Trying to minimize drug costs while maintaining innovation

[K9Buck]

This January, 2018 article discusses the balance between lowering the costs of drugs while maintaining innovations with regard to developing new drugs. The author contends that Europeans enjoy lower costs on drugs financed on the backs of American drug buyers. It's a great read.

The global burden of medical innovation

 

[Oddball]

Easy way to do that: abolish or privatize the FDA.

 

[Toro]

It's true.

However, when I last looked at it - albeit awhile back - the pharma and biotech industry had the highest profit margins in the world.

That means they are making excessive profits because of government protection.

 

[Oddball]

It's true.

However, when I last looked at it - albeit awhile back - the pharma and biotech industry had the highest profit margins in the world.

That means they are making excessive profits because of government protection.

FDA is the biggest protection racket ever devised.

 

[H B Lowrie]

It's true.

However, when I last looked at it - albeit awhile back - the pharma and biotech industry had the highest profit margins in the world.

That means they are making excessive profits because of government protection.

FDA is the biggest protection racket ever devised.

For profit health insurance is outlawed in nations with 21st century healthcare for all, because they provide nothing of value to anyone but insurance company investors and shareholders; they provide nothing of value to society as a whole, they're parasites. Let's take a look at how our system stacks up, shall we?

New York, N.Y., October 8, 2015 — The U.S. spent more per person on health care than 12 other high-income nations in 2013, while seeing the lowest life expectancy and some of the worst health outcomes among this group, according to a Commonwealth Fund report out today. The analysis shows that in the U.S., which spent an average of $9,086 per person annually, life expectancy was 78.8 years. Switzerland, the second-highest-spending country, spent $6,325 per person and had a life expectancy of 82.9 years. Mortality rates for cancer were among the lowest in the U.S., but rates of chronic conditions, obesity, and infant mortality were higher than those abroad.

“Time and again, we see evidence that the amount of money we spend on health care in this country is not gaining us comparable health benefits,” said Commonwealth Fund President David Blumenthal, M.D. “We have to look at the root causes of this disconnect and invest our health care dollars in ways that will allow us to live longer while enjoying better health and greater productivity.”

U.S. Spends More on Health Care Than Other High-Income Nations But Has Lower Life Expectancy, Worse Health | Commonwealth Fund


U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries

U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries


Major Findings
· Quality: The indicators of quality were grouped into four categories: effective care, safe care, coordinated care, and patient-centered care. Compared with the other 10 countries, the U.S. fares best on provision and receipt of preventive and patient-centered care. While there has been some improvement in recent years, lower scores on safe and coordinated care pull the overall U.S. quality score down. Continued adoption of health information technology should enhance the ability of U.S. physicians to identify, monitor, and coordinate care for their patients, particularly those with chronic conditions.

· Access: Not surprisingly—given the absence of universal coverage—people in the U.S. go without needed health care because of cost more often than people do in the other countries. Americans were the most likely to say they had access problems related to cost. Patients in the U.S. have rapid access to specialized health care services; however, they are less likely to report rapid access to primary care than people in leading countries in the study. In other countries, like Canada, patients have little to no financial burden, but experience wait times for such specialized services. There is a frequent misperception that trade-offs between universal coverage and timely access to specialized services are inevitable; however, the Netherlands, U.K., and Germany provide universal coverage with low out-of-pocket costs while maintaining quick access to specialty services.

· Efficiency: On indicators of efficiency, the U.S. ranks last among the 11 countries, with the U.K. and Sweden ranking first and second, respectively. The U.S. has poor performance on measures of national health expenditures and administrative costs as well as on measures of administrative hassles, avoidable emergency room use, and duplicative medical testing. Sicker survey respondents in the U.K. and France are less likely to visit the emergency room for a condition that could have been treated by a regular doctor, had one been available.

· Equity: The U.S. ranks a clear last on measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick; not getting a recommended test, treatment, or follow-up care; or not filling a prescription or skipping doses when needed because of costs. On each of these indicators, one-third or more lower-income adults in the U.S. said they went without needed care because of costs in the past year.

· Healthy lives: The U.S. ranks last overall with poor scores on all three indicators of healthy lives—mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60. The U.S. and U.K. had much higher death rates in 2007 from conditions amenable to medical care than some of the other countries, e.g., rates 25 percent to 50 percent higher than Australia and Sweden. Overall, France, Sweden, and Switzerland rank highest on healthy lives.

How the U.S. Health Care System Compares Internationally


No other advanced country even comes close to the United States in annual spending on health care, but plenty of those other countries see much better outcomes in their citizens' actual health overall.

A new Commonwealth Fund report released Thursday underscored that point — yet again — with an analysis that ranks 13 high-income nations on their overall health spending, use of medical services, prices and health outcomes.

