Someone wrote to me saying some people are allergic to ace-i and need entresto. These folks can take valsartan alone, which is cheap. No data that adding sacubitril is superior.
People truly allergic to ace inhibitors don’t take valsartan or any other ARB for that matter. Perhaps they referred to a cough, which is not an allergy obviously and does not preclude people from taking Ace inhibitors.
So if you were in heart failure you would forego adding sacubitril to your regimen. Would cost or side effects be your guild? Since 1 year outcomes are similar would you start the combo to see if your quality of life was improved? Of course you’re not a cardiologist but are clear in your lack of confidence of value.
Your observations will fall on deaf ears. I suspect that there was not a single medical expert involved in these negotiations since they were entirely political and not medical.
I used to defend drug companies, saying "well, someone has to spend the money to do the research for new drugs". But Covid turned my head around re Pharma and this entire issue. I was tuned in and could see how much money was (still is?) wasted on covid.
Someone has to spend money, but the way it's set up right now is a scam. Everything could be done at a fraction of the cost if research was done correctly and people are hiring actual scientists who think critically rather than sycophants with PhDs and MDs.
Lowering drug costs has nothing to do with lowering drug costs, and everything to do with politics. It's another magician's trick to fool the observer into not looking where the trickery is happening. One can be assured the pharmaceutical companies will be compensated by our government in some way that the public won't be told about. This sleight of hand and smoke and mirrors in presenting "information" to the public is getting intolerable. Then the "pundits" have the gall to call anyone who calls them out on their B.S. "misinformation" spreaders. How long do these charlatans think they can get away with it. I seem to remember some guy once saying something about, "you can fool all the people some of the time...." I guess our government never heard that quote. I want to scream, "STOP," at these compulsive liars. They aren't listening anyway. The best we can do is not buy the trashy products they sell and not vote for the criminal they put forth as "candidates for office".
It is dishonest to list drugs as negotiated “savings” when several of these drugs have patents that are about to expire, allowing competition via generic drug options - e.g.
Januvia 2026
Novolog 2024
Farxiga 2025
Jardiance 2025
Stelara 2023 (although a pay-to-delay agreement pushes competition off until 2025)
Dammit I did not need to see that Jardiance drug because now I have 1) that awful jingle dancing around in my overly crowded head and 2) images of obese people dancing.
They are hoping the shiny propaganda poster shown will be enough in this click-bait/instant gratification age will flip votes. Shrewd. Gonna take wise physicians who don't toe the party line to boldly go where most physicians dare go anymore: where the actual evidence leads...or doesn't lead.
It’s like nobody even asked us in primary care where the pain points are for our patients. Personally, I think it would be most beneficial if the dual or triple therapy inhalers as well as GLP-1 agonists would be slated for cost reduction.
On Aducanumab + other anti-amyloid drugs, the barriers for outcomes are too low. And the scientists and companies pushing are too invested already, so now they have to lie and lie and lie and pray to god that maybe one of them might actually work out for some random reason. And we gonna pay for that.
Of the 10 new price reduced drugs 8 are due to go off patent in 2025 or 2026. The new lower prices go into effect in 2026. Provided a patent extension is not granted to any of them the generic versions will be far cheaper than the negotiated rate. So in addition to the drugs having some reduced or questionable effectiveness the negotiation of reduced cost is dubious at best.
Besides, when a drug company has a patent and knows they may or may not be subject to price negotiation, they will release their drug to market at a higher price point than they otherwise would have. This could be a broad move for all new drugs and they will only negotiate on some.
Top down management is rarely cost effective and good clinical care simultaneously. Good primary care directed by physicians is often the most effective option…if only they got reimbursed like spinal surgery ;)
Isn’t that how the government does things? Case in point, Trump’s border wall cost was $5 billion, liberals said no. Same liberals have spent $12 billion for illegal migrant care just in New York City. It all makes perfect sense to them.
Someone wrote to me saying some people are allergic to ace-i and need entresto. These folks can take valsartan alone, which is cheap. No data that adding sacubitril is superior.
