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Fed Up with Drug Companies, Hospitals Decide to Start Their Own

nytimes.com

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Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#191

Post by yequalsx »

roadnottaken wrote: post #188
steiger wrote: post #182

Earlier quoted context omitted.

I live in Brazil and generics for drugs which patents are expired are widely available, accounting for 30~40% of all drug market. If I'm not mistaken, we even broke patents in some cases (HIV drugs), which is cool.

Why is that cool? Intellectual property law is necessary for industries like Pharma. No IP, no new drugs.

The people who do the actual discovery are not paid an exorbitant amount of money. They mostly just want to do research and solve problems while living a comfortable life. A pharma company making billions in profit isn’t necessary. It’s just the common way it currently is done. There are other ways to accomplish the same goal. We could try to replicate Jonas Salks’ way Of doing things.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#192

Post by thousandautumns »

GeekyBear wrote: post #179
mft_ wrote: post #165

Earlier quoted context omitted.

Assuming you're referring to the general development and supply of all drugs (in particular new drugs, as well as generics) the simple answer is that the process of discovering and developing new drugs is both high-risk and also heinously expensive. As such, whoever approaches it needs to have many billions to spend and --very likely-- lose. The current capitalist Pharma model has developed to suit: investors in Phar…

Research from the Pew Charitable Trusts shows that in 2012 alone 27 Billion dollars was spent by US Pharmaceutical companies to promote their drugs to doctors and patients. http://www.pewtrusts.org/en/research-and-analysis/fact-sheet... This is money that could have been spent on R&D instead of advertising if we moved to a non-profit pharmaceuticals model.

That's an incredibly naive take and one that completely fails to understand the realities of the economics of drug development.

Considering that in 2010, Forbes estimated that the cost of bringing a single drug to market, was between $4-11 billion dollars, you are buying between 2-6 extra drugs per year.

(https://www.forbes.com/sites/matthewherper/2012/02/10/the-tr...)

But that fails to account for the fact that the number of drugs doctors and patients have to choose from currently is staggering, and both groups have proven hesitant to switch to new therapies, and so by not advertising new drugs, the amount of money that can be made dramatically decreases, which further impacts the ability for pharma companies to invest in R&D.

No one thinks it is ludicrous for Google or Apple to throw as much money as they do at marketing. Its capitalism, and if you have a problem with it fine, but it isn't evil for pharma companies to work under the same model that every other industry on the planet has and which has been the driving force of the planet for the last several centuries.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#193

Post by thousandautumns »

siquick wrote: post #113
shykes wrote: post #86

This article makes it seem like drug companies alone are responsible for predatory pricing in US healthcare, with hospitals being somehow on the consumer's side of the issue. In reality US hospitals are just as guilty of predatory behavior. If they do achieve lower costs through a new generics company, I do not trust them one bit to pass on the savings to patients. Why would they?

> If they do achieve lower costs through a new generics company, I do not trust them one bit to pass on the savings to patients. Why would they? As a non-American (UK and Australia citizen) it bewilders me that this is considered a possibility. Why are hospitals doing the opposite to offering the best care possible to all citizens? Are they for-profit in the US?

American hospitals do offer the best care possible to patients. Thats actually the problem. Much has been made recently of the tendency of hospitals (in the US) to overdiagnose/overtreat patients, which is driving up the overall cost of healthcare. In other countries like the UK, I think that there is more caution regarding prescribing costly, unnecessary procedures. The result is that, yes, the actual healthcare is probably better than anywhere in the world, but the additional quality compared to countries like the UK or Australia is marginal considering the added cost, which for anyone with bad/no insurance, is insurmountable.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#194

Post by wu-ikkyu »

roadnottaken wrote: post #188
steiger wrote: post #182

Earlier quoted context omitted.

I live in Brazil and generics for drugs which patents are expired are widely available, accounting for 30~40% of all drug market. If I'm not mistaken, we even broke patents in some cases (HIV drugs), which is cool.

Why is that cool? Intellectual property law is necessary for industries like Pharma. No IP, no new drugs.

