More generics isn't really the solution. The US actually has more generic prescriptions as a percent of total prescriptions than most developed countries and US spend on drugs as % of healthcare spend is similar to other OECD countries. The cost comes from high priced innovative meds. They are high priced bc they are expensive to develop -- $2.7b to get a drug approved per most accepted estimate. Most of that is cost of failure. So the issue is if we cut those prices we stop innovation. R&d in most disease areas has already slowed dramatically bc it's too expensive / risky
The Best Fix for American Drug Prices Is Already on the Books
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Re: The Best Fix for American Drug Prices Is Already on the Books
#22Here’s the rub with developing something as important as a medicine. If it works, people often _need_ it to prolong their life or improve their health. What drug companies are selling... isn’t like what other companies are selling. We ought not look at it through our normal understanding of goods in a free market. Take, for example, Sovaldi, a drug which cures Hepatits C. After discovering this drug and confirming it…
Medicaid should consider medical tourism. Sure it’s absurd to have to ship patients halfway around the world to literally take some medicine but it would be cost effective...
Re: The Best Fix for American Drug Prices Is Already on the Books
#23Here’s the rub with developing something as important as a medicine. If it works, people often _need_ it to prolong their life or improve their health. What drug companies are selling... isn’t like what other companies are selling. We ought not look at it through our normal understanding of goods in a free market. Take, for example, Sovaldi, a drug which cures Hepatits C. After discovering this drug and confirming it…
One possible solution: have the government buy the rights for cost + some preset mark up. Then make it a government program to produce and transmit. Could earn some serious well wishing abroad by making it available for cost/free for developing nations. That’s how to lead the world.
Re: The Best Fix for American Drug Prices Is Already on the Books
#24One of the biggest reasons is that the US essentially subsidizes drugs for many other countries, such as Canada, that impose price controls, and threaten to allow other manufacturers to provide the drugs in their countries if the companies don't accept the imposed price. This enables these countries to get access to new medicine without paying the cost of developing the new medicine. Its time to end the trade war on…
Assuming that's true do you think that removing other countries ability to bulk purchase drugs would cause the prices in the US to actually drop?
Also given a capitalistic marketplace you'd think US drug consumers would also band together to bulk purchase and drive down the rates. You'd be crazy to make a law to prevent that kind of thing.
Re: The Best Fix for American Drug Prices Is Already on the Books
#25Here’s the rub with developing something as important as a medicine. If it works, people often _need_ it to prolong their life or improve their health. What drug companies are selling... isn’t like what other companies are selling. We ought not look at it through our normal understanding of goods in a free market. Take, for example, Sovaldi, a drug which cures Hepatits C. After discovering this drug and confirming it…
> If it works, people often _need_ it to prolong their life or improve their health. What drug companies are selling... isn’t like what other companies are selling.
It is very much like many other products. If you don't have food you will die of starvation, if you don't have shelter you will die of exposure, etc.
The real issue is drug patents. Nobody is complaining about the price of ibuprofen any more than they complain about the price of eggs. But the patent system is doing what it's supposed to here -- twenty years ago any patented drug didn't exist, and it nominally only exists now because the inventors judged it to be sufficiently profitable to conduct the research. If you make it less profitable, you'll get less research.
There is no drug research fairy. If you don't want the money to come from high insurance premiums that pay for high drug costs, it has to come from somewhere else. And just devising some other method (like taxes) of extracting the same money from the same general public isn't really going to change much.
Re: The Best Fix for American Drug Prices Is Already on the Books
#26One of the biggest reasons is that the US essentially subsidizes drugs for many other countries, such as Canada, that impose price controls, and threaten to allow other manufacturers to provide the drugs in their countries if the companies don't accept the imposed price. This enables these countries to get access to new medicine without paying the cost of developing the new medicine. Its time to end the trade war on…
This argument always strikes me as kind of odd. As far as I can tell, it boils down to "other countries like Canada are better negotiators than us, and our companies give them better prices." But if that's the case, it just seems like really good evidence that squeezing drug companies and making aggressive demands drives down drug costs and encourages them to move R&D costs out of the country. Why wouldn't the US be…
I think the argument is that the drugs would simply not be developed at all. Personally I'm inclined to call the bluff as it's not clear that the profit motive has led to the most effective drug development—there's a huge sales culture in pharmaceuticals that incentivizes prescription drugs beyond the balance that doctors and patients would naturally arrive at.
Re: The Best Fix for American Drug Prices Is Already on the Books
#27I would suggest anyone who is interested in reducing drug prices listen to this econtalk episode with Robin Feldman[0]. They discuss her book "Drug Wars how big pharma raises prices and keeps generics off the market"[1]
In the episode they discuss all sorts of shenanigans that pharmaceutical companies pull. If you want real reform you need to look at weak patents, eliminating "reverse payments" to generic companies, and obstruction to bioequivalence testing. Drug companies routinely manipulate the current laws, specifically Hatch-Waxman in order to stifle competition from generics.
[0] http://www.econtalk.org/archives/2017/06/robin_feldman_o.htm...
[1] https://www.amazon.com/Drug-Wars-Pharma-Raises-Generics/dp/1...
Re: The Best Fix for American Drug Prices Is Already on the Books
#28Here’s the rub with developing something as important as a medicine. If it works, people often _need_ it to prolong their life or improve their health. What drug companies are selling... isn’t like what other companies are selling. We ought not look at it through our normal understanding of goods in a free market. Take, for example, Sovaldi, a drug which cures Hepatits C. After discovering this drug and confirming it…
> If it works, people often _need_ it to prolong their life or improve their health. What drug companies are selling... isn’t like what other companies are selling. It is very much like many other products. If you don't have food you will die of starvation, if you don't have shelter you will die of exposure, etc. The real issue is drug patents. Nobody is complaining about the price of ibuprofen any more than they com…
Pharmaceutical R&D spending isn’t all that high. It’s around $300 per capita in the US. The money is not coming from high insurance premiums.
Re: The Best Fix for American Drug Prices Is Already on the Books
#29Crazy idea: all pharmaceutical research should be publicly funded and publicly-owned. No private ownership of drug patents, period. "But this will disincentive research!" Maybe. Or, tax people more in order to fund the research. The tax revenue would go directly to researcher salary, equipment, expenses. Even a large tax increase can't be worse than today, where people have to pay huge $$$ anyway, of which a large cu…
It’s clearly a market where large expenses are required to make progress. I’m thinking the discoveries should be made public goods through rewarding breakthroughs somehow. Or, devote some fraction of the National gdp to research. We’re talking at least the amount the market currently allocates, but preferably more.
Re: The Best Fix for American Drug Prices Is Already on the Books
#30Here’s the rub with developing something as important as a medicine. If it works, people often _need_ it to prolong their life or improve their health. What drug companies are selling... isn’t like what other companies are selling. We ought not look at it through our normal understanding of goods in a free market. Take, for example, Sovaldi, a drug which cures Hepatits C. After discovering this drug and confirming it…
My coworker's dad had this happen to him. He got Hep C through a blood transfusion for a routine surgery. The insurance company waited until he was almost dead before starting the treatment. Now his liver is in such bad shape that if he has any alcohol it will kill him. Ridiculous, especially since they were going to pay for it anyway.
Doctors should be the ones making the medical decisions, not the faceless employees working with spreadsheets at insurance companies. Our system is backwards and needs to be overhauled.