31–40 of 131 posts
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>Free samples to doctors are counted as a marketing expense at retail prices, not at marginal prices That doesn't sound like GAAP - is this proper accounting?
I don’t know if it’s proper accounting but there’s no way the marginal cost of producing drugs is high enough to cost as much in marketing costs as they do. > Between 1996 and 2000, they accounted for slightly more than half of the total promotional dollars spent by industry [22]. Although there is controversy about how best to tally the amount of money the pharmaceutical industry spends on free samples, a recent ana…
The answer will always be, "more expensive than they are now". It's not like there will ever be a point at which more money, if available, could not in any way be used for some kind of drug research that might be useful. It's like saying "how much money do you need in order to keep from ever dying?" There will always be health problems, and there will always be some at least semi-plausible way in which we could spend…
https://www.nytimes.com/2009/07/19/magazine/19healthcare-t.h... "Why We Must Ration Health Care" by Peter Singer. New York Times Opinion Section. Unfortunately this is a very difficult conversation to have between people and their physicians, between family members, and with ourselves. It ties into another very difficult discussion of facing death. In a democracy the lowest common denominator argument wins out with c…
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> drug companies spend more money on marketing drugs than researching them Free samples to doctors are counted as a marketing expense at retail prices, not at marginal prices > drug companies waste much of their research on copycat drugs rather than new treatments Marginal improvements are actually a huge deal and make for a lot of improvement. Because of our astonishing ignorance doctors will often go through multip…
> Marginal improvements are actually a huge deal and make for a lot of improvement. The problem is that these decisions are made on a marketability basis (hence, a plethora of impotence treatments for rich old men) rather than a public health basis. > If they don’t pay then either the pace of drug R&D will fall or some other mechanism will need to be found to pay for it. When you hear about it, the concept of public…
My preferred system of public funding would be one where the government buys out a patent and places it in the public domain or a prize system. The government would estimate the value to it (or to its citizens) of curing or alleviating some disease, with some objectively verifiable success criteria and then offer a prize of, say 0.7 that amount.
You get the good parts of private enterprise, like experimentation, knowledge elicitation and market coordination. You also avoid the bad parts of government provision, like endless bureaucracy, form filling and the legendary efficiency of Lockheed Martin. If government pharmaceutical research worked well we'd know. The Soviets developed a different psychiatric pharmacopeia and phages and the Chinese found artemisin but it’s not a great record compared to the West.
Fundamentally someone has to pay for this. Right now its the US consumer. If you want to put that cost onto the budget good luck in politics, whether you’re talking about the US budget, the German one or the Chinese.
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>Free samples to doctors are counted as a marketing expense at retail prices, not at marginal prices That doesn't sound like GAAP - is this proper accounting?
Yeah, I'm not a pharmaceutical, but I have a side hustle of sorts. When I give something away, I'm only allowed to deduct the marginal cost.
Any sufficiently large corporation is more likely than not to be an amalgamation of interconnected subsidiaries, for a wide variety of purposes. Once you're at that stage, there's a lot of room to get creative with how you structure intra-company charges to form whatever optics you want. It's entirely plausible that one internal entity may charge the marketing entity full retail price for samples, if they feel it's beneficial and have enough justification to satisfy accounting and auditors that it's a fair market value for the product (which list price would generally satisfy that requirement).
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The research part of R&D is publicly funded, the development part isn’t, and it’s very, very expensive. On average about a billion dollars.
The “for the public good” part is what’s missing in that setup
Deng Xiaoping
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The “for the public good” part is what’s missing in that setup
No matter if it is a white cat or a black cat; as long as it can catch mice, it is a good cat. Deng Xiaoping
Given how many people go bankrupt for drugs, and how much high drug prices distort the economics of healthcare overall, id argue our current setup is not catching mice.
A good alternative would be Public investment in healthcare to add fluidity to the labor market, and to prevent a single sectors profiteering from dragging down overall economic growth.
The answer will always be, "more expensive than they are now". It's not like there will ever be a point at which more money, if available, could not in any way be used for some kind of drug research that might be useful. It's like saying "how much money do you need in order to keep from ever dying?" There will always be health problems, and there will always be some at least semi-plausible way in which we could spend…
https://www.nytimes.com/2009/07/19/magazine/19healthcare-t.h... "Why We Must Ration Health Care" by Peter Singer. New York Times Opinion Section. Unfortunately this is a very difficult conversation to have between people and their physicians, between family members, and with ourselves. It ties into another very difficult discussion of facing death. In a democracy the lowest common denominator argument wins out with c…
If you need joint replacement surgery in Canada, you can expect a wait of many months to years. Canada has made the call that they will put a certain dollar amount into joint replacement and if the demand is higher, then people will just have to wait.
Same thing with the latest and greatest drugs. Some countries just say "no".
If you want an affordable healthcare system in the US, then rationing has to be a part of the equation. As others have pointed out, we already ration in the US, but trustfully, if you have good insurance, you'll get very good care in the US. The question is whether all that extra care is actually producing better outcomes.
Earlier quoted context omitted.
https://www.nytimes.com/2009/07/19/magazine/19healthcare-t.h... "Why We Must Ration Health Care" by Peter Singer. New York Times Opinion Section. Unfortunately this is a very difficult conversation to have between people and their physicians, between family members, and with ourselves. It ties into another very difficult discussion of facing death. In a democracy the lowest common denominator argument wins out with c…
When people always ask "how come healthcare is so much more affordable in countries outside the US?", the correct answer is rationing. If you need joint replacement surgery in Canada, you can expect a wait of many months to years. Canada has made the call that they will put a certain dollar amount into joint replacement and if the demand is higher, then people will just have to wait. Same thing with the latest and gr…