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

#151

Post by x5n1 » Mon, May 09, 2016, 4:55 AM UTC

refurb wrote: post #143

cheriot wrote: post #114

Eminent domain is not just for land. In extreme cases like this where a profit motive is the only thing keeping us from curing huge numbers of people, the US government should write a single check, take the rights, and start handing out pills. As far as the company is concerned, that could even be a preferable outcome. Cash now and the marketing benefits to promote its other drugs. Edit: Just a reminder that eminent…

Let's walk through this. Drug develop is mostly funded with private money. Yes, the NIH funds basic research that often support drug research, but private companies fund most of the bill. It's in the hundreds of billions each year. Now why would they do that? Well, they expect that they'll give a company $500M and it will turn into $2B or $3B. However, most of those companies will fail and the $500M will turn into $0…

Scientists are not profit motivated. Scientists don't work to produce more drugs faster just because the CEO is managing better. This is definitely something that can be funded by the public and should be funded completely by the public on a not-for-profit basis. Then we can no longer make these sort of ridiculous economic arguments.

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

#152

Post by pgodzin » Mon, May 09, 2016, 4:55 AM UTC

rayiner wrote: post #139

pgodzin wrote: post #134

Earlier quoted context omitted.

Yes, the company that actively prevents people from obtaining life-saving medicine for billions extra in profit is more reprehensible than the company that makes no pretenses about having anything to do with life and death. Creating the cure was admirable, what it has done with it is reprehensible. It certainly has the right to make a significant profit. But a monopoly on medicine paid for by dying people with no oth…

> Yes, the company that actively prevents people from obtaining life-saving medicine for billions extra in profit is more reprehensible than the company that makes no pretenses about having anything to do with life and death. So the moral impact of a company's actions depends not on the net good done by that company, but on the "pretenses" it does or does not put on? It's morally better to waste natural resources on…

> And if it's morally reprehensible to not save a life when you have the power to do so, aren't all of Apple's customers morally reprehensible for buying iPhones? That money could literally save the life of someone in the world that lacks basic necessities.

No, the decision to make billions extra in profits on top of the billions they would already be making at the cost of millions of lives is still definitely more reprehensible than someone spending a few hundred dollars more than they otherwise would on an essential device that provides information, communication and entertainment instead of giving it to someone less fortunate.

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

#153

Post by refurb » Mon, May 09, 2016, 4:55 AM UTC

tracker1 wrote: post #110

kangar00 wrote: post #36

Earlier quoted context omitted.

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…

But stronger patent protection won't improve pricing... competition will. I think we should reduce extension patents to 5 years, and possibly even have compulsory licensing fees ($10 per day, per prescription for the first year, $8 for the second ... 6... 4... down to $2, then $1) for prescription drug patents starting at 5 years. And the penalty for an insufficient patent application for a third party to properly ap…

What about drugs that cost more than $10 per day to produce? Hell that's only $3650 per year. How many manufacturing plans can sustain themselves on that sort of revenue, particularly if they are creating a drug for a disease that only affects 1000 patients in the world?

One of the reasons why generic drugs prices jumped so much in the last few years, if because manufacturers said "screw this" and just stopped making the drugs because the margins were so low.

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

#154

Post by ptaipale » Mon, May 09, 2016, 4:56 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.

There are many other ways to get hepatitis C. For instance, it is not an unknown phenomenon that drug addicts use needles as a weapon. Errors in healthcare, e.g. needles or blood transfusions.

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

#155

Post by refurb » Mon, May 09, 2016, 4:56 AM UTC

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.

Please list all of the drugs that public money has brought all the way to market. It's not that long.

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

#156

Post by cheriot » Mon, May 09, 2016, 4:57 AM UTC

nickpsecurity wrote: post #116

cheriot wrote: post #114

Eminent domain is not just for land. In extreme cases like this where a profit motive is the only thing keeping us from curing huge numbers of people, the US government should write a single check, take the rights, and start handing out pills. As far as the company is concerned, that could even be a preferable outcome. Cash now and the marketing benefits to promote its other drugs. Edit: Just a reminder that eminent…

We could do that. On other hand, we could just pay them the expected market value of the drug when they first invent it then give it to public for almost nothing. "You can cure cancer with those three drugs? Was going to make tens of billions? Here you go: guarantee of tens of billions of subsidies over next 20 years in exchange for the patent and license for anyone to produce it generically." Boom! Tens of thousands…

Agreed, that's exactly what I'm trying to suggest :) Eminent domain requires paying the property owner.

