Drugmakers raise US prices on 350 medicines despite pressure

Headline, paywall, and Trump angle

• Some note the HN title omitted “from Trump,” arguing this removed key political context; others defend it as avoiding flamewars.
• Confusion over “pressure” in the headline leads to discussion of whether the administration is actually constraining pharma prices or just posturing.

Pharma economics and international pricing

• One view: pharma is unusually capital‑intensive, with huge R&D costs, long timelines, and oligopolistic “moats.”
• Others counter that many companies spend more on marketing, sales, and lobbying than on R&D, so cost arguments are overstated.
• Strong debate about why US patients pay far more than other countries for the same drugs; several say US buyers effectively subsidize lower regulated prices abroad, while others argue companies simply charge what the US system allows.

“Free market” vs regulation

• Some claim US voters prefer “free markets” over nationalized healthcare; others cite polling (within the thread) suggesting the opposite and emphasize massive existing regulation.
• Healthcare is described as a dysfunctional or impossible “market” due to inelastic demand, information asymmetry, and concentration into cartels.

Opaque pricing, PBMs, and insurance

• Many see nontransparent list prices, rebates, PBMs, discount cards, and “usual and customary price” rules as core to the problem.
• Insurers and PBMs are accused of benefiting from inflated list prices and rebates, with sick patients effectively subsidizing healthy ones.
• Others argue insurers have thin margins and little real leverage over pharma, though this is challenged with data about large investment portfolios and shareholder payouts.

Real‑world billing chaos

• Multiple anecdotes: weeks of calls to get a quote for simple bloodwork, huge discrepancies between “cash” prices, insurance EOBs, and final bills, and aggressive balance billing by hospitals.
• This is contrasted with European experiences of simple, predictable charges or zero out‑of‑pocket costs.

Generics, patents, and global differences

• Discussion of generics (Brazilian “genéricos” vs US generics) highlights that while generics exist, patents and exclusivity periods (often extended) keep many key drugs expensive for years.
• Some note that US generic prices can be low, but PBMs and intermediaries can still overcharge relative to manufacturer prices.

Public funding, lobbying, and stalled reforms

• Participants highlight that US taxpayers already fund a large share of underlying research, yet companies retain patents and set high prices.
• Pharma and insurance lobbying are portrayed as a “corrupt nexus” that repeatedly weakens or kills stronger drug‑pricing bills, leaving only modest Medicare negotiation powers.

System‑level critiques

• Several argue the current US setup is “the worst of both worlds”: neither a coherent public system nor a transparent private market.
• Widespread sentiment: nearly everyone in the chain benefits from complexity and high prices—except patients.