Talk:Prescription drug prices in the United States

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Comment

Clearly only one point of view is reasonably expressed in this article. Perhaps someone familiar with the pharmaceutical/medical community's point of view can provide balance.—The preceding unsigned comment was added by Deli nk (talk • contribs) 13:27, 17 January 2006 (UTC).

Err, it appears to me that *only* the pharmaceutical point of view is presented. For instance, the article bemoans that only 11% of drugs make it past clinical trials, but it fails to mention that the vast majority of most drug companies' money (I believe it is around 2/3, though I do not have a source handy) is spent on advertising instead of R&D. Lode Runner 13:17, 29 August 2006 (UTC)

Leaving beside the political isses, I would be interested in someone explaining how drug prices are negotiated between drug companies, distributors, pharmacy chains, insurance companies, medicare, medicaide etc. I understand it's quite a complicated process. The net result is that the price for the same drug can vary by 2X depending upon a number of factors.--Nowa 22:54, 2 January 2007 (UTC)

Where is the opinion of the blue collared worker. This article looks like it was written by a doctor who is just trying to cover up what makes him richer.—Preceding unsigned comment added by Phiten14 (talk • contribs) 10:35, 12 November 2009

I would like to add another theory of why costs of pharmaceuticals might remain unusually high in a given market. Would it be reasonable to include a discussion of prescription drugs as an example of a natural/technical monopoly? Theophan (talk) 16:37, 1 July 2008 (UTC)

great beneficiary of this system are all other countries because they have same drugs for lower prices. without US, or if US would adopt similar approach, new drugs would come on slower rate and everyone would lose. on relative terms poorer americans would benefit but on absolute terms they would also lose( although less than richer americans, and even less then citizens of other countries.) —Preceding unsigned comment added by 78.0.248.199 (talk) 18:51, 3 May 2009 (UTC)

What??? You are trying to sell us "all new drugs worldwide are developed in the US" which is frankly a lie. People worldwide will benefit from high prices in the US? LOL ... what did you smoke, guy? --84.141.34.227 (talk) 21:41, 23 August 2009 (UTC)

Although the United States is only 5% of the world's population, it accounts for 36% of worldwide research and development of pharmaceutical drugs. Source. Grundle2600 (talk) 19:19, 17 March 2010 (UTC)

Response to above. That's only presuming that private medical research in the US produces significant new discoveries. They don't. Most of this research goes to developing copycat drugs and life-style drugs, which have little actual benefit. —Preceding unsigned comment added by 192.89.129.162 (talk) 09:27, 22 March 2010 (UTC)

I just added the tag for Original Research. See 4th paragraph, comparing prices for Lipitor. Weaseal (talk) 15:10, 29 March 2010 (UTC)

I think that the article in its current form definatly violates NPOV as it is currently writen. To me, the page looks like it is from the opinion section of the newspaper. I am also wondering if it may be better to delete this article (note: I am not nominating it for deletion, at least not yet).98.200.164.126 (talk) 19:59, 15 April 2010 (UTC)

I still don't see this article as being neutral. It needs a lot of work, somebody else want to help? Filpaul (talk) 06:11, 1 February 2011 (UTC)

I do understand the arguments of the pharmaceutical industry but the question remains why some of the basic generic drugs are also more expensive in the US. Take an example chlortalidone or even newer ones such as mirtazapine. The generic versions of these drugs are more expensive here in the US than the original versions sold in high priced countries in Europe. (Osterluzei (talk) 01:04, 4 August 2012 (UTC))

The section titled Pharmacy Benefit Managers seems biased to me. It only talks about PBMs raising prices. While this may be true of some PBMs, their job is to negotiate prices with companies to decrease the price for the ultimate customer. I am planning on adding information to the section titled effects and maybe value-based pricing --LNS1094 (talk) 23:35, 21 October 2016 (UTC)

Link not updated

Hello, I noticed while reading this that the link for source 9 is not up to date, however, I could not figure out how to insert the updated link. Sorry, I have limited knowledge of HTML :)

Anyways, here is the proper link for CUNY page source 9: http://archive.psc-cuny.org/drugprices.htm

(----) — Preceding unsigned comment added by Kassgeminid (talk • contribs) 20:23, 13 September 2012 (UTC)

This article...

Could be so much more interesting than a stale rehash of the same old sound bites used in Washington.

Pharmaceutial prices in the US are indeed too high. But while we pay 50% more for drugs than Europeans, we pay 150% more for hospiitaliation and 100% more for a Doctor appointment. Thats part of the context of the situation and you cant understand drug pricing without understanding why Americans tolerate high HC costs generally.

Rx drug prices are not set at the whim of the manufacturer, otherwise all drugs would be a million dollars a dose. There are some fascinating issues here. Lets build them into the article! 2600:1010:B104:9E55:686C:4A3E:9B8A:9E65 (talk) 03:54, 2 December 2015 (UTC)

Some suggested subtopics: PBMs Statutory rebates to medicare 340 b program Etc. 2600:1010:B104:9E55:686C:4A3E:9B8A:9E65 (talk) 03:56, 2 December 2015 (UTC)

And orphan drug pricing! 2600:1010:B104:9E55:686C:4A3E:9B8A:9E65 (talk) 03:57, 2 December 2015 (UTC)

2600:1010:B104:9E55:686C:4A3E:9B8A:9E65 - thank you for taking a stab, i appreciate your deletions, additions( except for 1, which i reverted) and suggestions!

