Gotta love our new insurance deductibles and their process...

[racrguy]

I think it is wise to understand what the ins is paying of course but when you say this drug costs x amount per month and it's not what you pay that's misleading. He now has a plan with a deductible that includes everything. He should make sure he knows the ins and outs of the plan so he's prepared. It's also just a deductible so it's not going to be that much each time. Yeah it sucks but that's just insurance they work hard to make sure they pay as little as possible. I'm also a republican with a credit score of over 800 so suck it

http://imgur.com/gallery/bOOGVY6

[8mpg]

not siding with the insurance company...but do you realize how much money they are losing on you?

[DON SVO]

not siding with the insurance company...but do you realize how much money they are losing on you?

Considering I'm not renewing my prescription or going to see my neurologist, they're losing a lot.

[Sean88gt]

http://imgur.com/gallery/bOOGVY6

hahahahaha!

[Sean88gt]

Considering I'm not renewing my prescription or going to see my neurologist, zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

Fixed.

[kingjason]

MF's

http://www.forbes.com/sites/matthewherper/2015/05/28/with-a-1-2-billion-hammer-the-ftc-closes-loophole-to-prevent-generic-drugs/?utm_campaign=yahootix&partner=yahootix

With A $1.2 Billion Hammer, The FTC Closes Loophole To Prevent Generic Drugs
Matthew Herper

Forbes Staff


This morning, the U.S. Federal Trade Commission drew blood: Teva Pharmaceuticals will pay $1.2 billion to reimburse insurers, drug wholesalers, and pharmacies who paid full price for the Provigil, produced by Cephalon, a company Teva bought in 2011, because Cephalon had paid generic drugmakers to delay launching cheaper versions of the blockbuster drug.

That comes after a $512 million settlement Teva reached with plaintiffs who said they’d been forced to overpay for Provigil as a result, and a second settlement, the value of which is undisclosed. Some of that money will be credited to the new amount.* By point of comparison, Teva spent $6.8 billion to purchase Cephalon in 2011, so these settlements effectively increase the cost of the deal by 18%. Petach Tikva, Israel-based Teva, the world’s largest generic drugmaker, will also enter into a legally binding agreement with the U.S. government that will prevent it from making agreements that the FTC deems anticompetitive.

“This is the largest settlement in FTC history for this type of case,” said Edith Ramirez, the FTC’s Chairwoman. “That’s a big sum and I think that will send a very strong signal to any company that is contemplating entering into any type of deal that is anticompetitive.”

The size of the penalty is probably big enough to make drug makers think twice about crafting deals that delay generics. It also should help clarify the convoluted process through which drugs go generic in the U.S. It builds on a Supreme Court ruling against Actavis that opened the door for the FTC to bring such cases.

The basic idea is simple. Drugs are protected by patents for 20 years after they are invented, allowing their makers to have a monopoly on their sale and charge whatever price the market will bear during that time. When that patent expires, generic drug companies that specialize in making copy-cat versions of medicines flood in, and competition between them can cause the cost of a medicine to plunge 60% or more in short order.

In order to try and protect their business, drug companies will often file multiple patents on single medicine – for treating different diseases, for differing formulations, or for manufacturing processes. To deal with this, Congress set up a system in which generic drug companies can benefit from challenging the patents on drugs. The first generic firm to file with the Food and Drug Administration gets to be the only copycat for six months, during which time it will charge a price only slightly less than the branded drug.

When a generic company files with the FDA, the company that makes the branded version sues it. And then they go to court. If the brand wins, no generic. If the generic wins, it gets to enjoy very high profit margins for six months, and then other generic firms flood the market.

But for Cephalon, keeping generics off the market was worth more than launching those generics was worth to generic makers including Ranbaxy and Mylan. In the first quarter after the sale to Teva, Provigil generated $350 million in sales. Earlier, the FTC had said that the deals Cephalon made with Ranbaxy and Mylan were worth $200 million, although they included not cash but intellectual property and manufacturing processes.

The FTC had already successfully argued that making cash payments to keep a generic from launching is anticompetitive and illegal. Now the same goes for deals. And the drug industry’s ability to defend its patents has taken a big hit.

*An earlier version of this story treated the settlements as totally separate.

[YALE]

Drew blood? That's cutting to the quick!

[Denny]

That's drawing blood?

[mikeb]

That mindset has got this country's healthcare system in the situation it is in today. Everyone inflates their prices to unrealistic levels because they know the insurance companies will pay up. This is why the drug companies offer discount codes, discount cards, and deductible subsidies when someone doesn't have insurance in place or the insurance company won't cover the drug.

It's the same story for the price of doctor's office visits. For example, I went to the doctor for a routine checkup about a month ago, and they billed my insurance company $350 after my $25 copay. When I saw the invoice, I was dumbfounded. When I called the doctor's office and asked them how much they would charge someone out-of-pocket for a routine checkup, they said $99. They charge the insurance company more, because they know they will pay it, and if the insurance companies refuse to pay it then the doctor's office negotiates with them to a price that they are willing to pay.

Our healthcare system a geared to extract as much as possible from anyone that walks in the door needing care. Healthcare costs have escalated so much and with the high deductibles that Obamacare has providers know that they stand a good chance of getting stiffed on the fees. For this reason it is becoming a common practice to require payment up front before services are rendered.

Obamacare is essentially a gift to the insurance companies - a policy is sold that doesn't cover anything, the insurance companies get paid for premiums and don't have to pay anything until some ridiculous deduction is met, and if you do happen meet the deductible they will most likely fight and refuse to pay any claims. The government has moved aggressively to shut down offshore pharmacies, limiting your ability to go around big pharma. Its all done with with payoffs and kickbacks to the politicians.

While we have an excellent healthcare system it is is rapidly moving toward a two tier healthcare system - those that have money can pay whatever is charged and stay healthy, those that don't have money will get left behind - sorry, no healthcare for you!. This is including more and more of the middle class - who the hell can afford thousands of dollars of deductibles? I dang sure don't have thousands of dollars sitting around in savings. I hope that I stay healthy.

Don - I hope that you figure out a solution. I was off of insurance once (pre-obamacare) and my blood pressure medication went from $25 to $515 a month