High cost drugs are bankrupting heath plans. Everywhere we go we are invariably asked “What can we do to lower our prescription drug costs?”
PBMs, pharmaceutical manufactures and all the large national insurance brokerage firms representing recognizable brand name insurance logos offer solutions that are often compatible with their own business interests which in most cases proves at variance with common sense, reason and logic. Few plan sponsors have demonstrated critical thinking skills that, if employed, would go a long way towards understanding and solving their problem.
You can’t fix what you don’t see. You don’t know what you don’t know. Critical thinking plan sponsors see opportunities others miss. They do what others don’t.
You have to know what questions to ask. A group of ours did just that by asking 8 questions that exposed the truth. A Texas county lowered their Rx costs by shifting risk on high cost drugs through several channels without adversely affecting the Rx needs of their employees. Another Texas county imports high cost drugs for significant savings of 50% and more.
A new book, “Solving The US Drug Conundrum” has been released. We ordered a copy this morning and can’t wait to read it. You might consider doing the same.
SOLVING THE US DRUG CONUNDRUM: WHY THE U.S. HAS THE HIGHEST PRESCRIPTION DRUG PRICES IN THE WORLD, AND WHAT CAN BE DONE ABOUT IT Paperback – December 4, 2024
by ANDRE WENCKER (Author), PASCAL ORLIAC (Author)
81% of the US public says, rightly, that drug prices there are unreasonable; they are indeed the highest in the world, while Americans finance billions in public health research that supports the industry!
Our book is here to find solutions to this sad, unjustifiable reality.
We begin by dissecting the mechanics of how the two main actors, Big Pharma and the PBMs, operate and their deep-seated complicity in extracting the maximum amount of money at the expense of the American public; we then evoke the huge damage in terms of health that this inflicts on the US public: every year for instance, 10.000 persons are dying due a lack of access to their insulin, and 100.000 persons have a limb amputated, in one of the wealthiest countries in the world!
We re-evaluate the glaring price differences between drugs sold in the USA and in major European countries ( France, Germany, and the UK) at the manufacturer level;
We follow with a presentation of what European countries are doing to obtain quality drugs at reasonable prices. Finally, based on two reforms, one recently carried out in a US state and the other proposed by an American group of public servants, we outline a solution to put an end to this shocking tragedy.
In Appendix 1, we retrace the history of the US healthcare systems. In Appendix 3, we propose “The Employer Health Benefits Guide to Outsmarting PBS (and Big Pharma),” intended for the people in charge of health benefits in US companies. The guide will help them find practical solutions to lower costs by asking the right questions, finding the right partners, and supporting their workforce access to the right treatments.
Spoiler alert: contrary to what is generally recommended in the US to solve healthcare issues that plague the system, the solution we propose has nothing to do with technology and everything to do with common sense, resolve, and political integrity, which is another major topic in the US and a crucial factor in resolving the US-specific drug pricing issue.
The book presents tens of tables, charts, illustrating and sustaining our demonstration at every step.