I also just arrived here and only started changing this page.- if you register I can more easily address / communicate with / thank you.--Wuerzele (talk) 04:27, 2 December 2015 (UTC)

Matt Herpers article on "The hidden world of drug rebates" is excellent. I used to have some good sources on this and will look for them.

 Done

You might also look at Fierce Biotech, an investor news site that seems reliable, for articles on Express Scripts and their hard line negotiating on drug prices. They refused to cover Pfizer's RA drug, which is the only one of the new ones that is oral. They also took a hard line on Sovaldi prices after Abbvie's somewhat inferior regimen was approved, negotiating an undisclosed discount wideky believed to be 40% by threatening to cover Abbvies only. Gives me too drugs a different flavor in this case. Overall, it really seems to be the relative megotiating power of pharma cos and PBMs that ultimately detrrmine prices here. The govt price is usially determined by some formula derived from the price negotiated by the PBMs.

Best, 2600:1010:B104:9E55:686C:4A3E:9B8A:9E65 (talk) 04:43, 2 December 2015 (UTC)

tendentious edits

Three edits made today by User Jytdog are reverting edits, removing well sourced evidence or adding unsourced opinion inside a referenced statement, in effect favoring the pharmaceutical industry.

• here he removed "Pharmaceuticals are the only major health care service, in which the producer is able to set prices relatively unrestrained." because the source is an editorial, yet that doesnt make the sentence untrue, instead of modifying it.
• here he added to a 12/2015 editorial (double standard?) the following: "pointing in particular to strategies carried out by Turing Pharmaceuticals and Valeant Pharmaceuticals to acquire rights to make and sell generic drugs that had administrative exclusivity and then raise the prices dramatically, which were widely condemned inside and outside the pharmaceutical industry." to diffuse the source's criticism, which was NOT "pointing in particular" at Turing and Valeant ( the recent scandal), but likewise at Pfizer, Eli Lilly etc. This addition is simply not supported by the source and needs to be sourced or cant be added.
• here he added another WP:OR or at best WP:SYNTH by adding "In response to these moves, " which is ambiguous (which moves?) or sloppy and not supported by the cited source from November 2015.

It should be noted that User Jytdog works for the pharmaceutical industry per his userpage.--Wuerzele (talk) 19:25, 8 March 2016 (UTC)

@Wuerzele: Jytdog is a regular at WP:MED and not someone that has a history of favoring industry. I am not aware of any reason to consider this person's edits in any sense other than their own merits.

For the first point, I think the original and Jytdog's change need compromise. I would change the text to, "A 2015 editorial in JAMA said that..." because the content is good for Wikipedia and also it is preferable to attribute editorial comments to the source rather than write as if the opinion is from Wikipedia itself. For the second point, I think that it would be best to avoid making a generalization about the entire pharma industry when this research is not doing that, and it is also incorrect to single out only two companies when the paper is discussing multiple ones. As Wuerzele says, listing more companies is better.

This discussion was a few months ago and I am not sure this issue is still relevant. Wuerzele, do you know the present state of things? Blue Rasberry (talk) 18:13, 1 August 2016 (UTC)

User:Bluerasberry, I am very familiar with jytdog, his project memberships and his edits.

you and I are clearly not on the same page re jytdog. but I do not want to argue your points. Being a regular at WP:MED is no passport for impartiality. It certainly means, that you 2 are in the same group, which I (FYI even with my qualifications which are on my user page), deliberately avoid. yes compromise is needed- as you see I didnt revert , did the civil thing, and dog never responded.--Wuerzele (talk) 19:59, 1 August 2016 (UTC)

Peer review and responses during the educational assignment in Winter 2016

The following discussion is closed and will soon be archived: The students in this discussion have not edited Wikipedia in 3 months, so I think they are done with their project here. I am closing this discussion to note that it is unlikely for the participants to say more. However, anyone else may re-open any of the issues raised here. Blue Rasberry (talk) 17:56, 1 August 2016 (UTC)

---

We are students from the University of Michigan enrolled in a Chemistry class working on a Wikipedia editing project. We have chosen this page to contribute new content. Specifically, we are adding in a section that concerns how drugs are priced from a number of factors in the United States. We have sub-divided this into: Research and Development Costs, Drug Benefits and Side Effects, Drug Uniqueness and Patents, and Stakeholders.

Our sub-section concerning Research and Development costs outlines how pharmaceutical companies use their R&D expenses as reasoning for determine prices. We have further sub-divided this into discovery (the costs related to determining the germs, viruses, and bacteria that cause a specific disease or illness that a drug will treat), the costs associated with Pre-Clinical and Clinical trials, and the expenses of past failed drugs. Then, we related these sections back to drug pricing.

