How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India • Hacker News Board

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#31

Post by gozur88 » Mon, May 09, 2016, 2:05 AM UTC

refurb wrote: post #5

Scoundreller wrote: post #2

The article is already off to a bad start, assuming the existing therapy they're talking about is Pegetron: > The interferon-based treatments weren't successful half the time, and the side effects were so debilitating few patients could endure the months-long punishing protocol. If the success rate is 50%, I would say that's pretty good, especially since we're talking about treatment, not just managing the disease (a…

I worked on one of the old interferon drugs before Sovaldi/Harvoni came along. They sucked. Patient compliance was low due to the side effects. From what I've heard, it was like having the flu everyday for duration of treatment. If you any mental health issues (depression, etc) you couldn't take it since the rate of suicide goes way up. The new HCV drugs are an amazing breakthrough.

I know someone who took interferon for Hep C. It permanently damaged the nerves in his extremities to the point where he can barely walk and is in constant pain. It changed his personality, and not in a good way.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#32

Post by bdcravens » Mon, May 09, 2016, 2:06 AM UTC

remicade wrote: post #20

rayiner wrote: post #10

Earlier quoted context omitted.

What exactly is "gouging?" The average wedding in the U.S. is almost $30,000. Average new car price is $33,000. Is $84,000 one-time an unreasonable price for a complete cure to a chronic disease?

Yes, for the affluent those are what you typically spend. You clearly have never been seriously ill with a chronic condition. I have to take a drug every six weeks (remicade) that costs $17,000 each time for the rest of my life. I'm 23. Let that sink in. This is the state of affairs in the US. It's horrid, I didn't ask for Crohn's disease, but I'm being punished for it.

I have Cystic Fibrosis. Orkambi is the closest we've been to a cure (treating it at cellular level). Retail: $260,000 a year. However, I pay $15/month. (insurance + manufacturer subsidy). Many of my other medicines (which would cost another $100k+) are similar. I picked one of the better insurance packages (about $375/mo); I pay another $100-200 a month in copays to get $400k or more in medicine.

I'm also in the US. Why is my experience so much different than yours?

(edit: some punctuation)

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#33

Post by netheril96 » Mon, May 09, 2016, 2:07 AM UTC

surrealvortex wrote: post #16

rayiner wrote: post #10

Earlier quoted context omitted.

What exactly is "gouging?" The average wedding in the U.S. is almost $30,000. Average new car price is $33,000. Is $84,000 one-time an unreasonable price for a complete cure to a chronic disease?

Most of the criticism against drug companies is that while they invest x for R&D and actual manufacturing, they earn back at least 100*x in profits. I don't think there are many other industries that allow this to happen. I'm not entirely familiar with what makes pharma patents that much different from software (you don't really have a monopoly even if you own a software patent), but that's basically what's happening…

> while they invest x for R&D and actual manufacturing, they earn back at least 100*x in profits.

If that is true, VC's money will be flooding over pharmaceuticals instead of Silicon valley. This "100x" number probably fails to account for the vast number of failed trials that is all cost and no profit.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#34

Post by bpodgursky » Mon, May 09, 2016, 2:07 AM UTC

hueving wrote: post #9

surrealvortex wrote: post #8

I'm conflicted about this article. On the one hand, the pharmaceutical companies gouging ordinary Americans is abominable. Doing something to circumvent their greed is something to support. On the other hand, if enough people exploit loopholes like this, and the pharma company actually felt a significant drain in revenue, they may decide not to license the manufacture of these drugs in India at lower prices. If $84,0…

Right now US citizens are basically subsidizing other countries when it comes to drug revenue via price gouging. I would rather it be done via some other more explicit mechanism (e.g. India government subsidies) rather than at the expense of poor healthcare availability to people in the US.

Yeah, but that's not going to happen. If a big pharm company doesn't provide India-priced versions of drugs, the Indian government just declares the patent invalid and lets generics produce it for free (yes, this happens).

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#35

Post by vdance » Mon, May 09, 2016, 2:08 AM UTC

selectodude wrote: post #21

coralreef wrote: post #12

Earlier quoted context omitted.

