Another new Brexit thread

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Chippy_boy said:
And how would this "screwing us over" happen then Bob? Threat of a nuclear strike unless we buy from US pharma businesses at higher prices? We would IMO never agree to such meddling with market economics, and if we did, then we'd agree to it only if it was in our best interests. i.e. for some gain of greater value. Either way, no big deal at all. Just another stick for lefties with an agenda to try to blow out of all proportion and beat the Tories with. Nothing to see here whatsoever.
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This.

You would expect any government of the day to negotiate fairly and with the best interests of the NHS at heart always.
 
BobKowalski said:
Nothing wrong with American companies. Just as long as they are not screwing us over. Same with any company.

The aim of US pharma companies lobbyists is ‘to ensure transparency, due process and appropriate value in pricing and reimbursements to US Pharma’. The aim of US trade negotiators in any U.K. trade deal, is along with market access, to ‘ensure Govt regulatory reimbursement regime is transparent and fair to US Pharma’.

Now ‘appropriate value’ means taking into account the money spent on research and development. In short no more NHS screwing us down. US negotiators will look to have that purchase power negated.

The US brief is to to protect US interests. Their mandate is published and is not a secret. US Pharma wants to sell us more product and secure a mechanism that allows for higher prices. That’s their job. Our job is not to give the shop away in return for a good headline in the Daily Mail.

Oh and given Trump has been handing our tariffs to all and sundry including threatening those the US has trade deals with then yes of course Trump is a factor. Only an idiot would discount it as a factor.
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Why are prescription drugs so much more expensive in the US than the U.K ? Some by a factor of ten. Do you have any insight into why?
 
Saddleworth2 said:
Why are prescription drugs so much more expensive in the US than the U.K ? Some by a factor of ten. Do you have any insight into why?
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Google quickly shows that you can buy a jar of 500 generic much like you would a supermarket own brand here for around 1 cent per tablet/less than $5.
 
Chippy_boy said:
And how would this "screwing us over" happen then Bob? Threat of a nuclear strike unless we buy from US pharma businesses at higher prices? We would IMO never agree to such meddling with market economics, and if we did, then we'd agree to it only if it was in our best interests. i.e. for some gain of greater value. Either way, no big deal at all. Just another stick for lefties with an agenda to try to blow out of all proportion and beat the Tories with. Nothing to see here whatsoever.
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Your faith in our negotiators after three years of EU negotiations is touching. Your sensitivity to anything that smacks of ‘Tory bashing’ is predictable :)

The US trade proposals for the U.K. are publicly available. Their aims for US Pharma are better or preferential access and to rid themselves of ‘unfair pricing mechanisms’. Standard stuff. If we want a trade deal with the US you have to give them goodies. The NHS is a goodie. Giving U.K. Banks better access to US financial markets in return will not go down well with the voters Johnson is (presumably) trying to attract in the next month or so.

This is just the reality of where we are and the political pressure on Tories/Brexiteers to score a ‘win’ which is what a US trade deal is all about. Do I trust a future Tory Govt not to sell out the NHS in a trade deal with the US just for the brownie points? Of course I don’t. Do I expect Brexiteers to cheer this? Of course I do. It’s symbolic. Like triggering A50 without a clue. Lots of cheering at the time followed by years of frustration.

Do I expect Labour to make this election about the Tories selling the U.K. to Trump? Yep. And all the while the US makes their intentions very clear and the more Johnson, Hancock et al bluster and splutter about it the more traction it will get because like all good campaign messaging it has truth buried in it.
 
blueinsa said:
Google quickly shows that you can buy a jar of 500 generic much like you would a supermarket own brand here for around 1 cent per tablet/less than $5.
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Prescription drugs are more expensive in the US and in some cases like insulin prohibitively so.
 
Saddleworth2 said:
Why are prescription drugs so much more expensive in the US than the U.K ? Some by a factor of ten. Do you have any insight into why?
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Pharma is about the only sector of the health industry that can set its own prices. The fact the the USA does not have a national healthcare system is the major reason why drugs are hugely more expensive in the States. The NHS (or the EU, in some cases) can negotiate volume discounts whereas the USA system invariably involves individual insurance companies or often, individual patients ,trying to negotiate on their own. The Republicans have always fought against a centralised negotiating system and have, in effect, allowed Pharma companies to set their own prices with no regard for anything. The advantage of our system is that NICE (National Institue for Clinical Excellence) agrees the 'value' of particular interventions and drugs. If that is too high, it will not approve them and the Pharma companies know this. What the NHS gives them though is some certainty. If NHS England says it will be funded (at a certain price or lower) then that is guaranteed. In the US, some insurance companies might say yes and others will say no. For any business, that is a difficult square to circle.
Admin costs when dealing with multiple companies are also much higher than when dealing with a non-National system.
For the ever increasing 'speciality drugs', which service a very small population, the price differences are even more marked. 20 year patents also, effectively, secure a monopoly position for many Pharma companies and, even the most die hard capitalist will admit that is far from an ideal situation.
All that is before you get to Orphan drugs.
Many Americans do not fill their prescriptions or take half doses to make them last longer, simply due to the cost, which cannot be a beneficial outcome.
Ultimately though, if you are purely profit focused, assuming similar production costs, would you rather make 1 pill and sell it for £1M or make a thousand pills and sell them for £1500?
All this suggests that Mr Trump has assumed (wrongly) that the USA is subsidising the rest of the world and this needs to stop. The truth is that the USA has a higher cost due to limited supply and a model which inherently promotes access for the few or the '1 pill for £1M' model over everything else. What the danger to the NHS is, is that a similar model is adopted here.
 