Our next sub-section concerned a drug's benefits and side effects. This talked about how the effects of the drug are compared to the benefits and how the comparison between those two can determine price. We referenced the drug Lipitor and its benefit of raising HDL compared to the minimal side effects it incurs.

Our next sub-section concerned drug uniqueness and patents. This was mainly about a drug's competition and the fact that higher competition leads to lower price. Lower competition and patents give pharmaceutical companies more power to charge premiums.

Our final sub-section concerned stakeholders. We talked about how patients and doctors have a say in the pricing of drugs, specifically referencing the case of Daraprim and how the price was gouged 5000%. As a result, public outcry as well as political influences forced Turing Pharmaceuticals to lower the price. We also referenced Solaris and it being an orphan drug and how insurance companies would pay for it because it was cheaper than the market alternative.

Peer Review 1

(A) Content:

         I'd just like to start off by saying how impressed I was with the additions you made to the page.  Starting with the introduction,  I like the inclusion of the chart about the price discrepancies of drugs in different countries, I would suggest though either deleting or elaborating on the sentence that reads "This does not indicate, however, that the United States is more interested in profits than other countries, but rather reflects the different processes countries use to determine the price of a drug."  Only because looking at the chart alone, I don't think it provides any detail of the processes of drug pricing in different countries, it only shows the differences in the prices. 
         As far as content length, I believe each section had an appropriate length. The only section that could use a little more length is the "Failed Drug" portion; maybe explain what constitutes a failed drug. All of the main terms seem to be appropriately linked to their respective pages and information does not seem to be repetitive/duplicated. 

(b) Figures:

          All the figures are relevant to the page and content; if possible I would enlarge the graph that portrays profit changes with patents.  Its a bit small on the page and I think it is a good graphic that should be easily seen by readers.  This graph is not an original image, but it does have necessary references to it to give credit to the original illustrator.  The chemical structure of simvastatin is an original work, but the one of Lipitor does not seem to be.

(c) References:

         There was a wide variety of references, including journal articles and news articles.  All the news articles were from reputable sources such as Forbes and Time and were correctly linked to the information that was being referenced.

(d) Overall Presentation:

           The overall presentation of the page was organized and well done.  For the title of the section "Uniqueness and Patenting", I would suggest maybe entitling it simply "Patenting" as that is the main focus of the section.  There are also some grammatical issues throughout the page and some word choice that does not accurately fit the context, such as "astronomical research".  Also, there is some repetitive adjectives in sections that make the reading a bit less fluid.  Just a simple read through and edits could fix these problems. 

S.zayec (talk) 02:11, 25 March 2016 (UTC)

Peer Review 2

Drug Pricing Factors reviewed by Morgan Groendyke (a) Content • Is the introductory section accessible for non-experts? Introductory section was not addressed by the edits, but it could have been improved. The current introductory section does not inform the reader of the following content.

• Do the contents of each section justify its length?

Some of the sections regarding research/development of drugs are too detailed about the processes of research. These sections should talk only about the factors that affect pricing, and they should try to trim down on data that would be more relevant on a page about drug development. The Benefits and Side Effects section seems large to contain information that is largely unrelated to pricing.

• Are all the important terms/concepts linked to their respective Wikipedia pages for further reference? 

Many important terms are linked with the exception of a few drugs, pharmaceutical companies, etc. (i.e. AstraZeneca, FDA, Roche, etc,) • Are the highlighted examples appropriate? Yes, all of the currently linked terms are appropriate. • Is the content duplicative of any other content already on Wikipedia? No, much of the content is additive to the current Wikipedia page. The information provided was very vague, but the editors did a good job of including every facet of drug pricing factors. Much of the current content includes snippets of the process, but the edits give the information more context.

(b) Figures • Are the figures original and of high quality? Yes, the two figures are high quality and original. The graph of pricing before and after patents is extremely important to the topic, and clearly shows the data. • Are the figures informative and add to the text? The figures are very informative. The clean layout of the numbers for the chart shows the exorbitant prices of the US compared to various other countries in a number of drugs. The graph showed the dramatic drop in drug prices after a patent runs out, and showed readers in a simple form how a patent increases prices. The graph linked well with their discussion of competitors versus demand versus pricing. • Are the substance and/or protein structures chemically accurate, aligned, and easy to read? Not applicable.

(c) References • Are the references complete? Yes, all information is referenced. • Are the references inclusive of non-journals sources? There was a good range of references from news articles and journals that were all credible.

(d) Overall Presentation • Provide a short summary of the entire content/figures/references, highlighting both what the group did well and well as what still needs to be improved.

The edits made were well researched and informative to the reader. The edits will make a considerable addition to the current page, but much of the current page could still use editing. The editors could have focused on revising the page’s current information rather than adding more. The opening section is vague and brief, and much of the current information has typos and other mistakes. The current page is disorganized and the information is not clearly presented. I like that the edits proposed talk more about the source of drug pricing in great detail rather than just saying that the prices are high in the US. The reference towards specific drugs gave the information context. The graph and data table used were both appropriate and informative. Some of the data on the process could be condensed in order to stay on topic, but the thoroughness of the data is good. The information they found was from credible sources and was always referenced.

