Talk:Prescription drug prices in the United States

message: Clearly only one point of view is reasonably expressed in this article.  Perhaps someone familiar with the pharmaceutical/medical community's point of view can provide balance.—The preceding unsigned comment was added by Deli nk (talk • contribs) 13:27, 17 January 2006 (UTC)
replies: text: Err, it appears to me that *only* the pharmaceutical point of view is presented.  For instance, the article bemoans that only 11% of drugs make it past clinical trials, but it fails to mention that the vast majority of most drug companies' money (I believe it is around 2/3, though I do not have a source handy) is spent on advertising instead of R&D. Lode Runner 13:17, 29 August 2006 (UTC)
replies: text: Leaving beside the political isses, I would be interested in someone explaining how drug prices are negotiated between drug companies, distributors, pharmacy chains, insurance companies, medicare, medicaide etc.  I understand it's quite a complicated process.  The net result is that the price for the same drug can vary by 2X depending upon a number of factors.--Nowa 22:54, 2 January 2007 (UTC)

text: Where is the opinion of the blue collared worker. This article looks like it was written by a doctor who is just trying to cover up what makes him richer.—Preceding unsigned comment added by Phiten14 (talk • contribs) 10:35, 12 November 2009
I would like to add another theory of why costs of pharmaceuticals might remain unusually high in a given market.  Would it be reasonable to include a discussion of prescription drugs as an example of a natural/technical monopoly?
Theophan (talk) 16:37, 1 July 2008 (UTC)

text: What??? You are trying to sell us "all new drugs worldwide are developed in the US" which is frankly a lie. People worldwide will benefit from high prices in the US? LOL ... what did you smoke, guy? --84.141.34.227 (talk) 21:41, 23 August 2009 (UTC)
replies: text: Although the United States is only 5% of the world's population, it accounts for 36% of worldwide research and development of pharmaceutical drugs. Source. Grundle2600 (talk) 19:19, 17 March 2010 (UTC)
thread_title: Comment

message: Hello, I noticed while reading this that the link for source 9 is not up to date, however, I could not figure out how to insert the updated link.  Sorry, I have limited knowledge of HTML :)
Anyways, here is the proper link for CUNY page source 9: http://archive.psc-cuny.org/drugprices.htm
(----)  — Preceding unsigned comment added by Kassgeminid (talk • contribs) 20:23, 13 September 2012 (UTC)
thread_title:  Link not updated 

message: The "prescription costs" article was forking content about prescription costs in the United States. I cut that content and am pasting it here. On that article, I replaced this text with the lead of this article. People should come to this article if they want to read the long story.
In the period 1994–2004 prescription costs were the most rapidly increasing cost of health care in the United States.  These increases, which averaged 12% during some years, are accounted for by increases in the number of drugs per person (treatment intensification), increases in the cost of a "market-basket" of drugs (price inflation), and increases in the use of newer drugs over older, less costly, alternatives.Prescription Drug Costs: Background Brief – KaiserEDU.org, Health Policy Education from the Henry J. Kaiser Family Foundation. Kaiseredu.org. Retrieved on 23 April 2011. Overall, experts estimate that treatment intensification increased by 68% and price inflation increased by 8.3% between 1994 and 2004.
A substantial body of evidence has documented the association between high out-of-pocket costs and many types of economic and non-economic hardship.  Between 20%–30% of patients in the United States report having skipped or stretched a prescription medicine during the previous 12 months because of the cost.  Other patients report cutting back on payments for their utilities or food in order to afford their prescription medicines. In 2011 and 2012, approximately 2% of individuals reported purchasing prescription drugs from another country to save money. A predictive index has been developed that differentiates individual risk of importing prescription drugs for personal use, thus potentially allowing policymakers to target resource-efficient interventions that minimize the potential risks of importation and improve access to affordable prescription medicines. 
Patients may be embarrassed to raise their concerns about the cost of drugs, concerned that doing so may compromise their quality of care, or under the impression that there is nothing that their health care provider can do to help.  Providers may also be embarrassed discussing costs, and feel too much time pressure to discuss these costs with patients.
 Blue Rasberry (talk) 15:56, 7 March 2017 (UTC)
thread_title:  content from "prescription costs" 

