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

#181

Post by WalterBright » Mon, May 09, 2016, 5:21 AM UTC

Houshalter wrote: post #175

WalterBright wrote: post #170

Earlier quoted context omitted.

> And why should the drug company itself get to determine the price, with no upper bound? Because they took the financial risk to develop the drug.

Sure. But if they demanded a trillion dollars per pill, the government shouldn't have to pay for it. It would bankrupt the country. They shouldn't be able to set a price and force the government to pay it. The only reason we have this crazy system is because people refuse to put an economic value on life.

> if they demanded a trillion dollars per pill

Then nobody would buy it and they would lose their investment.

> force the government to pay it

They can't force the government to do anything. Of course, the government can just take the pills from them, but if they did that, then no more cures would be developed.

> people refuse to put an economic value on life

People do all the time. Every time you (and everyone else) make a decision of risk vs cost vs utility, you do. For example, some cars are safer than others. How does that influence what you'll pay for a car?

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

#182

Post by lostlogin » Mon, May 09, 2016, 5:25 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.

Don't worry, with the Trans Pacific Partnership Agreement (TPPA) we are all signing up for we have agreed to be gouged deeply. New Zealand.

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

#183

Post by lostlogin » Mon, May 09, 2016, 5:28 AM UTC

verroq wrote: post #124

pgodzin wrote: post #119

Earlier quoted context omitted.

Or Gilead is exploiting dying people desperate to save their lives and have enough money to do so, while letting the rest die. And then I'm sure they are lobbying the government to make sure it won't do anything about it. Meanwhile, Apple is selling luxury products that people can buy if they would like to. And those that can't, survive just fine without one.

If all the poor people got naturally selected out then there won't be poor people anymore.

You may or may not have noticed that extreme poverty and hardship doesn't lead to less offspring, in fact the opposite occurs. Look at birth rates between wealthy and poor countries or groups.

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

#184

Post by cheriot » Mon, May 09, 2016, 5:34 AM UTC

WalterBright wrote: post #181

Houshalter wrote: post #175

Earlier quoted context omitted.

Sure. But if they demanded a trillion dollars per pill, the government shouldn't have to pay for it. It would bankrupt the country. They shouldn't be able to set a price and force the government to pay it. The only reason we have this crazy system is because people refuse to put an economic value on life.

> if they demanded a trillion dollars per pill Then nobody would buy it and they would lose their investment. > force the government to pay it They can't force the government to do anything. Of course, the government can just take the pills from them, but if they did that, then no more cures would be developed. > people refuse to put an economic value on life People do all the time. Every time you (and everyone else)…

>Of course, the government can just take the pills from them, but if they did that, then no more cures would be developed.

There seems to be a common misunderstanding of how eminent domain works. The Constitution requires "just compensation", which the courts interpret as fair market value.

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

#185

Post by pgodzin » Mon, May 09, 2016, 5:35 AM UTC

rayiner wrote: post #174

pgodzin wrote: post #152

Earlier quoted context omitted.

> 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 r…

Apple made $18 billion in profits last quarter. For half of that, they could have saved 2.7 million people from dying of malaria. In one quarter alone.[1] Apple's customers spent about $45 billion on iPhones last quarter. If they had gotten Android phones for half the price (which still provide essential information and communications), they could have saved 5 million children by investing in children's health progra…

I think we'll have to agree to disagree here. Your argument is totally valid economically, but I'm arguing the morality of it. I certainly don't think all companies and consumers should be providing every surplus dollar to helping others.

If this were a free market system where competition has resulted in $84k being the price at which it makes sense to produce then so be it. Instead, the company can lobby to make sure the government, who we both agree should be involved here for the public good, never gets involved and buy out any company that challenges its monopoly. Then, it can take advantage of global markets for additional profits, while the people who are actually dying can't and have two options - death or debt.

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

#186

Post by Lazare » Mon, May 09, 2016, 5:41 AM UTC

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…

> 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.

