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The EU: In, out, shake it all about.... (7 Viewers)

  • Thread starter jimmyhillsfanclub
  • Start date Jun 8, 2016
Forums New posts

As of right now, how are thinking of voting? In or out

  • Remain

    Votes: 23 37.1%
  • Leave

    Votes: 35 56.5%
  • Undecided

    Votes: 3 4.8%
  • Not registered or not intention to vote

    Votes: 1 1.6%

  • Total voters
    62
  • Poll closed Jun 15, 2016.
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SkyblueBazza

Well-Known Member
  • Oct 29, 2019
  • #45,361
Sky_Blue_Dreamer said:
The fear is that rather than have a list of allowed drugs and the doctors etc can prescribe those which they feel are best for the patient.

Under a trade deal a company could be given exclusive rights to produce certain drugs and effectively give them a monopoly, allowing them to charge what they like. This on top of other potential changes common in the US like lobbying and paying doctors to prescribe their specific brand even if it isn't the most cost-effective. It could effectively remove competition from the sector.

Think of it like in a football stadium. When it used to be different companies there was an element of price compeition. Now they're largely entirely filled with catering contracts by one company for the entire stadium (with a few different signs above the kiosks to give an impression of competition) prices can be astronomic.
Click to expand...

Mate, for any of what you describe and seem to fear to happen - the UK would have to make changes akin to what Screaming Lord Sutch might have suggested.

It is a scare story - I will give it that, but that is all it is.

Sent from my SM-G935F using Tapatalk
 

SBAndy

Well-Known Member
  • Oct 29, 2019
  • #45,362
SkyblueBazza said:
Mate, for any of what you describe and seem to fear to happen - the UK would have to make changes akin to what Screaming Lord Sutch might have suggested.

It is a scare story - I will give it that, but that is all it is.

Sent from my SM-G935F using Tapatalk
Click to expand...

I hope you are correct in your judgement but I really don’t think you are.
 

clint van damme

Well-Known Member
  • Oct 29, 2019
  • #45,363
SkyblueBazza said:
Mate, for any of what you describe and seem to fear to happen - the UK would have to make changes akin to what Screaming Lord Sutch might have suggested.

It is a scare story - I will give it that, but that is all it is.

Sent from my SM-G935F using Tapatalk
Click to expand...

We are going to have to make all sorts of huge wholesale changes in all sorts of industries if we want free trade with the countries high on the list of our free trade deal hit list.
States- NHS
Brazil- Agriculture
India- immigration

To name a few.

They aren't going to give us free trade for nothing.
 

Sky_Blue_Dreamer

Well-Known Member
  • Oct 29, 2019
  • #45,364
SBAndy said:
Which is rather ironic considering the US pharma companies’ arguments centre around having market-driven pricing.
Click to expand...

But it depends on how they define 'market driven'. They can argue 'market driven' for tendering a contract. If you win the contract then you've got it made - you have the market to yourself by law and how many of those contracts don't end up costing more than the tender price? Market driven is all the different options available to you and you choose the best depending on your needs and means.

It'd be like saying you want to buy a sofa but then agreeing your only going to buy from DFS.

Why do you think companies spend so much time when tendering for contracts lobbying politicians and wining and dining them? If it was just price based they're just wasting their own time and money.
 
C

CCFCSteve

Well-Known Member
  • Oct 29, 2019
  • #45,365
clint van damme said:
We are going to have to make all sorts of huge wholesale changes in all sorts of industries if we want free trade with the countries high on the list of our free trade deal hit list.
States- NHS
Brazil- Agriculture
India- immigration

To name a few.

They aren't going to give us free trade for nothing.
Click to expand...

Depends what the trade surplus/deficit is (also if the trade partner is a major competitor in certain industries)...amongst various other considerations

If a country is keen to export more to us, why wouldn’t they agree a free trade deal

Addressed the US - NHS on other thread. Might be bullshit but it’s not on the table
 

chiefdave

Well-Known Member
  • Oct 29, 2019
  • #45,366
Johnson has done a cracking job of getting Brexit delayed. Having got a positive vote on his WA it could have been full steam ahead but now we're going to be in election mode until 12th December.

Then, at best, a week before the Christmas recess. If they come back on the 6th that gives 4 weeks before the extended deadline.

Anyone confident of everything being sorted by then?
 
Reactions: Deleted member 5849

clint van damme

Well-Known Member
  • Oct 29, 2019
  • #45,367
CCFCSteve said:
Depends what the trade surplus/deficit is (also if the trade partner is a major competitor in certain industries)

If a country is keen to export more to us, why wouldn’t they agree a free trade deal

Addressed the US - NHS on other thread. Might be bullshit but it’s not on the table
Click to expand...
I didn't say they wouldn't sign them but they come at a cost.
The scenario Baz called out isn't as far fetched as he thinks in my opinion.
 

