THE 5% TO THE 1% THINK ALL THIS IS FUNNY.
The major cause of soaring prices is this====our health insurance and PHARMA are all global making our US health systems global so now they see market value as what the global 1% and their 2% will pay.
I used this one example because of a group of doctors calling themselves LEFT IN MEDICAL POLICY when they are not.
Dr. Berger's Accepted Insurance
Please verify insurance information directly with your doctor's office as it may change frequently.
Aetna Signature Administrators PPO
BCBS Blue Card PPO
CareFirst BlueChoice Advantage
CareFirst BluePreferred PPO
CIGNA Open Access Plus
Coventry Southern Health PPO
First Health PPO
Geisinger Health Plan
UHC Choice EPO
UHC Choice Plus POS
UHC Optimum Choice Preferred POS
UHC Options PPO
Just about every health insurer on the list above is already global -----no American health insurers and no Federal public health programs--
THIS ALL OCCURRED UNDER OBAMA WITH CLINTON NEO-LIBERALS PASSING POLICIES
'Bupa and BCBS companies will also develop new insurance products ... global provider network for people who require international health coverage, and other' ...
Here we see the same consolidation as occurred in Baltimore and across the nation. PA has its PUBLIC UNIVERSITIES all tied to global Wall Street--VERY CORPORATIZED as with our University of Maryland Medical System----DESIGNATED QUASI-GOVERNMENTAL---meaning it operates as a corporation and not a state medical facility.
If we look around Baltimore we see CVS PHARMACIES everywhere---they are now looking like SUBWAY AND 7-11 stores in their coverage of communities===THESE ARE MONOPOLIES-----and they are global MONOPOLIES. The consolidation of these public university campuses into what will be a global health tourism corporation ----all having a focus on educating simply for those industries tied to its campus. So we see the same BIOTECH RESEARCH TIED TO THIS NEW MEDICAL SCHOOL----as in Baltimore all looking for the BEST OF THE BEST IN THE WORLD for students and staff. Of course these are not the BEST OF THE BEST----they are no better or worse than our own US students and staff----THIS IS US FOREIGN ECONOMIC ZONE POLICIES----bringing US MEGACITIES filled with global labor pool serving the global 1% and their 2% with manufactured services and products.
We can yell at Trump all we like----Obama and Clinton neo-liberals created these structures knowing our health system was going to be made third world with total deregulation with global health executives deciding what is EVIDENCE-BASED MEDICINE which when global health executives create this data----it means how to provide health services as cheaply as possible to MAXIMIZE PROFITS FOR THESE GLOBAL HEALTH SYSTEMS.
So our JOHNS HOPKINS doctor----DR BERGER---has a long list of global health insurance corporations and this PA health system
Geisinger officially has a medical school
Geisinger's main campus in Danville, Pa. (Geisinger Health System )
By John Beauge | Special to PennLive
on January 01, 2017 at 4:55 PM, updated January 02, 2017 at 11:35 AM
SCRANTON - Commonwealth Medical College is now officially part of Geisinger Health System.
The integration, announced in September, took effect Sunday after the necessary regulatory approvals were received.
With the exception of the name and branding changes, it will be business as usual for students, faculty and staff, a news release states.
Now known as Geisinger Commonwealth School of Medicine, it opened in 2008 in Scranton and has campuses in Sayre, Wilkes-Barre and Williamsport.
Geisinger said it has long been involved in training doctors, and having a medical school "completes the continuum."
It offers doctor of medicine and master of biomedical sciences degrees. The news release hints at the possibility of creating more masters' degree programs in areas like genomics and information technology.
The college has awarded more than 250 doctor degrees and 300 master's degrees since the first class in 2013.
Geisinger Commonwealth School of Medicine is one of three medical colleges in Pennsylvania outside Pittsburgh and Philadelphia. The other two are Penn State College of Medicine in Dauphin County and Lake Erie College of Osteopathic Medicine in Erie.
"Joining together a world-class health system and health plan with a young, innovative school of medicine will make our region a hub for medical education, research and discovery," Dr. David T. Feinberg, Geisinger president and CEO, said in the release.
"Through this partnership, Geisinger Commonwealth will continue to realize the vision and mission of its original founders to provide high-quality healthcare to patients in the region for generations to come."
Dr. Steven J. Scheinman will continue to as the school of medicine's president and dean and becomes chief academic officer and executive vice president at Geisinger Health System.
The many relationships with community partners will be maintained, Scheinman and Feinberg said.
The physician-led Geisinger Health System is comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 12 hospital campuses, two research centers and a 551,000-member health plan.
It has absorbed the college's 185 staff members.
COVENTRY AND COVENTRY SOUTH are clearly identified as subsidiaries of AETNA-----A GLOBAL HEALTH INSURANCE CORPORATION.
So a doctor tied to Hopkins offers these insurance structures for his practice. This brings in global citizens who purchase from these global insurance corporations. Someone in China or Bahrain buys UNITED HEALTHCARE INSURANCE and they have access to our DR BERGEN in Baltimore's Johns Hopkins. This also ties those global health consumers to a HOPKINS health campus in most Foreign Economic Zones around the world. Notice they all give the same services all over the world. EYE EXAMS are a must for TECHNOLOGY AND FINANCE INDUSTRIES---and that is about all we have now.
