“End this shocking situation which sees the richest country in the world unable to treat all of its citizens”

In a pharmacy in Chicago (Illinois, United States), August 29, 2023.

“We don’t want any senior to have to choose between respecting their medical prescription and filling their fridge. » The promise of Kamala Harris, the vice-president of the United States, is not an empty statement. Today, nearly 9 million people in the country are forced into this choice. The challenge is to put an end to this shocking situation which sees the richest country in the world unable to treat all of its citizens.

The US government has just published the list of ten that will have to be negotiated between pharmaceutical companies and Medicare, the federal health insurance system for people over 65.

The products concerned are not small pills, but long-term, very expensive and very popular treatments, such as the anticoagulant Equilis produced by Bristol or the antidiabetic Jardiance from Lilly. All together, these represent an expenditure of nearly 50 billion dollars (46 billion euros) per year for Medicare. Its intention is to halve the bill and use these savings to cap the remaining costs for patients.

Punish the recalcitrant

This is an unknown aspect of the famous Inflation Reduction Act, the law enacted in August 2022 and from which the Europeans have mainly retained the protectionist aspect of aid for electric cars “made in the USA” or subsidies for green industries. The text included an important component on the price of , which authorized Medicare to negotiate the price. What he could not do until now. This is precisely the angle of attack chosen by the laboratories which are trying to block this decision in court. They argue about the unconstitutional aspect of this extension of the powers of this program which will be able to sanction the recalcitrant.

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The issue is therefore essential for the pharmaceutical industry in the United States and even beyond. If the substances on the list are for many at the end of their monopoly on patents, some are still good cash cows. Equilis represents an annual revenue of more than 11 billion dollars for Bristol. Beyond that, it is this gradual alignment of the United States with the social security systems in Europe that frightens manufacturers. It calls into question a well-established and efficient economic model. The price of healthcare in the United States is very high, both in hospitals and in pharmacies. Total expenditure is approaching 4,000 billion dollars, or nearly 18% of GDP. Much more than the 12% observed in France or Germany.

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