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

#281

Post by m_mueller » Mon, May 09, 2016, 1:07 PM UTC

icebraining wrote: post #264

m_mueller wrote: post #188

Earlier quoted context omitted.

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.

Of course, that just means they'll sell at the expensive price everywhere.

See the import tax that I included in the calculation? IMO this should be the way to solve this from a humanitarian standpoint. If a government wants to solve medical issues of poor countries, it can work together with drug corporations, dictate the price points (i.e. manufacturing+logistics without R&D) for offering these supplies and then protect the own market through import taxes on these products. But the point here is: It needs to be a transparent, i.e. democratic, process. The way it works now is just shady and anti free market.

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

#282

Post by rev_null » Mon, May 09, 2016, 1:10 PM UTC

halviti wrote: post #243

chris_wot wrote: post #237

Earlier quoted context omitted.

Actually, India basically refuses to recognise patents for a wide variety of pharmaceutical products. For a long time they refused to recognise patents for drugs that combat AIDS and a thriving market for generics sprung up. There was a lot of posturing and complaining by pharmaceutical companies in the U.S. and the U.S. Government tried to heavy the Indian Government, but to no avail. When it became apparent that th…

While I tend to lean more to your side of the argument, the devil's advocate in me has to point out the fact that you leave out the massive costs of research, development, clinical trials / fda approval, etc. that go in to getting a drug to market. This not to mention all the extra capital needed to fund research into all of the drugs that never make it to market before a company finds something that works.

This ignores the fact that the expensive, risky research is often funded by public money instead of by the pharmaceutical companies. So, the taxpayers pay for the research until it shows progress. Then it gets patented and sold to a large company which sells it back to the public for $1000/pill.

It's a pretty gross abuse of the original idea of patents.

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

#283

Post by refurb » Mon, May 09, 2016, 1:10 PM UTC

laurencerowe wrote: post #187

jessriedel wrote: post #77

Earlier quoted context omitted.

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...

Hyperbole seems to be getting worse on HN.

First off, no, marketing is not where most of the money is spent. Second, marketing spend has a positive ROI, so they get more money back than they spent.

Lastly, this entire discussion is about a wonder drug that cures a terrible disease and you claim most new drugs are minor tweaks.

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

#284

Post by pbhjpbhj » Mon, May 09, 2016, 1:14 PM UTC

emn13 wrote: post #245

x5n1 wrote: post #147

Earlier quoted context omitted.

It should be priced according to ability to pay based on income. The same is the reasoning why the drug is so cheap in other countries, their people can't possibly afford the prices. So it makes no sense for citizens of wealthy countries to have to pay huge markups if they don't have the money. It makes no sense from an economic perspective to force people to go into bankruptcy just because they got sick.

That's only fair if you believe that the seller has the moral right to maximize their earnings. I think that's questionable across the board, but certainly in the pharmaceutical industry. As in: the idea behind capitalism (the reason we put up with it) is not that price-gouging is some fundamental right we should worship, but because capitalism works . What's that mean? It efficiently allocates resources. How does it…

Capitalism uses a low value of human life for workers compensation and a high value when selling drugs. Perhaps we should force the maximum charge to be their lowest paid worker's income for the period of treatment ...

Capitalism allocates resources efficiently without external forces like patents. Patents are a fix to force capitalism to be more socially responsible with sharing of knowledge.

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

#285

Post by Zigurd » Mon, May 09, 2016, 1:17 PM UTC

rayiner wrote: post #96

Zigurd wrote: post #72

Earlier quoted context omitted.

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.

Let's say we stopped exclusive licensing for government funded research. Then, when commercialized, drugs would be available from multiple competing sources. Or the IP could be set free, for generics manufacturers to pick up.

Maximizing rent-seeking doesn't seem like the wisest course of action.

