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

#221

Post by kgwgk » Mon, May 09, 2016, 8:08 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'm sorry you have to take remicade for the rest of your life, but remicade won't cost $17k each time for the rest of your life. Generic versions of remicade are already available in Europe, and will be available in the US not later than Sep 2018 (when the patent expires, but in fact a biosimilar has already been approved by the FDA and could be launched "at risk" at any time).

On the other hand, it's likely that better treatments for your condition are developed in the future and at that point you will complain about how expensive those new drugs are.

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

#222

Post by linker3000 » Mon, May 09, 2016, 8:21 AM UTC

PieterH wrote: post #216

Surprised no-one has pointed to the real culprit here: the patent system, which allows individual companies to own knowledge like this and sell it at any rate it desires... private taxation by and for the rich, on the rest of society.

> Surprised no-one has pointed to the real culprit here

Finance and the monetary system.

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

#223

Post by airless_bar » Mon, May 09, 2016, 8:21 AM UTC

adrianN wrote: post #205

markvdb wrote: post #198

This is yet another perverse collision of care and market regulation. Other examples abound. Why do we accept this? Do we even dare think of alternatives? What if western governments stop enforcing drug development intellectual rights? Not going to happen before hell freezes over, but let's have a short thought experiment. Quality health care for all would probably blossom thanks to more access to affordable drugs th…

I wouldn't call cancer, heart disease, alzheimer's, ageing etc "the rarest disease puzzles", yet I'm not satisfied with the status quo of medical care for these problems.

Mainstream access to all existing drugs would still be a hugely more favorable outcome than the "chance" of new drugs at outrageous prices.

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

#224

Post by lucaspiller » Mon, May 09, 2016, 8:25 AM UTC

mikekchar wrote: post #212

PhasmaFelis wrote: post #210

Earlier quoted context omitted.

Is there a way to take the taxpayer money being spent on medicine that's priced high to recoup the research investment, and shift it to directly funding the research in the first place? Obviously you'd have to spend a while funding both R&D and Medicaid/etc, while the new drugs are in development and the old ones are still under patent, and I'm sure there's other details I've missed, but it seems like there should be…

I don't think you could get that to fly politically. While it is true that drugs require high prices to recoup research cost and that drug patents allow drug companies to charge those high prices, they don't just recoup prices. They charge as much as they can. From the point of view of trying to save as many people as possible for the money, that sucks, but from the point of view of encouraging investment in drug com…

> They charge as much as they can

How does it work in European countries where health care is (mostly) paid for by the government? Do these companies still charge the same prices as in the US?

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

#225

Post by lake99 » Mon, May 09, 2016, 8:31 AM UTC

ptaipale wrote: post #206

dragonmum wrote: post #196

Earlier quoted context omitted.

> You might get it if you buy it yourself, and bribe the prison staff to allow you to have it. > Sorry: this is not based on any real experience or references, just the overall assessment of how India stands currently. Jeez, you didn't have time to search but had time to fantasize like a Hollywood script writer hashing out more 3rd world stereotypes? Perhaps we should look at the treatment and hepatitis morbidity rat…

Thank you for correction; grant me at least that I knew I'm commenting based on prejudices. Note however that I don't view the American prison system as "our" ("mine") either (I'm not from the US). And still, what I read of Indian prison is just way, way worse than what I read about the American system. Overcrowding, horrible delays in trials, abysmal hygiene. I doubt that the HCV treatment there is very good, despit…

FWIW, I'm an Indian living in India, and I share your prejudices of Indian prisons. I have no direct or indirect accounts of Indian prisons.

In fact, I googled just now, and found out that a large fraction of the prisoners are sufferers of diseases that are otherwise easily treatable.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868089/

> A total of 252 (84%) prisoners had anemia.

Clearly, some of those who belong in prisons are on the wrong side of the bars.

Oh, and also, I will never trust Indian government reports or government info websites when they are reporting about their state of affairs.

