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If We Take Away The Drug Companies' Government FREE LUNCH, THE SKY WILL BE FALLING! Part 3 Of 4

1/22/2020

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 Let's set the stage by first establishing the logic behind not negotiating Medicare Drug prices.  The first is this will limit the development of new drugs because the drug companies will develop fewer drugs.  The other is that we will not have access to many of the current drugs for cancer which are currently available in the US but not in Europe or other countries.  Some very good arguments if they were at all credible.  But I would argue it is nothing more than Bogus Spin by Drug Companies and their lobbyists. The Drug Industries' efforts to  Pettifog the Public!  I will talk about each of these points in detail. 

Before I begin the analysis of these arguments, I  believe they all are in fact mute.  If our government was a government which represented the people, one would think that if 9 out of 10 members of the public believe we should negotiate Medicare D prices, how on earth could  it not be law NOW? Something is very wrong with our democracy, when just 10% of the people can DICTATE policy! 

With all of this doom and gloom you would think the Medicare Part D was the vast amount of the global drug spending.  However, in 2017 Medicare Part D spending was just $154.9 Billion of the total worldwide spending of $1135.0 Billion.  This is 13.6% of the world spending.  The Congressional  Budget Office(CBO)  projects a savings of $49 billion per year and at the average after tax profits of Pharma at 14%,  the impact on the bottom line of the international drug industry would be $6.9 Billion or just 6/10 or 1% if I were to provide a liberal estimate of the impact to pharma.  Let's just say, because we do not negotiate price the profit on Medicare is 3 times greater than the industry average or at 42%,  then the impact would be just 1.8%.  Someone seems to be trying to make a MOUNTAIN out of a molehill.  The source of much of this information can be seen if you CLICK HERE!  The CBO also estimates that the loss in revenue for drug manufacturers would lead to 8 to 15 fewer drugs coming to market over the next 10 years of the approximately 300 drugs expected to be approved during this period.  To me drug companies will continue to do what they have always done to improve profits and that is to JUST RAISE PRICE. With drug increases of over 10% each year for 5 years and 2017 at 8.4%, any impact of lost profits would be offset by just one year of price increases.

The final point on the suggestion negotiating price will limit the development of new drugs.   If you can make profits and your bonus by just raising the price of your existing drugs, why go though the heavy lifting to develop new drugs.  If we take away this FREE LUNCH, major drug companies will have a greater incentive to develop new drugs to achieve improved profits.  In addition, big pharma will more likely look to the small biotech companies who are a major incubator of drug development and help them to bring great ideas to the clinic.   The process used to be these small inventive companies would develop ideas conceived at Universities, the NCI,, Teaching Hospitals and Labs, bring them to a level of development and then be taken over or funded by large pharma which had the financial might to spend the $2.5 Billion to get these drugs to market.  This process has been disrupted when all you have to do is raise price to make bonus.  The inventive, small biotech companies now are starved for funding, and are seen as easy targets for destructive stock manipulation, which can and does bankrupt these small vulnerable agents of invention.

The last argument is just preposterous! The US will not have fewer cancer drugs with Medicare drug price negotiation.  New drugs are patented so drug companies can sell them as a monopoly for several years.  For the European's they negotiate the price based on a value of $50,000 per year of life saved by a drug, and the US has a number from ICER which is a benchmark at $150,000 per year of life saved.  Drug companies are not required as yet to follow even this more liberal US standard, so the USA will always be the first country to get drugs approved even if the ICER standards become mandatory in the US.   The ICER standard has a much higher threshold for drug denial at 3  times that used  in Europe.  

Just as an aside, I recently attended the ASH(American Society of Hematology Meeting) in Orlando and was amazed at the explosion in new treatment developments.
With this new backlog of drugs in later stage development, the future of FDA new drug approvals looks outstanding.  


The last important part is the graying of America and the world, which provides a HUGE tail wind to the growth in Pharma sales and profits.  This has been reflected in the  tremendous growth which we have seen in Medicare Part B and Part D spending..  In 2017 spending was $185.3 Billion of the total USA spending of $333 Billion.  This was 56% of the total but just 15% of the US population over 65.  The US population over 65 will increase to 21% of the US population in 10 years, 40% greater than today.  Logic would therefore imply Medicare spending would increase by 40% or $74 Billion without a price increase by Pharma just due to the aging of the US population.  A way to reduce Medicare costs are right here, without cutting Medicare funding at all.  NEGOTIATE PRICE!

