Name: Journalist Alex Berenson on the Real Cost of Pharmaceutical Incentives
Uploaded: 2023-09-20T17:15:33.000Z
Description: Watch the stand-up comedy video 'Journalist Alex Berenson on the Real Cost of Pharmaceutical Incentives' from PowerfulJRE on Comedy Buff. Published 2023-09-20. Transcript available.

Watch the stand-up comedy video 'Journalist Alex Berenson on the Real Cost of Pharmaceutical Incentives' from PowerfulJRE on Comedy Buff. Published 2023-09-20. Transcript available.

- The Joe Rogan Experience.
- People respond to incentives.
When there's money, companies respond,
doctors respond, everybody. - Unfortunately, right?
- Yeah, I mean, I guess, unfortunately, I mean, look,
it's why we have this, you know,
all these great things in this country, too, but.
- Yeah.
- I will give you, so, an ophthalmologist
called me a few weeks ago.
There's a drug, and the drug works, okay?
It's good, it's good for people if you,
if something called wet macular degeneration, okay?
It's something older people get, and it can blind you.
So there's a drug, there's a couple drugs
that actually work for it.
They block the flow of, they block blood vessel formation
at the back of the eye, they help you.
So these are administered,
ophthalmologists administer them in their offices.
So a drug like that, the ophthalmologist actually buys
and charges Medicare or the private insurer for.
Okay, what's happening, and I saw this with a different drug
when I worked at the New York Times 15 years ago,
so nothing ever changes,
these companies all play the same games,
is that the companies that make this drug
are giving doctors a rebate on the purchase price.
And the more you use, the bigger the rebate.
And this is a drug that costs thousands of dollars
per person per year, okay?
It's dosed multiple times a year for a lot of these people.
So what all this adds up to is if you're an ophthalmologist
who's using a lot of this, the company is cutting you a check
for five or sometimes six figures,
sometimes multiple times a year, okay?
Don't tell me that's not a bribe, okay?
Because that's a bribe.
It may be legal.
They may have found a way to do this.
And he showed me, he showed me the check that his company,
or that his ophthalmology practice had received,
and it was huge, okay?
And by the way, these doctors make a lot of money on their own
just doing the procedure.
They don't need this, but it's a way for the drug company
to get them to use this more.
And how does that get resolved?
Is there a way at this point, or is it the system itself?
Is it just a function of that's how human beings behave
when they have enough regulation where they can get away
with some stuff and they just want to make more and more money?
And it just becomes, that's what they're trying to do.
- I mean, I don't know.
- Is it just human beings?
- I mean, if you're that ophthalmologist in Florida,
do you need another Ferrari?
- But maybe you don't think that way.
You don't think that way.
You just think I can get it.
- Right.
- And I'm in this system and the system is fucked already.
- That's right.
And I'm using this drug 'cause I know it works
and it's good for patients.
The problem is you're then having incentives
to ignore the problem if there is one later.
And so in this case, the guy actually said to me,
he's like, this is a good drug.
It does work.
He said, but sometimes if we dose it too many times,
we can get, there can be sort of a paradoxical effect
where it stops working.
If you're one of those doctors who's on the tit
and getting that check every quarter or every six months,
or however frequently you get it,
you're gonna, it's gonna be harder for you
to see the problem because all of a sudden,
you have a financial incentive not to see it.
- Right.
- I don't know what we do about any of this.
Except talk about it and make sure people know.
- Talk about it and make sure people know.
And you need senators to call this stuff out.
And we need, you know,
you need people that run these companies to be,
just have to have ethical boundaries, you know,
'cause they make great stuff.
The thing about pharmaceutical drug companies is like,
I would never say we don't need them.
That's crazy.
- Right.
- I mean, people, they've helped.
- Yes.
- You know how many drugs the pharmaceutical companies
that we currently demonize because of this thing,
this for-profit aspect of it.
But how many of them have brought drugs to the market
that have fixed all sorts of problems
that people have been suffering for forever?
- Yes.
- Yeah.
- They just, they just can't go ham.
You can't go crazy and force people to take your stuff.
Like, that's a bad relationship.
A good relationship is a consumer and a provider.
And the provider develops these drugs
that are very beneficial to people.
And most of them are, a lot of them are, right?
- Some of them are.
- Some of them are.
But they do have drugs that they've developed
that are really beneficial for people.
They really do.
They're real.
And we can't fucking throw out the baby with the bathwater.
I just think that it just has,
the problem is also the process, right?
Because to bring a drug to market costs
so much fucking money, it costs it crazy.
It's so prohibitive for most,
if you were like some pharmacologist or some biologist
and you guys were working together
and you developed something,
you had this idea about a pathway
and you figured out something
and maybe this could fix it
and you really figured it out.
- Sure.
- Good fucking luck.
- Right.
- Good luck.
- Right.
- Getting that thing approved.
- I mean, one of the great disappointments for me in the last 10 years is
realizing that if you had to choose between a sewer system and a medical system,
you'd choose a sewer system.
- In other words, what's more efficient?
- What actually helps human health more?
The great gains for human longevity in the last 200 years have been really
simple things.
Clean water.
Try to get the air clean.
Don't bury, you know, don't have like meat packing plants in the middle of
cities.
Don't bury, don't have giant graveyards in the middle of cities.
Like that stuff.
- Have you seen, or excuse me, have you read Dissolving Illusions?
- I have not.
- It's a fantastic book about just that.
- Huh.
- And the beginning of it is they talk about the conditions that people lived
in.
Because you never really think about it.
Like what would it be like to live in a city before there were cars?
Well, guess what?
- Horseshit.
- But nothing gets to you.
- That's right.
- You're not getting fresh vegetables in the winter.
You're not getting vitamins.
- That's right.
- There's massive malnutrition, starvation, extreme poverty, people living in
squalor.
- Yep.
- Terrible sanitation.
- Yep.
- I mean, open outhouses for entire blocks of people.
- Yep.
- And just crazy diseases.
- Yep.
- And they all lived on top of each other.
And again, malnutrition, no vitamin D, no sunlight exposure in the winter, et
cetera,
et cetera.
And a lot of those people get horrible diseases because of that, just like they
did in the olden
times.
Like we know about when people dump shit in the streets.
- Yes.
- And the plague came.
- The first few decades of the Industrial Revolution were terrible for human
health.
People got crammed together.
They got sicker.
And then about 1850, they started to figure this stuff out.
For a hundred years, we did great.
But it wasn't really medicine.
It was really more basic than that.
And so the last 50, 60, 70 years, we've spent more and more and more money on
medicine, trying
to continue that growth in life expectancy.
And it turns out like there are limits to it.
There are just limits.
And we seem to be reaching them.
And the problem is, in the U.S. anyway, we're now spending so much money and
having so many
unnecessary medical procedures of marginal value.
I'm not even talking about the cost.
I'm talking about like value to people that we seem to have topped out.