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

#226

Post by y04nn » Mon, May 09, 2016, 8:34 AM UTC

The pharmaceutical industry is disgusting me. Their goal is no more to cure people but to generate that maximum amount of cash for shareholders. To chose a price point, they don't look at what research has cost, but what people, government aid and insurance are willing to pay for it and choose chose a price that max out the benefit. In developed country it becomes ridiculous.

As a note, when they have to make risky research they put the risk into a spin-off company with investors that share the risk, and this is how you end up with Gilead buying this probably co-founded research company.

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

#227

Post by airless_bar » Mon, May 09, 2016, 8:49 AM UTC

KaiserPro wrote: post #220

markvdb wrote: post #198

This is yet another perverse collision of care and market regulation. Other examples abound. Why do we accept this? Do we even dare think of alternatives? What if western governments stop enforcing drug development intellectual rights? Not going to happen before hell freezes over, but let's have a short thought experiment. Quality health care for all would probably blossom thanks to more access to affordable drugs th…

> What if western governments stop enforcing drug development intellectual rights? No new drugs. Pretty simple. Now you ask, is that a bad thing? well yes, yes it is. Right now, we are running out of (or have run out of) top end antibiotics. Partly from over use (I'm looking at you America.) mostly from using them to get much higher yields in farm animals (yup, thats right, last line antibiotics are being used on pig…

Americans brought the end of antibiotics onto themselves. Even if the world found new antibiotics, their culture is just not amenable to use them responsibly.

How to prevent them from spreading their new diseases to the rest of the world?

Let's follow the advise from their next president and put a wall around their country.

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

#228

Post by airless_bar » Mon, May 09, 2016, 8:51 AM UTC

lucaspiller wrote: post #224

mikekchar wrote: post #212

Earlier quoted context omitted.

I don't think you could get that to fly politically. While it is true that drugs require high prices to recoup research cost and that drug patents allow drug companies to charge those high prices, they don't just recoup prices. They charge as much as they can. From the point of view of trying to save as many people as possible for the money, that sucks, but from the point of view of encouraging investment in drug com…

> They charge as much as they can How does it work in European countries where health care is (mostly) paid for by the government? Do these companies still charge the same prices as in the US?

Of course not.

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

#229

Post by golergka » Mon, May 09, 2016, 8:53 AM UTC

OK, let me be a devil's advocate for a minute, before we get the pitchforks once again. Let's remember this:

> Gilead Science was first out the gate, bringing the new hep C drugs Harvoni and Sovaldi to market in 2014 and 2015, respectively. And they worked great: More than 90 percent of patients taking the new drugs saw the hep C virus wiped out in three months, and without the side effects that made interferon treatments so intolerable.

So, Gilead is exactly the company that created these drugs from the very beginning. I'm looking at it this way: in 2013 (situation A), there was no cure ("cure" is a simplification, of course, but for this kind of analysis it's not an important detail.). In 2016 (situation B), there is a cure, but it costs $86k.

Now, the moral question here is very simple: when you change the world (as Gilead did) from situation A to situation B, is it net good or net evil deed? In which world of these two would you prefer to live?

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

#230

Post by phaemon » Mon, May 09, 2016, 8:56 AM UTC

KaiserPro wrote: post #220

markvdb wrote: post #198

This is yet another perverse collision of care and market regulation. Other examples abound. Why do we accept this? Do we even dare think of alternatives? What if western governments stop enforcing drug development intellectual rights? Not going to happen before hell freezes over, but let's have a short thought experiment. Quality health care for all would probably blossom thanks to more access to affordable drugs th…

> What if western governments stop enforcing drug development intellectual rights? No new drugs. Pretty simple. Now you ask, is that a bad thing? well yes, yes it is. Right now, we are running out of (or have run out of) top end antibiotics. Partly from over use (I'm looking at you America.) mostly from using them to get much higher yields in farm animals (yup, thats right, last line antibiotics are being used on pig…

> No new drugs. Pretty simple.

I doubt that. There's no reason why the same research couldn't be academic research.

Global spending on drugs research is only $77 billion a year. Take the 20 richest countries in the world and that's less than $4 billion a year each. That's less than half the UK's EU rebate.

(EDIT: not enough coffee to add correctly)