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Comment by BearOso | Hacker News Reader

> I'm always immediately skeptical as to what drugs pharmacies are pushing out

Major nitpick here. Pharmacies aren't pushing anything. Pharmaceutical companies are pushing these drugs.

Worse yet, independent pharmacies have only been losing money selling GLP-1 agonists. Insurance companies have begun to collude using pricing networks. They claim that the market value that pharmacies get the drugs for is too high, even though they are still patented and brand-name, so the insurance and pharmaceutical companies together are the ones that set the price. Then they refuse to reconcile the cost minus the deductible. Last I knew, it was about -42$ on a month prescription.

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Pharmacies are absolutely pushing stuff, the DOJ has repeatedly investigated and fined pharmacies for things they did during the opioid epidemic. The entire industry is so incestuous that it's almost not even worth distinguishing as if the singleton Mom and Pop drug stores still exist, even if they do in some form these days.

Walmart, Walgreens, and CVS? You mean those small pharmacies--two of which also contain insurance companies, and the other one still has its own clinics?

Pharmacies can only give out what people are prescribed, the only things they can push are OTC products. They can't get and sell scheduled drugs without being explicitly tracked.

But you're right about health care in the US. We need a single-payer system to get prices lower, but that means fairness and cutting out unnecessary costs. The whole health insurance industry would cease to exist, and all the people abusing it don't want that to happen.

"Ask your doctor about <insert drug here>" is "pushing" the drug. "Pushing" is advertising, "selling" happens later.

> Pharmacies can only give out what people are prescribed, the only things they can push are OTC products. They can't get and sell scheduled drugs without being explicitly tracked.

I think they can - specifically, the pharmacies that mix drugs locally can mix and sell a drug that's declared in shortage. IIRC Ozempic was in that situation recently.

You mean compounding? They are allowed to dilute to create a specific strength or combine constituents, but they can't actually create stuff from scratch on site any more than you or I can. That would be a laboratory. It's not like you can just buy semaglutide or the derivatives anywhere. It would have to come from the pharmaceutical company.

I looked it up, and I believe what you've heard about ended up just being people offering fake Ozempic.

You're right, I was thinking about compounding pharmacies.

> It's not like you can just buy semaglutide or the derivatives anywhere. It would have to come from the pharmaceutical company.

Pharmaceutical companies don't make those on their own either, they're contracting it off to drug manufacturing plants. The thing I read the other day said that compounding pharmacies order the same stuff from the same factories directly.

EDIT: found the article I read: https://www.astralcodexten.com/p/the-compounding-loophole.

Cost Plus Drugs exist because the mega pharmacy chains have been colluding to keep prices of both patented and generic prescriptions artificially high. They're not pushing medications (that would require a physician's approval), but they are extracting money from patients once their doctor has done that.

Another problem with OTC is that it leads to healthcare discrimination based on income and insurance quality since these are often not covered.

The US desperately needs to do away with for-profit health insurance and mega hospital corporations, severely limit the patenting and absurd profiteering in pharma, and replace Medicaid and Medicare with better single-payer, universal healthcare like the rest of the world does more cheaply and with better outcomes.

It needs to -- but never will.

Take a look at the Fortune 500 and see how many top 20 are healthcare companies.

Then take a look at Global F500 and see how many of those are there.

They'll tank the US economy before they let for-profit healthcare die

Of course this is what I meant, and I'll update the original post. Thanks

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