MorganGroendyke (talk) 20:14, 26 March 2016 (UTC)MorganGroendyke

instructor comments

1) Content

A) Is the introductory section accessible for non-experts?

N/A. Introduction already exists.

B) Do the contents of each section justify its length?

Yes. One note: The Drug Pricing Factors discussion ends with sentence “Here are some of these pricing strategies”; however, no discussion of the pricing strategies follows. Either remove it or provide some discussion of these strategies.

C) Are all the important terms/concepts linked to their respective Wikipedia pages for further references?

Mostly. Some terms such as FDA, Pfizer, etc. have Wikipedia pages.

D) Are the highlighted examples appropriate?

Yes. For example, the authors did an excellent job on highlighting the price differences between Lipitor and Simvastatin.

E) Is the content duplicative of any other content already on Wikipedia?

No.

2) Figures

A) Are the figures original and of high quality?

Yes. The provided tables and figures are original and of high quality.

B) Are the figures informative and add to the text?

The Tables are very informative. The figures with chemical structures do not enhance understanding the material, and I would suggest removing them completely. Second Table (R&D section) should have the time span for the “Number of Drugs Approved” and “R&D Spending per Drug” columns.

C) Are the substance and/or protein structures chemically accurate, aligned, and easy to read? N/A

3) References

A) Are the references complete?

Yes

B) Are the references inclusive of non-journal sources?

Yes

4) Overall Presentation

The authors did an excellent job in adding a section that describes factors affecting drug pricing. Altogether this is one of the best articles I have seen thus far. The only minor change I would like to suggest is adding some discussion on why drug prices vary from country to country (i.e. explain content in Table 1). At least, the fact that some countries (i.e. Canada) have a ceiling as far as the drug prices are concerned should be mentioned.

Response to peer edits

Thank you both for your advice and recommendations. After reading what you had both said and looking at Professor Nagorno's comments, we think that we should definitely proofread more to fix errors. You mentioned a place that said "astronomical research" but really it was talking about the astronomical R&D expenses (we will make that clearer). We think that sometimes when copy and paste is used in Wikipedia, there might be some errors associated with the process. We will definitely look at the Sandbox page and fix those (my partner's page is the main page with the entire article, so that should not be a problem there). Professor Nagorny seemed to think that the level of detail throughout was nice so we will not mess with that. It was also suggested that our title for one of our sections should be changed so we will do that on this page. We also plan on making sure nothing in our piece is vague by Wikipedia-linking more or even using more citations. As Professor Nagorno mentioned, we will definitely consider elaborating more on the price discrepancies between countries and their various drug pricing methods. As he also mentioned, the chemical structures did not enhance our edits so we are looking to remove them completely and possibly find other images that could enhance our work. Besides that, we will look into minor edits such as making the chart bigger and organizing our sections better. Thank you all for your recommendations, we appreciate it!

Sdewas (talk) 02:08, 5 April 2016 (UTC)

Suggestions from ChemLibrarian

Great work with adding this needed section for the article. Here are a few suggestions before you post it to the main space.

1. Reference 11 and 12 are duplicated, please correct them as you did for previous repeated ones.
2. The last figure you used is from a journal article and it's an open access one shared under CC license. So, you chose the right way to share it. However, I do want to mention that not all open access articles are shared under CC license. Please remember to check that before you use any media files in the future. Also, please add some caption to the figure and may be making it bigger. Please see this tutorial Wikipedia:Picture tutorial for how to do it.

ChemLibrarian (talk) 18:23, 5 April 2016 (UTC)

Allanmc0913 (talk) 01:25, 17 March 2016 (UTC)

Proposal to fork some content into general article for "drug prices"

This article is called "Prescription drug prices in the United States". There is no Wikipedia article called "Drug prices". [I have redirected "Drug prices" to "Prescription costs" now User:Fred Bauder Talk 22:27, 1 August 2016 (UTC) ]Some of the information in this article is not about the United States, but actually, is about the general concept of drug prices. I was thinking about splitting some of this article away into a new article called "drug prices", which would be a general presentation of the concept.

Here are some contributors to this article -

• @Wuerzele: many edits in many months, including recently
• @Prowler08: many edits about 8 years ago - seems like an abandoned account
• @Fred Bauder: created the article in 2003
• @Allanmc0913: added a lot of content 3 months ago as a school project, but no edits since then. Students often leave after class assignments, and this person may not check in.

Does anyone have any objections to my moving some international content out of this article and into a new article? Is anyone familiar enough with this article to have suggestions for what could be moved out? There is a lot of content here, and I thought I would ask first before looking too deeply and changing things. Thanks for any comments.

I just created Category:Drug pricing. It seems like most of Wikipedia's coverage on this topic already focuses on the United States. Blue Rasberry (talk) 18:04, 1 August 2016 (UTC)

The United States is unique in that government programs such as medicare are forbidden by law to negotiate with the drug industry. Which is why there is a separate article. User:Fred Bauder Talk 18:48, 1 August 2016 (UTC)

Thanks Bluerasberry for bringing this up. I completely agree with you, that there is a ton of international (and unreferenced material) that doesnt belong here. I am very familiar with the article. If you look back, it was in reasonable shape until stuff was added during the "educational assignment" - I was too shy to criticise/edit /revert at the time, hoping the instructor would ( but didnt). I will take care of it.