People truly allergic to ace inhibitors don’t take valsartan or any other ARB for that matter. Perhaps they referred to a cough, which is not an allergy obviously and does not preclude people from taking Ace inhibitors.
Professor thank you for showing up to the forum!
So if you were in heart failure you would forego adding sacubitril to your regimen. Would cost or side effects be your guild? Since 1 year outcomes are similar would you start the combo to see if your quality of life was improved? Of course you’re not a cardiologist but are clear in your lack of confidence of value.
Your observations will fall on deaf ears. I suspect that there was not a single medical expert involved in these negotiations since they were entirely political and not medical.
I used to defend drug companies, saying "well, someone has to spend the money to do the research for new drugs". But Covid turned my head around re Pharma and this entire issue. I was tuned in and could see how much money was (still is?) wasted on covid.
Someone has to spend money, but the way it's set up right now is a scam. Everything could be done at a fraction of the cost if research was done correctly and people are hiring actual scientists who think critically rather than sycophants with PhDs and MDs.
Lowering drug costs has nothing to do with lowering drug costs, and everything to do with politics. It's another magician's trick to fool the observer into not looking where the trickery is happening. One can be assured the pharmaceutical companies will be compensated by our government in some way that the public won't be told about. This sleight of hand and smoke and mirrors in presenting "information" to the public is getting intolerable. Then the "pundits" have the gall to call anyone who calls them out on their B.S. "misinformation" spreaders. How long do these charlatans think they can get away with it. I seem to remember some guy once saying something about, "you can fool all the people some of the time...." I guess our government never heard that quote. I want to scream, "STOP," at these compulsive liars. They aren't listening anyway. The best we can do is not buy the trashy products they sell and not vote for the criminal they put forth as "candidates for office".
It is dishonest to list drugs as negotiated “savings” when several of these drugs have patents that are about to expire, allowing competition via generic drug options - e.g.
Januvia 2026
Novolog 2024
Farxiga 2025
Jardiance 2025
Stelara 2023 (although a pay-to-delay agreement pushes competition off until 2025)
Xarelto 2024
Eliquis 2026
Entresto 2025
Even with these reductions, the prices are still absurd.
Dammit I did not need to see that Jardiance drug because now I have 1) that awful jingle dancing around in my overly crowded head and 2) images of obese people dancing.
They are hoping the shiny propaganda poster shown will be enough in this click-bait/instant gratification age will flip votes. Shrewd. Gonna take wise physicians who don't toe the party line to boldly go where most physicians dare go anymore: where the actual evidence leads...or doesn't lead.
It’s like nobody even asked us in primary care where the pain points are for our patients. Personally, I think it would be most beneficial if the dual or triple therapy inhalers as well as GLP-1 agonists would be slated for cost reduction.
Why on earth were inhalers not top of these lists? The price of the highly effective asthma and COPD treatment is crazy.
Please never stop trolling Ashish Jha!
On Aducanumab + other anti-amyloid drugs, the barriers for outcomes are too low. And the scientists and companies pushing are too invested already, so now they have to lie and lie and lie and pray to god that maybe one of them might actually work out for some random reason. And we gonna pay for that.
Of the 10 new price reduced drugs 8 are due to go off patent in 2025 or 2026. The new lower prices go into effect in 2026. Provided a patent extension is not granted to any of them the generic versions will be far cheaper than the negotiated rate. So in addition to the drugs having some reduced or questionable effectiveness the negotiation of reduced cost is dubious at best.
Besides, when a drug company has a patent and knows they may or may not be subject to price negotiation, they will release their drug to market at a higher price point than they otherwise would have. This could be a broad move for all new drugs and they will only negotiate on some.
Top down management is rarely cost effective and good clinical care simultaneously. Good primary care directed by physicians is often the most effective option…if only they got reimbursed like spinal surgery ;)
Isn’t that how the government does things? Case in point, Trump’s border wall cost was $5 billion, liberals said no. Same liberals have spent $12 billion for illegal migrant care just in New York City. It all makes perfect sense to them.