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Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

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Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#81

Post by mastax »

arethuza wrote: post #33
lukasm wrote: post #22

Earlier quoted context omitted.

In UK government has almost a monopoly for buying drugs, so they have a leverage in negotiation and there is a lower overhead with paper work. Americans subsidize drugs for the rest of the world.

"I can buy a ventolin inhaler for £10 over the counter" Ventolin inhalers are apparently available over the counter in pharmacies in the UK - where does the government enter into that?

This part:

> if I went to the Doctor it would be free

probably reduces what people are willing to pay.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#82

Post by mikeash »

microcolonel wrote: post #78
mikeash wrote: post #49

Earlier quoted context omitted.

Are you proposing that every single patient using Thiola or Daraprim was either able to afford the new price or get someone else to pay for it?

He outright offered to send the drug at no cost to patients whose insurers did not cover it.

Before or after his name got dragged through the mud?

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#83

Post by drzaiusapelord »

klodolph wrote: post #79
drzaiusapelord wrote: post #71

Earlier quoted context omitted.

The drug was then unaffordable regardless of intent. You can't separate the two. Again, your solution doesn't stop this.

> Again, your solution doesn't stop this. I'm honestly quite confused here. What solution, exactly, are you talking about? I don't remember proposing a solution. In the Shkreli case, the drug price was raised in September 2015, and a cheap replacement was available on the market in October 2015 from a different company.

Many insurers didn't cover the competing product, so the real life lag time for healthcare consumers was either much longer or they simply had to pay the full cash price out of pocket.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#84

Post by wyldfire »

Chestofdraw wrote: post #73
lukasm wrote: post #22

Earlier quoted context omitted.

In UK government has almost a monopoly for buying drugs, so they have a leverage in negotiation and there is a lower overhead with paper work. Americans subsidize drugs for the rest of the world.

> Americans subsidize drugs for the rest of the world. Complete nonsense. I see this regurgitated again and again with nothing to back it up and it falls apart under the slightest inspection.

I have believed this "nonsense" for a while so I went looking for evidence that supports the claim. I'd always assumed it was just regional market segmentation that allowed them to change a lot more here in the US.

One of the Quora answers [1] to this question has lots of evidence and ultimately boils down to mostly marketing budgets (drugs are advertised directly to consumers here in the US and not elsewhere).

[1] https://www.quora.com/Does-the-US-subsidize-health-care-in-t...

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#85

Post by akiselev »

maxerickson wrote: post #75
akiselev wrote: post #70

Earlier quoted context omitted.

Do you have data to back this up? Cancer treatments cost a lot per dose because they usually have relatively tiny markets (in any given year), are some of the most complex to develop, and treat an acute disease without the potential for long term customers. Also, much of the cost of cancer treatment is the cost of complications, clinical face time, and end-of-life care, not the drugs. If I remember correctly, the ave…

Isn't the modal number of prescriptions 0? As far as Medicare, they don't pay "whatever", they pay what everyone else pays or less. I shouldn't have just said cancer drugs. Lots of specialty and small market drugs have enormous prices. Meanwhile, statins cost $0.30 a day: https://www.goodrx.com/lipitor

Do you mean the ideal number of prescriptions is zero?

Medicare does pay less than other insurers but only because of a general law blacklisting companies that charge the government more than other customers (on the assumption that the govt will always be the single biggest customer but more susceptible to political influence). Drug companies keep this in mind when negotiating with insurers so it's nowhere near as effective as the NHS, which can't pass its costs onto consumers except through new legislation and negotiates for the entire UK population at the same time.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#86

Post by microcolonel »

ceejayoz wrote: post #36
microcolonel wrote: post #27

Earlier quoted context omitted.

I've not seen a case that what Shkreli did reduced the availability of his niche drug to patients.

That's a strawman. Yes, most patients likely retained their access to the drug. The issue is more that we all wind up paying higher premiums so Shkreli can line his pockets with inflated proceeds and no alternatives.

I doubt much money is spent on Daraprim overall. $75k is apparently the overall cost of a course of treatment to insurers, in addition to the two or three other drugs prescribed to reduce the side effects of the drug.

It is apparently not in common use, Health Canada says that hospitals simply don't buy it anymore as of 2013, well before the price increase.

