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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

#431

Post by crdoconnor »

paulmd wrote: post #176
crdoconnor wrote: post #98

Earlier quoted context omitted.

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 t…

>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.

Pharma needs outright nationalization or competition from the public sector at the very least.

We've played these games before where monopolistic private companies threaten to flip the switch on critical services. The solution to this one is the same as it was to companies that refused to provide mail service or electricity when it "wasn't profitable enough". Nationalize them and provide it at cost. It's simple and proven. Hell, it's likely that the mere threat of it would be enough to panic pharma execs into playing ball.

A great deal of pharma profits comes from taking research from the public sector and commercializing it anyway. Cutting the fat from the process (executive salaries, marketing, bribes to doctors) would be vastly improve the efficiency of the system.

Even if research done in the private sector were 40% less efficient than that done by Pharma companies (and there's no evidence that it's any less efficient), by slashing marketing costs to zero we'd still come out ahead by nationalizing them.

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

#432

Post by zaroth »

codexon wrote: post #408
ken47 wrote: post #404

Earlier quoted context omitted.

If you do some research into this particular medicine, you will see that there are clear, non-free market roadblocks to producing a generic version.

I looked into it and I don't find any. It is not patented, and no law forces you to only use the brand Daraprim. If someone created a generic replacement, it would be on the fast track to be approved like every other generic. The synthesis method is even listed publicly. https://pubchem.ncbi.nlm.nih.gov/compound/4993#section=Use-a... The only roadblock to a generic version was because no one wanted to compete with $1…

What do you think it would it reasonably cost to setup a manufacturing line for pyrimethamine and get approval to sell it as a generic in the US?

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

#433

Post by knorby »

wdewind wrote: post #349
thephyber wrote: post #344

Interview with Shkreli about this price increase: http://www.bloomberg.com/news/videos/2015-09-21/why-turing-i...

I encourage everyone to watch this...maybe it's all bs but among the interesting points Shkreli says: -They have reduced or eliminated co-pays so no patient is paying as much out of pocket as they used to -The drug is still 50% given away to people who cannot afford it -The company ships drugs to patients before resolving disputes with insurance providers -Shkreli's view is that it is in the best long term interests…

An alternative interpretation is that Shkreli is a sociopath (other evidence of that) who's try to exploit people with no choice, and he's giving some hard to verify excuses to deflect criticism.

Maybe they will create a new drug with the extra money, but there is no reason to believe a generic drug manufacturer has anything in the way of research capability to do so. There is no reason to view this as anything but bullshit.

He had the company switch over to direct sales, which explains most every other point.

The only thing to note here is that they raised the price 5000% for a drug from the 40s.

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

#434

Post by Laforet »

technotony wrote: post #390
bedhead wrote: post #96

Earlier quoted context omitted.

That's the loophole though, the quantities are so small that realistically, no pharmaceutical company has the incentive to make their version of the drug, even at $750 per dose. There are still costs to making a drug that's off-patent, and sometimes the number of patients being treated is only in the double digits. Additionally, a competing drug released at say, $500 per dose would still be considered predatory anywa…

I don't get this, the drug is available from Sigma[1] for $51.50 per 250mg, with a dosage of 50-75mg per day for a patient. So clearly someone can make it more cheaply. I get that Sigma is research chemicals not medical grade, but seems to me someone could figure this out. FDA approval must be the issue. [1] http://www.sigmaaldrich.com/catalog/product/fluka/46706?lang...

One word: Bioequivalence. Having the correct active ingredient does not imply that drug delivery and efficacy are equivalent unless you can prove it by comparing it against a known and approved formulation in human volunteers, The burden of proof is significantly less than that of getting a new compound approved, but still a major sinkhole for money.

The correct way to handle this would be for the FDA to hand out compassionate use permits for patients to import their own drugs since it is clearly unavailable for a reasonable price in the US.

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

#435

Post by ken47 »

codexon wrote: post #408
ken47 wrote: post #404

Earlier quoted context omitted.

If you do some research into this particular medicine, you will see that there are clear, non-free market roadblocks to producing a generic version.

