The Market Ticker
Commentary on The Capital Markets- Category [Health Reform]

Is this really what this group believes - and wants to increase?

As one of the most common mental disorders in the U.S., depression is a serious condition directly affecting millions of people, as well as their surrounding support network of friends and family. In a response to the mounting awareness of mental health, figuring out who may be suffering and providing them with the help and support they need is crucial. In light of this, the U.S. Preventive Services Task Force (USPSTF) has recommended that doctors should screen everyone over the age of 18 for signs of depression, and provide them with the necessary care.

The advice is an update on the 2009 recommendations by the USPSTF – which is made up of an independent panel of experts – and as well as suggesting that all adults should be screened, they also advocate that pregnant women and those who have recently given birth should also be assessed, as they were not previously included in the earlier recommendations. The USPSTF say that they have found “convincing evidence that screening improves the accurate identification of adult patients with depression in primary care settings.”

Uh huh.

The problem with such a recommendation is that it sounds good but the arithmetic isn't so favorable.  In fact it's downright nasty and leaves one to wonder exactly what the motivation for this really is.

This is not a function of wanting to help (or not) people who are depressed.  It is about risk and placing diagnostic capability in the hands of those who are unfit to exercise it, especially when psychotropic, and specifically SSRI-class, drugs are involved.

I've gone through this before but it bears repeating: These drugs have serious warnings on them because they have the potential, in a small but material percentage of people, to cause mass-rage incidents.  This risk is especially pronounced in persons under the age of 25 for reasons we do not fully understand.

Specifically it appears from the literature that if you manage to give one of these drugs to someone who is in fact bi-polar you're running a terrible risk.  People who are mentally ill are often misdiagnosed and to ask an ordinary physician to make a diagnosis of this sort and potentially prescribe said drugs is asking for trouble.

Leave aside the other societal changes that certain people, including our President, want to make.  Specifically, they're very interested in declaring anyone who is "depressed" as mentally incompetent, which gives rise to a whole host of disabilities including removal of one's Second Amendment rights.  Being wrong about this diagnosis could lead to immediate confiscation of one's property and revocation of those rights, for starters.

But that risk pales beside creating rage monsters.

I have long advocated that nobody under the age of 25 should be prescribed these drugs except in a residential facility.  That would gross disrupt a whole lot of pharmaceutical profits but given the facts on these mass-shooting incidents it would have probably prevented nearly all of them, including Sandy Hook, Columbine and Aurora -- for starters.  Even worse is the fact that these drugs appear to often precipitate suicide as well, which is of course the exact opposite of "help."

The debate we must have is one over the benefits for the person taking the drug, which is open to plenty of question when it comes to this class of drug anyway, versus the risk that we create monstrously bad outcomes (read: dead people) for society as a whole.

I think there's a clean argument to be made that with proper monitoring these drugs can be safe and possibly effective in some members of the adult population over the age of 25.   But I maintain my stance, based on the public literature and outcomes that have been witnessed over the last couple of decades, that their use is indefensible in adolescents and young adults outside of a residential facility -- and I'm not alone in that view.

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Read this carefully folks....

Prescription drug costs have been rising faster than general inflation. Actually, they’ve been rising faster than health care costs overall. Last year alone, according to the Truveris National Drug Index, the cost of branded drugs was up 14.77 percent, the cost of specialty drugs was up 9.21 percent, and even the cost of generics rose 2.93 percent.

....

But without any fanfare, Pfizer began the New Year by raising prices on over 100 of its medications — some by as much as 20 percent. In the aggregate, a 20-percent increase on hundreds of drugs can have a much larger effect on health care costs than raising the price of a single drug, even an important one, by 5,000 percent.

....

One way to attack that problem is by stopping a practice that many Americans are totally unaware of: providing American subsidies for the medical care provided by other industrialized countries, such as Canada.

Of course there was no fanfare.  There was also no screaming from the political class in Washington DC as the pharmaceutical industry spends a whole lot of money on lobbying and "making friends."

Let's cut the crap, eh?

Yes, you could "pass a new law."  But you don't need a new law -- you just need the existing laws to matter.

Specifically, Robinson-Patman, for openers, although I'll take the Sherman and Clayton acts too, along with the first sale doctrine that has generally applied to any physical thing sold to anyone.

Heh, just apply those laws and.... poof!  Problem disappears.

Now here's the real ball-buster -- it's far worse than the cited article puts forward.

We're less than 10% of the world population with 330 million people, more or less.  So let's take a simple example with a drug that costs $10 "on average" in the rest of the world (on a population basis) and $100 here.

The total spend is (9 x $10) + (1 x $100), or $190.

If the price is leveled everyone sees a $19 price.

That's a "doubling" for everyone else, but it's a reduction of more than 80% for Americans.

Now let's assume the price is $50 in Canada (and elsewhere) and $100 here.

The same math applies: (9 x $50) + (1 x $100) = total spend is $550.

If we allow the market to level the price and enforce the law then the world-wide price is $55 for everyone.

Canada's price goes up by 10%, or $5, while ours goes down by $45, or nearly half!

Now tell me why the executives of these firms are not all in prison once again please.... and while you're at it you can try explaining why neither political party has taken this on and rammed it up the chute of the pharmaceutical industry.

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