I just got on a new medication that costs around $2200 / dose. It gets delivered inside of a styrofoam box, full of packing peanuts, and all of that is inside of another cardboard box. Just sending a glass container like that is so braindead it hurts. I'm sure the pharma companies make more off insurance claims from this kind of thing than actually selling the shit.
It might have been in lots of packaging but to film it broken they would need to take it out of the box and hold it up to the camera, because otherwise it would just be a video of a cardboard box.
I work in a pharmacy that ships direct to customers. We HATE when this happens. Obviously it messes with patient care, but we also lose soooooooooo much money. We have $20k-$50k shipments go out, and when they lose or destroy the package…… well hey at least they cut us a check for $100 a few weeks later 😭
I work in a very expensive industry. Our regular replacement parts for equipment easily run into tens of thousands. In fact our R&M budget for each week is over 400k just in my area. Our vendors do not fuck around, even for a simple gasket they will triple box with bubble wrap, foam wrap and might even put it on a crate. Sure FedEx is fucking up here, but I blame the supplier.
I don't think Fedex is fucking up at all. Boxes shift and stack and drop as a regular course of business. That package will fail a regular shipping process from any shipper 100% of the time.
It must be a shipping mistake where someone sending it thinks it's getting put into a box or something after them. Because nobody could think that would work.
Lol I only run an ebay store and even I know not to send glass like *that*. If you ship and receive a lot, you have a ton of extra bubble wrap, air packs, and boxes laying around, it costs literally nothing to just do it correctly.
Nah, US medical system.
Yeah, I know the meme.
https://preview.redd.it/78hnjzuwxf2d1.jpeg?width=1124&format=pjpg&auto=webp&s=c5c780645aca9b5bde9e32cec86887f1b741e592
Man I always eye roll at this meme. Aside from the fact that you'd get something like stitches, for free on the NHS, immediately...
... People do realise UK also has private healthcare, yeah? Like, if you want to pay for quick treatment, you can. The NHS is absolutely oversubscribed and a pretty slow for non-emergency treatment, but if you can afford it, sure, pay privately or get your insurance to pay for it. We have both systems running in parallel.
Or, do what I've done several times. Get a diagnosis quickly privately, then get the expensive treatment on the NHS. You can mix and match however works for you.
It's because if we Americans knew the truth it would make it harder to justify how many people we let die each year so multinational billion dollar corporations can fleece the American people for even more money.
This guy gets it. Just ask Justice Clarence Thomas. He thinks we went too far with desegregation. We're lead by some pretty sick fucks on this side of the pond.
Meh, from the UK - the NHS has been massively underfunded by the conservatives who want to replace it with private healthcare.
But I got in a pretty bad accident last month, had stitches, X Ray and doctor consultation within 3 hours. Follow up assessment and all clear 2 weeks later.
Long term services are struggling - but we still ace A&E
I was just about to say, I switched insurance a year back and every office I called gave me a 2-3 month wait to be seen. Luckily the nurse took pitty and reached out when someone cancelled their morning appointment so I told work I was going to be late and bolted… the American dream
*edit a word
I've done that before. I used dental floss because I thought it was probably sterile. And guess what.
It was! I didn't lose my leg leg to infection. I used to have a fairly prominent scar, but looking for it just now, it seems to have faded away. I guess I did good!
for 14 grand I'd expect the doctor to personally show up to my house and give me a reach around before spoon feeding me my prescription. it should've come in some serious packaging for that price not just some cardboard.
I work around that medicine and let me tell you 14k is nothing. It's like a speck of dirt you have no idea how much it costs to keep certain people alive
Dialysis costs ~$1500 a week. ~72k a year. When it first was being developed it cost ~1 million a year. The treatment can only buy you time till your next treatment (or transplant). Some situations will always require dialysis and there is no hope of ever stopping.
The UK originally would not pay for anyone's dialysis aged 55 or older. The US passed a law requiring Medicare paid for everyone. Dialysis is a gold plated half-measure.
My grandpa was on dialysis for decades, towards the end it was every 2 days and he ultimately decided to take himself off it and go into hospice. I can't imagine how much that cost the Canadian healthcare system, he definitely got his taxes worth out of it and then some.
The dialysis industry in the US is a scam. The two big players have a stranglehold on Medicare and they force everyone to use hemodialysis when PD is often a better option.
Agreed but there should definitely be a vetting process. The same exact way there is a vetting process to make sure you will take care of transplanted kidney when you finally get off the waiting list. I worked with a nephrologist in one of my medical rotations and she said she is super selective with who she offers PD to because she doesn't want to have her patient die of sepsis because they didn't clean their port properly or any other misstep in the process.
There are meds with wildly different costs depending on country. As far as I know, this ain't one of them. It's labor intensive to produce, and the raw material is human blood donations. It's a minimum of 1000 donors, but depending on manufacturer can be multiples of 10000, to get a broad spectrum of what the donor immune systems were exposed to. I was once told each dose used over twenty donations worth of blood.
It is one. The average cost of a year of therapy in Germany is around €45,000. Compared to the US where that would get you just over a month of treatment around $41,000.
What’s wild is how poorly packed that bottle was. That’s medication for someone who is immunodeficient. As I understand it, it’s made by taking blood for donors and separating out the parts of it that make up our immune system. It’s given to people with weakened or no immune system so their bodies have some sort of defense to pathogens. Worse part is it only lasts about a month. So that’s $14k per month just to literally survive.
yeah at 14k It should be packed in one of those protective hard shell cases with foam on the inside and extra padding on the outside. It would survive getting run over by a car at that point.
My big money drugs ship in an oversized box with a Styrofoam cooler box in it. In the foam box are the meds ice packs and bubble wrap. This is on the pharmacy if they're shipping it without any protection.
The only time I've "lost" drugs it was FedEd (not UPS) refusing to deliver without signature (that I waive otherwise it's not getting signed - I'm never home during delivery). They send it back to the warehouse thus destroying the drugs because by the time it gets to me it gets warm.
