Live data from Hacker News

The US spends more on healthcare for no gain says new report from Johns Hopkins

jhsph.edu

31–40 of 537 posts

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#31
post #26

Earlier quoted context omitted.

I’m not sure what kind of R&D the $800 or whatever it costs now Epipen is paying for. R&D for lobbyists? Or profits because the company gamed the market.

I don't understand your point. Obviously it's going toward R&D of new drugs unrelated to the EpiPen. What does the price of an EpiPen have to do with how the money is spent?

Except the company that made EpiPen doesn't even make EpiPen anymore. Mylan bought the rights to make the drug in 2007, and then other companies bought it from Mylan. I forget who owns EpiPen now, but the current owner is very far removed from the original researchers who made that drug.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#32
post #26

Earlier quoted context omitted.

I’m not sure what kind of R&D the $800 or whatever it costs now Epipen is paying for. R&D for lobbyists? Or profits because the company gamed the market.

I don't understand your point. Obviously it's going toward R&D of new drugs unrelated to the EpiPen. What does the price of an EpiPen have to do with how the money is spent?

That's not how it works. You invest if it's worth investing, not if you just have the money laying around.

Paying a few billion dollars to a big pharma company is not going to make them invest more in research. They will instead pay the money out as dividends.

The goal of patents is to create incentives for future research, but if you change the rules by increasing the extent of EpiPen patents after the drug was created, where is the incentive?

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#33

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

Except that every company involved in the healthcare industry in America (drug companies, insurance companies, hospitals, etc.) make hundreds of billions (or trillions) in profit each and every year.

The reason for the high prices is because healthcare in the US is an extremely, extremely lucrative for-profit industry.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#34
I think it’s hard to compare these numbers across countries. For example, a richer country could choose to spend more on stuff that ultimately makes little difference in outcomes. For example, fewer people per hospital room or better hospital food or shorter wait times for a non threatening disease.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#35

Earlier quoted context omitted.

Meh -- If this is the case, it would be far better to explicitly fund research and development in a separate appropriation rather than just mindlessly subsidizing all prescription meds. Calamities like the Valeant fraud would be much less common without the US dramatically overpaying for drugs. https://www.newyorker.com/magazine/2016/04/04/inside-the-val...

The Valeant fraud was 90% sketchy accounting and 10% price hikes, more Enron than Martin Shkreli. By anyone's standard, they are not representative of the U.S. Pharma market as a whole.

Without the accounting fraud, they're not far off the US pharma market as a whole...

Teva is doing the same nonsense with generics, Turing did with their toxoplasmosis drug, Mallinckrodt bought Ofirmev then jacked up the price by several hundred percent, Allergan & Pfizer were trying to merge solely to tax advantage of Ireland's (and the US's) dumb IP/tax laws, GSK, Abbott, and J&J have all paid billion dollar settlements for their fraudulent marketing practices. Look at the PBMs that are suddenly worth billions of dollars purely by being middlemen between Pharma and Insurance companies.

There is so much obnoxious 'financialization' and tax optimization to justify share prices.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#36
post #26

Earlier quoted context omitted.

I’m not sure what kind of R&D the $800 or whatever it costs now Epipen is paying for. R&D for lobbyists? Or profits because the company gamed the market.

I don't understand your point. Obviously it's going toward R&D of new drugs unrelated to the EpiPen. What does the price of an EpiPen have to do with how the money is spent?

Mylan gross profit in Q1-Q3 2018 was $2.3 billion, and R&D expenses were $600 million [0].

If I'm reading this right (and I may well not be), there is a lot of money not accounted for by R&D expenses.

[0]: Nov 6, 2018. Mylan, NV. Quarterly Fillings. Accessed from http://investor.mylan.com/static-files/2909eb6c-4430-452e-94... via http://investor.mylan.com/financial-information/sec-filings

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#37

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

R&D only comes to about $500 per capita per year. That doesn’t amount to a significant fraction of Americans’ inflated costs.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#38
post #3

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

If this is in fact true it means the rest of the world is freeloading off the US system. Not saying I'm convinced it is true. I'd like to see a deeper unbiased analysis.

"In Europe, drug prices are set by governments, not by pharmaceutical companies the way they are in the U.S. On average, the difference between the price of one drug in the U.S. and the same drug in France, Germany, Italy, Spain and the U.K. was 50 percent, an analysis by the consulting firm McKinsey has found.

“U.S. consumers are in fact subsidizing other countries’ public health systems, at least with respect to drug pricing,” Jacob Sherkow, an associate professor at New York Law School, said."

https://www.ibtimes.com/how-us-subsidizes-cheap-drugs-europe...

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#40

I think it’s hard to compare these numbers across countries. For example, a richer country could choose to spend more on stuff that ultimately makes little difference in outcomes. For example, fewer people per hospital room or better hospital food or shorter wait times for a non threatening disease.

I'm not sure this holds up to scrutiny. Why don't other rich countries (e.g. Canada, which lets you pay for your own healthcare if you want) have this problem?
Post reply on HN