And speaking of deals
There’s this explanation from Trump of the India/Pakistan ceasefire:
? JUST IN – TRUMP: "I said [to India/Pakistan] – let's stop it. If you stop it, we'll do trade. If you don't stop it, we're not gonna do any trade… and all of a sudden, they said, 'I think we're gonna stop.' And they have."
"We're gonna do a lot of trade with Pakistan, with… pic.twitter.com/IOYS87bLQ1
— Eric Daugherty (@EricLDaugh) May 12, 2025
Simplicity itself.
And then there’s this, which I see as another opening move:
President Donald Trump declared Monday that the U.S. “will no longer tolerate profiteering and price gouging from Big Pharma” as he signed an executive order implementing what his administration is calling “most favored nations drug pricing.”
“The principle is simple – whatever the lowest price paid for a drug in other developed countries, that is the price that Americans will pay,” Trump said at the White House. “Some prescription drug and pharmaceutical prices will be reduced almost immediately by 50 to 80 to 90%.”
Trump said that “starting today, the United States will no longer subsidize the healthcare of foreign countries, which is what we were doing. We’re subsidizing others’ healthcare, the countries where they paid a small fraction of what for the same drug that what we pay many, many times more for and will no longer tolerate profiteering and price gouging from Big Pharma.”
I suspect – although I don’t know – that his goal is to even out the prices; in other words, to lower our prices and raise the prices in other countries, so that the disparity isn’t as great. For example, he also said this:
For years, pharmaceutical and drug companies have said that research and development costs were what they are, and for no reason whatsoever, they had to be borne by America alone,” Trump said. “Not anymore, they don’t.”
So it’s a question of who will bear the cost of innovation. I have no idea whether this order is enforceable, and whether it will have the desired effect.
But I’ve long felt that the situation is more complicated than the “stick it to Big Pharma” people think, and I believe Trump is aware of that. For example:
The Pharmaceutical Research and Manufacturers of America trade group opposes the order, saying, “This Foreign First Pricing scheme is a bad deal for American patients.”
“Importing foreign prices will cut billions of dollars from Medicare with no guarantee that it helps patients or improves their access to medicines,” the group’s president, Stephen Ubl, said in a statement provided to Fox News Digital. “It will jeopardize the hundreds of billions our member companies are planning to invest in America, making us more reliant on China for innovative medicines.”
“To lower costs for Americans, we need to address the real reasons U.S. patients are paying more for their medicines. We are the only country in the world that lets PBMs, insurers and hospitals take 50% of every dollar spent on medicines,” Ubl also said. “In fact, hospital markups in 340B and the rebates and fees paid to middlemen in the U.S. often exceed the total cost of medicines oversees. Giving more of this money to patients will lower their medicine costs and reduce the gap with European prices.”
Not my field of expertise. Have at it in the comments.
His story about his ‘fat friend’ buying the ‘fat drug’ in the UK was absolutely classic Trump.
… which I see as another opening move:
I hope you’re right.
-Giving more of this money to patients will lower their medicine costs. Sure it will, sure: “giving more money to patients”? Typical leftist cost accounting.
Healthcare in the US looks the way it does the various players involved who are usually not spending their own money on themselves.
So here we see the pharmaceutical manufacturer trying to deflect blame onto hospitals, PBMs, insurers, everyone but them. But all these players, including employers, governments, and individuals, are all equally responsible for the mess we are in. They are all part of a system trying to do something for someone with someone else’s money. And they can all plausibly claim that they didn’t make the rules, they just are doing the best they can with what’s there.
Whenever this comes up I think of all those so-called new drugs advertised on TV and their lists of warnings and side effects. I think, why would any patient take them and why would a doctor prescribe such?
Then I recall Bernadette on the Big Bang Theory and how she worked for big pharma. She would say something like a new drug they had for arthritis, but the test mice grew a 5th leg, so the switched it to an asthma drug. The writers had big pharma nailed. I recall her company’s name was a play on Amgen.
physicsguy,
Do not take Xyxaltam if allergic to Xyxaltam.
Do not set yourself on fire if you might react poorly to being set on fire.
Do not wrestle an orangutan if your limbs may not stay attached.
The odds of keeping your limbs attached
Are not large
Over the last few years I’ve purchased the exact same ordinary generic drug from local pharmacies on three occasions, and from my Medicare part-D PBM.
The prices I’ve paid: $10/pill, $1.10/pill, $3/pill from the PBM, but later $8.5/pill quoted from the same PBM (no thank you), and lastly $1.85/pill from a local CVS.
Really? I suspect that a PBM will generally protect you from the very worst of the pricing excesses to some extent. But they have no interest in giving you great prices. They provide some conveniences if urgency is not an issue, but you pay dearly for that convenience.
I hope there’s a way to do this – to bring down American prices, though I don’t believe it needs to be to the prices paid in sub-Saharan Africa (Europe is another matter) – without killing research into new drugs. Didn’t Trump either do or suggest Most Favored Nation pricing for drugs sold in the US in his first term?
@TommyJay:I suspect that a PBM will generally protect you from the very worst of the pricing excesses to some extent. But they have no interest in giving you great prices.
You are not their customer. Your part D carrier is their customer. Your part D carrier definitely wants to pay less for drugs across the board, but you specifically are only one element in that calculation. They don’t expect to, and can’t, lower prices for every individual. They negotiate with the PBM for possibly lower drug prices in aggregate. I say “possibly” because the PBMs offer blandishments that are not just lower prices, and the carrier is who gets those, not the individual.