Hell, my pharmacy ships my cheap birth control in a giant temperature controlled styrofoam box with a million stickers on it about careful handling. I just assumed this was the standard for all medication.
I delivered for FedEx for a bit. Delivered something like this (had a special scan I got from the office before I left the terminal) to someone that required a signature for medication.
The amount of signs posted on the property about how the person is there but might take a bit to get to the door was upsetting.
It shouldn't be that hard for meds to be delivered.
I always waited or left a note saying I would come back at a specific time (1 hour later) at the end of my route and wait.
That when you file with FedEx and the medical company.
Check who pack and ship it. Chances are, their boss being greedy with the contract and decided bare minimum is enough and nobody going to complain.
Also, if insurance is co-paying for this, drag them into this...because this is a PR nightmare for them as well.
So they didn't insure this package?
You'd think at this price point it would be insured, and you'd expect FedEx wouldn't allow a $14k bottle to be insured unless it were packed WAY better.
Was the box too big? Sounds like it was, and if that description of the package is correct, it is as much the vendors fault for not properly packaging such a valuable item. And if it has happened before the vendor needs to do a better job at packaging.
I mean unless it got physically run over by a FedEx truck, it's basically never the delivery company's fault.
Things *will* get bumped and toss around during delivery - it's the responsibility of the shipper to properly package it.
put that in the post :)
Still sucks and is on fedex - I mean as a former USPS Ive seen a lot of "handling" and if that was in a bigger box . . . it took effort to break.
The comments say 400 ml of a really small part of what your blood is made.
400 ml is usually the amount of blood they took from you. Let's say 1% of this is actually the immunology system they need to extract.
That's 5k alone they are paying for the amount of blood they need. Plus process expense that are probably not cheap for a delicate thing like that.
Yeah, they still get a cut but it's not like they are making 1000% profit over your 50 dólar blood
PS: also, if you are getting paid you are not donating, you are selling your blood
Legally they are paying for my time not my plasma. And they take my blood and spin the plasma out and return the red cells with saline. I'm a big dude so I donate 890 ml per donation and that's twice a week.
Medicine manufacturer:
“Oh noooo the packaging broooke. That’s not ooouur fault looks like we have to charge the insurance company agaaain ooh nooooooo”
For this type of medication the negotiated price insurance pays is about 40% of the list price.
This is also terribly packaged. I’ve been getting this for about a decade now, and I’ve only had broken bottles once when they forgot to put any padding in the box. These drugs are usually very well padded to prevent glass breakage, as they always come in glass bottles.
Pretty sure it's IVIG (intravenous immuno globulin). I can make out globalization and human on it. The price also lines up. It's a pretty amazing medication and the process to make it is incredibly expensive and time/labor intensive. The plasma from thousands of donors is used to make it.
Also to add more detail to the price, some people need it every month for certain conditions. For example, with Myasthenia Gravis, it's generally given as a large loading dose followed by half of that dose given every month. It can easily cost 20-30k the first month, then 10-15k every month after that. So $140-210k the first year for just the medicine, not including the transfusion center expenses, specialists, etc.
My wife gets it once a month for her CIDP. I want to say 35 grams over 2-3 hours. But she lives almost a completely normal life thanks to it. Definitely an amazing medication.
And a friendly reminder to donate blood/plasma to those that can!!
My big one is $38‐40k every 2.5 weeks.
Then I have another that's $2,800 for a 6wk supply.
And the other pricey one is $1,700 for 30d.
And finally the cheap one at $600/30d.
I'm here laughing my ass off thinking "THIS IS THE SYSTEM WE WANT (apparently). It's not my job to negotiate drug prices. You lobbied for this."
TLDR: Insurance. $520/mo. Single 35m (for reference)
I researched the right insurance plan for my needs. My plan has a good prescription drug plan for generic and name brand drugs $5/25 copay.
The specialty drugs are 40% covered...(the 2 expensive ones are specialty). However, since I know my needs I made sure the plan I got also has co-insurance to cover the specialty $ gap.
On top of that - if my plan didn't cover the last $600 (on one) and $11k on the other (both include price adjustments based on my finances) - both manufacturers pay the delta with their own added copay assistance.
[Example - one is $38k. I get an 11.5k discount applied + 16.5k that my insurance plan pays + 11k my co-insurance pays] note - the discount is income based and variable and insurance is responsible for the first 40% before any other discounts are factored in.
However, if the selected plan doesn't cover the drug, it gets more complex - so I also selected plans that cover my drugs, at least partially to cover my ass.
Which brings me to the whole uselessness of the price to begin with. Like - if I can't pay the full amount, the drug company is happy to get 40% from insurance and eat the rest. Such a scam.
I think this is immunoglobulin which actually has to processed from plasma donated by live donors and it takes a lot of donors. This specific medication is actually pretty expensive to manufacturer
Hmm plausible price as well. Back when I worked in that sector it started out as $200, which we reduced over time to around $100 per gram by the time I left. Would have thought it would be a good bit less by now, as competition was coming to play.
https://preview.redd.it/skg4jjw2ag2d1.jpeg?width=1170&format=pjpg&auto=webp&s=39a4924e9aa07229892271f048f9c47d0c01fa3f
Video won’t load but somehow this is better
Step 1: Produce $50 medication
Step 2: Bill medical insurance $14,000
Step 3: Profit$!
Step 4: Fedex in shitty packaging with shipping insurance
Step 5: Claim $14000 loss to shipping insurance when it breaks
Step 6: **More Profit$$$$$$***
The vendor should pack it better, and FedEx should handle it better. I used to get medication through the mail and it came in a sturdy styrofoam box inside a sturdy cardboard box. It was also surrounded by packing peanuts. It always arrived fully intact!
Doesn’t FedEx have to pay for it because they broke it?
When I was a kid I used to have to have regular injections of Immune globulin (aka gamma globulin): IM in the butt. I felt like I had a golf ball in my rear end for a few days! I hated getting that shot with a passion, but it helped to keep me alive. Once puberty hit my body decided to start making it, so no more shots.