US commerce under right wing pols always tie public policy to MARKET BASED VALUE====MARKET BASED RATES====this means corporations charge whatever they think people will pay. Now, an American may be priced out of buying that fancy car---that fancy phone---because of MARKET-BASED RATES===but when we are priced out of health care-----education-----housing----this is why those areas have remained through modern history REMOVED FROM MARKET VALUE RATES. So, global Wall Street already has prices in health care far too high----profiteering on top of health industry fraud ====think what health care MARKET VALUE RATES look like when our local health systems are tying to a global 1% and 2% willing to take a health tourism trip to Baltimore for that developed nation quality of care.
PRICES WILL SOAR WELL BEYOND WHAT WE ARE SEEING TODAY.
That was the goal of CLINTON/BUSH/OBAMA and Affordable Care Act---don't let Republicans wanting to repeal ACA fool you---they wrote ACA all but the funding of Medicaid as well as the very, very, very, very bad HEALTH INSURANCE MANDATE.
Southern Health Insurance
Reviewed on September 29, 2011 /
Southern Health Services, Inc. is the parent company of Coventry Health Care and Southern Health. Coventry Health Care and Southern Health provide health insurance plans for residents of the state of Virginia.
Compare health insurance rates from active providers by clicking on the toolbox now!
Southern Health Services, Inc. has been in existence since 1985. The company offers insurance plans to employers of various sizes and needs.
Southern Health Quotes
Quotes for Southern Health products can be obtained by filling out the online brochure and then submitting it via the website. Quotes can also be obtained by speaking with a broker or sales representative from Southern Health.
Southern Health Online Services
The company’s website provides online services, which can be used to review your personal account information. For example, you can see your recent claims and laboratory bills and your prescription medication and uses. The site also provides access to a provider directory including physicians, pharmacies, and hospitals.
Southern Health Vision Plan
Southern Health is in contract with VSP, a vision insurance provider, to cover vision benefits to its policyholders. Under the benefits of this plan, the following are covered:
- Eye exams
- Prescription glasses
- Prescription sunglasses
- Non-prescription sunglasses
Southern Health offers many different health insurance policies to meet individual and group needs for quality affordable coverage. The plans include:
- Coventry Consumer Choice plans, which are also known as C3 plans
C3 Plans are designed to help save the employer money. The C3 plans are Coventry Consumer Choice plans, which include flexible spending accounts, health savings accounts, and health reimbursement accounts. These accounts are designed for employees and employers to take money out of their paychecks pre-tax to be used later for medical expenses. A Southern Health sales representative or broker can explain specific details on the C3 accounts in further detail.
Southern Health also participates in self and fully funded insurance products to lower the cost of insurance to the employer. These plans can also be made clarified by brokers and sales representatives of Southern Health.
Under Southern Health, the plans are in contract with over 11,000 in network providers and hospitals. A list of participating providers and hospitals can be located on the website.
Southern Health Mental Health Plans
Southern Health offers mental health coverage under its MHNet plan. The plan covers inpatient, outpatient, and substance abuse services.
The plan is run like an HMO, because you have to have a referral for inpatient or outpatient services. A list of mental health providers is also available on the Southern Health website.
All mental health claim forms can be downloaded from the Southern Health Insurance website. Claim forms are either for in network coverage or out of network coverage.
Southern Health Insurance Prescription Coverage
Southern Health Insurance offers prescription drug coverage through in network pharmacies or through the mail order company, Medco. A list of participating pharmacies is located on the company’s website along with a list of covered medication.
Under the prescription coverage plan, policyholders can view their recent medications, obtain and compare costs of medications. You can also read up on facts and side effects of prescription medication.
Southern Health Wellness Resources
Southern Health offers advice and information to encourage health and fitness to their policyholders. The website includes information on preventive care, immunization schedules, and ways to stop smoking. The site also provides guidelines for diet, nutrition, and exercise. In fact, there are gyms which offer a discount if you are a Southern Health policyholder.
In addition to these topics, there is help on substance abuse and disease. This section includes details on symptoms, causes, and treatments.
Kids Health is another section on the website, which provides:
- Helpful information on parenting
- Children’s health from birth to adolescence
- Social and mental development
Southern Health has offices in Richmond, Charlottesville, and Roanoke, Virginia.
The Richmond office is located at:
9881 Mayland Drive
Richmond, VA 23223
The Charlottesville office is at the following address:
1000 Research Park Blvd., Suite 200
Charlottesville, VA 22911
The Roanoke office can be found at:
6701 Peters Creek Rd. Suite 101
Roanoke, VA 24019
Because Affordable Care Act PRETENDED to be creating private STATE health systems all the global health corporations have been allowed to call subsidiaries different names making them sound regional ---when they are report to the same global corporation. Here is Coventry Southern Health's PARENT CORPORATION AETNA----and it has its own PHARMA----its own PRIVATE MEDICARE ---and its own ACO managed care system.....same with KAISER PERMANENTE/JOHNS HOPKINS/CVS.
As Baltimore fills with subsidiaries of each of these global health systems our entire health care structure is a monopoly.