Yeah, but, as your own link notes, courts (and the constitution) require fair market value for compensation. This doesn't save you any money at all; eminent domain can only have an impact when someone is refusing to sell at the market price. But Gilead is very very happy to sell at the market price. The issue is people upset at what that market price is.

If the US government could come up with the fair market value of the exclusive rights to manufacture Harvoni and Sovaldi, the problem wouldn't exist, because the same amount of money could also just buy all the doses of Harvoni and Sovaldi on the open market.

> 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.

Oh sure, they'd love for the US government to buy a million doses at $84k each and start handing them out. I don't think that solves any problems though.

Edit: Wait, or is your comment actually just an argument for single payer healthcare, and I'm just being obtuse? If so, my apologies for missing the joke, and I think you're right: The most obvious role for the government is funding universal catastrophic care, and I think this should be a part of that.

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

#187

Post by laurencerowe » Mon, May 09, 2016, 5:42 AM UTC

jessriedel wrote: post #77

Zigurd wrote: post #75

Earlier quoted context omitted.

No because the free riding is not actually substantive.

How so? The primary development incentive for the large majority of new drugs is the patent-protected revenue in the US.

Sadly most of that money is spent on marketing [1] and most new drugs are just minor tweaks to existing compounds [2], much safer bets than brand new approaches.

[1] https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-p...

[2] http://healthaffairs.org/blog/2015/07/06/serious-risks-and-f...

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

#188

Post by m_mueller » Mon, May 09, 2016, 5:47 AM UTC

refurb wrote: post #141

corvallis wrote: post #122

Something to keep in mind is the population that typically has chronic Hep C requiring this drug. It's IV drug users who share needles. Think they have $84K? Nope. Think they have insurance? Nope. Guess who pays for it. Oh that's right, it's Medicaid! It's you, the taxpayers. Where is there a large concentration of people that have Hep C? Prisons. Guess who pays for it then? Still you! The prison systems are obligate…

You don't think it's fair to price a product relative to the wealth in a given country? I think it's quite fair to be honest.

Certainly. And it should be just as fair to allow parallel imports of everything. Want to charge more than [retail price B + transport cost B->A + import tax A]? Guess what, the market is going to take care of this for you.

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

#189

Post by bogomipz » Mon, May 09, 2016, 5:48 AM UTC

rayiner wrote: post #51

bogomipz wrote: post #42

Earlier quoted context omitted.

That's a strawman argument and you know it. A car is financed over 5 years. You can't get financing on pharmaceuticals. The "average" wedding is an equally bad comparison and your figure is wrong - average is actully 26K with majority of weddings under $10k: http://www.costofwedding.com/ It is absolutely reprehensible behavior. If $1,500 is a reasonable price point and profit margin for a company elsewhere in the wor…

> A car is financed over 5 years. You can't get financing on pharmaceuticals. As a matter of economics, the value of something doesn't (or shouldn't) depend on how easy it is to get financing for that thing. In fact, your financing example cuts the other way . That $33k new car is actually worth more like $40k to the buyer, because that's how much they pay after financing it. The market shows that people value an ave…

Huh? Who said anything about "value"? You are the one who mentioned car pricing not me. My point is that cars are peoples single largest purchases outside of home ownership and for most people the only reason that is even viable is because a source of financing exists.

Why are you dragging iphones and Apple into this? You are way off point.

"the companies shouldn't be forced to basically be private charities." Wow, I don't anybody has ever compared a big pharma company to a private charity before. I had to reread that sentence twice.

How about Martin Shkreli the CEO of Turing Pharmaceuticals who overnight raised the price of an AIDS drug from $13.50 to $750.00 a pill overnight? Is that OK? He shouldn't in your words "be forced to basically be private charity" right?

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

#190

Post by seshagiric » Mon, May 09, 2016, 5:52 AM UTC

Not sure if there is one in the USA, however in India the law does impose a maximum price for critical and life saving drugs (hypertension, heart related, diabetes etc.). There is ongoing process for adding some cancer drugs too to this list. I think the key here is that businesses should be allowed to make a 'reasonable' profit.