Posted by: CMdeux
« on: February 18, 2017, 06:09:01 PM »Okay-- did some digging about this. Because I'm just curious like that.
Firstly, this business of "fair pricing is so old-school... it's not the cost to manufacture... no, more 'properly' it's the VALUE that the drug offers...."
eughhhh.... no.
http://www.fiercepharma.com/pharma/after-taking-mylan-sen-klobuchar-sets-sights-kaleo-s-4-500-auvi-q
Hmm.. so who is making the money... and HOW...... and HOW MUCH???
http://www.modernhealthcare.com/article/20170120/NEWS/170129991
Hmm... so... still no info on who is picking up the tab-- or at what profit margin??
http://perfscience.com/content/2145276-kaleo-prices-epipen-alternative-4500-insurance-companies-report
http://www.usatoday.com/story/news/politics/2017/01/19/epipen-competitor-out-february-free-200m-people/96777828/
Er-- well, then, why is that list price a thing??
That... just.. makes no sense. It just doesn't. I don't LIKE things that make no sense-- because there is usually something FISHY behind it.
I think that this is correct, actually--
http://www.latimes.com/business/lazarus/la-fi-lazarus-drug-pricing-evzio-20170217-story.html
Firstly, this business of "fair pricing is so old-school... it's not the cost to manufacture... no, more 'properly' it's the VALUE that the drug offers...."
eughhhh.... no.
http://www.fiercepharma.com/pharma/after-taking-mylan-sen-klobuchar-sets-sights-kaleo-s-4-500-auvi-q
Hmm.. so who is making the money... and HOW...... and HOW MUCH???
http://www.modernhealthcare.com/article/20170120/NEWS/170129991
Quote
It's been widely reported that the actual list price for Auvi-Q is $4,500, which will be the starting point for insurers to negotiate discounts and rebates. It appears Kaléo will foot the bill for patients with commercial insurers that choose not to cover the Auvi-Q.
It's a bold move that could offer serious competition to Mylan and its EpiPen products, which have no such guarantee of a $0 cost for commercially insured patients. Previous reports have suggested the Auvi-Q had a market share of only 10% when it was available.
"We wish we didn't have to do this, but the system is set up in a way that without this bold move, patients wouldn't get access and be able to afford Auvi-Q," Kaléo CEO Spencer Williamson told CNBC Thursday. "We're confident the model provides access and affordability, and that it is a sustainable model."
Hmm... so... still no info on who is picking up the tab-- or at what profit margin??
http://perfscience.com/content/2145276-kaleo-prices-epipen-alternative-4500-insurance-companies-report
http://www.usatoday.com/story/news/politics/2017/01/19/epipen-competitor-out-february-free-200m-people/96777828/
Quote
Still, the $4,500 list price — even with rebates — is "an attempt to push an extraordinary burden on to the commercial and federal (insurers)," says Michael Rea, CEO of Rx Savings Solutions, which represents insurers.
No one pays the list price, Kaleo CEO Spencer Williamson said Thursday. "Our view is that the most important price is the price to the patient," he said. Anything else would be paid by insurers, he said.
Although Williamson repeatedly said many plans will cover Auvi-Q, he refused to name any of them.
Er-- well, then, why is that list price a thing??
That... just.. makes no sense. It just doesn't. I don't LIKE things that make no sense-- because there is usually something FISHY behind it.
I think that this is correct, actually--
http://www.latimes.com/business/lazarus/la-fi-lazarus-drug-pricing-evzio-20170217-story.html
Quote
In his statement to me, Williamson said most people won’t pay anywhere close to $4,000 for Evzio. Even with a high-deductible insurance plan, he said, a patient won’t pay more than $360 and might end up paying nothing thanks to the company’s “enhanced patient access program.”
But that isn’t price transparency. That’s a magician’s trick known as misdirection. Williamson is saying, “Don’t look at the crazy list price in this hand, look instead at the sweet discounts in this hand.”
The upshot is that his company’s prices remain indecipherable.
“It's awfully hard to see much value in this opaque approach to real drug pricing,” said Nicholson Price, an assistant law professor at the University of Michigan who focuses on healthcare and regulation. “Especially if we want to have patients be more cost-conscious to keep costs down, opaque pricing does us no favors.”
What it does do, he added, is “create lots of opportunities for gaming and middlemen.”
Kaleo’s gamesmanship isn’t new. As my colleague Melody Peterson noted in a story about naloxone pricing last year: “Not long ago, a dose of the decades-old generic drug cost little more than a dollar. Now the lowest available price is nearly 20 times that.”
The reason Williamson can so confidently declare that the list price for Evzio isn’t worth fretting about is because he knows it’s completely arbitrary. Drug companies and hospitals routinely open their negotiations with insurers with a made-up price and then settle for a much lower amount, which is what the patient ultimately sees.
Unfortunately, that system, such as it is, no longer works. An increasing number of Americans face the full cost of healthcare as a result of high-deductible insurance plans.
Kaleo might pat itself on the back for its patient subsidies and protections, but the reality is that somebody has to pay the company’s bills, either the patient or the insurer. Sky-high list prices for insurers raise premiums for everyone.
What’s to be done? At the moment, the only effective tool is public shaming.