Our pharmacy benefits and services can help you make the best choices for your health and your budget.
- Individuals & Families
Legal notices: Health benefits and insurance plans contain exclusions and limitations.
Aetna Medicare: Find Medicare pharmacy and prescription drug information.
Aetna Rx Home Delivery®
Do you take maintenance drugs? These are drugs used to treat long-term conditions, such as high blood pressure or diabetes. You can use our home delivery service to get up to a 90-day supply of medicine by mail.
Aetna Rx Home Delivery refers to Aetna Rx Home Delivery, LLC, a subsidiary of Aetna, Inc., which is a licensed pharmacy providing prescription services by mail.
Find out about home delivery
Aetna Specialty Pharmacy®
Some long-term health conditions - such as multiple sclerosis, rheumatoid arthritis or cancer - require special medicines. They need to be sent quickly, safely and securely. With Aetna Specialty Pharmacy*, you can get these drugs by mail - sent to your home, doctor's office or anywhere you choose. With free standard shipping, too.
*Specialty medications through Aetna Specialty Pharmacy and the Specialty Pharmacy Network may not be available to California HMO members. Talk to your doctor about the appropriate way to get the specialty medications you need. Doctors may have agreed to dispense and administer these drugs to you themselves. Or they may write a prescription so you can fill them at any participating retail or mail-order pharmacy.
Aetna Specialty Pharmacy refers to Aetna Specialty Pharmacy, LLC, a subsidiary of Aetna, Inc., which is a licensed pharmacy that operates through specialty pharmacy prescription fulfillment.
Learn more about the specialty pharmacy
Get extra support with your pharmacy coverage
Being an Aetna prescription drug plan member has its perks. Our support programs offer extra help to people who have diabetes, a heart condition or migraines.
Get support program details
Support for some complex health conditions Treatment for certain chronic conditions often means taking a specialty drug. However, you don't have to do it alone. A nurse from the Aetna Specialty Health Care ManagementSM team can help you through your treatment.
Learn about extra nurse support
More about your medicationsSee if a prescription drug is covered. You’ll need the name of your pharmacy plan.
Look up a medicine
Find out more about the proper disposal of unused medicines from the U.S. Food and Drug Administration.
How to dispose of unused medicines
This is what will become a huge monopoly in Baltimore region and know why? Just as in PA where public universities merged with private structures to create that Geisinger Medical School with BIOTECH PARKS so too will our UNIVERSITY OF MARYLAND MEDICAL SYSTEMS merge with Johns Hopkins into one great big global health campus. UMMS now has several branches in the region===Hopkins is expanding in Montgomery County and Eastern Shore so what will be our choices for health care in the not-too-soon future?
A GREAT BIG GLOBAL MONOPOLY ABLE TO SAY ANYTHING THEY WANT GIVING ACCESS TO ANYONE THEY WANT FOR WHATEVER PRICE THEY WANT====THAT WAS THE GOAL OF AFFORDABLE CARE ACT.
Keep in mind---this is the Johns Hopkins CEO our local LOYOLA UNIVERSITY awarded a great for business award. Our religious institutions are of course now GLOBAL CORPORATIONS as well and are right in there with global tourism while 99% of Americans are dying from lack of access to ordinary care. THESE ARE NOT RELIGIOUS LEADERS----THEY ARE THE 5% TO THE 1% working for the global 1%!
LOVE THAT GLOBAL LABOR POOL AND MONSTER OLD WORLD MERCHANTS OF VENICE now tying to our health care around the world----global market value rates====ah, great health policy for all world citizens.
Kaiser Permanente, Johns Hopkins Medicine Announce Enhanced Strategic Collaboration
Designed to bring care closer to home, improve quality of care and better serve communities
Release Date: July 29, 2014
From left, Brian Gragnolati, Paul B. Rothman and Ronald R. Peterson from Johns Hopkins Medicine; and Robert Pearl, Kim Horn, Bernard Tyson and Bernadette Loftus from Kaiser Permanente.
Credit: Kaiser Permanente
ROCKVILLE, Md. — Kaiser Permanente and Johns Hopkins Medicine today announced plans to strengthen the successful collaboration between the two health care organizations. With the new agreement, Kaiser Permanente and Johns Hopkins Medicine will expand ways to deliver quality care by sharing evidence-based best practices, advancing population health programs, collaborating on education and research endeavors, and exploring how the organizations can work together to create better health care models for consumers and their communities.
“Kaiser Permanente is committed to providing high-quality health care and service, while also leading the nation in making health care more affordable for Americans,” says Kaiser Permanente Chairman and CEO Bernard J. Tyson. “This enhanced collaboration with Johns Hopkins will help us deliver on that commitment and continue to meet the evolving health needs and expectations of our members, patients and customers.”
“Health care today requires partnership among forward-thinking health care organizations,” says Paul B. Rothman, M.D., dean of the medical faculty and CEO of Johns Hopkins Medicine. “Through a strategic collaboration with Kaiser Permanente, we will be able to cultivate the human and intellectual capital found in both organizations to significantly improve the safety and quality of care while enhancing the patient experience.”
