It doesn’t, that was the suggested price. For anyone who is a candidate for this drug they will almost certainly be on Medicare or Medicaid and the gov negotiates a much lower price than retail.
The article you link directly contradicts your claim:
> So how do Medicaid and Medicare set drug prices?
Medicaid takes the lowest negotiated price by private payers. After which, states have the right to further negotiate price. Aetna, Express Scripts, and Oscar Insurance all negotiate with pharma companies for the best price. Perhaps Aetna and Oscar only receive 20% discounts while Express Scripts receives a 30% discount. This 30% discounted price is now the Medicaid price. Additional requirements ensure this price level adjusts to inflation. Although the federal government helps fund Medicaid, it’s managed at the state level. At the state level, Medicaid can indeed negotiate further discounts with pharmaceutical companies. However, the federal government is still prohibited.
While the fed might not be allowed to negotiate, states can and do. As can individual providers. Basically you’re making a bad faith argument and hoping I wouldn’t read your “source”
Also Medicaid and Medicare are two different programs. The reason it doesn’t get too involved in Medicaid is bec it’s a state controlled program and would appear to be outside of their purview.
EDIT::
I seem to be getting rate limited by HN due to downvotes so I’m gonna post my reply here:
That’s false.
Again, the amount paid is never the MSRP, not by Medicare and not by Medicaid. And generally not by any insurance company either.
You’re intentionally making a bad faith argument. Both Medicare and Medicaid use negotiated pricing whether they negotiated those prices or someone else did.
It is absolutely categorically false to state unequivocally or even imply that Medicare pays the MSRP.
In the context of this discussion it is totally false to claim that any medical insurance provider (public or private) will be paying $56k for this drug. Not only because insurance companies don’t pay MSRP, but also because that price was set before all this happened, under these new circumstances BioGen will absolutely be updating their MSRP as well to reflect the new reality (drug is only proven to lower an Alzheimer’s marker and not directly treat the disease itself).
I agree msrp is rarely paid. Even the uninsured can often get manufacturers discount. You raise a good point that there is a possibility that biogen will update msrp, but I wouldn't hold my breath.
