds to the pharmacy or transport of people to the pharmacy? many of the pharmacies around here deliver and many insurance plans offer direct delivery of prescriptions. where's the issue!?

i take a number of medications for heart issues, including one which life would be extremely difficult without. my only concern is that the pharmas stop making it or something. the only concern i've ever really heard from anyone about medication is the cost, which is for many drugs absolutely exorbitant - but it has nothing to do with the pandemic or whatever freedom windmills you're tilting at.

i read a report which stated that a sizable fraction of the medicare premium increase in the US (like a third or something) was related to one single new alzheimers drug!

 

[mschwett]

As a Canadian, I can tell you this move pissed us off more than a little. To the end that we had to place emergency parliamentary orders to limit exports to the US. We are a tiny market for pharmaceuticals, and we don't produce many here in-country. Most actually come from the US and abroad.

To use us as a discount drug center instead of fixing your own supply and pricing issues at the source (With legislation) is insulting. We price fix drugs...

the prices set in canada for drugs do not cover the massive cost of developing them, testing them, getting them approved, etc. if that was the only model, there would be no or few new drugs. american consumers pay all those costs.

a pharma company comes up with a model which justifies the cost of the drug based on the number of sales over their 20 year exclusive period in the united states at a specific price. the canadian government sets a price limit on the drug, and the drug manufacturer sells it there anyway because they've already recouped (or planned to recoup!) the cost of the drug in the united states (or other unregulated markets) alone. if everyone adopted canada's model, there wouldn't be any new drugs, unless the PMPRB set a price that actually took into account the complete cost of the drug.

the system is f'd up on both sides of the border.

In short, drug prices in Canada are lower because the Canadian government regulates the price. In Canada, a review board decides on pricing and what they believe are reasonable or excessive prices. If they decide a drug is priced too high, they will not allow it on the drug formulary. This board, the Patented Medicine Prices Review Board, is described in Canada as a quasi-judicial agency.

Before a prescription drug can be sold in Canada it is scientifically reviewed to make certain that it can do what it is supposed to do. A committee of experts known as the Human Drug Advisory Panel will make recommendations about other valid drugs on which to make comparison, in addition to recommendations for the categorization of new drugs. The level of therapeutic improvement of an existing patented drug is used to determine a ceiling price, known as the Maximum Average Potential Price, at its introduction.

U.S. Prices Set by Industry

The U.S. government is prohibited by law from negotiating prices for Medicare and other government programs. “Obviously, the drug company needs to recoup the cost of research, manufacture, advertising and the cost of getting the drug approved by the FDA,” Dr. Goldstein told his listeners. “The people in this country essentially pay for all of this work as countries like Canada do not allow their citizens to share the cost.” New drugs are issued a patent giving the drug company a monopoly on sale of the drug for 20 years. The drug company is free to set whatever price it likes for prescription drugs. Prices are then negotiated between insurance companies and the manufacturers.

Needed Drug Price Reforms

The U.S. and Canadian systems each present two very different models for drug pricing, neither of which is reasonable. The Canadian system does not allow enough incentive for new drugs to be created. The American system results in unaffordable prices. “There are several needed reforms,” Dr. Goldstein said. “We are not able to flip a switch and adopt the prices charged in Canada, though that would be nice.”

 

[Handlebars]

i'm not sure what you're getting at here. obviously the situation is somewhat different in canada, but other than a few days right at the beginning of the pandemic when nobody knew what was going on and there was a broad shelter-in-place order, it's hardly been any kind of challenge to get prescription medication. there are pharmacies in every direction (cvs, walgreens, duane reed, target, etc) in most american cities and i don't recall any of them being closed. what transport issues are you referring to? transport of meds to the pharmacy or transport of people to the pharmacy? many of the pharmacies around here deliver and many insurance plans offer direct delivery of prescriptions. where's the issue!?

I think these are not ordinary or normal times and that supplies may be interrupted.