message: We are students from the University of California, San Francisco (School of Pharmacy) enrolled in a Health Policy class. We were assigned to work on a Wikipedia editing project. We have chosen this page to contribute new content. Specifically, we are planning on adding more contents to the following sections: 
Thanh: Discounts + Generic sub-sections
My goal is to improve on the section with more strategies for patients to get discounts for prescription drugs and expand on the different programs available for discount. In the generic sub-section, I plan to expand on the drug approval process for generics v. brand to compare/contrast generics v. brand. I will continue to update with more details on the edits within this upcoming week. 
Angela: Canada Model + Healthcare provider sub-sections
This section is relatively short and vague. I want to expand this section by going a little more in depth about newly approved US policies and how it might change the way the US controls our drug pricing. I plan to write about P&T Committees at hospitals and giving formulary and drug cost information to providers and impact on medication cost and use (healthcare providers section). I will touch on how the US covering drugs for military personnel in more details through the TRICARE program. For Canada section, I will add details in Canadian policy that make drug prices cheaper.
Adam: Policy-makers - TBD on details of edits. 
Jayson: Value-based prices
I want to elaborate on the immediate and long term change to drug pricing with regards to the increased life expectancy. More details to come!
We are open to suggestions from the community on how we can best improve this page. Thank you!  — Preceding unsigned comment added by Thanhtu92 (talk • contribs) 06:54, 18 October 2017 (UTC)
thread_title: Student edits Oct 2017

message: With respect to group 9 reflecting a neutral point of view in their edits, I felt that they did an excellent job of staying neutral. Since the topic of their article is "Prescription drug prices in the United States" it could have been difficult to keep this neutral perspective given the controversial nature of the topic, but I felt that group 9 provided a lot of information regarding drug pricing in the United States while being unbiased. For example, the section on New Legislation provides information regarding Senate Bill 17, detailing the focus of the bill and purpose of the bill. This provides excellent information regarding new laws being passed regarding prescription drug prices in the United States. I also thought it was great that they expanded on  Canada's model on drug pricing, while again remaining neutral and unbiased as to whether that model was superior or not compared to the United States. As someone who wants information regarding United States drug pricing, this section on Canada provides a nice contrast to the United State's model, with information to make comparisons but neutrality in tact. My one suggestion would be to remove words and phrases such as "Fortunately" and "complicated picture"in the Discounts section of the article, as these may suggest some favoritism/bias. But other than those phrases, I thought the article remained informational and provided a lot of detail and context regarding drug prices in the United States and the reason for their variance.Vchopra86 (talk) 02:32, 8 November 2017 (UTC)
replies: text: Thank you for your feedback. I've edited out the words that may suggest bias in my edits (ie. deleting "fortunately" and "complicated picture"). Furthermore, I made minor edits to the "Discount" section for more clarity. I went back to make sure the lead sentence of this section has a clear purpose.Thanhtu92 (talk) 18:56, 9 November 2017 (UTC)

text: I appreciate the detailed feedback on the healthcare provider/Canada section that I edited. I have provided the FINAL edit for the Canada/health providers section. I found mild bias (that I eliminated), fixed sentence structure and paragraph organization. Angelalee102 (talk) 09:49, 15 November 2017 (UTC)

text: Repsonse to Peer Edit: Thank you for your feedback! I corrected the grammar along with adding sources in the New Legislation section Aarz1111 (talk) 17:25, 30 November 2017 (UTC)

text: Response to Peer Edit: Thank you for the feedback! I corrected and elaborated on my thoughts in the last sentence of the value based prices section.Jydeguzm (talk) 09:22, 15 November 2017 (UTC)