Sky_Blue_Dreamer

Well-Known Member
  • Oct 29, 2019
  • #45,368
CCFCSteve said:
Depends what the trade surplus/deficit is (also if the trade partner is a major competitor in certain industries)...amongst various other considerations

If a country is keen to export more to us, why wouldn’t they agree a free trade deal

Addressed the US - NHS on other thread. Might be bullshit but it’s not on the table
Click to expand...

Or it is on the table but not willing to admit it. Trump said it was and the look he got from May was 'shut the fuck up'. He then backtracked. My take on it was Trump once again couldn't help shoot his mouth off when he shouldn't.

It may be packaged as non-privatisation to make it more palatable, but the companies seem to be pushing for it with both the US govt and our own.
 
Reactions: clint van damme
C

CCFCSteve

Well-Known Member
  • Oct 29, 2019
  • #45,369
Sky_Blue_Dreamer said:
Or it is on the table but not willing to admit it. Trump said it was and the look he got from May was 'shut the fuck up'. He then backtracked. My take on it was Trump once again couldn't help shoot his mouth off when he shouldn't.

It may be packaged as non-privatisation to make it more palatable, but the companies seem to be pushing for it with both the US govt and our own.
Click to expand...

Johnson’s said NHS is not on the table (link on other thread)

If it’s a case of US companies having the ability to supply the NHS, I’ve got not issue, as long as it’s competitive tendering/procurement process. If it’s a move towards their insurance based system I’d be totally against (but can’t see it ever being accepted in this country)
 

chiefdave

Well-Known Member
  • Oct 29, 2019
  • #45,370
CCFCSteve said:
Johnson’s said NHS is not on the table
Click to expand...
Well that's convinced me, not like he's ever been caught lying.
 
Reactions: shmmeee, Sick Boy, skybluetony176 and 4 others

skybluetony176

Well-Known Member
  • Oct 29, 2019
  • #45,371
CCFCSteve said:
Johnson’s said NHS is not on the table (link on other thread)

If it’s a case of US companies having the ability to supply the NHS, I’ve got not issue, as long as it’s competitive tendering/procurement process. If it’s a move towards their insurance based system I’d be totally against (but can’t see it ever being accepted in this country)
Click to expand...
The problem is a lot of drugs are under the grip of the American pharmaceutical industry and if Trump pushes for the rest of the world paying the same as the US rather than the US paying the same as the rest of the world (already his confirmed stance) then it’s difficult to see how the supply of drug’s aren’t going to be on the table as part of agreeing a trade arrangement.
 

fernandopartridge

Well-Known Member
  • Oct 29, 2019
  • #45,372
CCFCSteve said:
Johnson’s said NHS is not on the table (link on other thread)

If it’s a case of US companies having the ability to supply the NHS, I’ve got not issue, as long as it’s competitive tendering/procurement process. If it’s a move towards their insurance based system I’d be totally against (but can’t see it ever being accepted in this country)
Click to expand...
US companies have the opportunity to supply the NHS already. Nothing is stopping them at all.

I'd imagine they'd want mandatory inclusion of US firms in competition + limits on the extent to which weighting could be applied to price criteria and Britain to be outside the scope of the Falsified Medicines Directive.

I've just awarded an NHS IT contract and some months ago had a conversation with a large American company who showed interest in bidding. They didn't like the idea that
1. We set a load of technical standards they'd have to meet before we'd award a contract to them, and;
2. We set an affordability cap on their pricing to limit what they could charge a service recipient


.
 
Reactions: skybluetony176, Sick Boy, Sky_Blue_Dreamer and 1 other person

skybluetony176

Well-Known Member
  • Oct 29, 2019
  • #45,373
fernandopartridge said:
US companies have the opportunity to supply the NHS already. Nothing is stopping them at all.

I'd imagine they'd want mandatory inclusion of US firms in competition + limits on the extent to which weighting could be applied to price criteria and Britain to be outside the scope of the Falsified Medicines Directive.

I've just awarded an NHS IT contract and some months ago had a conversation with a large American company who showed interest in bidding. They didn't like the idea that
1. We set a load of technical standards they'd have to meet before we'd award a contract to them, and;
2. We set an affordability cap on their pricing to limit what they could charge a service recipient


.
Click to expand...
Did you see Despatches last night FP? If you did I’d love to hear your take on it with you being our NHS expert.
 