BobKowalski said:
Prescription drugs are more expensive in the US and in some cases like insulin prohibitively so.
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Good job we dont live there then but i have to say, our prescription charges are high enough and not helped by abuse of prescriptions from both patients and doctors who should know and be trained better.

This one from small area, Cambridge and Peterborough.

Each time a patient visits their GP and gets a medication, that could be bought over the counter, it costs the NHS approximately £46 for the medication and the GP's time. We estimate the cost of time and money spent on GP appointments for patients who could have self-cared at £17.6million.

This is how much the local NHS spend on medicines and how much they cost patients to buy:

  • Dry skin/sunburn cost us to prescribe £1,114,496 Cost for you to buy £3 (200ml aftersun).
  • Vitamins cost us to prescribe £883,456. Cost for you to buy £1.99 (30 multi-vitamins).
  • Dry/sore eyes cost us to prescribe £720,037. Cost for you to buy £1.95 (10ml eye drops).
  • Hay fever cost us to prescribe £385,529. Cost for you to buy 80p (14 tablets).
 
blueinsa said:
Good job we dont live there then but i have to say, our prescription charges are high enough and not helped by abuse of prescriptions from both patients and doctors who should know and be trained better.

This one from small area, Cambridge and Peterborough.

Each time a patient visits their GP and gets a medication, that could be bought over the counter, it costs the NHS approximately £46 for the medication and the GP's time. We estimate the cost of time and money spent on GP appointments for patients who could have self-cared at £17.6million.

This is how much the local NHS spend on medicines and how much they cost patients to buy:

  • Dry skin/sunburn cost us to prescribe £1,114,496 Cost for you to buy £3 (200ml aftersun).
  • Vitamins cost us to prescribe £883,456. Cost for you to buy £1.99 (30 multi-vitamins).
  • Dry/sore eyes cost us to prescribe £720,037. Cost for you to buy £1.95 (10ml eye drops).
  • Hay fever cost us to prescribe £385,529. Cost for you to buy 80p (14 tablets).
Click to expand...

There's also the fact that people who give blood for free have their blood passed on at an eye watering £500+ per litre by the people who process the blood given for free. Alright there's logistics to take into account but someone's making money from the people who get squeezed.
 
The Light Was Yellow Sir said:
Pharma is about the only sector of the health industry that can set its own prices. The fact the the USA does not have a national healthcare system is the major reason why drugs are hugely more expensive in the States. The NHS (or the EU, in some cases) can negotiate volume discounts whereas the USA system invariably involves individual insurance companies or often, individual patients ,trying to negotiate on their own. The Republicans have always fought against a centralised negotiating system and have, in effect, allowed Pharma companies to set their own prices with no regard for anything. The advantage of our system is that NICE (National Institue for Clinical Excellence) agrees the 'value' of particular interventions and drugs. If that is too high, it will not approve them and the Pharma companies know this. What the NHS gives them though is some certainty. If NHS England says it will be funded (at a certain price or lower) then that is guaranteed. In the US, some insurance companies might say yes and others will say no. For any business, that is a difficult square to circle.
Admin costs when dealing with multiple companies are also much higher than when dealing with a non-National system.
For the ever increasing 'speciality drugs', which service a very small population, the price differences are even more marked. 20 year patents also, effectively, secure a monopoly position for many Pharma companies and, even the most die hard capitalist will admit that is far from an ideal situation.
All that is before you get to Orphan drugs.
Many Americans do not fill their prescriptions or take half doses to make them last longer, simply due to the cost, which cannot be a beneficial outcome.
Ultimately though, if you are purely profit focused, assuming similar production costs, would you rather make 1 pill and sell it for £1M or make a thousand pills and sell them for £1500?
All this suggests that Mr Trump has assumed (wrongly) that the USA is subsidising the rest of the world and this needs to stop. The truth is that the USA has a higher cost due to limited supply and a model which inherently promotes access for the few or the '1 pill for £1M' model over everything else. What the danger to the NHS is, is that a similar model is adopted here.
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I broadly agree with all of this apart from the last paragraph. The pharma companies spend billions on R&D and very few of the lines of research result in a new drug. They live and die based on their pipeline and the very few $1bn blockbusters that they bring to market very occasionally. All that cost has to be recovered against sales, and since the US market is so fragmented, with no coordinated buying power, it enables the drug companies to recover much more cost from American healthcare providers than it does from UK ones. If one company won't pay the price, they can sell to another one which will. It's a seller's market.