FYI: There is a generic article called Prescription costs, where some of this can be moved to.Wuerzele (talk) 19:43, 1 August 2016 (UTC)

We are continuing this conversation there. I was looking for that article - thanks for showing it to me. Blue Rasberry (talk) 15:12, 2 August 2016 (UTC)

About student edits

Wuerzele - it's great to be nice to students - like any other new editors - but don't feel like you need to treat their edits with kid gloves. And if you'd rather not get involved directly, please ping me. That's why I'm here. Ian (Wiki Ed) (talk) 20:21, 1 August 2016 (UTC)

wow, Ian (Wiki Ed) that was pronto ! you watch all past ed assignments? in reply, I have so far only had good experiences with students' edits, in the env/toxicology area, where I and students and instructor have truly interacted, and it was mutually beneficial. this here was the first "bad" experience.

Feedback fyi: I didnt see whom to ping, a single mega edit here came all of a sudden, like a dump, and nobody from the assignment reached out to editors actively at work on the article. I found that unaware/ clumsy behavior.

fyi I didnt know you are "the boss", and I wouldnt have spent time searching WP to find out whom to ping- I do suggest this should be an automatic courtesy edit w signature block (instructor and you ?) on every article's talkpage that students plan to edit, i.e. ahead of the actual edits.--Wuerzele (talk) 20:36, 1 August 2016 (UTC)

Wuerzele - I'm not the boss - I'm just the help. And yes, I know know people don't know I exist, hence my offer. Mostly I'm here to help students do better work (writing, sourcing, etc.), navigate Wikipedia...and not do things that piss off the community (too much). Ideally students would function like ordinary Wikipedians, but they don't always. And people don't quite know what to do with them when they pop up on pages they edit. (Even I'm not always sure what to do when students make major changes to an article I'm working on with my main account.)

We have a mechanism to tag every talk page with a template that links to the course page. Doing that gives people information about the course, who the instructor is, and who the "Content Expert" is. The "Content Expert" - me in this case - is an experienced Wikipedian/student wrangler. :) That didn't happen in this case. I need to make it a priority to ensure that students always have signed up for the page they plan to improve. Beyond that, we encourage them to say what they plan to do and engage with any active editors on the talk page. I need to do a better job of keeping track of this.

As for the edit - I agree, students shouldn't edit and run. They should add whatever they have to add with adequate time for feedback from the community, to fix things if they make a mess.

As for me finding this - it was just chance. I try to watchlist as many student edits as I can, but that doesn't mean I always look at every edit on my watchlist. Especially in the summer, when things are relatively quiet. Guettarda/Ian (Wiki Ed) (talk) 23:51, 1 August 2016 (UTC)

Ta, Ian (Wiki Ed). so who was the course instructor here? maybe you can ping them, since I am still ignorant.--Wuerzele (talk) 02:46, 2 August 2016 (UTC)

User:ChemLibrarian. The course page is here. Students should always have a link to it on the user page, like this one. Ian (Wiki Ed) (talk) 15:08, 2 August 2016 (UTC)

content from "prescription costs"

The "prescription costs" article was forking content about prescription costs in the United States. I cut that content and am pasting it here. On that article, I replaced this text with the lead of this article. People should come to this article if they want to read the long story.

Extended content

In the period 1994–2004 prescription costs were the most rapidly increasing cost of health care in the United States. These increases, which averaged 12% during some years, are accounted for by increases in the number of drugs per person (treatment intensification), increases in the cost of a "market-basket" of drugs (price inflation), and increases in the use of newer drugs over older, less costly, alternatives. Overall, experts estimate that treatment intensification increased by 68% and price inflation increased by 8.3% between 1994 and 2004. A substantial body of evidence has documented the association between high out-of-pocket costs and many types of economic and non-economic hardship. Between 20%–30% of patients in the United States report having skipped or stretched a prescription medicine during the previous 12 months because of the cost. Other patients report cutting back on payments for their utilities or food in order to afford their prescription medicines. In 2011 and 2012, approximately 2% of individuals reported purchasing prescription drugs from another country to save money. A predictive index has been developed that differentiates individual risk of importing prescription drugs for personal use, thus potentially allowing policymakers to target resource-efficient interventions that minimize the potential risks of importation and improve access to affordable prescription medicines. Patients may be embarrassed to raise their concerns about the cost of drugs, concerned that doing so may compromise their quality of care, or under the impression that there is nothing that their health care provider can do to help. Providers may also be embarrassed discussing costs, and feel too much time pressure to discuss these costs with patients.

Blue Rasberry (talk) 15:56, 7 March 2017 (UTC)

Student edits Oct 2017

We are students from the University of California, San Francisco (School of Pharmacy) enrolled in a Health Policy class. We were assigned to work on a Wikipedia editing project. We have chosen this page to contribute new content. Specifically, we are planning on adding more contents to the following sections:

Thanh: Discounts + Generic sub-sections My goal is to improve on the section with more strategies for patients to get discounts for prescription drugs and expand on the different programs available for discount. In the generic sub-section, I plan to expand on the drug approval process for generics v. brand to compare/contrast generics v. brand. I will continue to update with more details on the edits within this upcoming week.

