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Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

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Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#21

Post by gizmo »

harryh wrote: post #15
gaius wrote: post #12

Earlier quoted context omitted.

If the pill retailed for $0.04 in the US could the R&D be recouped? Americans should feel good about high drug prices: that's your aid to the Third World right there. Not the most efficient technique but still better than not doing it at all.

While in general I agree with you that is not the case here. The drug's patent expired decades ago. The issue is that there is only 1 US manufacturer giving them pricing power. It's unclear to me why another drug manufacturer doesn't come in and undercut the price. This is what happens in most other industries. My gut suspects the arduous FDA approval process, but I have no real evidence for this hypothesis.

Because there is no price the competitor can charge that the original supplier can't match. There is no profit to be made, unless there is only a single manufacturer.

Also, it's difficult to acquire approval needed from the FDA to demonstrate the new drug is safe and equivalent to the already approved because the original producer won't cooperate and provide relevant samples to their competition so they can demonstrate equivalence.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#22

Post by bufferoverflow »

empath75 wrote: post #4

The answer is that our insurance and medical billing system is a complete tirefire and needs to be burned to the ground and replaced with something sane.

Typical socialist answer. Burn a working system to the ground, so everyone suffers equally. At the very least the current system allows poor countries to enjoy cheap excellent drugs, researched and paid for by the wealthy western countries.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#23

Post by dragonwriter »

notyourday wrote: post #5
nasmorn wrote: post #3

Earlier quoted context omitted.

I think the FDA will fight to your death for your right to safe medicine.

I'm baffled by the snark. Could someone please attempt to reconcile the following positions for me: 1. We need regulation of drugs/medicine/etc because we do not want some snake oil peddlers peddling arsenic as medicine? 2. Regulations prevent us from getting shit cheap! Baaaaa!

The reconciliation is that some countries have what appears to be perfectly adequate regulations to address #1, but much smaller effect of #2, suggesting that some aspect of the US regulatory environment is suboptimal.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#24

Post by jklein11 »

notyourday wrote: post #5
nasmorn wrote: post #3

Earlier quoted context omitted.

I think the FDA will fight to your death for your right to safe medicine.

I'm baffled by the snark. Could someone please attempt to reconcile the following positions for me: 1. We need regulation of drugs/medicine/etc because we do not want some snake oil peddlers peddling arsenic as medicine? 2. Regulations prevent us from getting shit cheap! Baaaaa!

I enjoy having the option of buying drugs that are covered by strict regulatory controls. I understand that there is a cost associated with this.

If I choose to forgo that cost and roll the dice that I am getting arsenic as medicine that should be my prerogative.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#25

Post by notyourday »

jsjohnst wrote: post #13
notyourday wrote: post #5

Earlier quoted context omitted.

I'm baffled by the snark. Could someone please attempt to reconcile the following positions for me: 1. We need regulation of drugs/medicine/etc because we do not want some snake oil peddlers peddling arsenic as medicine? 2. Regulations prevent us from getting shit cheap! Baaaaa!

I think you are jumping to a conclusion without having enough supporting evidence. Regulation on drugs didn’t suddenly get 8,000x more expensive for drug companies in the last few years. An alternative theory, which I can’t prove any more than you can prove yours, is that due to some pharmaceutical companies realizing they were leaving serious money on the table, they tried hiking prices. Once they realized there wou…

It contradicts basic economics. If you raise prices 8000x and I will go into competition with you and raise prices 7999x i.e. do what MCI did to ATT and Vizio did to Samsung.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#26

Post by gaius »

gizmo wrote: post #16
gaius wrote: post #12

Earlier quoted context omitted.

If the pill retailed for $0.04 in the US could the R&D be recouped? Americans should feel good about high drug prices: that's your aid to the Third World right there. Not the most efficient technique but still better than not doing it at all.

Albendazole was developed in 1975. The R&D cost has been recouped ages ago.

Presumably there is other R&D to be done on other drugs? Or is the company making $399.96 profit on every pill?

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#27

Post by notyourday »

jklein11 wrote: post #24
notyourday wrote: post #5

Earlier quoted context omitted.

I'm baffled by the snark. Could someone please attempt to reconcile the following positions for me: 1. We need regulation of drugs/medicine/etc because we do not want some snake oil peddlers peddling arsenic as medicine? 2. Regulations prevent us from getting shit cheap! Baaaaa!

I enjoy having the option of buying drugs that are covered by strict regulatory controls. I understand that there is a cost associated with this. If I choose to forgo that cost and roll the dice that I am getting arsenic as medicine that should be my prerogative.

And it is - you can import those drugs just fine. It simply means you have to jump through some hoops.

What we do not want as a society is that the guy on a corner stall that sells $4.00 USB chargers that may or may not explode sell a million pills to little old ladies which may or may not do what they are supposed to. This is the current societal contract.

[Edit:] Now I personally think we should live in the more Darwinian society and in my view we should allow dude on a corner sell pills just like he can sell chargers and should some benefit manager buy the pills from the corner dude from Nigeria without vetting the corner dude from Nigeria and his suppliers and therefore killing and maiming a few thousand old ladies, we should throw the book at the benefits manager and not the corner dude from Nigeria (who should be thrown a book based on fraud and not manslaughter) but that's just me.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#28

Post by throwaway2016a »

No mention that the average wage in Tanzania is $45 to $50 a month? As a proportion to wage it is actually more comparable than at first glance.

As a solution though, I think we need reciprocity between drug regulatory agencies and open up drug sales between countries that have reciprocity. For example, if a drug is approved for sale in Canada it should be purchasable by people in the US and visa versa. It would allow competition between regulatory agencies (which should in theory make them more efficient because they have to compete) and lower the cost of bringing a drug to market because you no longer need to get approval in as many countries. Which in theory should lower consumer costs.

Combine that with transparent pricing so that everyone knows what the costs are before they need to make a purchasing decision and we might be part way to a solution.

Re: Why a Pill That's 4 Cents in Tanzania Costs Up to $400 in the U.S

#30

Post by stuaxo »

gaius wrote: post #12
empath75 wrote: post #4

The answer is that our insurance and medical billing system is a complete tirefire and needs to be burned to the ground and replaced with something sane.

If the pill retailed for $0.04 in the US could the R&D be recouped? Americans should feel good about high drug prices: that's your aid to the Third World right there. Not the most efficient technique but still better than not doing it at all.

Ben Godacre's book Bad Pharma is pretty good.

He points out that a large % of this R&D cost is actually marketing.

A lot of R&D is also spent on taking existing drugs and subtly changing them so that a non-generic one can be launched.

So it's not as cut and dried as it seems.

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