This is hugely to the detriment of Americans and is entirely their own fault, however it is true that they are effectively subsidizing our drug consumption with their higher prices and its obvious why Trump does not like it.

I did not like it when you could buy for $25,000 a BMW which retailed for £30,000+ in the UK, when the exchange rate was $1.50 to the pound. Car prices in the US have for decades been significanly lower than across Europe, even for European manufactured cars. BMW and others have been subsidizing sales in the US for decades by changing us over the odds, so that they can shift volume in the US at reduced prices. Same with many other products too.

So with pharma, fuck 'em, they can suck it up. What goes around comes around. And there is no prospect whatsoever of us deliberately fragmenting our demand so that the pharma companies can play one CCG off against another. It would be idiotic for us to do this whilst our current model of being the dominant party in the price negotiations is working so well. It's entirely to our detriment to change this so no-one ever would.
 
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blueinsa said:
Good job we dont live there then but i have to say, our prescription charges are high enough and not helped by abuse of prescriptions from both patients and doctors who should know and be trained better.

This one from small area, Cambridge and Peterborough.

Each time a patient visits their GP and gets a medication, that could be bought over the counter, it costs the NHS approximately £46 for the medication and the GP's time. We estimate the cost of time and money spent on GP appointments for patients who could have self-cared at £17.6million.

This is how much the local NHS spend on medicines and how much they cost patients to buy:

  • Dry skin/sunburn cost us to prescribe £1,114,496 Cost for you to buy £3 (200ml aftersun).
  • Vitamins cost us to prescribe £883,456. Cost for you to buy £1.99 (30 multi-vitamins).
  • Dry/sore eyes cost us to prescribe £720,037. Cost for you to buy £1.95 (10ml eye drops).
  • Hay fever cost us to prescribe £385,529. Cost for you to buy 80p (14 tablets).
Click to expand...
We would be far better off getting rid of prescription charges altogether but not allowing GP's to prescribe anything you can buy over the counter for less than £5.
 
The Light Was Yellow Sir said:
We would be far better off getting rid of prescription charges altogether but not allowing GP's to prescribe anything you can buy over the counter for less than £5.
Click to expand...
Without crunching the exact numbers, difficult to say. But I agree, prescribing at a cost of £9, paracetamols which are 30p in Tescos, is bloody ridiculous.
 
The Light Was Yellow Sir said:
Pharma is about the only sector of the health industry that can set its own prices. The fact the the USA does not have a national healthcare system is the major reason why drugs are hugely more expensive in the States. The NHS (or the EU, in some cases) can negotiate volume discounts whereas the USA system invariably involves individual insurance companies or often, individual patients ,trying to negotiate on their own. The Republicans have always fought against a centralised negotiating system and have, in effect, allowed Pharma companies to set their own prices with no regard for anything. The advantage of our system is that NICE (National Institue for Clinical Excellence) agrees the 'value' of particular interventions and drugs. If that is too high, it will not approve them and the Pharma companies know this. What the NHS gives them though is some certainty. If NHS England says it will be funded (at a certain price or lower) then that is guaranteed. In the US, some insurance companies might say yes and others will say no. For any business, that is a difficult square to circle.
Admin costs when dealing with multiple companies are also much higher than when dealing with a non-National system.
For the ever increasing 'speciality drugs', which service a very small population, the price differences are even more marked. 20 year patents also, effectively, secure a monopoly position for many Pharma companies and, even the most die hard capitalist will admit that is far from an ideal situation.
All that is before you get to Orphan drugs.
Many Americans do not fill their prescriptions or take half doses to make them last longer, simply due to the cost, which cannot be a beneficial outcome.
Ultimately though, if you are purely profit focused, assuming similar production costs, would you rather make 1 pill and sell it for £1M or make a thousand pills and sell them for £1500?
All this suggests that Mr Trump has assumed (wrongly) that the USA is subsidising the rest of the world and this needs to stop. The truth is that the USA has a higher cost due to limited supply and a model which inherently promotes access for the few or the '1 pill for £1M' model over everything else. What the danger to the NHS is, is that a similar model is adopted here.
Click to expand...
Thanks for taking the time to respond. That was very informative. Moving to an American model health system would be a disaster for us.
 
Just over an hour and we leave - Johnson PROMISED it would happen - Francois "looked him in the eye" and believed it will happen - I assume all Leavers have the fireworks at the ready and their glasses charged in preparation?
 
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