Angela: Canada Model + Healthcare provider sub-sections This section is relatively short and vague. I want to expand this section by going a little more in depth about newly approved US policies and how it might change the way the US controls our drug pricing. I plan to write about P&T Committees at hospitals and giving formulary and drug cost information to providers and impact on medication cost and use (healthcare providers section). I will touch on how the US covering drugs for military personnel in more details through the TRICARE program. For Canada section, I will add details in Canadian policy that make drug prices cheaper.

Adam: Policy-makers - TBD on details of edits.

Jayson: Value-based prices I want to elaborate on the immediate and long term change to drug pricing with regards to the increased life expectancy. More details to come!

We are open to suggestions from the community on how we can best improve this page. Thank you! — Preceding unsigned comment added by Thanhtu92 (talk • contribs) 06:54, 18 October 2017 (UTC)

Peer Review Edits

With respect to group 9 reflecting a neutral point of view in their edits, I felt that they did an excellent job of staying neutral. Since the topic of their article is "Prescription drug prices in the United States" it could have been difficult to keep this neutral perspective given the controversial nature of the topic, but I felt that group 9 provided a lot of information regarding drug pricing in the United States while being unbiased. For example, the section on New Legislation provides information regarding Senate Bill 17, detailing the focus of the bill and purpose of the bill. This provides excellent information regarding new laws being passed regarding prescription drug prices in the United States. I also thought it was great that they expanded on Canada's model on drug pricing, while again remaining neutral and unbiased as to whether that model was superior or not compared to the United States. As someone who wants information regarding United States drug pricing, this section on Canada provides a nice contrast to the United State's model, with information to make comparisons but neutrality in tact. My one suggestion would be to remove words and phrases such as "Fortunately" and "complicated picture"in the Discounts section of the article, as these may suggest some favoritism/bias. But other than those phrases, I thought the article remained informational and provided a lot of detail and context regarding drug prices in the United States and the reason for their variance.Vchopra86 (talk) 02:32, 8 November 2017 (UTC)

Thank you for your feedback. I've edited out the words that may suggest bias in my edits (ie. deleting "fortunately" and "complicated picture"). Furthermore, I made minor edits to the "Discount" section for more clarity. I went back to make sure the lead sentence of this section has a clear purpose.Thanhtu92 (talk) 18:56, 9 November 2017 (UTC) Thanhtu92 (talk) 06:27, 15 November 2017 (UTC)

I appreciate the detailed feedback on the healthcare provider/Canada section that I edited. I have provided the FINAL edit for the Canada/health providers section. I found mild bias (that I eliminated), fixed sentence structure and paragraph organization. Angelalee102 (talk) 09:49, 15 November 2017 (UTC)

All of the peer edits were very detailed and thorough with solid evidence to support their statements and facts. Group 9's edits spanned many of the Wikipedia page's topics and were very interesting to read. I liked that they used many different sources and did not use sources that were not credible. The sources were freely accessible and credible, coming from NEJM, Health Resources and Services Administration, Consumer Reports, NPR, FDA, Senate bills, healthcare journals, AARP, AHA, and AMCP. The number and need for citations under Healthcare providers were clear and done well for this larger edit. However, I do have some criticism of the group's edits though although overall the edits were good. Under Solutions-Discounts I would like to see a source/citation for the last sentence of the first paragraph. The second paragraph of this section also has the word listed in quotations, and I was a little confused on why that word is in quotation marks. The last sentence of Value based prices is also not a full sentence. Under New legislation, I would like to see more sources and citations as it is a larger chunk of text, and the grammar for the last sentence should have an 's' after medication. Anniechang17 (talk) 23:36, 7 November 2017 (UTC)

Repsonse to Peer Edit: Thank you for your feedback! I corrected the grammar along with adding sources in the New Legislation section Aarz1111 (talk) 17:25, 30 November 2017 (UTC)

Response to Peer Edit: Thank you for the feedback! I corrected and elaborated on my thoughts in the last sentence of the value based prices section.Jydeguzm (talk) 09:22, 15 November 2017 (UTC)

Response to Peer Edit: Thank you for your feedback. I went ahead and made the edits suggested (removed unnecessary quotations, revised the fragment sentence and added 1 citation). Your feedbacks are greatly appreciated! Thanhtu92 (talk) 18:51, 9 November 2017 (UTC)

Thank you for the detailed review of our sources- my group will ensure all statements that supported by a source in our final review.Angelalee102 (talk) 19:54, 9 November 2017 (UTC)

Assessing for plagiarism: Upon cross-referencing the added information and the cited articles, it appears that the added information about prescription drug pricing does not violate Wikipedia's plagiarism policy. Great job on summarizing the available information and making it easy to understand. Nguyenpe (talk) 02:32, 8 November 2017 (UTC)

Are there viewpoints that are overrepresented, or underrepresented?