>No IP, no new drugs

Maximizing profits for shareholders is not the only motivation that we as humans have for creating life saving medicines. There are countless examples throughout history of new drugs being invented without IP laws. This is akin to how advertisers say the internet wouldn't exist without them.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#195

Post by mannykannot »

indescions_2018 wrote: post #61

I always assumed it would be CVS that got into the game. There are are probably a dozen or so drugs that account for the majority of consumption. Flu vaccines, blood pressure, cholesterol, thyroid, insulin, asthma, progesterone, beta-blockers, gerd, etc. Providing these at minimum cost, as well as community public health services. Could be enormously cost effective. And extend general wellness and productivity many t…

I would not think that CVS, as a retailer, has much incentive - it is not paying the cost of the branded drugs. It is the insurance companies that I half-expected to make this move, unless there are anti-trust issues, or specific legislation (bought by the drug companies) to prevent them from doing so.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#196

Post by roadnottaken »

yequalsx wrote: post #191
roadnottaken wrote: post #188

Earlier quoted context omitted.

Why is that cool? Intellectual property law is necessary for industries like Pharma. No IP, no new drugs.

The people who do the actual discovery are not paid an exorbitant amount of money. They mostly just want to do research and solve problems while living a comfortable life. A pharma company making billions in profit isn’t necessary. It’s just the common way it currently is done. There are other ways to accomplish the same goal. We could try to replicate Jonas Salks’ way Of doing things.

I work in drug discovery. You're right that the bench-scientists don't usually get rich. But it's an extraordinarily risky, expensive, and unpredictable business and for every billion dollar drug there's a graveyard of failed companies and projects that didn't make it. The only business reason to take those risks are for a chance at patent-protected profit. And those bench scientists wouldn't have labs to work in if investors and rich companies weren't willing to pay for it.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#197

Post by thousandautumns »

A lot of people here seem to conflate the pharmaceutical companies causing the issue with the entire pharmaceutical industry. Even in the article, the hospital reps say they are specifically targeting the handful of bad actors, like Valeant Pharmaceuticals and Martin Shkreli types, who specialize in buying up cheap/old drugs and jacking up the prices. This is not a group of hospitals trying to take on the entire industry. Nor is it an entire industry taking advantage of hospitals/patients.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#198

Post by pmyteh »

jonlucc wrote: post #185
GeekyBear wrote: post #179

Earlier quoted context omitted.

Research from the Pew Charitable Trusts shows that in 2012 alone 27 Billion dollars was spent by US Pharmaceutical companies to promote their drugs to doctors and patients. http://www.pewtrusts.org/en/research-and-analysis/fact-sheet... This is money that could have been spent on R&D instead of advertising if we moved to a non-profit pharmaceuticals model.

Pharma researcher here (on the early science side, not market research or that kind of thing) I think people vastly overestimate their physicians' ability to stay on top of newly published research, and that includes new drugs' safety and efficacy profiles. If I want the stuff I work on to reach patients (and I do), then I want doctors to know about it. In the absence of pharma marketing dollars aimed at doctors and…

In Britain, we rely more on guidance from the National Institute for Health and Care Excellence (NICE). It does comparative reviews to make recommendations on the most suitable drugs to use.

Motivation is primarily to restrict crazy-expensive drugs to those situations where they're actually going to represent value for (the public's) money, but also to point clinicians towards new approaches which can improve the quality of treatment.

So hugely expensive advertising towards physicians is not the only way to do it.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#199

Post by jonlucc »

pmyteh wrote: post #198
jonlucc wrote: post #185

Earlier quoted context omitted.

Pharma researcher here (on the early science side, not market research or that kind of thing) I think people vastly overestimate their physicians' ability to stay on top of newly published research, and that includes new drugs' safety and efficacy profiles. If I want the stuff I work on to reach patients (and I do), then I want doctors to know about it. In the absence of pharma marketing dollars aimed at doctors and…

In Britain, we rely more on guidance from the National Institute for Health and Care Excellence (NICE). It does comparative reviews to make recommendations on the most suitable drugs to use. Motivation is primarily to restrict crazy-expensive drugs to those situations where they're actually going to represent value for (the public's) money, but also to point clinicians towards new approaches which can improve the qua…

That sounds like a fantastic resource that I can not imagine passing in the United States any time soon. Is it funded along with the rest of the NHS?

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#200

Post by gremlinsinc »

mmanfrin wrote: post #136
jopsen wrote: post #133

Earlier quoted context omitted.

> The drug companies will contract with a generic company that never, actually gets to production (wink, wink). Sounds like I should setup shop as "generic drug company" and land me one of those contracts where I promise to never reach market :)

Finally, a career fitted to my sharp ability to never follow through on goals.

Sounds like a good career move for Bighead (Silicon Valley)
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