“Combining the expertise of the nation's leading integrated care delivery organization with the expertise of the country's leading academic medical center will allow us both to provide even better quality and service to their patients,” says Robert Pearl, M.D., executive director and CEO of the Mid-Atlantic Permanente Medical Group. “As the United States works to improve its health care system, this partnership will provide powerful and important insights into how care can be provided to patients in new and innovative ways.”
The agreement between the two health care organizations will initially focus on:
• Sharing best practices and leveraging electronic medical records to accommodate the growing need among providers and patients to access clinical information quickly and efficiently.
• Strengthening the relationship between Kaiser Permanente and Suburban Hospital, a member of Johns Hopkins Medicine, by combining their collective expertise to create an advanced model of care.
• Bringing care into the home to meet the evolving needs of patients by exploring and leveraging technology to deliver personalized medicine.
• Building on the existing collaboration between Kaiser Permanente and Johns Hopkins’ Armstrong Institute for Patient Safety and Quality to advance the patient experience and improve treatment outcomes while reducing costs.
• Pursuing opportunities to develop educational programs and research-based best practices that benefit the overall health of the people in the communities we serve.
“This new agreement builds on the relationship Kaiser Permanente of the Mid-Atlantic States and Johns Hopkins Medicine have had for more than 15 years,” says Ronald R. Peterson, president of The Johns Hopkins Hospital and Health System and executive vice president of Johns Hopkins Medicine. “Care providers from both organizations successfully have been working together to deliver high-quality care. This is demonstrated through the Kaiser collaboration with Suburban Hospital in Maryland, where physicians from both care teams work side by side to ensure the best patient outcomes.”
“Working more closely with Johns Hopkins Medicine will help us deliver an innovative care experience for our members that will translate into quality care that’s also affordable,” says Kim Horn, president of Kaiser Permanente of the Mid-Atlantic States. “This strategic collaboration will facilitate additional population health research and innovative practices benefiting both individual patients and the larger community.”
“The collaboration between Johns Hopkins Medicine and Kaiser Permanente will escalate medical solutions from the bench to the bedside,” says Brian Gragnolati, senior vice president of the Johns Hopkins Health System. “Together we can find solutions that provide patients with value-based care.”
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve approximately 9.3 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.
About Kaiser Permanente of the Mid-Atlantic States
Kaiser Permanente of the Mid-Atlantic States region, headquartered in Rockville, Maryland, provides and coordinates complete health care services for more than 510,000 members through 29 medical centers in Maryland, Virginia and Washington, D.C. Founded in 1980, Kaiser Permanente of the Mid-Atlantic States is a total health organization comprising Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. and the Mid-Atlantic Permanente Medical Group, P.C., an independent medical group that features more than 1,000 physicians. Kaiser Permanente of the Mid-Atlantic States was ranked in the nation’s 20 top commercial health plans and 10 top Medicare health plans — and was named the number one commercial and Medicare plan for Maryland, Virginia and Washington, D.C. — in the National Committee for Quality Assurance’s Private Health Insurance Plan Rankings 2013-2014. For more information about Kaiser Permanente of the Mid-Atlantic States, visit kp.org or follow us on Twitter @KPMidAtlantic.
About Johns Hopkins Medicine
Johns Hopkins Medicine (JHM), headquartered in Baltimore, Maryland, is a $7 billion integrated global health enterprise and one of the leading health care systems in the United States. JHM unites physicians and scientists of the Johns Hopkins University School of Medicine with the organizations, health professionals and facilities of The Johns Hopkins Hospital and Health System. JHM's vision, “Together, we will deliver the promise of medicine,” is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care. Diverse and inclusive, JHM educates medical students, scientists, health care professionals and the public; conducts biomedical research; and provides patient-centered medicine to prevent, diagnose and treat human illness. JHM operates six academic and community hospitals, four suburban health care and surgery centers, and more than 30 primary health care outpatient sites. The Johns Hopkins Hospital, opened in 1889, has been ranked number one in the nation by U.S. News & World Report for 22 years of the survey’s 25 year history, most recently in 2013. For information about JHM, its clinical programs or for help in choosing a personal physician, call 410-955-5000 or visit www.hopkinsmedicine.org.
We had to watch this morning what will be a constant TV news topic=====people unable to access ordinary health care and PHARMA----insulin prices are soaring because it is now sold globally and the Foreign Economic Zones overseas with all those MCDONALDS====STARBUCKS=====US sodas and snack food now have a global diabetes crisis and those global rich are the ones partaking and they are paying more and more and more to access that diabetes PHARMA and health care.
The second reason this and all PHARMA will see increase is what PHARMA corporations correctly call the MIDDLE-MEN----these are the NEW AFFORDABLE CARE ACT health system groups we are told are now making things affordable. They are PRIVATE CORPORATIONS tagging on more and more fees for their services all of which was done by our Federal government and we were not charged. All those Federal public health services built into public health care have now been privatized to create multiple levels of fees and costs TO CONSUMERS---not these global health systems.
As we watch our national news show the sadness of people not able to access health care====they all knew this would be the result of ACA and never allowed any left social Democratic view shouting what these policies would REALLY DO.
ABSOLUTELY NO DISCUSSION ON ACA OUTSIDE OF A REPUBLICAN NOT LIKING IT AND A DEMOCRAT LIKING IT BECAUSE IT HELPED THE POOR.