C

CCFCSteve

Well-Known Member
  • Oct 29, 2019
  • #45,374
fernandopartridge said:
US companies have the opportunity to supply the NHS already. Nothing is stopping them at all.

I'd imagine they'd want mandatory inclusion of US firms in competition + limits on the extent to which weighting could be applied to price criteria and Britain to be outside the scope of the Falsified Medicines Directive.

I've just awarded an NHS IT contract and some months ago had a conversation with a large American company who showed interest in bidding. They didn't like the idea that
1. We set a load of technical standards they'd have to meet before we'd award a contract to them, and;
2. We set an affordability cap on their pricing to limit what they could charge a service recipient


.
Click to expand...

Interesting stuff Fernando, I hope you never have to soften those type of criteria ! (they’re essential I’d say !) Price criteria is rather important when we/government is paying though so a government giving this control away would be bizarre. Stand to be corrected in future though
 

skybluetony176

Well-Known Member
  • Oct 29, 2019
  • #45,375
Drug costs should be a 'prominent issue' in Trump trade talks: Mount Sinai Health CEO
 
Reactions: clint van damme
S

SkyblueBazza

Well-Known Member
  • Oct 29, 2019
  • #45,376
SBAndy said:
I hope you are correct in your judgement but I really don’t think you are.
Click to expand...
There are mostly alternatives to the US Pharma's drugs...from UK or EU companies. So if the US companies want to price themselves out of the market that is up to them. If you are thinking our Prescribers will be swayed by bribery of some sort, by US Pharma, as a whole I am confident that won't get to the start line let alone off the blocks. There are Medicines Optimisation programs in place that need to be binned - how that would be justified I cannot imagine. Prescribers almost to a man have patient best interests at heart.

Plus there are already British & European Pharma making shedloads from selling drugs to the NHS...& US Pharma already here doing business. Maybe the deal would open doors for more British Pharma innovations?

Sent from my SM-G935F using Tapatalk
 
S

SkyblueBazza

Well-Known Member
  • Oct 29, 2019
  • #45,377
Sky_Blue_Dreamer said:
But it depends on how they define 'market driven'. They can argue 'market driven' for tendering a contract. If you win the contract then you've got it made
Click to expand...

Quite...& the model in the US is patients being advertised to directly so once the Doctor prescribes, the patient can buy their drug anywhere. Here they can buy illegally on the internet or other unauthorised sources...but generally - it is from a reputable source at the NHS price

Sent from my SM-G935F using Tapatalk
 
S

SkyblueBazza

Well-Known Member
  • Oct 29, 2019
  • #45,378
chiefdave said:
Johnson has done a cracking job of getting Brexit delayed. Having got a positive vote on his WA it could have been full steam ahead but now we're going to be in election mode until 12th December.

Then, at best, a week before the Christmas recess. If they come back on the 6th that gives 4 weeks before the extended deadline.

Anyone confident of everything being sorted by then?
Click to expand...
Yes. The near the death deal that Boris offers will be accepted by parliament.

Sent from my SM-G935F using Tapatalk
 
S

SkyblueBazza

Well-Known Member
  • Oct 29, 2019
  • #45,379
clint van damme said:
I didn't say they wouldn't sign them but they come at a cost.
The scenario Baz called out isn't as far fetched as he thinks in my opinion.
Click to expand...
What I call out is the cost of changes necessary to bring about the scenario suggested would be so massive & so disruptive - I doubt they will be possible within 20yrs

Sent from my SM-G935F using Tapatalk
 
S

SkyblueBazza

Well-Known Member
  • Oct 29, 2019
  • #45,380
skybluetony176 said:
The problem is a lot of drugs are under the grip of the American pharmaceutical industry and if Trump pushes for the rest of the world paying the same as the US rather than the US paying the same as the rest of the world (already his confirmed stance) then it’s difficult to see how the supply of drug’s aren’t going to be on the table as part of agreeing a trade arrangement.
Click to expand...
What drugs Tony??? Give us some examples

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chiefdave

Well-Known Member
  • Oct 29, 2019
  • #45,381
SkyblueBazza said:
Yes. The near the death deal that Boris offers will be accepted by parliament.
Click to expand...
Certainly hope so. The other option would be stalling for a few more weeks and falling out by default with no deal if the EU refuse to extend further.

Get the feeling they are getting pissed off with extensions being requested and then wasted on leadership elections and general elections and might not be open to any further extension.
 

skybluetony176

Well-Known Member
  • Oct 29, 2019
  • #45,382
SkyblueBazza said:
What drugs Tony??? Give us some examples

Sent from my SM-G935F using Tapatalk
Click to expand...
I gave you a link to a paper that explained it all but although you replied to it you clearly didn’t read it. You can take a horse to water and all that. It’s basically every drug. Some are double the price, some are as high a six times what the British government currently pays for the exact same thing.
 