The study data, which is from 2013, predates the full implementation of Obamacare, which took place in 2014. Obamacare is designed to increase health coverage for Americans and stem the rise in health-care costs.

The findings indicate that despite spending well in excess of the rate of any other of those countries in 2013, the United States achieved worse outcomes when it comes to rates of chronic conditions, obesity and infant mortality.

One rare bright spot for the U.S., however, is that its mortality rate for cancer is among the lowest out of the 13 countries, and that cancer rates fell faster between 1995 and 2007 than in other countries.

"Time and again, we see evidence that the amount of money we spend on health care in this country is not gaining us comparable health benefits," said Dr. David Blumenthal, president of the Commonwealth Fund. "We have to look at the root causes of this disconnect and invest our health-care dollars in ways that will allow us to live longer while enjoying better health and greater productivity."

US health care: Spending a lot, getting the least


Ranking 37th — Measuring the Performance of the U.S. Health Care System
NEJM - Error


Health Care Outcomes in States Influenced by Coverage, Disparities
https://www.usnews.com/news/best-st...-in-states-influenced-by-coverage-disparities


One explanation for the health disadvantage of the United States relative to other high-income countries might be deficiencies in health services. Although the United States is renowned for its leadership in biomedical research, its cutting-edge medical technology, and its hospitals and specialists, problems with ensuring Americans’ access to the system and providing quality care have been a long-standing concern of policy makers and the public (Berwick et al., 2008; Brook, 2011b; Fineberg, 2012). Higher mortality rates from diseases, and even from transportation-related injuries and homicides, may be traceable in part to failings in the health care system.

The United States stands out from many other countries in not offering universal health insurance coverage. In 2010, 50 million people (16 percent of the U.S. population) were uninsured (DeNavas-Walt et al., 2011). Access to health care services, particularly in rural and frontier communities or disadvantaged urban centers, is often limited. The United States has a relatively weak foundation for primary care and a shortage of family physicians (American Academy of Family Physicians, 2009; Grumbach et al., 2009; Macinko et al., 2007; Sandy et al., 2009). Many Americans rely on emergency departments for acute, chronic, and even preventive care (Institute of Medicine, 2007a; Schoen et al., 2009b, 2011). Cost sharing is common in the United States, and high out-of-pocket expenses make health care services, pharmaceuticals, and medical supplies increasingly unaffordable (Commonwealth Fund Commission on a High Performance System, 2011; Karaca-Mandic et al., 2012). In 2011, one-third of American households reported problems paying medical bills (Cohen et al., 2012), a problem that seems to have worsened in recent years (Himmelstein et al., 2009). Health insurance premiums are consuming an increasing proportion of U.S. household income (Commonwealth Fund Commission on a High Performance System, 2011).

Public Health and Medical Care Systems - U.S. Health in International Perspective - NCBI Bookshelf


Once again, U.S. has most expensive, least effective health care system in survey

A report released Monday by a respected think tank ranks the United States dead last in the quality of its health-care system when compared with 10 other western, industrialized nations, the same spot it occupied in four previous studies by the same organization. Not only did the U.S. fail to move up between 2004 and 2014 -- as other nations did with concerted effort and significant reforms -- it also has maintained this dubious distinction while spending far more per capita ($8,508) on health care than Norway ($5,669), which has the second most expensive system.

"Although the U.S. spends more on health care than any other country and has the highest proportion of specialist physicians, survey findings indicate that from the patients’ perspective, and based on outcome indicators, the performance of American health care is severely lacking," the Commonwealth Fund, a New York-based foundation that promotes improved health care, concluded in its extensive analysis. The charts in this post are from the report.


Once again, U.S. has most expensive, least effective health care system in survey


US healthcare system ranks 50th out of 55 countries for efficiency
http://www.beckershospitalreview.co...-50th-out-of-55-countries-for-efficiency.html


The U.S. healthcare system notched another dubious honor in a new comparison of its quality to the systems of 10 other developed countries: its rank was dead last.

The new study by the Commonwealth Fund ranks the U.S. against seven wealthy European countries and Canada, Australia and New Zealand. It's a follow-up of previous surveys published in 2010, 2007, 2006 and 2004, in all of which the U.S. also ranked last.

Although the U.S. ranked in the middle of the pack on measures of effectiveness, safety and coordination of care, it ranked dead last on access and cost, by a sufficient margin to rank dead last overall. The breakdowns are in the chart above.

Conservative pundits hastened to explain away these results after the report was published. See Aaron Carroll for a gloss on the "zombie arguments" put forth against the clear evidence that the U.S. system falls short.

http://www.latimes.com/business/hiltzik/la-fi-mh-the-us-healthcare-system-20140617-column.html

U.S. Health Care Ranked Worst in the Developed World
http://time.com/2888403/u-s-health-care-ranked-worst-in-the-developed-world/

 

[K9Buck]

HB, did you read the article in the op?