All of those smiling faces on the post of Johns Hopkins and its merger with Kaiser------our Loyola University who awards a Hopkins CEO for his work KNOW THIS WAS THE GOAL OF AFFORDABLE CARE ACT.
This is only ONE disease vector---the real losses of lives will NOT BE TELEVISED.
So CVS will not cover LANTUS----all of Baltimore is covered with CVS---this is how monopoly will literally kill.
Why treating diabetes keeps getting more expensive
By Carolyn Y. Johnson October 31, 2016
Rising insulin prices leaves Type 1 diabetes patient living in fear
Laura Marston is one of the 1.25 million Americans who suffer from Type 1 diabetes, an autoimmune disorder in which a person’s pancreas can’t make insulin. She hoards vials of the life-saving medicine in her refrigerator to protect herself from the drug's rising prices. (Jorge Ribas/The Washington Post)At first, the researchers who discovered insulin agonized about whether to patent the drug at all. It was 1921, and the team of biochemists and physicians based in Toronto was troubled by the idea of profiting from a medicine that had such widespread human value, one that could transform diabetes from a death sentence into a manageable disease.
Ultimately, they decided to file for a patent — and promptly sold it to the University of Toronto for $3, or $1 for each person listed. It was the best way, they believed, to ensure that no company would have a monopoly and patients would have affordable access to a safe, effective drug.
“Above all, these were discoverers who were trying to do a great humanitarian thing,” said historian Michael Bliss, “and they hoped their discovery was a kind of gift to humanity.”
But the drug also has become a gift to the pharmaceutical industry. A version of insulin that carried a list price of $17 a vial in 1997 is priced at $138 today. Another that launched two decades ago with a sticker price of $21 a vial has been increased to $255.
[This 90-year-old fight over insulin royalties reveals just how much has changed in medicine]
Seventy-five years after the original insulin patent expired — a point at which drug prices usually decline — three companies have made incremental improvements to insulin that generate new patents and profits, creating a family of modern insulins worth billions of dollars.
The history of insulin captures one of the mystifying complexities of the pharmaceutical market — how long-standing drugs become more expensive with time and competition fails to hold down prices. Companies point to improvements in their drugs, but medical experts say some of those changes are simply a strategy to keep prices high with new patent protections. They question how much the molecular tweaks to insulin really improve patients’ health.
Some of the improvements have been substantial, replacing insulin derived from animals with a genetically engineered human version with fewer side effects. But the latest generation of “ultra-long acting” insulins, in particular, has generated a debate about whether the newest versions are really worth the cost.
“I don’t think it takes a cynic such as myself to see most of these drugs are being developed to preserve patent protection,” said David Nathan, a Harvard Medical School professor. “The truth is they are marginally different, and the clinical benefits of them over the older drugs have been zero.”
The nation faces a diabetes epidemic: About 6 million American adults depend on the drug. As is true with many medicines, most patients don’t pay the full list price. The rising cost of insulin is often masked by health insurance.
But people with gaps in insurance, skimpy health coverage, or who break or lose a vial have learned the hard way how much the price has risen.
Among them is Laura Marston, 34, of the District, who has been on insulin for more than half of her life. When she was diagnosed with Type 1 diabetes as a teenager, meaning her body can’t make insulin, she took Humulin, a drug invented the year she was born. With insurance, her insulin cost $10 for a month’s supply.
Shortly after, Marston’s doctor switched her to a brand-new insulin called Humalog, which took effect faster. The drug was just as affordable with insurance.
Then, in 2012, Marston abruptly lost her job and health insurance. She found herself suddenly on the hook for the full price of Humalog, which was listed at $140 a vial — and she needed three vials each month. She managed to obtain a very pricey insurance plan, but the insulin still cost her about $200 a month.
An older insulin could have been cheaper, but she didn’t know it was an option. She had years of experience and comfort managing her disease on her current regimen. But she’s been closely tracking the price of new and old insulins ever since.
“Nor will I, ever again, go on a new insulin. I’ve learned my lesson,” Marston said.
Drug companies commonly say that their rising prices reflect, in part, the costs of future innovation — the research and development to create new and better drugs. That makes Marston feel trapped: Companies say they charge high prices for old drugs so they can launch newer and better ones — and charge more for them, too.
“If the justifications pharma is giving are true, then it never ends for us,” Marston said.
Laura Marston holds up a vial of Humalog, the insulin she takes for Type 1 diabetes. When she was diagnosed at age 14, the list price for the drug was $21 per vial. Now it's more than $250 a vial.
(Jorge Ribas, The Washington Post)Irl Hirsch remembers when insulin cost 75 cents a vial. The 58-year-old doctor has used insulin for more than half a century and knows firsthand that pricing and access weren’t an issue for much of that time.
Drugstore ads from the 1960s published in The Washington Post advertised insulin for as little as 84 cents a vial — less than a bottle of Breck shampoo, three bags of Halloween candy bars or a can of Suave hair spray. The most expensive version listed in the ad was less than $2 a vial.
For years, the price was affordable as far as he knows, Hirsch says — as it should be.
“This is not a concierge medication,” he said.
