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Drug Goes from $13.50 a Tablet to $750, Overnight

nytimes.com

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Re: Drug Goes from $13.50 a Tablet to $750, Overnight

#171

Post by darkr »

fnordfnordfnord wrote: post #104
pessimizer wrote: post #92

Earlier quoted context omitted.

The US government currently spends more per capita on healthcare costs than Britain, France, or Canada.

Is that true? Because when you combine that with the amount that US citizens spend on private insurance and other self-funded health care expenses, wow.

Edit: Actually I found some OECD stats[4] on that suggest that _public_ spend in the U.S is actually higher than the _public_ spend in Canada/UK/France (though for the latter two they are almost in margin of error territory) so the parent is correct.

Original post:

No, it's not true. In 2010-2011[1], US had the highest expenditure in the world on health per capita according to WHO and OECD, but those stats are combined public _and_ private expenditure.

World Bank stats show Norway & Switzerland as spending more per capita[2] over the same period, but then says that 'data is in current U.S dollars'. The data for these stats is from WHO, so not sure if currency fluctuation or something else is a factor here?

According to [3], per capita public healthcare budget for 2011 was $3,768 vs. an overall spend of $9,146, so 41% of the total healthcare spend was public money.

In any case, I think all these stats can reliably posit is is that combined public and private spending on healthcare in the U.S per capita is one of the highest, if not the highest.

1: https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...

2: http://data.worldbank.org/indicator/SH.XPD.PCAP?order=wbapi_...

3: http://www.usgovernmentspending.com/year_spending_2011USdn_1...

4: https://www.oecd.org/unitedstates/Briefing-Note-UNITED-STATE...

Re: Drug Goes from $13.50 a Tablet to $750, Overnight

#173

Post by LordKano »

JulianMorrison wrote: post #141
LordKano wrote: post #133

Earlier quoted context omitted.

That makes for a superficially witty slogan but look at inner cities. Poor people have been voting for Democrats for 50 years and they're still poor. Getting people out of poverty is a lot more complicated than which political party one supports.

Mayor does not trump congress, unsurprisingly.

It depends on the issue at hand.

A Mayor can put together a deal that will bring an employer(and all of the jobs that it brings along) to a municipality, congress doesn't do that.

A Governor can influence the business climate of a state. There's a reason why manufacturing jobs are moving to southern states.

Re: Drug Goes from $13.50 a Tablet to $750, Overnight

#174

Post by Bluestrike2 »

cmiles74 wrote: post #85
bedhead wrote: post #55

I am a fund manager and I have followed Martin Shkreli since his prior company, Retrophin, went public about two years ago. Simply put, Martin is a sociopathic criminal with a well-established, and consistent track record of deceit, recklessness, failure, and just plain old stupidity. But he is also hyper-aggressive. He is currently living in Switzerland, and it's my understanding that he fled the country in order to…

It seems to me that the overall result would be other companies start manufacturing the generic and sell the drug for maybe 20% less than Martin and over time the price drops back down towards where it once started. In the meantime, this company either goes bankrupt or is sold off. Or the government passes a law capping how much you can raise the price of a generic drug over so many years.

That's exactly what would happen, but the generics companies can't procure sufficient samples due to the changes in how Daraprim is distributed. So long as Shkreli is able to control distribution tightly enough, there's no worry about a generic coming onto the market.

Re: Drug Goes from $13.50 a Tablet to $750, Overnight

#175

Post by ctlby »

Retric wrote: post #156
ctlby wrote: post #127

Earlier quoted context omitted.

Drugs are a complex good created through the intensive efforts of highly intelligent, trained human beings. They are anything but a natural right.

Replace drug with aircraft and few people will say the military should be private.

You can believe that the government should provision military defense and still find laughable the claim that one "deserves" a sophisticated fighter jet flying overhead.

Re: Drug Goes from $13.50 a Tablet to $750, Overnight

#176

Post by paulmd »

crdoconnor wrote: post #98
ams6110 wrote: post #72

Earlier quoted context omitted.

Depends on how you define "better." In any nationalized system with controlled prices, you will have shortages.