 

[PDoz]

I want all my dog's needs met without spending $500 every time at the vet's office. I want Bayer worm meds. I want stomach meds for coating and antibiotic action to be on-hand just in case - because those problems can be lethal in 24 hrs.
I don't even want to take my pet to the vet unless necessary, just like I don't want to be in a doctors office where all the sick people go.

I'd prefer to not live in a world where antibiotics / anti parasitics can be randomly administered to animals without suitably qualified clinicians ensuring they are appropriate. MULTI-RESISTANT infection comes to mind....

If you think $500 is an excessive vet bill, then talk to the vet? Don't want to visit, then perhaps develop a mutually trusting relationship with your vet so they are comfortable dispensing without a visit? But that might involve only using those medications on the dog......or at least the vet being sure they aren't likely to get dragged in front of the court when you ingest ivermectin.

For what it's worth, my recent Aus vet bill was the equivalent to $1100 us. That got me $25 of antibiotics, but also anesthetic , surgical, histopathology , and xry fees, lots of vet time and a full day in recovery. I consider that a fair price to remove / diagnose an aggressive cancer, treat the infected amputation site with appropriate antibiotics, deal with the liver toxicity caused by those antibiotics, and sit down to a difficult discussion about the biopsy sample going missing ( poor vet) , then another sit down discussion about treatment / further investigation options - I expect the poor vet had spent hour researching treatment options, she almost looked relieved when I suggested we just do an xry and if there are mets accept the inevitable.

 

[Handlebars]

Following that line of thought, illiterate villagers in Africa should be denied receiving medicines to self administer against river blindness

I'd prefer to not live in a world where antibiotics / anti parasitics can be randomly administered to animals without suitably qualified clinicians ensuring they are appropriate. MULTI-RESISTANT infection comes to mind....

 

[PDoz]

Following that line of thought, illiterate villagers in Africa should be denied receiving medicines to self administer against river blindness

You have a strange way of navigating.

Remember the fork in the road where the cost of appropriately qualified supervision was discussed? Go back and think again.

 

[Handlebars]

You have a strange way of navigating.

Remember the fork in the road where the cost of appropriately qualified supervision was discussed? Go back and think again.

I think your objection could be considered to be nebulous, really - to be kind.

 

[Handlebars]

I'd prefer to not live in a world where antibiotics / anti parasitics can be randomly administered to animals without suitably qualified clinicians ensuring they are appropriate. MULTI-RESISTANT infection comes to mind....

If you think $500 is an excessive vet bill, then talk to the vet? Don't want to visit, then perhaps develop a mutually trusting relationship with your vet so they are comfortable dispensing without a visit? But that might involve only using those medications on the dog......or at least the vet being sure they aren't likely to get dragged in front of the court when you ingest ivermectin.

For what it's worth, my recent Aus vet bill was the equivalent to $1100 us. That got me $25 of antibiotics, but also anesthetic , surgical, histopathology , and xry fees, lots of vet time and a full day in recovery. I consider that a fair price to remove / diagnose an aggressive cancer, treat the infected amputation site with appropriate antibiotics, deal with the liver toxicity caused by those antibiotics, and sit down to a difficult discussion about the biopsy sample going missing ( poor vet) , then another sit down discussion about treatment / further investigation options - I expect the poor vet had spent hour researching treatment options, she almost looked relieved when I suggested we just do an xry and if there are mets accept the inevitable.

Following that line of thought, illiterate villagers in Africa should be denied receiving medicines to self administer against river blindness

PDoz said:


You have a strange way of navigating.

Remember the fork in the road where the cost of appropriately qualified supervision was discussed? Go back and think again.

Wasn't the first statement that you made what I first queried?

PDoz said:


I'd prefer to not live in a world where antibiotics / anti parasitics can be randomly administered to animals without suitably qualified clinicians ensuring they are appropriate. MULTI-RESISTANT infection comes to mind....