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Comment by caycep | Hacker News Reader

I would say the cost of a vial of medicine for neuromuscular spasms and dystonia (the initial purpose, not cosmetic) is cost prohibitive for a lot of people. Usually, insurance should cover it, but the cost is $1,000/vial for a medicine that was approved over 30 years ago, and the price has only gone up, not down. Some plans (off the top of my head, some Blue Shield plans and anyone who is on straight Medicare/Medicaid) won't cover the cost.

There are a couple of competitors that work roughly the same and are slightly cheaper but it def seems like an oligopoly to keep the costs artificially high.

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You go to any country outside of North America and you can get medicines the exact same ones for a fraction of the cost on the dollars. US generally is up charged due the ability squeeze insurance and then the patient. So definitely greed, some regulations should be applied. Insurance companies would be happy to not be squeezed, if some sort of regulation was made to prevent squeezing it would be nice. Even a culture where doctors were glorified over YouTube stars would help too. Asia for example if you're a doctor you're making money! But the scary thing is that doctors in Asia don't charge 100,000 USD for said surgery. Just think about it.

I would hope so...not sure what the EU or Canada cost of a 100U vial but I would hope and be pleased if it were much less than $1k US

I plan to retire in my wife's home country where family values and everything else is just that much better.

I'm the last to defend the drug companies, but at a basic level, they get the right to sell at high prices because of the cost to bring to market which is absolutely enormous. Once it goes to market the cost of producing the drug is often very low compared to the price but it's in order to encourage companies to invest in future drugs.

In this case, the drug is 30 years old. I’d say any cost to bring to market is well paid now, and even if it isn’t, this is why the public should fund the research via taxes, not locking profits up via corporate entities.

The product is long off patent. The only thing stopping someone from selling it cheaper in the US is the government itself and limited economic returns.

Not patented, trade secret.

Sure, but it's only the USA paying the most truly ridiculous prices. They're usually quite affordable in the rest of the world.

The reason is that labs can decipher the drug contents and produce the drugs at a fraction of the cost. Of course, these companies never paid for the research and cost to bring to market. So yes US citizens end up carrying the cost, but in practicality, a very big number of life-saving drugs originate in US companies. I am definitely not defending these companies just pointing out the basics.

They are often sold by the same companies that make them in the US as most pattens are international. It is really they are expensive because we can and people will pay it.

> Insurance companies would be happy to not be squeezed, if some sort of regulation was made to prevent squeezing it would be nice.

Insurance companies are bound by ACA profit caps where 80% of revenue has to go to “medical claims”. This leads to a perverse situation where their theoretical maximum profit is tied to higher cost of services. If they’re at that limit and actually negotiated lower prices, they’d be in violation of those (perverted) profit caps.

This is very interesting and completely new to me (I'm European). Suddenly so much of the situation in the American health business makes sense.

> So definitely greed, some regulations should be applied.

Regulations are what prop up the high prices. Allow people to import drugs from overseas or Canada and you would see prices start plummeting overnight.

Regulations don't really it is an excuse every country has a board or ministry of health and some relationship to drugs.

It's like 100 usd/vial in some countries in Europe, more expensive in some others. Still ridiculously expensive.

Accusing businesshumans of greed is like accusing gas molecules of pressure. It's just part of the thing.

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