13 June 2021
Home » US Medical Reform: discounts on drugs for low-income Americans & the end of middlemen kickbacks

US Medical Reform: discounts on drugs for low-income Americans & the end of middlemen kickbacks

President #Trump signed a series of #executiveorders on July 24, which will significantly lower the prices of prescription drugs, such as, but not limited to lifesaving #insulin and #epinephrine (allergy-countering pill). This bill is aimed at easing the struggle of the poorest part of the #American population, who are not covered by any kind of a corporate medical insurance or federal programs such as #Medicare and #Medicaid. The cost of a single vial for #diabetes not covered by insurance oscillate around $250, which corresponds to spendings of $500+ per month; the full price of epinephrine is over $600 per kit.

But the situation of the beneficiaries of the Medicare programs hasn’t been much better. The generic drug prices rose by 47% between 2010 and 2015, from $175 to $257 and that topped the bare insurance policy cost. Many recipients ended up with a high debt caused by medical bills and insurance premiums, one example being $15,000.

President explained, that the way Federally Qualified Health Centers (FQHC) currently operate created a situation, where they diverted huge discounts (up to 50%!) on #medicines obtained from drug companies, from the original intended recipients, i.e. patients, to themselves. Health plan sponsors and pharmacy benefit managers (PBMs) or #middlemen, as Trump simply called them, were enabled by the rulings of previous administrations, and fortified themselves further by introducing very detailed reform-proof regulations. In consequence, some lawmakers tried passing new laws for over 25 years, and still wouldn’t see them being implemented. Meantime, the PBMs were profiting of off the rigged meds distribution system and collecting large sums of money from patients – the People, whom they swore to serve. Understandably, the sole work of the middleman is to make profit, and they don’t contribute at any step of the production or the distribution process. On top, certain legislations banned pharmacists from advising patients on the most competitive drugs and drug alternatives prices!

#POTUS pointed out the corrupt behavior of those state entities and called the income, acquired from the pharmacy shoppers under the aegis of the long-enforced laws, a #bribe:

“These rebates are the functional equivalent of #kickbacks, and erode savings that could otherwise go to the Medicare patients taking those drugs. Yet currently, Federal regulations create a safe harbor for such discounts and preclude treating them as kickbacks under the law.”

Trump announced an end to this corrupt behavior and signed an order that will prevent such unlawful deals from taking place in the future. From now on, all the discounts negotiated by the middlemen will benefit the patients. The Medicare recipients will be able to purchase insulin for up to $35 per month; and the prices for uninsured and those with high unmet deductible will be lowered to the level of the pricing for middlemen. More low cost health insurance plans are being introduced simultaneously.

Another issue taken on the agenda was the inability of the US to negotiate the drug prices for purchase from foreign manufacturers. Americans were restricted by #Congress in these regards; it was actually made #illegal!

The cost of producing drugs is extremely high due to long approval awaiting time etc. The brokers and intermediaries bulge the prices even higher; and those eventually break an average Joe. POTUS’ executive order will allow the import of the same medicines, but at a cheaper price from #Canada and other countries and make it available to American patients for the value lower by 30% – 90%. This is the amount paid by other more or less developed countries. The reason the US paid such high costs until now was the fact that it was obligated to pay the FULL production cost, including the research and development. The other developed nations not only weren’t contributing their fair share; on the contrary – they were reaping the benefits by distributing cheap drugs, paid from the pocket of an American taxpayer, among their population. Trump tagged it as “global freeloading on the backs of American patients and American seniors” perpetrated by countries like Canada and #Germany and explained that “the U.S. taxpayers are effectively subsidizing the #socialist healthcare systems of foreign #welfare states and many other countries. We will end that abuse and restore the principles of free enterprise (…)”.

The last order signed is called “favor nations” (I don’t think I have to explain, that the name is purely sarcastic!) and it is being postponed until August 24, as the courtesy toward #pharmaceutical companies, which are given a chance to offer some significant drops for medicines costs. If they don’t show any initiative, the US will automatically enact the above law and start paying the amount equal to any other economically advanced country.

Trump also reminded about the #RightToTry bill which is underway, and which makes possible for #terminallyillpeople to try a drug that hasn’t been approved for their specific condition yet (it takes about 3 years under current regulations to fulfill the safety standards for testing), but show a promise of being effective, because it has already been authorized for use for corresponding diseases. The #BigPharma was not in favor of this one, even though the alternative for the patient was death, and thus had been successfully blocking it… for 42 years. #Hydroxychloroquine aka #HCQ has been proposed by the #TrumpAdministration as a treatment for #coronavirus, and it comes as a set with #Zinc and #Azithromycin (#Zithromax or #ZPak); another drug highly praised by POTUS as an effective #covid cure and included in the Right To Try program is #Remdesivir.

The president and this team have worked on medical reform from the beginning of their tenure. As a result, in 2018 Medicare premiums for prescription drugs have been cut by $1.9 billion, and lowering the cost of generic drug prices reduced the #medicalexpenses of the #USpatients by $26 billion.

Source:

https://www.whitehouse.gov/presidential-actions/executive-order-access-affordable-life-saving-medications/

https://www.whitehouse.gov/articles/congress-didnt-act-on-prescription-drug-prices-so-president-trump-did/

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