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

#157

Post by gaius » Mon, May 09, 2016, 4:58 AM UTC

x5n1 wrote: post #151

refurb wrote: post #143

Earlier quoted context omitted.

Let's walk through this. Drug develop is mostly funded with private money. Yes, the NIH funds basic research that often support drug research, but private companies fund most of the bill. It's in the hundreds of billions each year. Now why would they do that? Well, they expect that they'll give a company $500M and it will turn into $2B or $3B. However, most of those companies will fail and the $500M will turn into $0…

Scientists are not profit motivated. Scientists don't work to produce more drugs faster just because the CEO is managing better. This is definitely something that can be funded by the public and should be funded completely by the public on a not-for-profit basis. Then we can no longer make these sort of ridiculous economic arguments.

Do they hand out sainthoods with PhDs now? A scientist working in the commercial sector has the same motivations as anyone else.

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

#158

Post by Houshalter » Mon, May 09, 2016, 4:58 AM UTC

refurb wrote: post #143

cheriot wrote: post #114

Eminent domain is not just for land. In extreme cases like this where a profit motive is the only thing keeping us from curing huge numbers of people, the US government should write a single check, take the rights, and start handing out pills. As far as the company is concerned, that could even be a preferable outcome. Cash now and the marketing benefits to promote its other drugs. Edit: Just a reminder that eminent…

Let's walk through this. Drug develop is mostly funded with private money. Yes, the NIH funds basic research that often support drug research, but private companies fund most of the bill. It's in the hundreds of billions each year. Now why would they do that? Well, they expect that they'll give a company $500M and it will turn into $2B or $3B. However, most of those companies will fail and the $500M will turn into $0…

I think the government should put a value on every life (or quality adjusted life year, whatever), and offer to pay that much for any drug that saves lives.

From that perspective, $84k per life saved doesn't sound that unreasonable, and creates a huge incentive to develop similar drugs in the future.

But I don't think valuing every life at $84k would be sustainable. And why should the drug company itself get to determine the price, with no upper bound?

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

#159

Post by refurb » Mon, May 09, 2016, 4:59 AM UTC

rayiner wrote: post #69

andrewchambers wrote: post #63

Earlier quoted context omitted.

It sounds more like a lack of real competition.

You can't have "real competition" in the drug industry. While the status of patents is debatable in software (where actual copying is rare), the generics manufacturers are always directly copying from the drug inventors. They don't have the capability to do their own R&D, or often even to develop a lot of the ancillary protocols themselves. So you either have a regulated market, or massive free-riding, neither of whi…

You can't have perfect competition in the drug industry, but you can get close. Gilead dropped the price of Sovaldi/Harvoni by almost 30% when Abbvie launched their HCV therapy.

In fact, one of the best way to introduce competition is through "me-too" drugs. You know, the ones everyone complains about.

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

#160

Post by Dylan16807 » Mon, May 09, 2016, 4:59 AM UTC

rayiner wrote: post #135

Dylan16807 wrote: post #130

Earlier quoted context omitted.

You're doing the math wrong. The suggestion is not a billion dollar profit on 26 billion dollars of costs. Most of the 26 billion dollars is profit. Chopping the cost tremendously would still leave a healthy profit margin. As to risk, they bought an already-proven drug. That's not the sort of thing that earns massive returns.

I did do that math wrong, but to be fair, the article is comparing apples and kumquats. $26 billion is how much Gilead has in cash, which has little to do with Sovaldi at this point. $1 billion profit (let's say that's annual, rather than over the life of the drug) on an $11 billion purchase would be less than 10% annual ROI. That's very low for what was still a very risky investment (unapproved drug).

I think in the author's ideal world, the lowered profit for Gilead would mean they aren't rushing to provide Sovaldi a multi-billion dollar profit either. So the price drops well below $11 billion, and you get a solid profit margin without gouging people that need the drug.