text: Response to Peer Edit: Thank you for your feedback. I went ahead and made the edits suggested (removed unnecessary quotations, revised the fragment sentence and added 1 citation). Your feedbacks are greatly appreciated! Thanhtu92 (talk) 18:51, 9 November 2017 (UTC)

text: Thank you for the detailed review of our sources- my group will ensure all statements that supported by a source in our final review.Angelalee102 (talk) 19:54, 9 November 2017 (UTC)
thread_title:  Peer Review Edits 

message: The leading section is relatively short and not detailed.  The authors sections vary greatly in length. Sections such as “Drug Rebates” are only three short sentences, while other sections are relatively longer. Th article can benefit from more detailed information and expansion in most sections. ChiaO (talk) 16:06, 22 January 2018 (UTC)
replies: text: You say that the author's sections vary in length. Did you know that you are the author and that you can edit Wikipedia? We do not have any staff standing by to edit the articles. If you think of a way to improve something then please edit.  Blue Rasberry (talk) 17:10, 22 January 2018 (UTC)
thread_title:  Are there viewpoints that are overrepresented, or underrepresented? 

message: Edited to add a few citations
The entire "Solutions" section is filled with misleading or inaccurate statements. I won't provide a full catalog, but here are a few:
(1) "The high cost of upfront research that the brand-name products have to go through to ensure safety and efficacy largely account for the high discrepancy in pricing between the two groups."
This is misleading. The proximate explanation for the high-cost of (patented) brand-name drugs is market exclusivity, not the cost of research and development. If the cost of research were a significant factor in drug pricing, then the price should be low for off-patent drugs being sold by companies that did not develop them. But the price for such off-patent drugs is often very high when the company has an effective monopoly (e.g. Turing pharmaceuticals, which did not pay for the research and development of Daraprim). Pharmaceutical companies set prices with the aim of maximizing profits, not with the aim of recouping R&D costs. And when a company possesses a monopoly, profits are often maximized by setting a high asking price -- whether or not the company paid the R&D costs for the drug in question.
* "pharmaceutical firms can be expected to charge different profit-maximizing prices in different markets. That is, given the low cost of production and absence of trade, the profit-maximizing price will vary across countries because the patent holder will charge a price that reflects the demand factors in each market."
Pharmaceutical Price Controls in OECD Countries, US Dept. of Commerce, 2004, p. 16. <https://2016.trade.gov/td/health/DrugPricingStudy.pdf>
The high cost of research is an explanation of the high cost of (patented) brand-name drugs only in the sense that: (1) the high cost of a patented drug is possible because of market exclusivity, and (2) market exclusivity is granted in order to incentivize costly research and development.
* "the high cost of developing and testing a new drug means that no profit-maximizing firm would make the investment needed to bring new and innovative medicines to the market in the absence of patent protection. To overcome this obstacle, countries offer patent protection as a reward for innovation by conferring the right to use of the resulting chemical compound for a specific period of time. Such patent protection affords innovative pharmaceutical manufacturers significant pricing power."
Ibid., p. 15.
(2) "Quality-Adjusted Life Years (QALY) is a cost-effective measure that determines the value of a drug in terms of the quality of life achieved after taking a prescription drug, rather than the number of years the medication extends a patient's life."
When QALYs are used to make decisions about the allocation of resources, the number of years that an intervention extends life is taken into account, contrary to the claim just quoted -- and as the article itself acknowledges later in the same paragraph ("QALY ... takes into account both the quality and quantity of life lived by an individual").
(3) "However, QALY is subjective ... The subjectiveness of QALY is apparent on a case by case basis as it takes into account both the quality and quantity of life lived by an individual, with quality of life being the primary subjective factor."
This is misleading, as QALYs are calculated neither on a "case by case basis" nor on the basis of the subjective preferences of the patient. Rather, a weight between 0 and 1 is associated with each of a large number of health states, and the same weight is applied to all individuals in that health state.
(4) "Prescribing combination drugs instead of two separate medications can also potentially reduce monthly copays."
This is literally the opposite of what the cited source says on the issue: 
'A manufacturer attempts to “evergreen” a product when it applies for patent and market exclusivity
protections for a “new” product that is essentially the same as the original product, such
as extended release formulations or combination therapies that simply combine two
existing drugs into one pill. What generally happens is that, while the older version of the
drug is no longer patent-protected and, therefore, generic alternatives may be offered,
drug manufacturers promote the newer version as the “latest and greatest.'
<https://web.archive.org/web/20170608154237/http://www.aha.org/content/16/aha-drug-policy-recommendations.pdf>
The combination drug is more expensive in this case, not less, because it is under patent.
This section badly needs the attention of an expert. Unfortunately I don't have the time to correct all the problems, or to dig up whatever citations Wikipedia would require for the claims I've made above (though they should be familiar to anyone who works in this area).
24.228.255.49 (talk) 22:38, 13 April 2019 (UTC)
thread_title:  "Solutions" section 

