I saw a show earlier this week, an insulin shot costs 2$ in rest of the world and 100+$ in the US.
Isn't this loot?
How expensive do prescription drugs need to be to fund research?
51–60 of 131 posts
Re: How expensive do prescription drugs need to be to fund research?
#52Earlier quoted context omitted.
The idea that development is not publicly funded is a myth. Regulators define every step, put in a good deal of the money, and do a lot of the organizing. A lot of the rest is done in coordination with researchers at hospitals and universities that are often publicly funded. As with most large industry involved research efforts, the government and academia are heavily involved in the effort. Only the profit is privat…
If your model of the pharmaceutical industry were true they would have very, very high profit margins. They don’t. Privatised profit and socialised losses is a great way of making an individual profit but the pharmaceutical industry is not politically connected enough to do that. https://www.forbes.com/sites/johnlamattina/2018/01/23/about-... > The average return on equity for key industries from 2014 – 2016 shows th…
This is an industry that has had 15-20% returns for decades. I'm not sure what "computer sciences" is as an industry separate from the rest of software, but saying there are some sectors more profitable than pharma says not much. Pharma is huge as a fraction of GDP and consistently profitable because its profit is based on rents. If it is flagging in recent years it is because public sector spending on research is flagging and hasn't yielded as many cash cows as usual.
Re: How expensive do prescription drugs need to be to fund research?
#53However expensive it is, it should cost the same in all markets globally, whether it's being purchased by a patient in cash, by an NGO, by a state Healthcare system, or by an insurance company. I'm tired of paying a five hundred percent markup to subsidize markets thousands of miles away.
Really? So a country with a per capita income of $5,000 should pay the same as what a country with a $50,000 per capita income? That would be a terrible outcome.
You should extend this line of reasoning to other goods. Pay 10x for your food, too, so someone else could get theirs for less. Pay $50 per gallon of gas, stuff like that.
The op's POV might seem cruel, but only if you're in an ivory tower. There are _plenty_ of people right here in the US who can't afford drugs because we insist that they should be 10x the price in the US than everywhere else.
In fact, I'd say those people comprise a _majority_ of US healthcare consumers, due to just how unequal the incomes are.
There's also another negative side effect: due to what amounts to dumping, other countries essentially don't have any pharma research of their own, likely because it wouldn't be profitable. That includes pretty much all of them other than Switzerland (where both the health insurance and drugs are pretty expensive).
Re: How expensive do prescription drugs need to be to fund research?
#54Earlier quoted context omitted.
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…
Rationing also makes some outcomes summarily worse. If you have a relatively minor problem, you're put in a line. For months (or years) of waiting, your problem becomes worse, and when you finally get to be treated, the treatment is much costlier and less effective. This is to say nothing about your actual suffering from the problem, and from knowing that it's deliberately not being treated.
Joint replacement waiting a few months likely won't cause that much harm. I mean it can but it's statistical probably justified. And in fact it's guaranteed that these systems are trying to balance that.
Re: How expensive do prescription drugs need to be to fund research?
#55Earlier quoted context omitted.
I don't think that is true at all, it is very clear that identical procedures and materials cost less in other countries.
Price caps play a role, but rationing plays an even bigger role. Google search for the McKinsey paper on US healthcare costs. The volume of outpatient procedures in the US is quite shocking compared to other countries. Yes, things cost more in the US, but the volume is also quite a lot higher.
Interesting about the volume being higher. In most logistical systems that would drive avg price down.
Re: How expensive do prescription drugs need to be to fund research?
#56Earlier quoted context omitted.
> 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…
Racism and ageism aside I agree with you, but I have serious concerns about any but incremental changes to the system we have, since it works. There’s lots and lots of drug development and we get new and better treatments every year. 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…
> Racism
?????
> bad parts of government... Lockheed Martin
????
What you say is absolute FUD. The US already has publicly funded biomedical research, which works fine (the NIH). Just needs to do it all that way and put all the research into the public domain.
> 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.
Weak argument. The US consumer is already being ripped off by drug and insurance companies, and would save money from a public system.
Re: How expensive do prescription drugs need to be to fund research?
#57Earlier 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…
It's not only rationing care. In these other countries doctors earn a lot less than they do in the US, particularly specialists. They still make a good living though (excepting perhaps Cuba). Also administrative costs are lower and when insurance companies exist they're generally not allowed to make a profit on basic coverage, or they're not allowed to deny claims and must pay on a price schedule fixed by the government. Some of these policies can lead to shortages (i.e. if you pay doctors too little, you'll get fewer doctors), but there seems to be a middle ground that other countries have gotten closer to than the U.S.
Re: How expensive do prescription drugs need to be to fund research?
#58Earlier quoted context omitted.
Yeah, no. Regulators put no money into it other than what it costs to fund it's own regulatory process. And, under PDUFA, drug manufactures pay >$1M to fund the review of their drug. It's paid for by industry. Yes, clinical trials are often run by hospitals and universities, but manufacturers pay for everything. Drugs, people, etc. And you forgot to mention that failures are privatized too. Spend $500M on a trial tha…
It's the public's money, since the only reason that the investors have that money is they are given patent monopolies that allow them to take in 1.5% of GDP in rents every year.
And my house is a public good, since the only reason it's not being vandalized/robbed/burnt down is that the public spends x.y% of the GDP on law enforcement
Re: How expensive do prescription drugs need to be to fund research?
#59Earlier quoted context omitted.
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…
Rationing also makes some outcomes summarily worse. If you have a relatively minor problem, you're put in a line. For months (or years) of waiting, your problem becomes worse, and when you finally get to be treated, the treatment is much costlier and less effective. This is to say nothing about your actual suffering from the problem, and from knowing that it's deliberately not being treated.
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Re: How expensive do prescription drugs need to be to fund research?
#60This is such a complicated issue, I'd highly recommend the following as a primer: https://www.forbes.com/sites/matthewherper/2015/10/13/four-r... Also Derek Lowe is invariably awesome in this space, one highlight: https://blogs.sciencemag.org/pipeline/archives/2019/02/05/ta... Drugs occasionally need to be expensive, particularly on-patent drugs, to make the endeavor worthwhile. That said, it's a two-way street. Maki…
> With abusive practices like this, how can you ask patients to trust you when you say, "yes but this time I actually need it to be this high"?
I think part of the problem is that it's not the same people. Some companies are pursuing aggressive price gouging tactics, and others are legitimately charging a lot of money for something that either costs a lot to make or that they invested a lot of research dollars in.