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

#286

Post by bunnymancer » Mon, May 09, 2016, 1:20 PM UTC

ubernostrum wrote: post #193

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…

Actually a significant population in the US was infected by blood transfusion; the US didn't start properly/universally screening blood and taking precautions for hep C until 1992. This is why there's a spike in infection rate among older people, and why hep C is considered a looming cost crisis for Medicare -- we don't yet know the full extent of the infectious disaster that was unscreened blood, but it's ticking aw…

There's something rather unsettling about the realization that Jehova's Witnesses had a point about something once..

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

#287

Post by airless_bar » Mon, May 09, 2016, 1:28 PM UTC

chimeracoder wrote: post #278

lucaspiller wrote: post #224

Earlier quoted context omitted.

> 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?

> Do these companies still charge the same prices as in the US? The majority of global R&D happens in the US market, even though the entire world benefits from it. So pharmaceutical companies have come to expect to recoup their R&D costs from the US market. Ultimately, this means that European markets benefit from the research without having to shoulder the bulk of the costs from it. If they couldn't do that here, th…

This is utter non-sense.

Companies charge as much as they can, they don't follow some altruistic "we love Europe" plan.

I understand your point though: Of course it's easier to bask in American exceptionalism than facing the truth that corporations rule the US and the only human value they are interested in is the amount of dollars extractable through any means imaginable.

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

#288

Post by chimeracoder » Mon, May 09, 2016, 1:34 PM UTC

airless_bar wrote: post #287

chimeracoder wrote: post #278

Earlier quoted context omitted.

> Do these companies still charge the same prices as in the US? The majority of global R&D happens in the US market, even though the entire world benefits from it. So pharmaceutical companies have come to expect to recoup their R&D costs from the US market. Ultimately, this means that European markets benefit from the research without having to shoulder the bulk of the costs from it. If they couldn't do that here, th…

This is utter non-sense. Companies charge as much as they can, they don't follow some altruistic "we love Europe" plan. I understand your point though: Of course it's easier to bask in American exceptionalism than facing the truth that corporations rule the US and the only human value they are interested in is the amount of dollars extractable through any means imaginable.

> some altruistic "we love Europe" plan.

Nobody said anything about altruism, or 'loving Europe'. I don't know where you're getting either of those ideas from.

> Of course it's easier to bask in American exceptionalism

This is hardly a claim of American exceptionalism. It's a non-normative observation about the existing structure of the markets. It is not a statement that this is how it always must be, or that this is how it should be. It is merely a description of what currently is.

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

#289

Post by airless_bar » Mon, May 09, 2016, 1:45 PM UTC

chimeracoder wrote: post #288

airless_bar wrote: post #287

Earlier quoted context omitted.

This is utter non-sense. Companies charge as much as they can, they don't follow some altruistic "we love Europe" plan. I understand your point though: Of course it's easier to bask in American exceptionalism than facing the truth that corporations rule the US and the only human value they are interested in is the amount of dollars extractable through any means imaginable.

> some altruistic "we love Europe" plan. Nobody said anything about altruism, or 'loving Europe'. I don't know where you're getting either of those ideas from. > Of course it's easier to bask in American exceptionalism This is hardly a claim of American exceptionalism. It's a non-normative observation about the existing structure of the markets. It is not a statement that this is how it always must be, or that this i…

Wrong.

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

#290

Post by nkozyra » Mon, May 09, 2016, 1:46 PM UTC

JoeAltmaier wrote: post #268

nkozyra wrote: post #82

Earlier quoted context omitted.

> People are priced out of better lives all the time But again, this is not what we're debating. It's why the "average car price" does not apply.

Clearer: its not 'ok' that segments of the population are 'priced out'. Its just economics. Life is hard.

Look everybody knows it's economics that drives this. That's not the point. We have mechanisms in place that can isolate certain aspects of life and remove them from the capitalist machine.

On a grand scale it's socialized medicine but even on a smaller scale it's health insurance. And it's why hospitals don't kick out a dying person just because they're destitute. What we're talking about isn't "why does medicine X cost $Y?" Most people understand that.

And that's why it's unfair to compare life-saving medication to buying a luxury vehicle.