The leading section is relatively short and not detailed. The authors sections vary greatly in length. Sections such as “Drug Rebates” are only three short sentences, while other sections are relatively longer. Th article can benefit from more detailed information and expansion in most sections. ChiaO (talk) 16:06, 22 January 2018 (UTC)

@Chia0: You say that the author's sections vary in length. Did you know that you are the author and that you can edit Wikipedia? We do not have any staff standing by to edit the articles. If you think of a way to improve something then please edit. Blue Rasberry (talk) 17:10, 22 January 2018 (UTC)

"Solutions" section

Edited to add a few citations

The entire "Solutions" section is filled with misleading or inaccurate statements. I won't provide a full catalog, but here are a few:

(1) "The high cost of upfront research that the brand-name products have to go through to ensure safety and efficacy largely account for the high discrepancy in pricing between the two groups."

This is misleading. The proximate explanation for the high-cost of (patented) brand-name drugs is market exclusivity, not the cost of research and development. If the cost of research were a significant factor in drug pricing, then the price should be low for off-patent drugs being sold by companies that did not develop them. But the price for such off-patent drugs is often very high when the company has an effective monopoly (e.g. Turing pharmaceuticals, which did not pay for the research and development of Daraprim). Pharmaceutical companies set prices with the aim of maximizing profits, not with the aim of recouping R&D costs. And when a company possesses a monopoly, profits are often maximized by setting a high asking price -- whether or not the company paid the R&D costs for the drug in question.

• "pharmaceutical firms can be expected to charge different profit-maximizing prices in different markets. That is, given the low cost of production and absence of trade, the profit-maximizing price will vary across countries because the patent holder will charge a price that reflects the demand factors in each market."

Pharmaceutical Price Controls in OECD Countries, US Dept. of Commerce, 2004, p. 16. <https://2016.trade.gov/td/health/DrugPricingStudy.pdf>

The high cost of research is an explanation of the high cost of (patented) brand-name drugs only in the sense that: (1) the high cost of a patented drug is possible because of market exclusivity, and (2) market exclusivity is granted in order to incentivize costly research and development.

• "the high cost of developing and testing a new drug means that no profit-maximizing firm would make the investment needed to bring new and innovative medicines to the market in the absence of patent protection. To overcome this obstacle, countries offer patent protection as a reward for innovation by conferring the right to use of the resulting chemical compound for a specific period of time. Such patent protection affords innovative pharmaceutical manufacturers significant pricing power."

Ibid., p. 15.

(2) "Quality-Adjusted Life Years (QALY) is a cost-effective measure that determines the value of a drug in terms of the quality of life achieved after taking a prescription drug, rather than the number of years the medication extends a patient's life."

When QALYs are used to make decisions about the allocation of resources, the number of years that an intervention extends life is taken into account, contrary to the claim just quoted -- and as the article itself acknowledges later in the same paragraph ("QALY ... takes into account both the quality and quantity of life lived by an individual").

(3) "However, QALY is subjective ... The subjectiveness of QALY is apparent on a case by case basis as it takes into account both the quality and quantity of life lived by an individual, with quality of life being the primary subjective factor."

This is misleading, as QALYs are calculated neither on a "case by case basis" nor on the basis of the subjective preferences of the patient. Rather, a weight between 0 and 1 is associated with each of a large number of health states, and the same weight is applied to all individuals in that health state.

(4) "Prescribing combination drugs instead of two separate medications can also potentially reduce monthly copays."

This is literally the opposite of what the cited source says on the issue:

'A manufacturer attempts to “evergreen” a product when it applies for patent and market exclusivity protections for a “new” product that is essentially the same as the original product, such as extended release formulations or combination therapies that simply combine two existing drugs into one pill. What generally happens is that, while the older version of the drug is no longer patent-protected and, therefore, generic alternatives may be offered, drug manufacturers promote the newer version as the “latest and greatest.' <https://web.archive.org/web/20170608154237/http://www.aha.org/content/16/aha-drug-policy-recommendations.pdf>

The combination drug is more expensive in this case, not less, because it is under patent.

This section badly needs the attention of an expert. Unfortunately I don't have the time to correct all the problems, or to dig up whatever citations Wikipedia would require for the claims I've made above (though they should be familiar to anyone who works in this area).

24.228.255.49 (talk) 22:38, 13 April 2019 (UTC)

CP133 2019 Group 4

Group Members: Hanna Y., Danielle P., Christine H., Melanie Z.

We propose to add the following section: “Effects of Drug Prices on Consumers” . A similar section exists in the Wikipedia Article “Prescription Costs”, and we believe that a similar section in this article could address the unique problems faced by patients in the United States. Our edits include a discussion about the majority of bankruptcies resulting from patients unable to pay their medical bills, which include increasing prescription costs in the US, and provide statistics and data regarding the rate of medical bankruptcies in the United States compared to similar western countries. Furthermore, we also would like to point out the dichotomy between two concerning trends in US healthcare: increasing prescription prices and decreasing health outcomes. The decrease in outcomes can be related directly to the increasing prescription prices, as patient adherence highly depends on accessibility to expensive medications. Frequent negative impacts that consumers experience from high drug prices include difficulties finding alternative yet affordable medications, medication non-adherence, inaccurate price forecasts due to unexplained fluctuations, and increased government scrutiny on manufacturers. — Preceding unsigned comment added by HannaYakubi (talk • contribs) 00:59, 17 October 2019 (UTC)

Upon further review, our group has identified multiple underdeveloped sections within the article that we plan to update. We find this to be a more effective method of article improvement.