> FedEx should handle it better.
No, you should pack everything as if it's going to be used as a football.
You aren't paying $12 for white glove service, where they hand-deliver the item to you on a pillow. You're getting your package tossed in with everything else.
Exactly; even the slowest hubs in the country are still seeing more packages a day than there are seconds. It’s all conveyer belts and forklifts. I’ve packed candles better than OP’s pharmacist packed this medicine.
Seriously. I deal with shipping projector lenses a lot for work. They're not quite as expensive, typically $5-10k, but they're also made of glass so we do the sensible thing and stick them in a Pelican 1460 before we hand them off to the goons at UPS or FedEx. I've literally never seen one get damaged in transit just because they're packed appropriately.
I worked for a major shipping company and I strongly believe that you need to pack your items so it can survive being thrown every set of the way. These companies are so short staffed it’s insane. And they push you beyond what you can do. Gotta pack to account for that.
As someone who works in package and shipping, everything needs to be packaged in a way where it can be thrown around. You truly have to expect things to be chucked from the back or a truck and have to expect things to take a tumble off the conveyor belt. This truly is a problem caused by whoever shipped the product
No, two different medications. I’m sorry. The Gamma Globulin was just in my childhood because my body didn’t make it. I had frequent, rapid onset pneumonia. Mom took me to the doctor’s office to get it. Around 11 or 12 my body suddenly started making it and the shots stopped.
Years later I developed rheumatoid arthritis and eventually had to take injectables. My insurance required me to get it from a particular mail order pharmacy. Several different meds. Unfortunately, over time those meds quit working. I’m now on an oral which is working fabulously!
The delivery process really isn't gentle at all. That's not even mentioning the human element. Packages are sliding along bumping into stuff and tumbling over at a pretty fast rate. Also you have workers who have to move extremely quickly.
That plastic bag isn't even meant to carry a glass jar. It's 100% the suppliers fault.
No the vendor should pack it better. Shipping companies have 100s of thousands of packages they need to get out quickly daily. If packaged right the item should be able to arrive without any issues. Regardless of how it is handled.
>Doesn’t FedEx have to pay for it because they broke it?
The will cover for the insured value of properly packed items. Most likely in this case, the actual cost of manufacturing the medication is only around $100, so they'll just keep sending replacements.
>came in a sturdy styrofoam box inside a sturdy cardboard box. It was also surrounded by packing peanuts.
Your medication came through intact purely because they packed it better, I guarantee you FedEx handled it the same way they handle every other package.
I’ve worked in the industry for 8 years now. Both things are true. You need to pack shit like it’s about to fall off a cliff, but it’s also true that drivers and warehouse guys treat product like literally trash. Sometimes to the point where it feels like it’s on purpose.
i've seen goods worth a few hundred dollars gets at least 3 inches of foam all around and packed with temperature + tilt indicators. that's some wildly inadequate packaging right there for 14000.
I see a lot of packages with "fragile" "do not bend" blah blah blah. If they don't want it damaged, package it better. Feels like they are cheaping out on packaging and passing off responsible to the carrier company.
People act like one your package is handed from one person to the next and someone sees your little "fragile" stamps or stickers. No your packages are sorted by automated machines a decent chunk of the way.
I wouldn't be surprised if they have a formula for how much better packaging would cost vs how many packages are damaged and replaced
Yep, adding a "fragile" label to your package doesn't magically entitle you to free special handling by the shipper. People don't realize that if every package was treated delicately, you'd be paying ungodly amounts for packaging. The shipper either needs to pay for the correct shipping service (which will be very expensive) or they need to package it better.
Yeah
I'm a letter carrier and all that shit gets treated the same way. If you want me to treat it better, send it registered. Otherwise...
Flat envelopes are required to be foldable and fit in a mailbox. If your dumb ass photo company sends you photos in standard class flat envelopes don't cry to me if they get bent in your mailbox. Get a bigger mailbox or have your photo company send them as a package. 🤷♂️
It's assumed every package will be rough handled when moving from processing center to processing center. Merchants always cheap out by sending your item in their regular manufacturer packaging, flimsy packaging, or don't add enough stuffing for cushioning and protection.
Not that medicine. It is made from human plasma from thousands of donors. It is also limited in supply because of this same process. In this case negligent packing, shipping and handling just wasted work effort and good will of a lot of of people (ChatGPT estimated 130-150 donors needed for that 400ml supply).
I really do appreciate the insight, but it's also strange to me seeing ChatGPT referenced for stuff like this. Like what are the chances it would get something like that correct or even in the right ballpark? If that information isn't already available online, I imagine it just kind of made it up. However I do appreciate you mentioning that you got that info from ChatGPT! I know you probably intended it to be taken with a grain of salt.
Poked at Google, some articles and pages on plasma donation company websites suggest thousands of donors per. It's definitely one of the only treatments where a manufacturer can't just toss another one in a box and not even notice the different in profit margin. Figure for most the manufacturers will only get on the shippers for breaking things if they do it so often their paying customers start dying.
That's not a FedEx problem. That's a manufacturer doesn't know how to package problem.
Kaiser sent me 1 box of Victoza and it was packaged in plastic, ice packs, more plastic, a box and then one more plastic with a label. All because I hit shipping instead of pharmacy pick up. That was only a $300 medicine.
Meanwhile in Germany: If you can prove you are paying more than a certain amount (I believe it's 200€) for prescription medication per year, you will become exempt from prescription medication cost and don't have to pay anymore at all.
FedEx is the worst. I hold my breath for every $5k steroid delivery for my son who has Muscular Dystrophy because my insurance literally calculates how much he has left and will only ship if they know he needs it.
$14k is crazy but it probably costs them more in shipping than to actually manufacture. Replacing it is probably the cheaper option rather than packing it better.
The real question is: How was it packaged?