As a diabetes specialist at the University of Washington School of Medicine in Seattle and as a patient, Hirsch has witnessed insulin’s evolution: a scientific quest driven by an effort to make insulin molecules that more closely mimic the way the hormone works in the body. The first insulin he took was crude by today’s standards, extracted from the macerated pancreas of farm animals. Some patients had allergic reactions, such as skin rashes.
The modern age of insulin innovation kicked off with Eli Lilly’s introduction of Humulin, in 1982. Using genetic engineering, biologists figured out a way to modify bacteria into tiny, specialized factories that could create insulin that matches the kind the human body produces. Allergic reactions became rare as more people used the newer version.
Humulin could be created in vats instead of harvested from cows or pigs, and it relieved doctors’ worries that the looming diabetes epidemic would cause a shortage.
“These were an incredibly efficient way of making insulin. We’d never run out; it would keep the prices under control,” Nathan said. “How that has changed.”
The Danish company Novo Nordisk began making its own bioengineered human insulin in 1991. Rather than lower the price, however, competition had an unusual effect: The list prices began to rise.
As concerns about drug prices have simmered among the public and politicians, the long history of insulin shows the ripple effect of the industry-wide practice of raising list prices of existing drugs: All boats rise with the tide. Price increases on old drugs recalibrate how much it costs to treat the disease, paving the way for new drugs to be launched at ever higher prices.
According to a Washington Post analysis of Truven Health Analytics data, over the past two decades, Eli Lilly and Novo Nordisk raised prices on their human insulins 450 percent above inflation, closely in sync.
That’s not what Eli Lilly anticipated, at least not publicly. When Humulin was introduced in 1982, company spokesman Ronald Culp told the New York Times, “The long-term desire is that the cost will come down, but at this point we cannot speculate on just how far.”
Since then, other insulins have come on the market in faster-acting or longer-lasting formulations. Experts have been divided about how beneficial those advancements are and whether they are necessary for many patients. Meanwhile, the new drugs’ prices have risen rapidly. Humalog, for instance, has soared from $21 a vial to more than $250 in the past 20 years.
“Yes, in a dramatic fashion, the newer insulins may not have been as large . . . as those previous leaps,” said Todd Hobbs, chief medical officer of Novo Nordisk in North America. “I think it’s tough to compare the price increases over the decades, but if you look at the advancements from where we were 25 years ago, it’s been considerable.”
Critics don’t argue that the new drugs are ineffective or that there aren’t subsets of patients who do better or prefer the newer drugs. Instead, the debate centers on whether the benefit is worth the increased cost.
Pharmacy benefit managers — the middlemen hired by insurers to negotiate prices with drugmakers — have been among the loudest voices in that debate.
“In some ways you might want to put the [word] ‘improvements’ or ‘improved’ in quotes,” said Glen Stettin, a senior vice president at Express Scripts Holding, the largest pharmacy benefit manager. “For some people, some elements of convenience or how the insulin works for them may be different. But for most people, most of the time the improvements are not really improvements at all.”
Drug companies have long argued that list prices are fiction. Health insurers hire pharmacy benefit managers to bargain for secret rebates and discounts off the list price. Insurance, and in some cases financial-assistance programs, then help patients with the rest of the tab.
All three drug companies that dominate the insulin market said that list-price inflation is deceiving for these reasons. But increasingly, as drug prices have grown and insurance companies have changed how benefits are structured, they do matter. There’s growing evidence that patients are shouldering more of the cost of their drugs.
Still, drug companies do not always realize the profit from the rising list price of insulin, said Enrique Conterno, a senior vice president at Eli Lilly. As the price increases, he said, drugmakers often give deeper rebates to pharmacy benefit managers. Those that don’t might receive less-favorable coverage from insurers, he said.
That’s led to a situation in which the list price for Humalog has increased about 150 percent since 2009 — but the net price of the drug after rebates has been flat, Conterno said.
That’s not to say that drug companies aren’t benefiting from list-price increases over the long term, or even in a given year. Last year, Lilly reported that the revenue from Humalog grew 9 percent in the United States, driven mostly by price increases. But last week, Lilly reported that Humalog’s U.S. revenues in the past quarter declined compared with a year ago, even though the company sold more of the drug, because of deeper rebates and discounts.
Ken Inchausti, a spokesman for Novo Nordisk, said in an email that price increases of its insulins “were offset by those rebates and other fees charged by wholesalers and others in the supply chain.”
Sanofi said that the net price for its best-selling drug, the insulin Lantus, has fallen over the past five years. Express Scripts said that the net price for that drug declined nearly 14 percent in 2015.
There have been few efforts to create a cheaper insulin. Walmart, for instance, sells Novo Nordisk's human insulin under the name ReliOn for $25 a vial. Eli Lilly is expected to release the first copycat insulin analog, a chemically altered form of insulin, at the end of this year.
But insulin is a large, complex molecule that can’t be easily made into a pill like a traditional generic. It requires an expensive process using living cells and a bioreactor.
In her kitchen in Washington, D.C., Laura Marston, 34, checks her insulin pump after putting in a new vial of the drug. (Jorge Ribas, The Washington Post)Jeremy Greene, a physician and historian of medicine at Johns Hopkins University School of Medicine, said that when he began practicing medicine in Baltimore, he was surprised to find patients coming in with poorly controlled blood sugar. They weren’t taking their insulin, they said, because it was too expensive.
