Can someone explain how "certain cancer drugs won't be generic" = "cancer drugs won't be available"?

[HamdenRice]

I can see why this part of the bill is bad, but for different reasons. It seems to me that it means that the insurance companies and p.o. will have to pay full price for drugs that should be generic, not that they will deny the use of the drugs. The bill contains regulations on the insurance companies on dropping coverage and out of pocket limits.

I think the provision is bad because it's a giveaway to big pharma, but I really don't understand how we've jumped to the conclusion that the drugs won't be made available to cancer patients.

Can someone explain how the first statement equals the second statement?

[dionysus]

1. i don't think it does at all. of course in a bill ofthat scope there's going to be some bad shit in

there. but the people screaming how this bill is going to kill people is just exaggeration to the extreme.

[HamdenRice]

2. So it's just more "the sky is falling" crap? Figures. nt

[dionysus]

3. there are going to be things in a bill this size that aren't right. but to see people acting like

they are going to be purposefully letting cancer patients die is a hideous strawman.

[Statistical]

13. Not really a strawman.

Most insurance plans don't cover high end drugs.

Cancer drugs w/ no generic equivalent can run $48K to $300K a year.

So if you are not a millionaire and no generic is available then you won't get the drug. That simple.

No generic = no cancer drug (unless you can handle a $300,000 co-pay).

[ChicagoSuz219]

4. Only recently found out...

...the only differences between non-generic drugs (the famous ones) & generic ones are TIME, DRUG NAME and, of course, PRICE.
I think the pharmaceutical companies get 10-12 years before they go generic to recoup research, development, focus groups, marketing, advertising, etc. costs.
With Medicare Part D it's the difference in me paying $2.40 or $6 co-pay for a Rx... either way, remarkably affordable! No idea how much it is with private insurance companies, or how these cancer drugs are charged.
It doesn't matter how good healthcare in the US is or how great the drugs are if people can't afford them.

[leftstreet]

5. All drugs will be available to those who can afford them n/t

[Warpy]

6. Unfortunately, we have a long and bitter history

of insurance companies dealing in bad faith with their subscribers, insisting on generic drugs even when there is a medical necessity for the patented drug, simply refusing to pay for them when push comes to shove.

This "never off patent" is also going to cover biologic drugs that are quite literally life savers for people with severe autoimmune disease.

This seemingly innocuous little amendment is going to cost a lot of lives down the line unless the cost of manufacturing the drug and delivering it to consumers is the basis for the pricing, not drug company greed as is presently the case.

[RaleighNCDUer]

7. Even with the help of insurance, some drugs will be too costly for some, maybe

many, people.

For instance, I have a prescription for a pill (not a cancer treatment, but a preventative) that would cost $400. My insurance for that cuts it down to $60. If it could go generic it might cost me $15. Sure, $60 is a lot better than $400, but that is for a single daily pill. A lot of people are paying out hundreds of dollars a month for prescriptions even with insurance - this means that they will so no relief to that expense. Lose your job and insurance, and suddenly you can't afford your medication at all.

Not good.

[OHdem10]

8. There is an effective Breast Cancer Drug. It costs 48,000 (thousand)

dollars for a course of treatment. It is not available in
Generic form. There are all kinds of policies which will not
cover this drug especailly those who provide only Generics.

All they are saying is Drugs that are not available in Generic
form are not available to a huge number of people. The American
Way --best HC in the world if you can afford it. You must have
very expensive policy which covers these drugs or be rich enough
to pay cash for them.

[Oregone]

10. Why would Democrats, who control the Congress and executive, block generics of these drugs?

Just curious. Can anyone come up with a reasonable explanation?

If you cannot, does that impact your "faith" in the efficiency of the rest of the bill?

[T Wolf]

9. Very easy to explain. Personal story - wife takes many meds. Generics have ZERO copay while

the brand name ones have a FIFTY DOLLAR co-pay. We can (almost) afford that.

Now, compare a co-pay of $0.00 with one that is $500 or $1,000 PER MONTH which the more exotic (e.g., cancer) drugs will have and you should be able to see that most will not be able to afford that.

By protecting and preventing the development of generic versions, the pharma corps get richer and people will die.

Simple as that.

from upthread, I see that my dollar figures were far too low. people will have to come up with tens of thousands of dollars per month to survive if they are unfortunate to need one of those cancer (or other) meds.

[Statistical]

12. Even worse many times insurance companies will simply not cover expensive cancer drugs at any price.

Not even a %. If the drug is on the prohibited formulary none of it will be covered by the plan.

Some caner drugs run $48,000 to $300,000 a year. Yes there is a Lupus cancer drug that runs $300K a year.

No generic + no insurance covers them = no cancer drug if you are poor (or hell even upper middle class).

So it is a defacto no cancer drug available.

[sabrina 1]

11. The question is a good one and causes even more skepticism ~

that these drugs, so expensive now, as the bill guarantees, will be available. Those in support of the bill claim that the Insurance Industry will have to pay for them.

I have not seen anything to back that up. Right now, they are refusing to cover expensive patients and their medications. The Insurance Industry threw a temper tantrum over lowering the fines for poor people who will not be able to afford their mandated premiums, even though they got everything else they wanted in the Baucus Bill. And they are agreeing to this? Something doesn't sound right here.

I have not seen anything from them objecting to being forced to pay for these medications for all Americans who need them. This will seriously cut into their profits so it's extremely out of character for them to go along with it.

I have searched for something to back up the claim that no one with cancer has anything to worry about now regarding these expensive medications.

If someone has a link to the Industry agreeing to this, I would appreciate it.

Sorry to be skeptical, but I seriously doubt the Ins. Industry would be happy with this. And since making them happy has been the #1 aim of Congress and the WH so far, I am pretty skeptical of claims that they are now going to accept this huge loss of money.

[Statistical]

14. Where in any bill is there a provision that insurance companies will be required to cover all drugs.

Would like to see it.

Anyone who believes any of health care reform being considered will require insurance companies to cover ALL drugs and ALL treatments.... well I got a couple bridges to sell.


1) Expensive treatments will be excluded
2) Without generics cancer drugs are prohibitively expensive
3) Those without hundreds of thousands of dollars to pay out of pocket will have no cancer drug in some situations.

Having something be "available" but cost 10x your annual salary might as well be unavailable.