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Turing CEO Defends $750 Pill in Reddit AMA

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Re: Turing CEO Defends $750 Pill in Reddit AMA

#42
post #12

The problem with healthcare in America is insurance. When you are insured and insurance is paying for everything patients don't care how much anything costs. (See Tragedy of the Commons). And the drug companies charge $250 to $750 a pill or $14,000 for a years worth of drugs (recent cholesterol drugs Repatha and Praluent) to $250,000 (cancer drugs) and the drug companies justify it by saying insurance pays for it any…

The problem is not insurance. First of all insurance companies are not that good at shielding patients from costs; most people have deductibles and out of network expenses if they even have insurance at all. Second, even with insurance medical bankruptcy is rampant (the main cause of bankruptcy). Third, insurance companies have an obvious incentive to lower costs, it means they make more profit. They just don't have the power.

This is something that changed in the 90s, when attempts at managed care tried to use insurance companies to push down costs. Hospitals responded by consolidating into local monopolies (provider networks) that insurance could not out bargain.

The problem is simply that providers have too much power. Doctors regulate the supply of their profession; doctors in the US make 2X the oecd average. Pharma companies and medical get patent monopolies; drugs cost $300 billion a year above their generic price. Hospitals have local monopolies and patients don't know how to bargain for cheaper care; MRIs cost thousands of dollars.

Insurance takes home a few paltry percent of every dollar spent on health care. The real takers are the health care providers, but we are all too busy shutting on insurers to notice.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#43

What a slimy piece of crap: "People hate because they think I'm charging people $750 per pill even though it costs patients less than $10 out of their pocket" No. People hate because you ARE charging $750 per pill. They may only have to pay $10 out of pocket immediately, but one way or another, through co-pays, deductibles, premiums, opportunity cost when employers pay premiums, patients ARE paying $750 per pill. I h…

He's taking advantage of government imposed barrier to entry costs. Perhaps by going all out in extracting benefits from the government protection it will point out to the public how much they're being taken advantaged of by the pharmaceutical companies in general and prompt them to demand changes from the authorities. And by tearing down these walls it would benefit his company, because his company is very small startup in the pharmaceutical world. As a startup he doesn't have much incentive to keep the status quo as it is and it is advantageous for him to rock the boat as much as possible. Would he have gotten so much coverage of the inefficient part of the pharmaceutical industry by preaching to the converted, or as he's done and go all out and squeezing it for all he can?

Re: Turing CEO Defends $750 Pill in Reddit AMA

#44
post #36

What a slimy piece of crap: "People hate because they think I'm charging people $750 per pill even though it costs patients less than $10 out of their pocket" No. People hate because you ARE charging $750 per pill. They may only have to pay $10 out of pocket immediately, but one way or another, through co-pays, deductibles, premiums, opportunity cost when employers pay premiums, patients ARE paying $750 per pill. I h…

What he thinks is that people are going to be outraged over this and new regulations will drive down the stock price of other pharmaceuticals which he has shorted, and if that fails he will still make some money off the pills. It's an excellent bet even if it is extremely immoral.

And so far it's working. Look at Valeant for a timely example. And they aren't the only ones facing federal inquiries.

http://fortune.com/2015/10/22/valeant-debt/

http://www.streetinsider.com/FDA/House+Oversight+Committee+D...

https://aishealth.com/archive/ndbn100915-04

Re: Turing CEO Defends $750 Pill in Reddit AMA

#45
post #12

The problem with healthcare in America is insurance. When you are insured and insurance is paying for everything patients don't care how much anything costs. (See Tragedy of the Commons). And the drug companies charge $250 to $750 a pill or $14,000 for a years worth of drugs (recent cholesterol drugs Repatha and Praluent) to $250,000 (cancer drugs) and the drug companies justify it by saying insurance pays for it any…

[deleted]

Re: Turing CEO Defends $750 Pill in Reddit AMA

#46
I love this as an example of how broken the USA is. Democracies, for better or worse, mean that the government represents the will of the people. Determine 'will' however you want (majority vote, enlightened representatives, reddit poll, &c), and you would find overwhelming support for at least stopping Shkreli from doing this, and probably worse.

What do we get instead? Shkreli will gain a few hundred million dollars from this scheme, and Millennials will complain about him on message boards.

And don't think that the system is broken because corrupt system is unyielding and impenetrable. It's broken because our generation lacks the constitution (and possibly aptitude) to push for the changes necessary. There has never been an easier place and time to than 2015 USA to enact the changes you want to see. But we're content eating fast food and watching Netflix instead.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#47
Despite me not liking what he has done, I can't really find any faults with what he has done. If he purchased the drug legally then why can't he charge as much as he want? Can anyone point me to the law that says he can't do that? I'd be curious to know if he has done anything illegal.

Additionally, I wonder if he is doing this on person to make a point about drug pricing in the USA.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#48
post #17

Earlier quoted context omitted.

Drug costs are ~10% of total healthcare costs in the US. Are drug prices a problem? Yes. Are they the main cause of our outrageous healthcare spending? No.

How does that compare to each other little area of spending? If you have 100+ categories of spending to look at, 10% of the market in a single spending area can be some pretty low hanging fruit.

Spending in physician/nurse compensation is higher than spending in drugs. If reducing the price of drugs to European levels would result in big savings to the system, imagine the effect if the compensation of healthcare professionals was reduced to European levels.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#49
post #17

Earlier quoted context omitted.

Drug costs are ~10% of total healthcare costs in the US. Are drug prices a problem? Yes. Are they the main cause of our outrageous healthcare spending? No.

How does that compare to each other little area of spending? If you have 100+ categories of spending to look at, 10% of the market in a single spending area can be some pretty low hanging fruit.

Let's say we reduced US drug prices down to EU levels. Branded drug sales are about 80% of all US drug sales. Reduce that by 25% and we've reduced US healthcare spending by 2%. Decent, but certainly not enough to solve our healthcare spending problem.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#50
post #46

I love this as an example of how broken the USA is. Democracies, for better or worse, mean that the government represents the will of the people. Determine 'will' however you want (majority vote, enlightened representatives, reddit poll, &c), and you would find overwhelming support for at least stopping Shkreli from doing this, and probably worse. What do we get instead? Shkreli will gain a few hundred million dollar…

> It's broken because our generation lacks the constitution (and possibly aptitude) to push for the changes necessary.

If you mean Gen X or Y, that's just wrong. Those two generations basically got Obama elected in 2008 (who got out and canvassed, and ran his Internet campaign and much of his meatspace campaign, and voted), and look what happened: vontinued never-ending war, police brutality on the rise, drug war on the rise, continued mass incarceration and surveillance state, ridiculous Dem/Repub back and forth showmanship, and so forth.

And please don't say we should have picked better in 2008. Who? Clinton? Biden? McCain/Palin? Anyone outside of the two parties has no chance, witness the party Sanders ran under this cycle.

Could it be that we simply see the game is fixed, and simply no longer wish to participate in or implicitly support this system?

> There has never been an easier place and time to than 2015 USA to enact the changes you want to see.

Oh really? Well, such a pliable system sure has proved remarkably impervious to change.

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