“It shocked me . . . that it could be true that this drug that had been around for 95 years was not available generically,” Greene said.
That leaves diabetes patients subject to the decisions that drugmakers and insurers make behind closed doors.
Patricia Bailey, 66, of Springville, Tenn., said that her insurer once switched her to a another brand of insulin without explanation or warning. Although the new drug works the same, she said, it’s disquieting to feel at the whim of a process she can’t control, and in the past she’s had allergic reactions to certain insulins. Her costs have only gone up, and now she pays about $400 out of pocket for a three-month supply.
Bailey is frugal with her insulin now. When she gets a “low reservoir” warning from her pump, she’ll leave it until the tubing is completely empty of insulin. If she runs out at night, she’ll leave it for a few hours, even though it means her blood sugar goes up.
She doesn’t consider it rationing, just stretching her insulin as far as it can possibly go — and she doesn’t tell her doctor.
That leaves a mixed legacy for one of the most important advances in modern medicine: Patients who were once called “living skeletons” on starvation diets can now live normal lives, thanks to drugs that are being constantly tweaked. But they feel like they’re being held captive to an ever-rising price tag on their lives.
This will be the next step to getting rid of all US citizens and their costly disease vectors----we will be told we have to travel to India where Johns Hopkins will have that global health system facility filled with Wells Fargo foreign medical school grads while in the US 99% of citizens will not be able to access these heart procedures because the costs will grow and grow and grow since this is global market value rates now. Medicare used to protect us from these profiteering costs----but Medicare was privatized under Obama and Clinton neo-liberals with the AFFORDABLE CARE ACT.
We shouted 4 years ago during all the ACA confirmations this is exactly what it would look like. Think what media outlets and organizations brought WE THE PEOPLE out to support these health policies-----and know they are GLOBAL WALL STREET 5% TO THE 1% CLINTON/OBAMA PLAYERS.
OH, THIS IS WHY JOHNS HOPKINS AND WELLS FARGO BROUGHT MEDICAL STUDENTS FROM AROUND THE WORLD-----TO STAFF THESE OVERSEAS FACILITIES WHILE DENYING ACCESS TO US CITIZENS HERE IN THE US!
When I hear someone in Baltimore tell me Hopkins is great with health care this is what I judge.
Heart Surgery in India for $1,583 Costs $106,385 in U.S.
July 28, 2013, 2:30 PM EDT
Devi Shetty is obsessed with making heart surgery affordable for millions of Indians. On his office desk are photographs of two of his heroes: Mother Teresa and Mahatma Gandhi.
Shetty is not a public health official motivated by charity. He’s a heart surgeon turned businessman who has started a chain of 21 medical centers around India. By trimming costs with such measures as buying cheaper scrubs and spurning air-conditioning, he has cut the price of artery-clearing coronary bypass surgery to 95,000 rupees ($1,583), half of what it was 20 years ago, and wants to get the price down to $800 within a decade. The same procedure costs $106,385 at Ohio’s Cleveland Clinic, according to data from the U.S. Centers for Medicare & Medicaid Services.
“It shows that costs can be substantially contained,” said Srinath Reddy, president of the Geneva-based World Heart Federation, of Shetty’s approach. “It’s possible to deliver very high quality cardiac care at a relatively low cost.”
Medical experts like Reddy are watching closely, eager to see if Shetty’s driven cost-cutting can point the way for hospitals to boost revenue on a wider scale by making life-saving heart operations more accessible to potentially millions of people in India and other developing countries.
“The current price of everything that you see in health care is predominantly opportunistic pricing and the outcome of inefficiency,” Shetty, 60, said in an interview in his office in Bangalore, where he started his chain of hospitals, with the opening of his flagship center, Narayana Hrudayalaya Health City, in 2001.
Cutting costs is especially vital in India, where more than two-thirds of the population lives on less than $2 a day and 86 percent of health care is paid out of pocket by individuals. A recent study by the Public Health Foundation of India and the London School of Hygiene & Tropical Medicine found that in India non-communicable ailments such as heart disease are now more common among the poor than the rich.
One in four people there die of a heart attack and per-capita health spending is less than $60 a year. Yet the country performs only 100,000 to 120,000 heart surgeries each year, well short of the 2 million Shetty estimates are needed. The mortality rate from coronary artery disease among South Asians is two to three times higher than that of Caucasians, according to a study published in 2008 in the journal Vascular Health and Risk Management.
“There has been fast urbanization in India that’s brought with it a change in dietary patterns and lifestyle,” said Usha Shrivastava, head of public health at the National Diabetes, Obesity and Cholesterol Foundation. “It’s leading to this huge jump in cardiovascular disease.”
The average age for a first heart attack in India, Pakistan and other South Asian nations was 53 years, compared with 58.8 years in countries outside the region, according to a study published in 2007 in the Journal of the American Medical Association.
The biggest impediment for heart surgery in India is accessibility. Shetty aims to bridge that by building hospitals outside India’s main cities. He said he plans to add 30,000 beds over the next decade to the 6,000 the hospital chain has currently, and has identified 100 towns with populations of 500,000 to 1 million that have no heart hospital.