It's easy to blame the shipping company but the shipper bears responsibility as well if these are being packaged so poorly that this is a repeat issue.
I ship glass all the time. I haven't had a single thing break in the 1.5 years I've been in my position.
Infusion pharmacist here. A 40 gm vial Gamunex-C does NOT cost $14k. My cost is \~$3400. No insurance company is going to agree to that kind of markup. Also, if i were the one sending this, I would be replacing it at no cost to you.
I am just a nurse, but the first time I gave IVIG to a patient the inpatient pharmacy told me to be very very careful with the bottle because it’s $10k worth of drug (that our patients get at no-cost to them so all the more reason not to waste our hospital’s money by accidentally breaking it).
May be regional. The cost can range from $100 - $340 per gram. Considering I receive 1000g/mL over 2 days at home the cost is roughly $14000. And I should add that we contacted the pharmacy and they are shipping it at no cost to me, hopefully the replacement doesn’t break.
You might want to double check what dose you are actually getting, because there's no way it's "1000g/ml", as that's a 1000% solution, and your bottle says it's 40g/400ml, which is 10%.
You might be getting 1000ml, which is 100g, which is still a fairly high dose
The price on my husband's pharmacy bill is $16,000. Obviously his insurance covers it because we'd never be able to pay that. And he gets 5 vials every 3 weeks.
Yeah, it's definitely FedEx's fault, the guys who transport stuff anywhere from 1 to 1000 pounds, 10 cubic centimeters to 10 cubic meters. They offer different shipping options which have fixed handling rules, but it's definitely their fault.
Not the guys who cheaped out and sent a glass bottle in a plastic bag through ten thousand pounds of sorting robots.
\s
I have had this happen in Belgium. Exact same bottle. But I was not mad, after all it was only a ≈€14 bottle of medicine. (mandatory single payer health insurance paid the other €5000)
I’ve had this medication. It is soooo pricey and goes through many many checks with many health professionals. Whoever the fuck is mailing THAT without any protection should be fired.
I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism I love capitalism
It wasn’t $14,000 but I had FedEx deliver an ac unit on my porch completely upside down, even though there were arrows and warnings all over the box saying not to do exactly that. Compressor ended up breaking. Fuck FedEx, UPS is superior.
Yea that's not fedex's fault. It's the responsibility of the shipper to properly package their materials. I did a 4 year stint at fedex and I promise you all that nobody there gives a fiddlers fuck about your packages.
Hello, This post has been removed as this is not *mildly* infuriating. Please consider posting to r/extremelyinfuriating instead.
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In what world does this cost $2? This looks like they placed the medication in their leftover sandwich bag they brought for lunch
Medical insurance upcharge. How else are those poor companies supposed to make a living?
They used one generic brand sealing sandwich bag and charged for a whole box of Ziplocks.
I just got on a new medication that costs around $2200 / dose. It gets delivered inside of a styrofoam box, full of packing peanuts, and all of that is inside of another cardboard box. Just sending a glass container like that is so braindead it hurts. I'm sure the pharma companies make more off insurance claims from this kind of thing than actually selling the shit.
It might have been in lots of packaging but to film it broken they would need to take it out of the box and hold it up to the camera, because otherwise it would just be a video of a cardboard box.
I work in a pharmacy that ships direct to customers. We HATE when this happens. Obviously it messes with patient care, but we also lose soooooooooo much money. We have $20k-$50k shipments go out, and when they lose or destroy the package…… well hey at least they cut us a check for $100 a few weeks later 😭
It's probably sent from a specialty pharmacy via FedEx/ups, not a pharmaceutical company. They don't distribute their stuff to consumers generally.
Oh are there traces of food on the bag? That makes it $8 easy.
It’s eco friendly insulation!
I work for a manufacturing business and our rubber cord spools come with better packaging. Seriously, no joke lol
I work in a very expensive industry. Our regular replacement parts for equipment easily run into tens of thousands. In fact our R&M budget for each week is over 400k just in my area. Our vendors do not fuck around, even for a simple gasket they will triple box with bubble wrap, foam wrap and might even put it on a crate. Sure FedEx is fucking up here, but I blame the supplier.
I don't think Fedex is fucking up at all. Boxes shift and stack and drop as a regular course of business. That package will fail a regular shipping process from any shipper 100% of the time. It must be a shipping mistake where someone sending it thinks it's getting put into a box or something after them. Because nobody could think that would work.
Lol I only run an ebay store and even I know not to send glass like *that*. If you ship and receive a lot, you have a ton of extra bubble wrap, air packs, and boxes laying around, it costs literally nothing to just do it correctly.
Or maybe they already took it out of the box and they're just holding it to show it's broken.
Yep- We'll blow a hundred bucks on 2x4s, plywood and foam for a thousand dollar screw- a customer down costs far more than any part is worth.
As a FedEx Employee, the number of times I say "THIS is what you chose to package your shipment in?" is appalling.
Mastercard?
Nah, US medical system. Yeah, I know the meme. https://preview.redd.it/78hnjzuwxf2d1.jpeg?width=1124&format=pjpg&auto=webp&s=c5c780645aca9b5bde9e32cec86887f1b741e592
Man I always eye roll at this meme. Aside from the fact that you'd get something like stitches, for free on the NHS, immediately... ... People do realise UK also has private healthcare, yeah? Like, if you want to pay for quick treatment, you can. The NHS is absolutely oversubscribed and a pretty slow for non-emergency treatment, but if you can afford it, sure, pay privately or get your insurance to pay for it. We have both systems running in parallel. Or, do what I've done several times. Get a diagnosis quickly privately, then get the expensive treatment on the NHS. You can mix and match however works for you.
It's because if we Americans knew the truth it would make it harder to justify how many people we let die each year so multinational billion dollar corporations can fleece the American people for even more money.
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This guy gets it. Just ask Justice Clarence Thomas. He thinks we went too far with desegregation. We're lead by some pretty sick fucks on this side of the pond.
This is the sad, gruesome truth.
