AstraZeneca recently set the price of its new Brilique blood thinner, which it hopes will become its next blockbuster drug, at €1.69 ($2.38) per pill in Ger­many.  Whether it will be allowed to maintain that price in Europe’s largest drug market remains to be seen.  You see Europe has a new pricing law that requires pharmaceutical companies to prove not just that a drug works but that it is actually worth more than older therapies. If a drug maker can’t convince German regula­tors that its compound has greater ef­ficacy or additional benefits, then it cannot charge more than rival medi­cines already on the market. The same or similar regulations are in place throughout Europe. (the source for this information is Businessweek June 6, 2011 edition)  

Compare this justification procedure with laws in the United States.  There are no such laws in this country. The government does not regulate pricing on any product or service with the exception of some insurance (California law demands justification of insurance rates for auto coverage).

Rather than not develop new drugs, the pharmaceutical companies have developed economic reviews of their products and plan to provide life impact justifications.  The review of the data will delay the initial release of new products but will help to control the cost of medical care.

A new study showing that the chemotherapy drug Vemurafenib can prolong the lives of people with malignant melanoma — the especially aggressive and dangerous form of skin cancer that kills about 8,700 Americans each year — has rightfully lifted the spirits of doctors and patients alike.  It was a feature item recently on ABC World News.   However the Los Angeles Times reports interviewing Tim Turnham, executive director of the Melanoma Research Foundation. He told the Times “There’s been a lot of hype in the news, but this is not a home run. It’s a really solid single.” An expensive single, at that. Vemurafenib will likely cost tens of thousands of dollars per year. (Turnham’s off-the-cuff guess is $50,000.)

Should Medicare or any insurance company pay for high-priced specialized care?  If it’s for your mother, your father, your brother the answer is YES.  Sadly society cannot afford everything.  Why can’t Medicare negotiate drug costs?  Perhaps capitalism is not always the right answer.

From Kaiser Permanente  “partners in health e-newsletter”

Every year, about 790,000 people in the U.S. have a stroke, according to the National Stroke Association. While stroke can affect anyone, African Americans are more impacted by stroke than any other group in the American population.

Strokes can occur suddenly, but if you know the symptoms and how to respond, you can help limit long-term damage. The faster you get medical attention, the better your chances of recovery.

If you suddenly experience these six signs of stroke — or see them in a friend — call 911 right away.

1. Sudden vision changes
2. Numbness, weakness, tingling, or paralysis in your face, arm, or leg, especially on one side of your body
3. Trouble speaking or understanding simple statements
4. Confusion
5. Problems with walking or balance
6. A severe headache that is different from other headaches you’ve had before

Even if you have one of these symptoms and it goes away, you should see your doctor. It may be a warning that a stroke may happen soon.

You can help decrease your risk of stroke by making a few important lifestyle changes:

• · don’t smoke
• · maintain a healthy weight
• · manage your cholesterol and blood pressure
• · eat a heart-healthy diet — including lean protein, whole grains, and plenty of produce — and limit alcohol and salt
• · aim for 2½ hours of moderate activity each week, or just 30 minutes a day (check with your doctor about the right level of exercise for you)

First of all let’s be clear about one fact. Health insurance companies are “for profit” businesses.  Here is a list of largest health insurers in the United States.  They operate in most large metropolitan areas using different names and are incorporated separately.  I believe that is done to hide their actual profits.

Blue Cross

CIGNA

Blue Shield

Aetna

Health Net

United Healthcare

Humana

Pacificare

California’s Department of Insurance does not have the power to control the rates that health insurers charge.  The best that the department can do is strong arm the insurance companies to keep rate increases at a modest level. 

The insurance companies have found a way to obtain the rates they want to charge without facing regulation of their rates.  They announce to the subscribers and the media their plans to increase rates by 25% to 35%.  Everyone screams “thieves” and the Department of Insurance says they will conduct a “review.”  After that “review” is completed the insurance companies agree to raise their rates by 9% to 10% which is the rate increase they really wanted.  The public is relieved that the increase was not the feared 25% to 35%.

Executives and shareholders of the five biggest for-profit health insurers, UnitedHealth Group Inc., WellPoint Inc., Aetna Inc., Humana Inc., and Cigna Corp., enjoyed combined profit of $12.2 billion in 2009, up 56 percent from the previous year. It was the best year ever for Big Insurance.

Imagine a society where no company earns a profit providing health care. The immediate impact would be a savings of $12.2 billion just by eliminating the “for profit” insurance companies.   I wonder how many hospitals and other providers are “for profit.” While that amount won’t solve all the problems of high health care costs it is a beginning.

While I agree that Obamacare is a mistake the Republicans have not offered an alternative. The reason I opposed Obama’s health care plan is that it did nothing to control costs.

Just today David Lazarus wrote an article in the Los Angeles Times about a woman who has an outpatient surgery at Cedars-Sinai Medical Center in Los Angeles. The surgery began at 10:40 a.m. By 3 p.m., she was on her way home. The cost for this event was $65,000. Fortunately she had insurance.

[http://www.latimes.com/videobeta/d5592c27-fd83-4490-bbc3-a0a0ac4f7397/Business/Why-would-a-short-hospital-stay-cost-so-much-]

Why would a four hour simple procedure cost that much money? Mr. Lazarus does not have an answer.