message: Group Members: Hanna Y., Danielle P., Christine H., Melanie Z.
We propose to add the following section: “Effects of Drug Prices on Consumers” . A similar section exists in the Wikipedia Article “Prescription Costs”, and we believe that a similar section in this article could address the unique problems faced by patients in the United States. 
Our edits include a discussion about the majority of bankruptcies resulting from patients unable to pay their medical bills, which include increasing prescription costs in the US, and provide statistics and data regarding the rate of medical bankruptcies in the United States compared to similar western countries.
Furthermore, we also would like to point out the dichotomy between two concerning trends in US healthcare: increasing prescription prices and decreasing health outcomes. The decrease in outcomes can be related directly to the increasing prescription prices, as patient adherence highly depends on accessibility to expensive medications. 
Frequent negative impacts that consumers experience from high drug prices include difficulties finding alternative yet affordable medications, medication non-adherence, inaccurate price forecasts due to unexplained fluctuations, and increased government scrutiny on manufacturers.  — Preceding unsigned comment added by HannaYakubi (talk • contribs) 00:59, 17 October 2019 (UTC)
thread_title:  CP133 2019 Group 4 

message: Carmen:
1. I believe that group 4 improved the article significantly as described in the “guiding framework” many very important and relevant additions. In particular, I think the added section on the epinephrine price spike gave a great, albeit very important example of an event that reflected the state of United States prescription drug prices. This addition references a very important piece of news that provides relevant context for the state of prescription drug prices. The tone in this paragraph was also very neutral and gave a good amount of detail to give context. I also appreciated the addition of the sentence where the Orphan Drug Act was passed in 1983 to again provide important context amidst an entire paragraph gong over orphan drugs in the United States. I did notice a typo in the same paragraph with the word “successfull” in that following sentence, so I would recommend someone to initiate an edit for that. 
2. Group 4’s overall edits did a good job in reflecting a neutral tone while displaying additional important facts. The language focuses on delivering facts rather than personal opinions. There was no expression of approval or disapproval of high prescription drug prices. Relevant and neutral statistics, policy information, epinephrine background, and additional facts were added. Cleung160 (talk) 19:18, 6 November 2019 (UTC)
thread_title:  CP 133 2019 Group 3 Peer Edits 

message: *https://www.npr.org/sections/health-shots/2019/12/31/792617538/a-decade-marked-by-outrage-over-drug-prices
Looks useful. --Hipal/Ronz (talk) 18:46, 28 February 2020 (UTC)
thread_title:  Potential ref - NPR "A Decade Marked By Outrage Over Drug Prices" 

message: — Assignment last updated by ChrisMisu (talk) 16:15, 17 October 2023 (UTC)
thread_title: Wiki Education assignment: Research Process and Methodology - FA23 - Sect 202 - Thu