So why not fix both problems? Deal with the drug companies now, and then take on the hospitals and insurance companies later.
Too many people assuming that ‘European Prices’ are fixed. Surely there are many medicines that are so important that they will pay more if that’s the only way to get them.
In the case of poorer countries, it makes sense to allow for substantially lower prices than the US price. Most drugs have a high % of their cost in the up-front development and testing, with the incremental manufacturing and distribution cost per unit being relatively low. In businesses with this economic structure, it make sense to offer lower pricing to those who have lower ability to pay.
Deals?
Fresh from the “Oy” File…
https://thedailyscroll.substack.com/p/may-12-will-trump-knife-israel
H/T Powerline blog.
@Abraxas:So why not fix both problems? Deal with the drug companies now, and then take on the hospitals and insurance companies later.
Because the people who are happy with the current system will scream if they lose anything. Because hospitals and insurers are major employers with lots of money for lobbying. Because it’s all well and good for the mice to agree to put bells on the cat now and the dog later, but it’s a very different thing to actually do it.
Related:
This can’t be right…can it?
https://dallasgop.org/flip-texas/
H/T Instapundit.
Somewhat related:
Apparently a dynamite book on someone who survived the psych-med system…and how she did it…
“Psych Meds And Veblen Goods”—
https://www.zerohedge.com/markets/psych-meds-and-veblen-goods
Key grafs:
Seeing the messages so far, I just can’t resist semi-hijacking the thread on just one point – sorry:
Miguel cervantes
Wrote two-thirds of a haiku
There’s always been people writing on how psychiatrists are Doing It Wrong, and a religion based on that (Scientology) has been around over 70 years now. I doubt psychiatrists have All The Answers, I know for a fact they don’t, but it’s not very likely that the profession itself is completely off-base.
Recently I learned that one of the most damning indictments of psychiatry that I had known of was most likely fraudulent. It was the one where supposedly students who had no mental health issues got themselves committed.
I’ve long read complaints that the FDA blocks approval of drugs from European companies that would compete against American products.
Maybe so and maybe not.
NC
Yup. Rosenhan was big stuff for a long time.
One of the issues was that it seemed to fit what we thought we knew about such facilities.
How do you tell if someone is mentally ill if all you see of him is his going through the daily routine of being in a facility? Lots of mentally ill people can learn, and can take the easy way as long as their particular Thing isn’t awakened.
Yup. Rosenhan went along with popular and in some cases professional wisdom, so to speak.
I remember a line from the first episode of The Sopranos. It’s during Tony’s first visit to his therapist, Jennifer Melfi. At the end of their appointment, Melfi says, “With today’s pharmacology, there’s no reason anyone should suffer from their psychological issues.” And she writes a prescription for Xanax.
That one moment is an excellent indictment of the mental health business, and I’m sure it was intentional. For the next seven years, Tony takes his meds and goes to therapy, but he never gets any better, because he never faces the real problem: he’s a homicidal maniac who has lived with violence or the threat of it his whole life, going from a victim to a victimizer.
Most people don’t have the same problems as Tony, but they have been convinced by therapists to take the drugs instead of really confronting the things that are causing their mental troubles.
In my mind, the therapy sessions in that show are the best acting and the backbone of the show.
Mitchell Strand:
I don’t usually defend therapists, because I think so many of them are poor at what they do, and a significant number push harmful ideas such as “gender affirming therapy.” However, I take issue with your characterization.
Any even halfway decent therapist is well aware that drugs are no panacea and often don’t even work very well. But more to the point, it’s only psychiatrists who prescribe them (or regular MDs). For the most part today, psychiatrists are pill prescribers and don’t do traditional talk therapy, but they are the least numerous of the “therapist” types out there. Psychiatrists have MD degrees. However, the vast majority of therapist have MAs or MSs or MSWs or sometimes (less otten) PhDs. They are the ones who do talk therapy or related therapies like EMDR. For the most part, they consider drugs an adjunct to talk therapy. The idea of talk therapy is to “really confront the things that are causing their mental troubles,” although its track record is varied. For psychoses such as schizophrenia, however, drugs are still the treatment of choice because the cause is thought to be largely physical.
The thing is, there is another way to get them: break the patents. Making the drug is the cheap part of the process, and if you applied for a patent you’ve already told the government how to make the drug.
Those lower prices are negotiated with that threat in mind, that lower prices are better than being cut out altogether.
Neo–
It was only after I posted the comment that I remembered your profession. Since you have more knowledge than I do, I won’t necessarily retract what I said, but I’ll concede that any accuracy there was in my statement was arrived at by chance, rather than by real knowledge.
You make me think about something, though. Jennifer Melfi, while being a decent, good person, may not have been a very good therapist, which merely adds another layer of conflict to an already terrific show. In subsequent seasons, there are plotlines where we see Jennifer agonize over her therapeutic relationship with Tony. She has to go “on the lam” when the Mob learns of her existence and one of her patients kills herself in her absence. She thinks about informing Tony of her rapist’s identity after being attacked. And over the whole show, she’s conflicted about trying to help a recalcitrant criminal. It makes me admire Lorraine Bracco even more for portraying such a complex character.
Mitchell Brand:
I’m certainly not practicing, but I do know a great deal about the profession, years ago and to a lesser extent now.
But I never got into The Sopranos. However, I find that, in general, portrayals of therapists in movies and TV shows often take liberties. Of course, therapists also sometimes take liberties.