Hacker News Reader

Comment by DoubleDerper | Hacker News Reader

Can anyone from a socialized medicine country explain how this particular treatment would be dispensed in their country? I'm an American and wondering, for example, would government of the Netherlands truly front this $1mm per treatment cost for every cancer patient?

View on HN

I'm not from such a country, but I do listen to The Weeds (a policy podcast) and they have discussed how it works. Roughly speaking, there are committees that look at the efficacy of new treatments and their costs, and they decide what they will pay for a given treatment. Then the drug maker decides if they will sell it at that price. There are cases where the government will not pay the drug maker's reserve price. For example, there was a period of time where Kadcyla was not available in the UK. Then, after a while, the drug maker decided to reduce their reserve price, and now it seems the Britons can get the drug.

This national pricing leverage is a big part of why drugs are cheaper in countries with national price setting. Socialized medicine is actually less of a factor in this space. What matters is whether a single entity has the ability to set prices for the entire market (or a sufficiently large slice of it).

https://pharmaphorum.com/news/kadcyla-set-regular-nhs-fundin...

This just makes so much more sense than the US's broken system. Is there a corollary to what you describe such that the governments could periodically publish a list of priorities, thus incentivizing private research into a particular categories (certain types of cancers, alzheimers, etc)?

I'm not from an EU country, but I'm familiar with it.

A lot of European countries do a health technology assessment to determine the cost effectiveness. If it's not cost effective, they don't pay for it.

Glybera was approved in the EU and Germany pays for it and it costs $1M.[1] Of course, very very few patients have or will be treated with it.

[1]http://blogs.nature.com/tradesecrets/2015/03/03/1-million-pr...

Reply on news.ycombinator.com