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

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

#311

Post by lhopki01 »

jessriedel wrote: post #59
rdtsc wrote: post #56

Earlier quoted context omitted.

> Right now US citizens are basically subsidizing other countries when it comes to drug revenue via price gouging. I am ok with that. They can take even more taxes out every month if it means people get access to better healthcare.

Does it bother you that Europe and the rest of the developing world also free-ride subtantially?

Where is your basis for this statement? Pharmaceutical industry profit margins are about 17% which about the highest of any industry. Pharmaceutical companies spend more on advertising than research and development. Looks less like Europe and the rest of the world are free riding and more like the US is being conned.

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

#312

Post by irremediable »

coredog64 wrote: post #296
irremediable wrote: post #248

Earlier quoted context omitted.

I'm fairly sure most drug companies now spend more on marketing than on R&D/testing.

If you're going to parrot Marcia Angell, at least get the substance right: They spend more on marketing and administration than they do on R&D. Where "administration" is stuff like IT, HR, etc.

I've never read her work, so I'm hardly parroting her. IIRC I've read about this in a few news articles about pharma finances, and in Ben Goldacre's "Bad Pharma". I don't know whether the marketing/sales figures include administration, but it does appear to be true, and I'd be inclined to think it's bad...

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

#313

Post by mhalle »

Our medical and social systems are ill-equipped to deal with cures for widespread diseases, which is what Harvoni and its related drugs are. We are used to paying for disease on time: relatively small amounts of money for periodic treatments that might last a lifetime, however long that lifetime may be. And we (at least in the US) often think more about the value of the treatment to the patient rather than the value of a healthy person to society.

These questions of cost and value go far beyond HCV. It is a popular, medical, and entrepreneurial dream to cure cancer wholesale with a single easy course of treatment. While cancer isn't a single disease, perhaps we should begin asking now how we could assess the value and pay the price for such a "miracle" should a cure for any of the most common cancers be developed.

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

#314

Post by swalsh »

maxerickson wrote: post #303
swalsh wrote: post #299

Earlier quoted context omitted.

I worked for a company that developed some PA criteria for these drugs, I can assure you a lot of debate went into this criteria.. these two specific drugs are probably the most hotly contested drugs. If we sold them at the 84k price tag to anyone that COULD use it, the entire insurance industry would go bankrupt, literally. Not even an exaggeration. While your logic is sound, the drug is cheaper than a liver transpl…

Do you have a sense of the production costs? If they aren't very high, the US government could start making the company look like jerks by offering $50 billion for the patent. I'm pretty sure they would be able to calculate a nice return based on a payment like that. The math works fine for that, there's ~3 million people just in the US to treat, paying $50 billion would save a substantial amount just treating those…

I don't, there's a lot of people in government trying to make change (Bernie Sanders for one!), any public information that is out there, is probably about as twisted as Enrons finance sheets.

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

#315

Post by greeneggs »

tomc1985 wrote: post #49
refurb wrote: post #44

Earlier quoted context omitted.

Do you think charging $300K for a liver transplant is gouging too? Because that's what this $84K drug just replaced.

Yes, $300k is even more unconscionable. Medicine in the US is wwaaaaaaaaaaay overpriced. Things that are critical for life needs to be priced at a reasonable flat rate above costs, and conducted with the attitude of public service and human actualization. Let big pharma reap their R&D costs some other way

> Let big pharma reap their R&D costs some other way

How?! You think they should create a social network for doctors? A billion dollars in ad sales is somehow morally better than a billion dollars from saving lives? They're making their money by saving lives, and being criticized for it. You're effectively saying that they shouldn't do any R&D, like the Indian generic drug companies.

Sorry for the exclamation points. I think that you have a particular system of morality, that is more important than saving lives. To me this is like arguing for abstinence-only sex education, which demonstrably does not work. I wish in general people would be more willing to look at data and outcomes.

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

#316

Post by greeneggs »

tomc1985 wrote: post #45
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?

That's 2x to 3x the before-tax income of your average non-tech-employed American. Are you kidding?!?!

But isn't it worth two or three years of income to save your life? It seems absolutely worth it to me, frankly a much better value than almost anything I spend money on (I mean, Netflix?).

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

#317

Post by greeneggs »

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…

> Notably, patents of life-sustaining medicines utterly destroy that cornerstone of capitalism. People can and will pay almost anything to get that drug, so the seller can charge what it wants - that's not capitalism as it's supposed to work, that's a hostage scenario.

I don't think it is appropriate to compare a drug company that created a life-saving drug to a hostage taker. And in this scenario it is particularly inappropriate, because they are charging less for the drug than the previous best treatments cost!

Furthermore, there is an alternative here. The patent only covers this one cure. You are welcome to go out and spend $2-3 billion to try to create your own drug. (But that would be pretty risky, wouldn't it? And good luck raising the money if you plan on giving the drug away.)

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

#318

Post by greeneggs »

chongli wrote: post #271
emn13 wrote: post #245

Earlier quoted context omitted.

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…

The best alternative is really quite simple: public funding for lifesaving medicines. This model also works for the provision of medical care and is used throughout the entire developed world, with one exception.

As far as I know, this is not true anywhere in the world. What drugs out there have had their development and trials fully (or majority) funded by governments, either in Europe or---apropos here---India?

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

#319

Post by jessriedel »

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...

Although those two points are interesting and relevant, my statement doesn't conflict with them.

Or are you claiming that Europe isn't meaningfully free-riding simply because new drug development just isn't valuable, and we'd be better off with much less drug research? I think that's a defensible claim, but it's very contentious and should be stated clearly if you believe it.

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

#320

Post by nickpsecurity »

rtkwe wrote: post #293
nickpsecurity wrote: post #172

Earlier quoted context omitted.

Ok, that makes more sense. So, I modify the question to be U.S. workers threatening mass suicide by gun or whatever with a good number at one plant over time. Then, the plant starts taking preventative measures against various suicide equipment instead of investing in working conditions. This actually has more odds of happening.

You'd probably have to go back a ways to at least the early 1900s I'd guess to get the right combination of horribleness to get that. These days workplace suicides are relatively rare 1-2 per million workers. Also being poor sucks but US workers are waaay more mobile than a rural Chinese person who move into a company town from their home town/village so before they'd get to 'I'll kill myself in protest' they'll prob…

That's what I'm thinking. Commenter talking like the situation in China and in the U.S. are equal seemed way, way off.
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