I looked into it and I don't find any. It is not patented, and no law forces you to only use the brand Daraprim. If someone created a generic replacement, it would be on the fast track to be approved like every other generic. The synthesis method is even listed publicly. https://pubchem.ncbi.nlm.nih.gov/compound/4993#section=Use-a... The only roadblock to a generic version was because no one wanted to compete with $1…

Look around the responses for the notion of controlled access to the drug, and the obstacles it imposes on putting out a generic.

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

#436

Post by Daishiman »

crusso wrote: post #393
llamataboot wrote: post #378

Earlier quoted context omitted.

Where is the government interference here? How is the FDA or whomever enabling this behavior?

The FDA was the big lever that Skreli was attempting to use to skew the market in his favor. If the FDA weren't so powerful, flawed, and easily corruptible, the strategy would make no sense.

So on a weaker FDA it would be exactly the same, except that now your guarantees about the safety and efficacy of the drug are reduced. How is that better?

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

#437

Post by eimai134 »

nickff wrote: post #267
infamouscow wrote: post #263

Earlier quoted context omitted.

Because we've agreed that the public can't hunt these people down and kill them for this kind of nonsense.

I have re-read your comment a dozen times, trying to grasp what you mean, and come up short each time. Do you mean to say that whenever a business makes a decision that you disagree with, you (or someone else) should feel morally entitled to go a kill the individuals working there? Or do you mean that whenever a business makes a decision that you disagree with, the state is entitled to focibly take the company? I per…

Check out the book The Sociopath Next Door - it talks about how there are so many sociopathic people today because societies used to conveniently do away with them. I'd guess this is similar to what the person is referring to.

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

#438

Post by randyrand »

robotresearcher wrote: post #265
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.

That is absolutely true, and is also true of clean drinking water, sewage treatment and security of the person. We can choose to make these things available by our common efforts.

That is a bad comparison. It makes no sense to have competition for water. Network effects matter.

Pharma research does not have network effects

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

#439

Post by tmd83 »

Frondo wrote: post #286
tmd83 wrote: post #255

Earlier quoted context omitted.

I'm not sure I understand the point about economics being about utility vs. wealth. If its free market then aren't people free to choose between utility vs. wealth and in such case pure free market don't have much defense against a few sciopaths trampling all over the not so sociopaths?

Since all markets are human inventions--there's no "free market" particle--what you're getting at is: Let's invent a system that makes explicit the choice of dollars over human lives, and let's call that "the free market". And of course, since freedom is one of those ideas that, in popular use, has been oversimplified to uselessness (e.g. freedom is good, more freedom is more good, without nuance), this "free market"…

Ohh I prefer regulation with the hope for honest regulators. I was trying to understand the parents angle.

As for the enlightened self interest its really tricky. Enlightenment isn't easy and if that directly conflicts with his primary job (for business earning money) its much more difficult to address that. Also it forces enormous amount of co-ordination on the side of the customers which is difficult to achieve in every little matter. On the other hand a regulars primary job at least is to think the overall good. Now whether we can choose a proper regular or regulator having a second interest (corruption) is a different matter. The fact that we choose wrong regulator (aka the customers of regular cannot wisely choose even that) only makes me think free market can never be as rosy as some paints it to be.

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

#440

Post by antr »

jjoonathan wrote: post #379
antr wrote: post #120

Earlier quoted context omitted.

When you say "cheaper" you mean to partialy subsidised services. I'm refering to tollroads, train networks, healthcare, pensions, etc. What you "pay" is not the real cost, but paid for in good part by the Government's budget.

Did you not click on the link? IMO the site does a pretty good job of making it crystal clear that it's referring to the full cost (all levels of government + business + individual + other).

Sure, I did see the link to the data you provided. Unfortunately that doesn't provide the entire picture, lets not be naïve about it. US healthcare cost is not "expensive" because it is private. Some of the main reasons why it is expensive are (i) lack of pricing transparency, (ii) redudant test culture in US healthcare, (iii) lack of expenditure in preventive care vs curative, etc. This issues can be addressed without the need of nationalising any industry.

Showing just a healthcare expenditure vs GDP figure doesn't address the root cause problem, and it defiently doesn't explain that public is better than private, and vice versa. I'm not talking out of ignorance, as my father is a orthpeadic surgeon in the public healthcare system here in Europe, and the above is a logical fallacy that doctors are well aware of.

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