Drugmakers raise US prices on 350 medicines despite pressure
U.S. drugmakers’ plans to raise prices on hundreds of branded medicines, including vaccines and cancer treatments, reignite criticism of how the American healthcare and pharmaceutical pricing systems work. Commenters contrast the opaque, multi-layered U.S. regime of insurers, pharmacy benefit managers, rebates and list prices with systems in Europe and elsewhere where governments negotiate directly and prices are far lower. Many argue that patents, regulatory capture, and the lack of clear, uniform pricing create a de facto cartel that prioritizes shareholder returns over patients, with U.S. consumers effectively subsidizing both industry profits and cheaper drugs abroad.
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.