Good luck and God Bless your Cancer Journey/ [email protected]
For more information on multiple myeloma CLICK HERE and you can follow me on twitter at: https://twitter.com/grpetersen1

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Mayo’s Myeloma And You: A Day For Patients And Caregivers

1/14/2020

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When Pat Killingsworth started Pat’s Myeloma Survival School he wanted to develop something which focused on the Patient and Caregiver.  He had attended many of the meetings like ASH and ASCO and found they were designed with a focus on the medical community, and lacked a patient focus.   At the time these sessions were held in the Jacksonville area so Mayo had a big part to play in them.  I got the same feeling at Mayo’s Myeloma And You Program as I had at Pat’s Survival School. This is why!  

-  The first 3 speakers were either patients of caregivers with lots of time for questions
-  Doctor Asher Canaan Khan and Dr. Sikander Ailwadhi have an uncanny way of providing a patient friendly presentation with humor
-   The second half of the program was all about supportive care
-  Dr. Mohamed Kharfan-Dabaja and Dr. Sikander Ailwadhi discussed the new CAR T program at Jacksonville, and the work they are doing with several malignancies including myeloma.
-  Dr. Ailwadhi discussed the many clinical trials which are currently available including AMG 701, BiTES, CAR T, ADC, Selinexor, and CLR 131.
-  Dr. Asher Chanan Khan discussed breakthroughs and Immunotherapy. He highlighted a new vaccine therapy which he feels just may be the BREAKTHROUGH for cure we have been hoping for.  Many vaccines have been tried and failed in the past but he feels he has finally found the key!  I hope he has, he is usually right!
​-  This Mayo Myeloma And You Program is just 2 years old and the growth has been exponential and the cost at $20 per person is a deal. Over 200 participants this year.  The drug companies like Takeda, Celgene, Sanofi, & Karyopharm helped to fund this program.  

Knowledge is power and for myeloma it is LIFE!  Thanks to all who helped to bring this patient and caregiver focused program to the myeloma patient population.  To me more should be presented using the Pat Killingsworth Survival School Template.


Good luck and may God Bless your families cancer journey. For more information on multiple myeloma CLICK HERE and you can follow me on twitter at: https://twitter.com/grpetersen1

A few pictures from the meeting.



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If USA Healthcare Was Affordably Accessible, The Very Sick Would Love Drug Companies, Insurance Companies, Government, And Medicare!  Part 2 Of 4

1/10/2020

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As a myeloma patient I feel blessed to have had great insurance through my wife who had great union benefits as a teachers aide.  I  had kidney failure so I could get Medicare coverage as a secondary insurance.  In addition this coverage allowed me to be treated at Mayo and UAMS, two of the world's best Myeloma Centers.  So personally I loved my doctors, hospitals, and drug companies because I had AFFORDABLE ACCESS to excellent health care.  I, plus perhaps 50% of Americans, are equally blessed.  This leaves the remaining 50% without affordable access to our system, and this makes all the sense in the world why the following statements are true, and all else is bogus spin.

We spend twice as much as the highest per capita spending of any other nation in the world.  Over twice as much as the average of all other developed countries.  We should have a healthier population than the rest of the world, but over and over on any measure life expectancy, child death rate, etc. we are seldom even in the top 10.  We do not get what we PAY FOR !

Drug Prices are 2 to 10 times more  expensive than in most other counties.  All other nations and commercial insurance negotiates for lower prices, but Medicare does not.  It is like everyone gets to buy a car at half price except the US which must pay list!  Whatever drug companies give up to other great negotiators is made up by increasing list on Medicare!

Insurance companies, PBM's and Medicare base copays as a percent of List price, and not of negotiated price.  If the insurer get a 50% discount you still pay the SAME % of List.  Also as the price of drugs increase the copay cost goes up.,  The copay for generic drugs is low $5 to $10 per prescription, but Tier 4 and specialty drugs(like cancer drugs) far greater and can be as much as 30 to 35% of the list price or as much as $5000 per per prescription.  The copays must be limited to $100 to $200 per prescription. 

Medicare Part B has no out of pocket maximum, so 20% or $500,000 for a stem cell transplant is HUGE!  A Medigap plan would be required at an additional $3000 to pick up this extra 20%. 

The new laws in the House and Senate do not address the issue of affordability, but could with some key modifications.  The following discusses most of the above and more.





For more information on multiple myeloma CLICK HERE and you can follow me on twitter at: https://twitter.com/grpetersen1

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    Author

    Gary R. Petersen
    [email protected]
    CLICK HERE for my myeloma journey

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