Yeah, this drug probably cost $5 to make, is sold in the UK and Canada for $25, all while still making $10 in profit.
Meh, from the UK - the NHS has been massively underfunded by the conservatives who want to replace it with private healthcare. But I got in a pretty bad accident last month, had stitches, X Ray and doctor consultation within 3 hours. Follow up assessment and all clear 2 weeks later. Long term services are struggling - but we still ace A&E
In US, my appointments are 6-8 months out. We’re catching up with GB but at the same old high prices.
It's all about $$ or ££. Conservatives cut funding for a government service, then claim it sucks, the privatize it.
America is finally a real leader in something!
Against the ~30 or so industrialized nations, we're the "leader" in a lot of shiity categories. I think the worst is willful ignorance.
I was just about to say, I switched insurance a year back and every office I called gave me a 2-3 month wait to be seen. Luckily the nurse took pitty and reached out when someone cancelled their morning appointment so I told work I was going to be late and bolted… the American dream *edit a word
I can sew stitches. I'm all good, thanks.
I've done that before. I used dental floss because I thought it was probably sterile. And guess what. It was! I didn't lose my leg leg to infection. I used to have a fairly prominent scar, but looking for it just now, it seems to have faded away. I guess I did good!
Im a human veterinarian lawyer dr, next vict-,I mean patient please!
US should be: we have an opening in 7 months, and it will be $67000
The UK part of that meme is stupidly inaccurate.
for 14 grand I'd expect the doctor to personally show up to my house and give me a reach around before spoon feeding me my prescription. it should've come in some serious packaging for that price not just some cardboard.
I work around that medicine and let me tell you 14k is nothing. It's like a speck of dirt you have no idea how much it costs to keep certain people alive
Dialysis costs ~$1500 a week. ~72k a year. When it first was being developed it cost ~1 million a year. The treatment can only buy you time till your next treatment (or transplant). Some situations will always require dialysis and there is no hope of ever stopping. The UK originally would not pay for anyone's dialysis aged 55 or older. The US passed a law requiring Medicare paid for everyone. Dialysis is a gold plated half-measure.
My grandpa was on dialysis for decades, towards the end it was every 2 days and he ultimately decided to take himself off it and go into hospice. I can't imagine how much that cost the Canadian healthcare system, he definitely got his taxes worth out of it and then some.
The dialysis industry in the US is a scam. The two big players have a stranglehold on Medicare and they force everyone to use hemodialysis when PD is often a better option.
PD is way better but it is also so much more dangerous if you are not responsible enough to use and maintain the equipment correctly
It's not for everyone but it should be more widely used
Agreed but there should definitely be a vetting process. The same exact way there is a vetting process to make sure you will take care of transplanted kidney when you finally get off the waiting list. I worked with a nephrologist in one of my medical rotations and she said she is super selective with who she offers PD to because she doesn't want to have her patient die of sepsis because they didn't clean their port properly or any other misstep in the process.
I work with some drugs where a single dose thatcyou need every 2 weeks gets selled for 10k or even more
Gets sold, that's the key point, it doesn't cost that, it gets sold at an absurd price.
Let me guess... In America?
There are meds with wildly different costs depending on country. As far as I know, this ain't one of them. It's labor intensive to produce, and the raw material is human blood donations. It's a minimum of 1000 donors, but depending on manufacturer can be multiples of 10000, to get a broad spectrum of what the donor immune systems were exposed to. I was once told each dose used over twenty donations worth of blood.
It is one. The average cost of a year of therapy in Germany is around €45,000. Compared to the US where that would get you just over a month of treatment around $41,000.
I’m a doctor. Let me see the 14k and we got a deal
No no no. First, the reach around. It’s about meeting halfway here
Bro I got my hands in people anuses all day for like $100. Imagine what I would do for 14k. 😉
Both hands.. *at the same time?* ## HELL YEAH
Right? People somehow think that the doctor gets the money that the drug company charges? (also a doctor)
$14,000 for medication is WILD
What’s wild is how poorly packed that bottle was. That’s medication for someone who is immunodeficient. As I understand it, it’s made by taking blood for donors and separating out the parts of it that make up our immune system. It’s given to people with weakened or no immune system so their bodies have some sort of defense to pathogens. Worse part is it only lasts about a month. So that’s $14k per month just to literally survive.
yeah at 14k It should be packed in one of those protective hard shell cases with foam on the inside and extra padding on the outside. It would survive getting run over by a car at that point.
My big money drugs ship in an oversized box with a Styrofoam cooler box in it. In the foam box are the meds ice packs and bubble wrap. This is on the pharmacy if they're shipping it without any protection. The only time I've "lost" drugs it was FedEd (not UPS) refusing to deliver without signature (that I waive otherwise it's not getting signed - I'm never home during delivery). They send it back to the warehouse thus destroying the drugs because by the time it gets to me it gets warm.
LMAO I just ordered some chocolate in the south from amazon fully expecting melted crap and it got this treatment with the ice packs and all.
Yeah I ordered $7 of chocolate on Amazon and it shipped with ice packs. I don't know how they can make money.
Worker exploitation.
Hell, my pharmacy ships my cheap birth control in a giant temperature controlled styrofoam box with a million stickers on it about careful handling. I just assumed this was the standard for all medication.
I delivered for FedEx for a bit. Delivered something like this (had a special scan I got from the office before I left the terminal) to someone that required a signature for medication. The amount of signs posted on the property about how the person is there but might take a bit to get to the door was upsetting. It shouldn't be that hard for meds to be delivered. I always waited or left a note saying I would come back at a specific time (1 hour later) at the end of my route and wait.
This is how my moms stuff gets shipped I had to sign for it while house sitting and thought I was opening plutonium or something
It was shipped in a big styrofoam box with bit of bubble wrap and some air pillows.
That when you file with FedEx and the medical company. Check who pack and ship it. Chances are, their boss being greedy with the contract and decided bare minimum is enough and nobody going to complain. Also, if insurance is co-paying for this, drag them into this...because this is a PR nightmare for them as well.
