Comment by gm | Hacker News Reader

Comment by gm | Hacker News Reader

Parent Full thread

I'm not sure what your point is: It seems you are cherrypicking and then generalizing. For example Duloxetine (generic for Cymbalta) is $4 at CostPlus and $15 at the Walmart link. That in and of itself really does not prove anything either. I may be wrong, though, it's just one additional data point.

Maybe you can do the analysis you mention and publish it? The worst that will happen is that all us laypeople will be better informed.

I think though that CostPlus, if nothing else, has opened the eyes of a great many people who just assumed medicine was like any other product where the manufacturer controls the price and if someone is making obscene profit, it's an outlier like the Shkreli douchebag. Now a lot more people know that it's possible to pay a lot less. Even on TikTok I'm seeing people paying much less for their prescriptions when they bypass the insurance company and pay full retail price, which is counterintuitive as hell, and I personally would have never guessed.

So all in all, I think it's hugely positive that the secrets are getting out, and CostPlus is invariably a large part of that.

> I think though that CostPlus, if nothing else, has opened the eyes of a great many people who just assumed medicine was like any other product where the manufacturer controls the price

Like any other product? There are zero products like that. Manufacturers aren't legally able to control the price even if they propose a contract with a resale price clause. That's why everything has a "manufacturer's suggested retail price" printed on it.

Unless the manufacturer is also the retailer, such as Tesla

I meant the manufacturer controls the price at which they sell. Ie, if drug X costs $15 to make, and the manufacturer chooses to sell it to retailers/distributors at $2000, they are free to do that.

If that's what you meant, all those people who assumed medicine was like any other product were correct.

The difference is who you buy from and how difficult they are to go around to get to the manufacturer.

The difference would appear to be whether you buy a name-brand drug or a generic equivalent.

I don't think that has any impact whatsoever. If people think they are buying a drug from a manufacturer they are wrong. Typically they are paying insurance who pays the pharmacy, who pays the PBM who pays the Manufacturer. This is true for generics and brand-name. Each step has price negotiations and a bunch of mixed incentives.

> I don't think that has any impact whatsoever.

Then you've never bothered to compare the price of a branded drug with a generic in the same pharmacy.

I'm agree that the prices are different. Im Saying that the parties who negotiate the your ice are the same for generic and brand drugs

>If people think they are buying a drug from a manufacturer they are wrong.

No one is saying that (at least on this thread).

All I'm saying laypeople assume the mfg is the bad guy when it comes to high drug prices. Time and time again on the news we are told that X drug costs $$$$$ in the US and the exact same drug costs orders of magnitude less in some other country. Everyone points the finger at the drug mfgs.

What I'm saying is that it's good that the secret is getting out that the mfgs are not necessarily the bad guys, and there's all these other companies involved in the drug price crisis.

But that's wrong. Those high prices come from high prices set by the manufacturer. (Side note - why is there a "g" in "manufacturer"?)

Other parties are still free to mark up their goods for resale. But drugs they bought for cheap get sold for (less) cheap, and drugs they bought at a high price get sold at a high(er) price. When you see an eye-popping price, that's because the manufacturer charged an eye-popping price.

I don’t know anything about the legality, but UMRP is very common.

UMRP has no legal effect. It's just a declaration by the manufacturer that "if we catch you pricing below this point, we will stop selling to you". Once you have the item, you can price it however you want.

But that’s the point: UMRP is not illegal. It gives the manufacturers de facto control of retail pricing.

Resale price maintenance agreements were legalized in the US in 2007.

No, they weren't. What was legalized was refusing to sell, in the future, to someone who violates such an agreement. But you can't enforce the agreement.

Note that refusing to sell to people was already legal before 2007.

Reply on news.ycombinator.com