I suspect that if there's an entire first-world nation which no longer purchases the drug in hospitals or pharmacies, sales volume is probably pretty low in the U.S. I don't see what kind of premium increase you could attribute to that.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#87

Post by kamaal »

afandian wrote: post #54
dethswatch wrote: post #14

Earlier quoted context omitted.

>It costs a quarter to manufacture each pill but the >manufacturers charge several dollars for that pill. What are the manufacturing costs for software?

All software is different. I'm only replying because my first answer is "nothing", then I thought about it. One data point from my experience: - developer time to prepare, document a build, release notes - build engineer to submit, check build, co-ordinate - build machine hardware - build machine OS license - cryptographic signing hardware - QA engineer time to test - QA automation engineer's time to set up tests and…

I'm pretty sure getting to the final version of the pill pretty much has similar processes/iterations.

Its really not like they arrive one morning to the office, mix a few chemicals in a test tube, file a patent and then start selling them.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#88

Post by protomyth »

makmanalp wrote: post #67
protomyth wrote: post #53

If the government really wanted to lower the price of drugs it would pay for the FDA clinical trials[1] and lengthen the amount of time a drug company can collect royalties. I remember when I was at a place that did clinical trials the cost of one protocol was $50,000 a day because of all the test kits that needed to have lab work done each day and the drug company only really had 3 years to get back its investment (…

I understand the idea of the government paying for clinical trials, but then doesn't that incentivize pharma companies throwing stuff on the wall and seeing what sticks, and basically wasting money on trials that they know are long shots? I think the trial costs belonging to the company is right. Anyway, regardless, what if pharma was only slightly or moderately profitable instead of insanely profitable? I don't want…

Well, frankly, having a big bag of cash is what got us a lot of the specialist doctors in tough areas requiring a lot of years of work. There is nothing wrong with making money if you provide a service worth it. We get nowhere when we deamonize money.

Don't pay for failure if you care about that, but maybe we need a whole heck of a lot more throwing it at the wall than we have now. I can see some startups wanting to play where they cannot now.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#89

Post by [deleted] »

akiselev wrote: post #76
cmdrfred wrote: post #64

Earlier quoted context omitted.

Also if the risk is so high why are drug companies so profitable over the long term? Pharma firms are head and shoulders the most profitable firms in the S&P 500 every single year.

High risk, high reward. Why would anyone take a higher risk for a lower reward? Pharmaceutical companies in the S&P500 are so profitable because of barriers to entry, massive capital requirements, and a whole biotechnology industry feeding them acquisitions. Biotech startups going under with zero revenue after raising hundreds of millions of dollars from VCs and institutional investors is a regular occurrence. Since…

[deleted]

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#90

Post by soundwave106 »

microcolonel wrote: post #27
deepnotderp wrote: post #15

Earlier quoted context omitted.

This is great, we're trying everything except what the real problem is! Look at the Martin shkreli situation, there was another one like that before too. How did patents play a role there? High profit margins are not a bad thing, as long as people can still afford them. What we need is the proper type of regulations, I agree we need to streamline the fda process, but that alone is not going to solve things. There are…

I've not seen a case that what Shkreli did reduced the availability of his niche drug to patients.

The issue is the reverse. Shkreli used existing FDA regulations to carve out a monopoly -- from what I understand from the Wiki (https://en.wikipedia.org/wiki/Pyrimethamine#cite_note-45), he largely leaned on current FDA bioequivalency standards to put a barrier to entry for the business that was higher than many generics would want to risk (given the low volume of the compound).

Once the virtual monopoly was obtained, he subsequently jacked up prices. In this he probably made a mistake by being way too greedy. With "ordinary" medication pricing, patients may not notice the very high prices, largely because American medical pricing is not terribly transparent. Instead, the higher costs tend to translate to higher insurance premiums and higher medical bills to the taxpayer.

Pyrimethamine is an old 1950s drug and as I understand it the synthesis is relatively easy. If the current American regulatory system wasn't so broken and we had a truly free market, Shkreli wouldn't even have a business plan with that sort of price increase, low volume notwithstanding.

The good news out of this is what Shkreli did was so egregious, the flaws in the system ended up being headline news.

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