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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

#111

Post by mikeash »

rayiner wrote: post #61
mikeash wrote: post #50

Earlier quoted context omitted.

I don’t understand how comparing it to the GDP of small foreign countries adds context. The important context is what I stated: it’s about $300 per person. That means that it’s a very small portion of our ~$10,000/year per capita health care expenditures. Anyone who knows how much their health insurance costs per year can immediately see how much of that funds their share of pharma R&D. The answer will almost always…

Pharmaceutical expenditures are about $1,000 per capita. Turning $1,000 of revenue into $300 in R&D compares very favorably to other tech industries.

I’m not sure how that’s related. My point is that pharma R&D is not a significant cause of high insurance premiums or high health care costs in general.

Re: The Best Fix for American Drug Prices Is Already on the Books

#112

Post by rayiner »

khazhoux wrote: post #19

Crazy 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 a huge flaw in thinking to assume that the money is going to “senior executives.” There are a thousand employees making $150,000 (costing the company $150 million) for every “senior executive” making $15 million. (This is, by the way, true at most companies. Apple computers wouldn’t be cheaper if you cut “senior executive” salaries.)

Re: The Best Fix for American Drug Prices Is Already on the Books

#113

Post by rayiner »

danShumway wrote: post #64
jandrewrogers wrote: post #51

Earlier quoted context omitted.

The reality is that governments have demonstrated limited interest in effective biomedical R&D. Europe does not invest proportional to their population or economy, their governments are happy to outsource it to the US (and Asian) private sector. And there is the longstanding issue that what governments do fund is biased by political fashion and not the areas of research that will maximize benefit. There has been a hu…

Many software developers do take massive pay cuts to make the world a better place. People like Linus Torvalds could be much, much wealthier if they wanted to. Jason Scott is probably the single most important digital archivist alive right now; he's currently running a podcast to help himself get out of debt while he works for a company that doesn't offer a pension plan. I'm not just talking about fringe developers e…

Don’t look at anecdotes, look at the numbers. How many brilliant Stanford graduates are going to work for the advertising industry every year instead of something that’ll make the world a better place? There is no correlation between brilliance and altruism.

Re: The Best Fix for American Drug Prices Is Already on the Books

#114

Post by rayiner »

khazhoux wrote: post #78
KKKKkkkk1 wrote: post #60

Earlier quoted context omitted.

Back when the HIV epidemic started, President Reagan and his administration took the view that HIV is a deserved punishment from god for homosexuality and promiscuity. Now what are the chances that that administration would have invested even $1 in developing drugs for AIDS? Do we want to live in that kind of world?

That's a singular example. And, that viewpoint eventually gave way.

It’s also a really glaring one, because so many people are affected and the private sector made such a huge improvement in the decades it took for public opinion to turn around.

I’d bet drugs for depression, sexually transmitted diseases like herpes, cervical cancer, etc., would be treated similarly.

Re: The Best Fix for American Drug Prices Is Already on the Books

#115

Post by throwaway84742 »

khazhoux wrote: post #19

Crazy 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…

This sounds like an excellent way to burn a trillion dollars with no tangible result. Government == money black hole, with very few exceptions.

Re: The Best Fix for American Drug Prices Is Already on the Books

#116

Post by EliRivers »

throwaway84742 wrote: post #115
khazhoux wrote: post #19

Crazy 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…

This sounds like an excellent way to burn a trillion dollars with no tangible result. Government == money black hole, with very few exceptions.

Aren't governments meant to be money holes? You put money in, you get governing out. They're not meant to be turning a profit.

Re: The Best Fix for American Drug Prices Is Already on the Books

#117

Post by refurb »

disordinary wrote: post #81
refurb wrote: post #74

Earlier quoted context omitted.

Surely though the best marketing is the effectiveness of the product, if it's a good product then doctors will prescribe it. That's true for very few physicians. The ones that are leaders in their field and do research know the ins and outs of new drugs, but your average doctor knows very little.

But, they all have access to knowledge bases and information and guidelines provided by the government.

That is true, but setting aside time to do research is a much bigger hurdle than taking 10-15 min to listen to someone give you the highlights.

And in case anyone was wondering, doctors are very skeptical of drug reps and always verify anything they say before believing it. But it gives them a starting point.

Re: The Best Fix for American Drug Prices Is Already on the Books

#118

Post by throwaway84742 »

EliRivers wrote: post #116
throwaway84742 wrote: post #115

Earlier quoted context omitted.

This sounds like an excellent way to burn a trillion dollars with no tangible result. Government == money black hole, with very few exceptions.

Aren't governments meant to be money holes? You put money in, you get governing out. They're not meant to be turning a profit.

They are also not meant to do R&D. For one thing they don’t pay market rate, so their access to top talent is non-existent. For another, there’s no accountability and no “fear of death”, since the government essentially can’t run out of money. Why try to use resources wisely if you can just tax people, or if that doesn’t work, print more money, and thereby tax their children and grandchildren. No, I’d much rather this risk was compartmentalized.

Another issue is, you’re de facto giving the rest of the world a free ride on US taxpayer largesse. Even better free ride than what they’re getting now: paying a dime on the dollar for newest genetic drugs without spending any money on their development. I’d go along with that in the poor countries like India, but I see no reason whatsoever why I should be paying 5-6x as much as some dude in Western Europe, all while he tries to lecture me about their “free” healthcare. I’d much rather I paid less and they paid the same as me.

Re: The Best Fix for American Drug Prices Is Already on the Books

#119

Post by refurb »

DomreiRoam wrote: post #110
refurb wrote: post #71

Earlier quoted context omitted.

So under your system, a drug for a super rare, low sales product would never get produced because no generic company wants to make it?

Under a pure market approach, if a drug is not profitable it will not be produced ans sold. If you have a rare disease, you would probably prefer a mixed approach like a mix public and private medical research.

There is a middle ground where it's profitable for one company to make a drug, but not profitable for two companies to do it.

Re: The Best Fix for American Drug Prices Is Already on the Books

#120

Post by refurb »

IneffablePigeon wrote: post #104
refurb wrote: post #68

Earlier quoted context omitted.

The pharmacist should do that, but they don't. I've done it before at a doctor. "Here is the latest drug!!". "Can we start with a generic?", "Sure". My co-pay just went from $50 per month to $5. I work with a lot of doctors, they don't think it's their job to save patients money. They'll do it if asked though.

I find that kind of astounding. In the UK you pay a flat fee per prescribed medication, and multiple times I've had doctors prescribe me larger amounts on my repeat prescriptions so that I have to pay the flat fee less often - completely unprompted by me.

Docs will do that in the US too sometimes, but one challenge is that the "fee" you owe with private insurance differs from plan to plan. Doctors can't track the hundreds of different plans, so they don't know if the more expensive branded drug will cost you $10 more per month or $100 more per month. If you share that info with your doctor they are more than happy to work with you.
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