US spends $ 500 billion on drug prescription costs. US Hospitals spend $ 200 billlion on medical devices.US pays twice as much as other developed countries

Prescription Drug Costs

Health Affairs article of 11/24/20: Despite accounting for 90 percent of 5.8 billion U.S. outpatient prescriptions in 2018, generic drugs comprised only 20 percent of drug spending, averaging just $19 per prescription. In contrast, practitioners’ prescriptions for brand drugs were 80% of the total prescriptions in 2018, with an average price of $428 per prescription at the pharmacy. A subset of brand drugs—biologic or specialty drugs—comprised only 2.2 percent of outpatient prescriptions but accounted for half of the outpatient drug spending. Prescription drugs in the United States, on average, cost around 2.5 times more than those same drugs do in other Western countries, according to a new report from the nonprofit, nonpartisan research organization RAND Corporation. All told, countries in the study (U.S., UK, Australia, New Zealand ) spend nearly $800 billion on prescription drugs annually, with the United States accounting for 58 percent of the total.

For 2019, the cost of prescription drugs in the US amounted to $509 billion, about 15 % of NHE. (National Health Expenditures)   Out-of-pocket expenses were $67 billion, 15 % of Rx costs; for Medicare Part D, out-of-pocket expenses for seniors were $16 billion and rising. Due to cost concerns, seniors did not fill 9% of all Rx. For Rx costing more than $125.00, 45 % did not fill the prescription; for Rx over $500.00, 60% did not fill the prescription. According to a 2018 clinical journal article, U.S. hospitals spend approximately $200 billion on medical devices. This figure represents 6 percent of the total U.S. healthcare spending of $3.81 trillion estimated by CMS for 2019. The health insurance reimbursement system encourages the adoption and prevalent use of technological advancements, often before the cost-benefit of these technologies is known. 

It’s a startling reality in the US-we’re paying between one-third and twice as much for the same procedure or brand-name medication compared to other developed countries. This significant disparity in drug costs is a pressing issue that needs to be addressed.

NY Times article on 11/13/2020 says the following about inappropriate drug administration in the USA.

Seniors in the US face a significant risk of adverse drug reactions (ADRs) due to the high number of medications they take. On average, they’re prescribed seven medications daily, substantially increasing the risk of drug-drug interaction.

It’s unfortunate that many patients in the US receive unnecessary or inappropriate drugs. This issue, which many observers conclude, is a byproduct of heavy commercial promotion,  that puts millions of patients at risk. Companies have developed elaborate marketing networks with leading clinicians to promote unauthorized or off-label uses, leading to the prescription of drugs with no valid evidence of benefit.

(“Therapy NNT Reviews,” 2020). The term “risk-benefit ratio” hides the harms and highlights the benefits.

Although drugs improve some surrogate outcomes  (Naci et al., 2020), most are not improved. 

Since the mid-1990s, independent reviews have also concluded that 85–90 percent of new drugs provide patients little or no clinical advantage (Lexchin, 2018; Prescrire Editorial Staff, 2019).

FDA reported that  65% of its operating budget to regulate medicines comes from industry user fees (U.S. Food and Drug Administration, 2019). 

Clinical guidelines are based on them, developed by expert committees that usually have several members on retainer with manufacturers of the relevant drugs (Lexchin, 2020a)

June 11, 2013