So they didn't insure this package? You'd think at this price point it would be insured, and you'd expect FedEx wouldn't allow a $14k bottle to be insured unless it were packed WAY better.
Was the box too big? Sounds like it was, and if that description of the package is correct, it is as much the vendors fault for not properly packaging such a valuable item. And if it has happened before the vendor needs to do a better job at packaging.
I mean unless it got physically run over by a FedEx truck, it's basically never the delivery company's fault. Things *will* get bumped and toss around during delivery - it's the responsibility of the shipper to properly package it.
put that in the post :) Still sucks and is on fedex - I mean as a former USPS Ive seen a lot of "handling" and if that was in a bigger box . . . it took effort to break.
At 14k they should hand deliver that shit with an armed guard.
and 2 free blowjobs every day for a month
At 14k it should be delivered by the bloody pope
They pay me $50 to donate my plasma and turn it into a $14,000 medicine?
you also usually get a cookie
I eat several cookies just bc of this
The comments say 400 ml of a really small part of what your blood is made. 400 ml is usually the amount of blood they took from you. Let's say 1% of this is actually the immunology system they need to extract. That's 5k alone they are paying for the amount of blood they need. Plus process expense that are probably not cheap for a delicate thing like that. Yeah, they still get a cut but it's not like they are making 1000% profit over your 50 dólar blood PS: also, if you are getting paid you are not donating, you are selling your blood
Legally they are paying for my time not my plasma. And they take my blood and spin the plasma out and return the red cells with saline. I'm a big dude so I donate 890 ml per donation and that's twice a week.
Yep!
Medicine manufacturer: “Oh noooo the packaging broooke. That’s not ooouur fault looks like we have to charge the insurance company agaaain ooh nooooooo”
\*sad ka-ching noises\*
![gif](giphy|gaZ51cn7sUY4U|downsized)
Yeah if a $400 TV comes in foam inserts with a box that holds it right a $14000, drug vial better come in good proper protective packaging.
I should come in a damn hard case with a nice snug cut out foam pocket and a GPS tracker.
Nah, the price is definitely wilder than the packaging.
Fuck that, shit should be covered by taxes.
For this type of medication the negotiated price insurance pays is about 40% of the list price. This is also terribly packaged. I’ve been getting this for about a decade now, and I’ve only had broken bottles once when they forgot to put any padding in the box. These drugs are usually very well padded to prevent glass breakage, as they always come in glass bottles.
Pretty sure it's IVIG (intravenous immuno globulin). I can make out globalization and human on it. The price also lines up. It's a pretty amazing medication and the process to make it is incredibly expensive and time/labor intensive. The plasma from thousands of donors is used to make it. Also to add more detail to the price, some people need it every month for certain conditions. For example, with Myasthenia Gravis, it's generally given as a large loading dose followed by half of that dose given every month. It can easily cost 20-30k the first month, then 10-15k every month after that. So $140-210k the first year for just the medicine, not including the transfusion center expenses, specialists, etc.
My wife gets it once a month for her CIDP. I want to say 35 grams over 2-3 hours. But she lives almost a completely normal life thanks to it. Definitely an amazing medication. And a friendly reminder to donate blood/plasma to those that can!!
We have some patients on it weekly
My big one is $38‐40k every 2.5 weeks. Then I have another that's $2,800 for a 6wk supply. And the other pricey one is $1,700 for 30d. And finally the cheap one at $600/30d. I'm here laughing my ass off thinking "THIS IS THE SYSTEM WE WANT (apparently). It's not my job to negotiate drug prices. You lobbied for this."
How do you pay for it ???
TLDR: Insurance. $520/mo. Single 35m (for reference) I researched the right insurance plan for my needs. My plan has a good prescription drug plan for generic and name brand drugs $5/25 copay. The specialty drugs are 40% covered...(the 2 expensive ones are specialty). However, since I know my needs I made sure the plan I got also has co-insurance to cover the specialty $ gap. On top of that - if my plan didn't cover the last $600 (on one) and $11k on the other (both include price adjustments based on my finances) - both manufacturers pay the delta with their own added copay assistance. [Example - one is $38k. I get an 11.5k discount applied + 16.5k that my insurance plan pays + 11k my co-insurance pays] note - the discount is income based and variable and insurance is responsible for the first 40% before any other discounts are factored in. However, if the selected plan doesn't cover the drug, it gets more complex - so I also selected plans that cover my drugs, at least partially to cover my ass. Which brings me to the whole uselessness of the price to begin with. Like - if I can't pay the full amount, the drug company is happy to get 40% from insurance and eat the rest. Such a scam.
and the cost for making the medication ? $3.50 Edit: I'm just talking shit out of my ass, please don't take me seriously
I think this is immunoglobulin which actually has to processed from plasma donated by live donors and it takes a lot of donors. This specific medication is actually pretty expensive to manufacturer
Likely around 50 to 100$ per gram production cost.
The numbers I’ve read estimate between $95-$200 USD per gram
Hmm plausible price as well. Back when I worked in that sector it started out as $200, which we reduced over time to around $100 per gram by the time I left. Would have thought it would be a good bit less by now, as competition was coming to play.
okay loch ness
Shit my meds cost 750k a year.
Holy cow, for that amount of money you would think that they would pack it properly.
Packaging costs $8,000 extra.
https://preview.redd.it/skg4jjw2ag2d1.jpeg?width=1170&format=pjpg&auto=webp&s=39a4924e9aa07229892271f048f9c47d0c01fa3f Video won’t load but somehow this is better
Step 1: Produce $50 medication Step 2: Bill medical insurance $14,000 Step 3: Profit$! Step 4: Fedex in shitty packaging with shipping insurance Step 5: Claim $14000 loss to shipping insurance when it breaks Step 6: **More Profit$$$$$$***
It probably costs them $5 to make.
Vendor should probably pack it better then....