Hanna Yakubi -- I will be focusing on the Orphan Drug section. In particular, I hope to add more information about what exactly orphan drugs are, why drug companies tend to target these, and ramifications of the Orphan Drug Act. I also hope to give examples of drug companies adopting orphan drugs and then price gouging.

Christine Huynh -- I shall be focusing on further developing the "Drug company profits" section by adding more specific examples of drug companies making substantial drug price increases, as well as adding any pertinent information about the consequences of these increases on consumers. — Preceding unsigned comment added by HannaYakubi (talk • contribs) 20:46, 30 October 2019 (UTC)

CP 133 2019 Group 3 Peer Edits

Carmen:

1. I believe that group 4 improved the article significantly as described in the “guiding framework” many very important and relevant additions. In particular, I think the added section on the epinephrine price spike gave a great, albeit very important example of an event that reflected the state of United States prescription drug prices. This addition references a very important piece of news that provides relevant context for the state of prescription drug prices. The tone in this paragraph was also very neutral and gave a good amount of detail to give context. I also appreciated the addition of the sentence where the Orphan Drug Act was passed in 1983 to again provide important context amidst an entire paragraph gong over orphan drugs in the United States. I did notice a typo in the same paragraph with the word “successfull” in that following sentence, so I would recommend someone to initiate an edit for that.

2. Group 4’s overall edits did a good job in reflecting a neutral tone while displaying additional important facts. The language focuses on delivering facts rather than personal opinions. There was no expression of approval or disapproval of high prescription drug prices. Relevant and neutral statistics, policy information, epinephrine background, and additional facts were added. Cleung160 (talk) 19:18, 6 November 2019 (UTC)

Jason:

1. Overall, the article is written in a neutral perspective with no overrepresentation or underrepresentation. There may be more content in regards to the high price of drugs in the United States but that is just stating the reality in this country with supporting citations, which we think is appropriate for this topic. Jwei3 (talk) 21:00, 6 November 2019 (UTC)

2. Overall, the citations for resources are appropriately cited and we couldn't find anything that may be inappropriately cited. However, further examination is needed to ensure the accuracy of these citations as it is only reviewed by the four of us. Jwei3 (talk) 21:00, 6 November 2019 (UTC)

3. The majority of the content in this article is appropriately cited with supporting documents. However, there were some statements which did not have supporting citations stated. For instance, under "Discounts", the statement "When it comes to US drug prices, many factors are at hand to result in unaffordable drug prices for patients. There are programs in place to help the consumer navigate to obtain affordable drugs." Seems to be an assertion by the author with no supporting documents citing this statement. Jwei3 (talk) 21:00, 6 November 2019 (UTC)

Christina:

I believe Group 4s edits substantially improve the quality of the article as described in the Wikipedia peer review “Guiding framework”, since they provided much more detail into prescription drug prices and the impact it has on consumers and drug companies. I believe that the additions to the history of Orphan Drug Act and drug rebates, especially the consumers concerns that "pharmaceutical rebates increase out-of-posts and overall insurance costs" offers additional insight into drug prices, and greatly improves the quality of the article overall. Overall, I do believe that this group has achieved their goals for improvement as mentioned on the Talk Page. As Jason mentioned, their additions and resources are properly cited. Additionally, their edits are consistent with Wikipedia’s manual of style. Chrliao (talk) 22:16, 6 November 2019 (UTC)

Miranda:

1. I believe that Group 4s edits did help to improve the overall quality of the article as specified in the Wikipedia peer review "Guiding framework." This is largely thanks to their decision to explain what exactly an Orphan drug is and explained the policy that was enacted and how it affected the various stakeholders involved.

2. As mentioned I noticed everything they added was properly cited and there appeared to be no evidence of plagiarism as defined by Wiki guidelines. The members of Group 4 did a good job of phrasing their additions in their own words without providing any sort of bias or adding unnecessarily long quotations. Mwade94 (talk) 06:21, 7 November 2019 (UTC)

Potential ref - NPR "A Decade Marked By Outrage Over Drug Prices"

• https://www.npr.org/sections/health-shots/2019/12/31/792617538/a-decade-marked-by-outrage-over-drug-prices

Looks useful. --Hipal/Ronz (talk) 18:46, 28 February 2020 (UTC)

Wiki Education assignment: Research Process and Methodology - FA23 - Sect 202 - Thu

This article was the subject of a Wiki Education Foundation-supported course assignment, between 6 September 2023 and 14 December 2023. Further details are available on the course page. Student editor(s): ChrisMisu (article contribs).

— Assignment last updated by ChrisMisu (talk) 16:15, 17 October 2023 (UTC)