A 300-bed, pre-fabricated, single-story hospital in the city of Mysore cost $6 million and took six months for construction company Larsen & Toubro Ltd. to build, Shetty said. Only the hospital’s operating theaters and intensive-care units are air-conditioned, to reduce energy costs.
One of the ways in which Shetty is able to keep his prices low is by cutting out unnecessary pre-op testing, he said.
Urine samples that were once routine before surgery were eliminated when it was found that only a handful of cases tested positive for harmful bacteria. The chain uses web-based computer software to run logistics, rather than licensing or building expensive new systems for each hospital.
When Shetty couldn’t convince a European manufacturer to bring down the price of its disposable surgical gowns and drapes to a level affordable for his hospitals, he convinced a group of young entrepreneurs in Bangalore to make them so he could buy them 60 percent cheaper.
In the future, Shetty sees costs coming down further as more Asian electronics companies enter the market for CT scanners, MRIs and catheterization labs -- bringing down prices. As India trains more diploma holders in specialties such as anesthesiology, gynecology, ophthalmology and radiology, Narayana will be able to hire from a larger, less expensive talent pool.
One positive unforeseen outcome may be that many of the cost-saving approaches could be duplicated in developed economies, especially in the U.S. under health reform.
“Global health-care costs are rising rapidly and as countries move toward universal health coverage, they will have to face the challenge of providing health care at a fairly affordable cost,” said the World Heart Federation’s Reddy, a New Delhi-based cardiologist who is also president of the Public Health Foundation of India.
I don't want to knock the importance to citizens in Baltimore who may find this LATEST MEDICAL PATENTED PRODUCT life-saving----we should be thinking about WHY so much heroin is in Baltimore and why Baltimore has only BLACK MARKET ECONOMIES for 50% of its citizens pushing them to exposure to these drugs----OH, THAT'S RIGHT ---GLOBAL WALL STREET BALTIMORE DEVELOPMENT AND JOHNS HOPKINS DELIBERATELY CREATE THIS MASSIVE UNEMPLOYMENT through stagnation of local economies and global labor pool saturation. So our supposed best in the world health institution is driving the worst in the world PUBLIC HEALTH CRISES----
BALTIMORE HAS PUBLIC HEALTH OUTCOMES WORSE THAN ANY THIRD WORLD NATION----BUT THAT CEO AT HOPKINS---WHAT A BUSINESS GUY!
Baltimore Public Health and global Wall Street pols and players touted this AS A PUBLIC HEALTH WIN. All of these players knew of the public health losses coming to 99% of Baltimore citizens with an end to access to ORDINARY DISEASE VECTOR CARE----but they have your back in mental health issues.
Hopkins was ground zero for creating the food deserts in surrounding communities pushing people to fast food consumption ---cheapest food is filled with most sugars.
The callous disregard for human life brought by global Wall Street Development, Greater Baltimore, and Johns Hopkins is APPALLING----PUBLIC HEALTH LEADERS----what an insult to humanity!
Baltimore officials tackle heroin epidemic
Price of drug naloxone keeps rising
Updated: 5:16 PM EDT Jul 13, 2015
The city of Baltimore is tackling the heroine epidemic. There's a new push in preventing overdoses using the ever more expensive drug naloxone.
BALTIMORE --The city of Baltimore is tackling the heroine epidemic. There's a new push in preventing overdoses using the ever more-expensive drug naloxone.
The focus of the task force is saving lives. A billboard is part of that effort.
The price of naloxone continues to skyrocket. It's a drug widely used by EMS crews to counteract heroin and opium-based pill overdoses.
The price of just one dose has more than doubled in the past eight months from $19 to $41.
U.S. Rep. Elijah Cummings is urging everyone from the governor's to the attorney generals' office to take aggressive steps to negotiate an agreement with the drug's maker.
"When drug companies increase their prices and charge exorbitant rates, they decrease the access to the drug and there is something awfully wrong with that picture," Cummings said.
The jacked-up price comes at a critical and unfortunate time. City health officials estimate as many as 18,900 people have used heroin in the past year. There were 192 overdose deaths.
"This is a life-or-death issue, one that affects our friends, our neighbors and our family members," Mayor Stephanie Rawlings-Blake said.
Rawlings-Blake and Baltimore City Health Commissioner Lena Wen want naloxone available to more than just health care professionals.
"We have to get naloxone in the hands of each and every person who can save a life, which is all of us," Wen said.
Other efforts to combat the epidemic include the city launching a new public information campaign. There are billboards announcing a website called dontdie.org.
The mayor's heroin treatment and prevention task force is also recommending a 24-7 counseling and referral service, and 24-7 treatment center. The goal is really treatment on demand, to allow people with addictions to walk into any emergency room or office and get help.
Also in the works is a data-tracking system to keep tabs on addicts and space available in treatment centers. Recovering addicts, like a man named David, said it's tough to get into treatment.
"They were there in the winter, in the summer. They didn't care what I looked like. They didn't care where I came from. They said if you want it, we can help you, but it's limited," he said.
The city is seeking $20 million from the feds over three years to help pay for some of these initiatives.