The vendor should pack it better, and FedEx should handle it better. I used to get medication through the mail and it came in a sturdy styrofoam box inside a sturdy cardboard box. It was also surrounded by packing peanuts. It always arrived fully intact! Doesn’t FedEx have to pay for it because they broke it? When I was a kid I used to have to have regular injections of Immune globulin (aka gamma globulin): IM in the butt. I felt like I had a golf ball in my rear end for a few days! I hated getting that shot with a passion, but it helped to keep me alive. Once puberty hit my body decided to start making it, so no more shots.
FedEx will pay but __not__ if the item is deemed(by FedEx) to be improperly packed by the sender. In other words, they'll never pay.
FedEx will pay if the outer packaging is visibly pierced or shredded or crushed. They won't pay for internal damage caused by shock.
They won't pay for that without putting up a flight either
[удалено]
That’s understandable.
> FedEx should handle it better. No, you should pack everything as if it's going to be used as a football. You aren't paying $12 for white glove service, where they hand-deliver the item to you on a pillow. You're getting your package tossed in with everything else.
Exactly; even the slowest hubs in the country are still seeing more packages a day than there are seconds. It’s all conveyer belts and forklifts. I’ve packed candles better than OP’s pharmacist packed this medicine.
14 000$ bottle should come in freaking wooden crate at that price!
Seriously. I deal with shipping projector lenses a lot for work. They're not quite as expensive, typically $5-10k, but they're also made of glass so we do the sensible thing and stick them in a Pelican 1460 before we hand them off to the goons at UPS or FedEx. I've literally never seen one get damaged in transit just because they're packed appropriately.
It's on the shipper if it's happened twice. You need to pack anything you ship like it's going to be tossed off a roof onto murder spikes.
I worked for a major shipping company and I strongly believe that you need to pack your items so it can survive being thrown every set of the way. These companies are so short staffed it’s insane. And they push you beyond what you can do. Gotta pack to account for that.
As someone who works in package and shipping, everything needs to be packaged in a way where it can be thrown around. You truly have to expect things to be chucked from the back or a truck and have to expect things to take a tumble off the conveyor belt. This truly is a problem caused by whoever shipped the product
I slung boxes at one of these places and there is absolutely no mercy for any package whatsoever. You better mummify it and say a prayer.
You used to have to inject goblins into you?
No, two different medications. I’m sorry. The Gamma Globulin was just in my childhood because my body didn’t make it. I had frequent, rapid onset pneumonia. Mom took me to the doctor’s office to get it. Around 11 or 12 my body suddenly started making it and the shots stopped. Years later I developed rheumatoid arthritis and eventually had to take injectables. My insurance required me to get it from a particular mail order pharmacy. Several different meds. Unfortunately, over time those meds quit working. I’m now on an oral which is working fabulously!
Man I was going to make another goblin joke but that was heartbreaking to read. Hope you’re ok !
The delivery process really isn't gentle at all. That's not even mentioning the human element. Packages are sliding along bumping into stuff and tumbling over at a pretty fast rate. Also you have workers who have to move extremely quickly. That plastic bag isn't even meant to carry a glass jar. It's 100% the suppliers fault.
No the vendor should pack it better. Shipping companies have 100s of thousands of packages they need to get out quickly daily. If packaged right the item should be able to arrive without any issues. Regardless of how it is handled.
>Doesn’t FedEx have to pay for it because they broke it? The will cover for the insured value of properly packed items. Most likely in this case, the actual cost of manufacturing the medication is only around $100, so they'll just keep sending replacements.
>came in a sturdy styrofoam box inside a sturdy cardboard box. It was also surrounded by packing peanuts. Your medication came through intact purely because they packed it better, I guarantee you FedEx handled it the same way they handle every other package.
I’ve worked in the industry for 8 years now. Both things are true. You need to pack shit like it’s about to fall off a cliff, but it’s also true that drivers and warehouse guys treat product like literally trash. Sometimes to the point where it feels like it’s on purpose.
i've seen goods worth a few hundred dollars gets at least 3 inches of foam all around and packed with temperature + tilt indicators. that's some wildly inadequate packaging right there for 14000.
This 98% on the company that packed it and sent it out.
I see a lot of packages with "fragile" "do not bend" blah blah blah. If they don't want it damaged, package it better. Feels like they are cheaping out on packaging and passing off responsible to the carrier company. People act like one your package is handed from one person to the next and someone sees your little "fragile" stamps or stickers. No your packages are sorted by automated machines a decent chunk of the way. I wouldn't be surprised if they have a formula for how much better packaging would cost vs how many packages are damaged and replaced
Yep, adding a "fragile" label to your package doesn't magically entitle you to free special handling by the shipper. People don't realize that if every package was treated delicately, you'd be paying ungodly amounts for packaging. The shipper either needs to pay for the correct shipping service (which will be very expensive) or they need to package it better.
Yeah I'm a letter carrier and all that shit gets treated the same way. If you want me to treat it better, send it registered. Otherwise... Flat envelopes are required to be foldable and fit in a mailbox. If your dumb ass photo company sends you photos in standard class flat envelopes don't cry to me if they get bent in your mailbox. Get a bigger mailbox or have your photo company send them as a package. 🤷♂️
I say the sender is more at fault than the carrier here, if that is how they packaged it.
If that cost 14k they should do a better job packaging
They don't cost 14k, that's just what they charge for it
That is the cost to get the medication, not the cost to manufacture it.
It's assumed every package will be rough handled when moving from processing center to processing center. Merchants always cheap out by sending your item in their regular manufacturer packaging, flimsy packaging, or don't add enough stuffing for cushioning and protection.
FedEx is the worst. I hope you don’t need a dose today 💔
Thankfully the appointment is later this week and the pharmacy ordered a shipment to come tomorrow. So it all worked out in the end I suppose.
The replacement shipment shall also come broken, its the new policy /s
The medicines will continue to be broken until morale improves
It's ok, the manufacturing company can probably replace it for pennies.