S

SkyblueBazza

Well-Known Member
  • Oct 29, 2019
  • #45,383
skybluetony176 said:
Drug costs should be a 'prominent issue' in Trump trade talks: Mount Sinai Health CEO
Click to expand...
This link?

If a different one then please let me know where it is & I promise I shall read it.

Sent from my SM-G935F using Tapatalk
 

skybluetony176

Well-Known Member
  • Oct 29, 2019
  • #45,384
SkyblueBazza said:
This link?

If a different one then please let me know where it is & I promise I shall read it.

Sent from my SM-G935F using Tapatalk
Click to expand...
No. The link in the post you originally replied to of mine on this subject.
 
S

SkyblueBazza

Well-Known Member
  • Oct 29, 2019
  • #45,385
skybluetony176 said:
No. The link in the post you originally replied to of mine on this subject.
Click to expand...
Ah, ever the child I see?!

Well having tracked back the only drugs referred to in that link are generically available. That means anyone & everyone can produce them if the so wish & get regulatory approval to do so.

In fact if you research the top 100 most prescribed drugs in the UK they are virtually all available generically. That means that if the US manufacturers want to charge the earth for the brands they produce, the NHS will simply go buy the cheapest available alternative...then the next cheapest...etc until all generic supplies are exhausted before buying the perceived expensive US brands.

Sent from my SM-G935F using Tapatalk
 
Reactions: dutchman
B

Brighton Sky Blue

Well-Known Member
  • Oct 29, 2019
  • #45,386
SkyblueBazza said:
Ah, ever the child I see?!

Well having tracked back the only drugs referred to in that link are generically available. That means anyone & everyone can produce them if the so wish & get regulatory approval to do so.

In fact if you research the top 100 most prescribed drugs in the UK they are virtually all available generically. That means that if the US manufacturers want to charge the earth for the brands they produce, the NHS will simply go buy the cheapest available alternative...then the next cheapest...etc until all generic supplies are exhausted before buying the perceived expensive US brands.

Sent from my SM-G935F using Tapatalk
Click to expand...

The 'big pharma' company I made medicines for had a contract with the NHS. We and a generic manufacturer were the only ones who produced the compound in question but we were chosen despite being more expensive since the quality was more reliable and trustworthy. This was a while ago but the risk always exists with generics that you get what you pay for.
 
Reactions: skybluetony176 and clint van damme
S

SkyblueBazza

Well-Known Member
  • Oct 29, 2019
  • #45,387
Brighton Sky Blue said:
The 'big pharma' company I made medicines for had a contract with the NHS. We and a generic manufacturer were the only ones who produced the compound in question but we were chosen despite being more expensive since the quality was more reliable and trustworthy. This was a while ago but the risk always exists with generics that you get what you pay for.
Click to expand...
The active ingredient is the active ingredient. That is what produces the medicinal effect.

Most generics fall short via adverse effects caused by the various 'inactive' ingredients. A bit like some people don't eat garlic because it upsets their stomach only sometimes the effect is enough for them to want to stop taking the drug despite the beneficial effect.

The NHS is already in a culture of prescribing cheaply for well-established generically available drugs. Indeed all the fears people have about big-Pharma influence are countered by Precriber bans on Pharma interactions either by individuals, or whole GP Practices, Hospital Departments, CCGs etc. Medicines Optimisation teams make frequent wholesale changes from brands to generics to save money.

That is fine, but it stifles profit which stifles investment in new drug development. 20yrs ago, that was definitely needed as Pharma spent loads developing drugs with a miniscule tweak on the 1st to market to then charge the same or sometimes more for it. Things are much tighter now. It is much more hit & miss for the Pharma companies. One or two win with their brands, most make relatively little...so struggle to get money to invest in developing a future pipeline

Sent from my SM-G935F using Tapatalk
 

fernandopartridge

Well-Known Member
  • Oct 29, 2019
  • #45,388
CCFCSteve said:
Interesting stuff Fernando, I hope you never have to soften those type of criteria ! (they’re essential I’d say !) Price criteria is rather important when we/government is paying though so a government giving this control away would be bizarre. Stand to be corrected in future though
Click to expand...

When you hear about removal of LPF obligations in Boris Johnsons deal, this is the sort of thing that is implied (to a lesser extent though)
 
Reactions: clint van damme
B

Brighton Sky Blue

Well-Known Member
  • Oct 29, 2019
  • #45,389
SkyblueBazza said:
The active ingredient is the active ingredient. That is what produces the medicinal effect.