But you can choose to have a cheap wedding, and choose to buy a used car.

You can also choose to not share dirty needles.

are there really people this naive lingering on this forum?

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#36

Post by kangar00 » Mon, May 09, 2016, 2:08 AM UTC

surrealvortex wrote: post #8

I'm conflicted about this article. On the one hand, the pharmaceutical companies gouging ordinary Americans is abominable. Doing something to circumvent their greed is something to support. On the other hand, if enough people exploit loopholes like this, and the pharma company actually felt a significant drain in revenue, they may decide not to license the manufacture of these drugs in India at lower prices. If $84,0…

I agree the real problem is the high cost.

It can be solved by extending patents in return for lower prices. Then the government must enforce patents internationally by putting pressure on countries that ignore patents.

Another concern is poor quality from knockoff manufacturers. You can partially solve that by lowering costs because the original product becomes more competitive. You can also try to apply pressure on countries that don't honor patents.

You can complain about the cost, but you can't just make pharma companies sell their products for less because you believe they are too expensive. You need to give them a reason to believe that they can continue to sell a good product and make money off of the research investment they put in. You also need to give them incentive not to make small changes to drugs to renew patents when the original version of the drug might be a better version.

Granted, it is sick when people make an excessive amount of money at the expense of those most in need. But, most of the bad that happens in pharma is due to suboptimal patents and suboptimal patent enforcement.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#37

Post by imgabe » Mon, May 09, 2016, 2:09 AM UTC

rayiner wrote: post #10

surrealvortex wrote: post #8

I'm conflicted about this article. On the one hand, the pharmaceutical companies gouging ordinary Americans is abominable. Doing something to circumvent their greed is something to support. On the other hand, if enough people exploit loopholes like this, and the pharma company actually felt a significant drain in revenue, they may decide not to license the manufacture of these drugs in India at lower prices. If $84,0…

What exactly is "gouging?" The average wedding in the U.S. is almost $30,000. Average new car price is $33,000. Is $84,000 one-time an unreasonable price for a complete cure to a chronic disease?

"Average" is just that. There are many car options cheaper than the average, and many wedding options cheaper than the average. There are no other cheaper options for this drug except what the OP did.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#38

Post by bdcravens » Mon, May 09, 2016, 2:10 AM UTC

selectodude wrote: post #21

coralreef wrote: post #12

Earlier quoted context omitted.

But you can choose to have a cheap wedding, and choose to buy a used car.

You can also choose to not share dirty needles.

The #1 killer in the US is heart disease, but insurance companies cover those medicines quite readily, despite the fact that one can choose not to eat fast food or smoke.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#39

Post by nkozyra » Mon, May 09, 2016, 2:10 AM UTC

rayiner wrote: post #10

surrealvortex wrote: post #8

I'm conflicted about this article. On the one hand, the pharmaceutical companies gouging ordinary Americans is abominable. Doing something to circumvent their greed is something to support. On the other hand, if enough people exploit loopholes like this, and the pharma company actually felt a significant drain in revenue, they may decide not to license the manufacture of these drugs in India at lower prices. If $84,0…

What exactly is "gouging?" The average wedding in the U.S. is almost $30,000. Average new car price is $33,000. Is $84,000 one-time an unreasonable price for a complete cure to a chronic disease?

You're essentially saying it's ok to price out large segments of the population for life-saving medication. This is life or death, not a new Audi versus a used Hyundai. There is an ethical consideration that your analogues ignore.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#40

Post by codegeek » Mon, May 09, 2016, 2:11 AM UTC

selectodude wrote: post #21

coralreef wrote: post #12

Earlier quoted context omitted.

But you can choose to have a cheap wedding, and choose to buy a used car.

You can also choose to not share dirty needles.

Choose not to share ? A lot of times it is difficult to tell and if you have dishonest nurses like the one below [0], what do you then ? Victim blaming is easy but people can get infected not due to their own fault.

[0] http://www.nj.com/healthfit/index.ssf/2015/10/eeuw_nurse_in_...