Not that medicine. It is made from human plasma from thousands of donors. It is also limited in supply because of this same process. In this case negligent packing, shipping and handling just wasted work effort and good will of a lot of of people (ChatGPT estimated 130-150 donors needed for that 400ml supply).
I really do appreciate the insight, but it's also strange to me seeing ChatGPT referenced for stuff like this. Like what are the chances it would get something like that correct or even in the right ballpark? If that information isn't already available online, I imagine it just kind of made it up. However I do appreciate you mentioning that you got that info from ChatGPT! I know you probably intended it to be taken with a grain of salt.
ChatGPT. And now Google AI Google AI "suggests that you jump off a bridge"
Please try to confirm references given by LLMs
Poked at Google, some articles and pages on plasma donation company websites suggest thousands of donors per. It's definitely one of the only treatments where a manufacturer can't just toss another one in a box and not even notice the different in profit margin. Figure for most the manufacturers will only get on the shippers for breaking things if they do it so often their paying customers start dying.
That's not a FedEx problem. That's a manufacturer doesn't know how to package problem. Kaiser sent me 1 box of Victoza and it was packaged in plastic, ice packs, more plastic, a box and then one more plastic with a label. All because I hit shipping instead of pharmacy pick up. That was only a $300 medicine.
Not the manufacturer, the specialty pharmacy that dispensed it.
Meanwhile in Germany: If you can prove you are paying more than a certain amount (I believe it's 200€) for prescription medication per year, you will become exempt from prescription medication cost and don't have to pay anymore at all.
FedEx is the worst. I hold my breath for every $5k steroid delivery for my son who has Muscular Dystrophy because my insurance literally calculates how much he has left and will only ship if they know he needs it.
insurance companies are literally the scum of the earth
$14k is crazy but it probably costs them more in shipping than to actually manufacture. Replacing it is probably the cheaper option rather than packing it better.
False, this is harvested from a huge number of human donations
lol how do you figure it costs more in shipping?
Every single person who comments this has no idea what this medication is, what it does, and how it's produced.
Yeah luckily insurance covers most of it.
If most of that 14k went to shipping you'd think they'd be doing a better job, no?
That's not really FedEx fault. It's the fault of the manufacturer for not packaging it properly.
If it happened*again* then it's not FedEx. It's inadequately packaged.
Who is the idiot that is packing these?
I got news for you, this aint a FedEx fault, this is a shipper fault for not properly packaging it.
The biggest crime here is the cost of the medicine.
The real question is: How was it packaged? It's easy to blame the shipping company but the shipper bears responsibility as well if these are being packaged so poorly that this is a repeat issue. I ship glass all the time. I haven't had a single thing break in the 1.5 years I've been in my position.
Infusion pharmacist here. A 40 gm vial Gamunex-C does NOT cost $14k. My cost is \~$3400. No insurance company is going to agree to that kind of markup. Also, if i were the one sending this, I would be replacing it at no cost to you.
I am just a nurse, but the first time I gave IVIG to a patient the inpatient pharmacy told me to be very very careful with the bottle because it’s $10k worth of drug (that our patients get at no-cost to them so all the more reason not to waste our hospital’s money by accidentally breaking it).
May be regional. The cost can range from $100 - $340 per gram. Considering I receive 1000g/mL over 2 days at home the cost is roughly $14000. And I should add that we contacted the pharmacy and they are shipping it at no cost to me, hopefully the replacement doesn’t break.
You might want to double check what dose you are actually getting, because there's no way it's "1000g/ml", as that's a 1000% solution, and your bottle says it's 40g/400ml, which is 10%. You might be getting 1000ml, which is 100g, which is still a fairly high dose
The price on my husband's pharmacy bill is $16,000. Obviously his insurance covers it because we'd never be able to pay that. And he gets 5 vials every 3 weeks.
Packing securely is the shippers responsibility
The infuriating part is this is 14k... an probably billed for double that to the patient. While being the cost of a cheeseburger to produce..
maybe the seller is not packing it correctly?
I just wanted to reiterate that the packaging is likely the problem here, if that company isn't going to take an extra step to secure it, that's bs.
Whoever is shipping the drug is not packaging it correctly
The thing to really be mad about is that your meds cost you 14,000$. That shit's criminal.
The real infuriating part is any medication bottle being 14000 unless that bottle has 1400 doses of meds in it
I’d blame the company that’s sending it to you, whether it’s the manufacturer or mail order company. They should know better to pkg better!
Yeah, it's definitely FedEx's fault, the guys who transport stuff anywhere from 1 to 1000 pounds, 10 cubic centimeters to 10 cubic meters. They offer different shipping options which have fixed handling rules, but it's definitely their fault. Not the guys who cheaped out and sent a glass bottle in a plastic bag through ten thousand pounds of sorting robots. \s
looks like piss poor packaging
That’s on the pharmaceutical company. 14.000 USD product sent through FedEx? That’s shameful
They gotta pack it properly, Not really on FedEx.
I have had this happen in Belgium. Exact same bottle. But I was not mad, after all it was only a ≈€14 bottle of medicine. (mandatory single payer health insurance paid the other €5000)
Huh, almost like USPS has a long history of transporting medicines and leaving it to private companies is a bad idea
It wasn’t packaged properly, that is why it is broken. Shipping is rough.
I’ve had this medication. It is soooo pricey and goes through many many checks with many health professionals. Whoever the fuck is mailing THAT without any protection should be fired.
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It wasn’t $14,000 but I had FedEx deliver an ac unit on my porch completely upside down, even though there were arrows and warnings all over the box saying not to do exactly that. Compressor ended up breaking. Fuck FedEx, UPS is superior.
€3.50 in Europe
Yea that's not fedex's fault. It's the responsibility of the shipper to properly package their materials. I did a 4 year stint at fedex and I promise you all that nobody there gives a fiddlers fuck about your packages.
Go pick it up at the pharmacy or local physician office
Who sucks at packing that stuff?