You define it as better healthcare outcomes (life expectancy, infant mortality, etc.) at 50% of the cost (UK). Or, in one extreme case - the same healthcare outcomes at 1/10th of the cost (Cuba). >In any nationalized system with controlled prices, you will have shortages. In any system where there is scarcity you will have shortages. Period.

Cuba is a really interesting example because it demonstrates the importance of least-common-denominator care. You're not getting high-tech imaging or brand new drugs, but they deliver a basic level of care pretty uniformly across its population. And the outcomes speak for themselves - on average they're just as good as the US.

The problem with US outcomes is really disparity. A lot of people have very little access to health care and that drags our averages down like crazy. If we could get these kind of "solved-problem" drugs out to everyone who needs them, our average outcomes would jump quite a bit.

Cost is a whole different situation, and that's a much more difficult one to solve. Everyone from manufacturer to insurer to doctor wants their cut, the elasticity of demand for a good without which you will die is zero, so there's very little incentive to keep cost down. There's a few places you can point that are particularly excessive (direct-to-patient marketing, excessive spending on terminal patients circling the drain, etc), but in general it's the death of a million cuts.

Pumping generics is one of those cases that's clearly abusive. With regard to the specific problem, if you try to limit their profits pharmas will simply take their ball and go home - they won't produce it. For a real-world example of this, you can no longer get the Lyme Disease vaccine for humans - nobody makes it anymore, you can only get it for the veterinary market. Evergreening is a similar problem.

In such cases the government really needs to either contract out production of a supply, at-cost (including interest, distribution, etc). If no one will do it, bite the bullet and make it ourselves. If our national labs can figure out how to manufacture high-quality biological or chemical agents, we can figure out how to make high-quality vaccines and drugs as well. Public health is a matter of national security when you get right down to it. Shouldn't we be able to ramp up production of an Ebola vaccine if we really needed it?

Re: Drug Goes from $13.50 a Tablet to $750, Overnight

#178

Post by thomnottom »

odonnellryan wrote: post #151
thomnottom wrote: post #109

Earlier quoted context omitted.

When I saw the headline I had a feeling it would be Turing. I was contacted by a recruiter last year and had a couple conversations about joining them as they were looking for an IT guy - the CIO was doing all of that work and they wanted someone else to be hands-on and eventually build a team. Sounded like a great opportunity and things were progressing. Then I bothered to Google them... Once I read up on Martin Shk…

How did they respond?

I never got a direct response from them, but since the recruiter continued to reach out to me for other opportunities they must not have been too upset about me bailing on the meeting. I did avoid using any terms like "criminal behavior" in my response. :)

Re: Drug Goes from $13.50 a Tablet to $750, Overnight

#179

Post by mvanvoorden »

if_by_whisky wrote: post #115
JulianMorrison wrote: post #108

Earlier quoted context omitted.

It really isn't comparable. Computers are tools. Drugs are health. They are a public good and a natural human right. Holding people's health hostage is unacceptable whether you do it with a knife in an alley, or a capitalist health system. Mixing them up like the USA system does is a category error.

Your solution would stop innovation in any industry

Innovation happens because people are curious and want to make their (or other's) lives easier, this has nothing to do with patents, or if it's private or government run.

Want to see real innovation? See for example the home made radio receivers people made in WWII, that fit in a small tin can, or visit an Amish settlement (http://kk.org/thetechnium/amish-hackers-a/). Not to mention hacker/maker spaces and fablabs, which all work on open source principles and sustain themselves through donations or member fees.

Re: Drug Goes from $13.50 a Tablet to $750, Overnight

#180

Post by emodendroket »

esarbe wrote: post #157

This is insane. But then again; the whole pharmaceuticals business is insane. Why again do we have a problem with antibiotics resistant bacteria? Because we stopped researching antibiotics in the 1970, because antibiotics weren't profitable anymore. (That, and the practice to feed antibiotics to our livestock to enhance growth, I guess.) Research and trials shouldn't be done by the companies. Instead it should be don…

I agree but a somewhat less ambitious and still workable idea would be to have post-patent stuff like this manufactured by a state entity or by a private one with state support.
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