Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

alternet.org

Post reply on HN
Print view View original

91–100 of 355 posts

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

#91

Post by zaroth »

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 think you should be conflicted for a slightly different reason :-)

Should Americans pay for a disproportionate share of pharma revenue? I for one am so happy for all the medical research that we fund in this country, it is probably the best thing we can possibly do for the world. Of all the American foreign aid and foreign intervention, very little else will compare to the amazing impact of widespread access to Harvoni/Sovaldi in India. That is truly an amazing gift that America is giving to India, and it's made possible exactly by extreme price discrimination.

This is an amazing miracle cure for a deadly disease. My understanding is that it cost a lot of money to develop, and took a lot highly skilled work, and involved a fair measure of risk of total loss. We want wins like this to be rewarded. We want a significant fraction of the dollars this drug earns to ultimately be re-invested in more of this kind of R&D. We definitely want more drugs like Harvoni/Solvaldi coming to market.

So the conflict I have is, when manufacturing is not the bottleneck, you want to get this cure out to people everywhere, but at the same time you can't afford to pay for it all to happen in one year. So you see cases like OP where they won't pay for the treatment until you are showing symptoms. But the cure is so easy, nobody wants to wait for symptoms, and how can you blame them?

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

#92

Post by refurb »

cowsandmilk wrote: post #73

(1) As someone who was following the market when Gilead paid $11 billion for PharmAsset, it was not a sure thing that it would be first to market or a premier drug. They announced $137/share on November 21 for a stock that opened at $65.49 on November 11. People like to point out how much money Gilead made on the deal, but that is Monday morning quarterbacking on something where they easily could have lost billions.…

As someone who was following the market when Gilead paid $11 billion for PharmAsset, it was not a sure thing that it would be first to market or a premier drug.

This is a fantastic point. I remember when Gilead announced their acquisition of Pharmasset. They were ridiculed in the press. How could they be so stupid to pay that much? Many people thought that $11B was as good as gone.

That's the risk involved with drug development. It's like VCs, you spend a ton of money on a lot of investments, most of which fail. Unless you get a few huge winners, it's not a feasible business.

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

#93

Post by dannylandau »

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.

Does anyone know the prevalence of the most common side effects for Harvoni?

I usually defer to the following site but they don't have info on the drug -- http://www.healthbee.co/

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

#94

Post by hourislate »

I was under the impression most Pharma Companies will give it to you for free if you don't have insurance and can't afford it. Maybe it's different if you have insurance and they won't pay for it.

The article is unfair mentioning Shkreli. He has always offered his drugs for free to anyone that couldn't afford them. It has always been his policy and continues to be so.

I think it was the Insurers and their paid for Politicians that created the stink. To this day I still haven't heard of one person that had to pay the $750.00 a pill but just their co-pay and if they had no insurance they got it for free.

Surprised this drug isn't available for free for those without insurance or is it?

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

#95

Post by discardorama »

paulcole wrote: post #71
MichaelBurge wrote: post #64

A quick Google search shows that they paid $11 billion for the company that sells the drug(Sovaldi), and earned $1.3 billion off of it[1] in 2016. They make half of that in the US, and something like 10% of it in all places that aren't the US, Europe, or Japan. That's a 12% return in 2016, which isn't nearly as good as the comments in this thread would have you believe. It's an okay return, but it wouldn't really be…

Just out of curiosity, at what point would the cost of the drug not met your definition of fair?

I'd say that a 20% ROI on the price of the development of the drug sounds reasonable. But the 11B was NOT the price of development; that would have been much lower. Assuming it was 1B (typical number thrown about), then a profit of 200M per year seems reasonable. Cost of manufacture of most drugs is negligible. Assuming they sell 100M pills/year, charging $10/pill (of $840/dose) seems quite fair.

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

#96

Post by rayiner »

Zigurd wrote: post #72
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…

Lots of research in the US is university and government lab-based. Even if private sector drug development were cut back, it would not end useful drug development. I suspect the way government and university research is monetized could be improved so that more competition would exist.

Let's say we shut down Silicon Valley and had the government do computer research. You think that would be efficient and effective?

At the end of the day, you need to give smart people a reason to make their lives' work saving lives instead of selling financial products or advertising algorithms. That's not going to happen if going into drug development means topping out at GS-15 in a government lab.

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

#97

Post by rayiner »

discardorama wrote: post #95
paulcole wrote: post #71

Earlier quoted context omitted.

Just out of curiosity, at what point would the cost of the drug not met your definition of fair?

I'd say that a 20% ROI on the price of the development of the drug sounds reasonable. But the 11B was NOT the price of development; that would have been much lower. Assuming it was 1B (typical number thrown about), then a profit of 200M per year seems reasonable. Cost of manufacture of most drugs is negligible. Assuming they sell 100M pills/year, charging $10/pill (of $840/dose) seems quite fair.

How do you think Silicon Valley would work if the ROI on their unicorns was limited to 20%?

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

#98

Post by tn13 »

> In the United States, there is nothing stopping pharmaceutical companies from charging whatever they think the market will bear.

That is how it should be. The moment government controls prices, it will slow down overall capital investment in invention of new drugs. I think $80k price is perfectly fair given the scenario.

Until Giliad Science invented that medicine the alternative to the medicine was assured death by cancer. Have you ever paid medical bills for cancer ? $80k does sound like a reasonable amount to pay for one's life in a developed country like USA. In India value of life is much less and I am not surprised Indians are willing to pay much less for their life.

Poor Indians are benefiting at the expense of rich Americans. Indian would prefer to die than borrow and buy a $80k medicine.

I think if Americans can save money by offshoring the cheap call centers to India they can also save money by getting their health treatment in India. The thing to remember here however is that if you die in an operation theater in USA your family might get millions in compensation. In India you have to say bad luck and move on. The pills that you buy from India could be nothing but horseshit packaged in wrappers and you can basically do nothing even if you find it out.

US is at the forefront of drug inventions because markets are allowed to function, surely companies are making ton of profits but I suggest you try setting up a company and invent the same drug and sell it for cheaper price. Inventing drugs is like a startup, a giant number of research projects fail, handful of succeed. People remember Facebook and its obscenely rich Zukerberg they don't remember Bozo inventor of JokerBook, a social network for clowns.

It would be good if Americans learn to appreciate what they have rather than complain about everything.

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

#99

Post by drauh »

ikeboy wrote: post #57
voodootrucker wrote: post #18

Earlier quoted context omitted.

So it's fair for a multi-billion dollar company to exploit the "global market" by farming work out to 3rd world countries... But not for a customer who is literally dying to take advantage of that same "global market" to save himself? Like everything else in the global economy, laws are only enforced to protect the strong against the weak, and yet we wonder how all the wealth is accumulating in the hands of the few.

How is giving people jobs exploiting them again?

https://en.wikipedia.org/wiki/Foxconn_suicides

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

#100

Post by gradstudent »

bpodgursky wrote: post #34
hueving wrote: post #9

Earlier quoted context omitted.

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).

That sounds terrific?
Post reply on HN