Medicare would become cheaper tomorrow if the government would negotiate drug prices down. Trump isn't going to do that.
[1] https://www.cms.gov/inflation-reduction-act-and-medicare/med...
Is "we just won't fund your drug, even though people will die and you're the only option on the market" actually something that could happen? Would that be politically palatable to anybody?
I guess there's patent invalidation and forced genericization, but that would kill innovation real quick.
I think a far better idea would be to impose very strict caps on admin / non-medical costs, potentially at the expense of paying a bit more to fraudsters, changing FDA regulations to minimize (death from side effects + death from no available drugs) instead of just the former, as well as becoming a lot more aggressive about expensive and unnecessary procedures that doctors perform to get rich quick.
On the side, he may open the door for generic substitutes as well from CAN etc.
A simple price directive would be set at the same time, without any negotiation:
The price US medicare will pay will only be the average price for each drug, in all OECD countries.
With no legal precedent supporting him but absolutely no resistance from the branches of government meant to keep him in check.
The government has all the cards, negotiation is really just a matter of will.
If there is only 1 company to negotiate with, the government is really the only entity that can threaten to simply create a competitor and give them the IP rights (by legal fiat) to do so. If you tell the existing company that your alternative solution is to compete with them using taxpayer money, they might choose to take the lesson of history and accept the government's negotiating position.
Presumably the government also has the option to permit purchase of pharmaceuticals from other countries. "Oh, you've raised the cost of X? That's okay, we'll buy it from licensed suppliers in the EU for a tenth of the price."
Actually is that possible? Are the EU suppliers allowed to resell at the gov negotiated price? Or are the gov negotiated price only for internal market?
(I've been wondering since I don't understand why swiss drug price are so much higher given that EU suppliers are next door)
Most EU countrys payed $40-$60 (per unit, shipped by 3rd party courier, who do their own billing), SE Asia and Australia $60-$80 and the US $1500-$2000. Before I left we started also shipping to Canada, dunno about the prices anymore, but substantially less.
The head of our institute was apparently involved in the negotiations and although I didn't get a chance to talk to him directly, the popular story was that our guys showed up, were presented with a pretty much done deal and told that the price and payment terms were nonnegotiable. Also, during meetings, he would refer to the Amis often as "Die, die nicht mehr alle Tassen im Schrank haben", which roughly translates to "The crazy ones."
Also, the product they wanted specified a significantly less complex and cheaper pooling procedure than we were able to offer...
Literally all the leverage.