Most generics fall short via adverse effects caused by the various 'inactive' ingredients. A bit like some people don't eat garlic because it upsets their stomach only sometimes the effect is enough for them to want to stop taking the drug despite the beneficial effect.

The NHS is already in a culture of prescribing cheaply for well-established generically available drugs. Indeed all the fears people have about big-Pharma influence are countered by Precriber bans on Pharma interactions either by individuals, or whole GP Practices, Hospital Departments, CCGs etc. Medicines Optimisation teams make frequent wholesale changes from brands to generics to save money.

That is fine, but it stifles profit which stifles investment in new drug development. 20yrs ago, that was definitely needed as Pharma spent loads developing drugs with a miniscule tweak on the 1st to market to then charge the same or sometimes more for it. Things are much tighter now. It is much more hit & miss for the Pharma companies. One or two win with their brands, most make relatively little...so struggle to get money to invest in developing a future pipeline

Sent from my SM-G935F using Tapatalk
Click to expand...

It is no secret that the biggest pharmaceutical successes have not laid in infectious diseases but in cancer, anti-asthmatics, statins etc...the protein target won't change every 6 months. The further into clinical research a drug candidate goes the more invested in its success you become. Thankfully because we aren't quite at the stage of the American system we don't have pharmaceutical sales reps pushing dodgy products onto individual doctors. The government is also still yet to catch up with the fact that a complex compound can be given a miniscule tweak to circumnavigate existing regulations. But these are conversations for another day.

Working on the other side of this, it would be nice if people recognised the years and years of work we do as scientists to get these things right.
 
Reactions: skybluetony176, shmmeee and clint van damme

fernandopartridge

Well-Known Member
  • Oct 29, 2019
  • #45,390
SkyblueBazza said:
Ah, ever the child I see?!

Well having tracked back the only drugs referred to in that link are generically available. That means anyone & everyone can produce them if the so wish & get regulatory approval to do so.

In fact if you research the top 100 most prescribed drugs in the UK they are virtually all available generically. That means that if the US manufacturers want to charge the earth for the brands they produce, the NHS will simply go buy the cheapest available alternative...then the next cheapest...etc until all generic supplies are exhausted before buying the perceived expensive US brands.

Sent from my SM-G935F using Tapatalk
Click to expand...
That's what happens today but the direction of travel big US pharma wants is in the opposite direction, with unrestricted or even preferential access to the NHS.

There are generally no tariffs for imports of finished drugs under WTO rules, but the list of products in scope has not been updated for years, it is being held up by the USA for reasons unknown.
 
Reactions: skybluetony176 and clint van damme

Sky Blue Pete

Well-Known Member
  • Oct 30, 2019
  • #45,391
70bn lost

Brexit deal means ‘£70bn hit to UK by 2029'

love that experts aren’t listened to now
 

clint van damme

Well-Known Member
  • Oct 30, 2019
  • #45,392
Sky Blue Pete said:
70bn lost

Brexit deal means ‘£70bn hit to UK by 2029'

love that experts aren’t listened to now
Click to expand...
They must be communists!
 

Mcbean

Well-Known Member
  • Oct 30, 2019
  • #45,393
16 year olds would offer nothing except the opportunity for McDonnell to offer them the sweet shop for free - most when out of school are more interested in shagging than voting
 
Last edited: Oct 30, 2019

clint van damme

Well-Known Member
  • Oct 30, 2019
  • #45,394
Grendel said:
In theory no
Click to expand...

just watched an interview with Laura Piddock who said Corbyn had agreed to the GE now no deal is off the table.
When the interviewer said it's not she said they classed the extension as no deal of the table because it meant we couldn't crash out on the 31st.

I don't think many people would class that as no deal off the table. Chance of no deal delayed but not off the table.
 

skybluetony176

Well-Known Member
  • Oct 30, 2019
  • #45,395
SkyblueBazza said:
Ah, ever the child I see?!

Well having tracked back the only drugs referred to in that link are generically available. That means anyone & everyone can produce them if the so wish & get regulatory approval to do so.

In fact if you research the top 100 most prescribed drugs in the UK they are virtually all available generically. That means that if the US manufacturers want to charge the earth for the brands they produce, the NHS will simply go buy the cheapest available alternative...then the next cheapest...etc until all generic supplies are exhausted before buying the perceived expensive US brands.

Sent from my SM-G935F using Tapatalk
Click to expand...
This link Drug pricing trends in the EU versus in the US - Results Healthcare
 
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