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How expensive do prescription drugs need to be to fund research?

theatlantic.com

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Re: How expensive do prescription drugs need to be to fund research?

#101

Post by scotty79 »

naasking wrote: post #83
scotty79 wrote: post #74

When the question is stated like that it becomes really questionable whether cost of drugs should have anything to do with drug research cost. Those two things look like they should be completely separate, done by separate entities with separate funding.

Should the cost of CPUs be separate from the cost of CPU research? I understand it seems distasteful to place a cost on health and life, but isn't that just a reality? Everything has a cost. As long as the cost of drugs were reasonable , we wouldn't need to have these conversations.

> Should the cost of CPUs be separate from the cost of CPU research?

Maybe not now when researching CPUs is fairly easy. But a century in the future? When faster CPUs will be very hard to invent but essential to human survival? Maybe.

Business is great at researching processes of manufacturing. Not so good when it comes to researching actually new stuff.

> As long as the cost of drugs were reasonable, we wouldn't need to have these conversations.

But they must become unreasonable at some point if they cost as much as the incentive for research for companies. Companies are most risk-averse entities in existence. It's not unexpected that they need unreasonably high incentives to take up the risk of doing research.

Re: How expensive do prescription drugs need to be to fund research?

#103

Post by astazangasta »

credit_guy wrote: post #58
astazangasta wrote: post #50

Earlier quoted context omitted.

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

Your house, if it is like mine, is a lot more reasonably a public good than it is "private property". I didnt build this thing, will "own" it for probably 5% of its existence and do little to maintain it myself. Yeah, you are right. We owe a lot more to the "public" than we usually acknowledge.

Re: How expensive do prescription drugs need to be to fund research?

#105

Post by testpostpls »

ergothus wrote: post #100
Nf508 wrote: post #64

Interestingly in the case of the the Abiraterone example used in the article, none of the R&D was even done by JNJ. The original work was done at The Institute of Cancer Research, an academic/charity drug discovery institute. JNJ actually only market this drug because of acquisitions rather than R&D efforts. Which is the way that a lot of pharma is going these days, letting smaller biotechs take the high risk of deve…

As others have said, you cant ignore the purchase price of the research, and the buyer has that because they sell high priced drugs ...that said, it makes a good point about how the incentives work. If the govt did Xprize-like rewards for medical goals, it would work similarly: you stop paying for failed research and only pay for success, just like the examples you cite. All told, I think too many electrons are spill…

I don’t quite understand your point about govt-funded Xprize-like rewards—who is paying for failed research under such a regime? Is a govt-provided IP monopoly not itself an “Xprize-like reward?”

Re: How expensive do prescription drugs need to be to fund research?

#106

Post by danaris »

stevenwoo wrote: post #10
berbec wrote: post #9

Earlier quoted context omitted.

I never understood the change in US law allowing direct-to-consumer advertising of prescription-only medication. Doctors are told not to write scripts to family, friends and themselves, so how the hell can I make an informed decision about my cancer treatment using a 30 second infomercial?

Doesn't this boil down to Citizens United - if corporations are allowed to use money as they see fit because money is roughly equivalent to free speech then all three branches of government are responding to the entities with the most of it - in this case big pharma.

Citizens United wasn't the decision equating money with speech. I don't know offhand which that was, but it was much earlier.

IIRC, Citizens United was the decision that allowed much more and much more opaque spending on political campaigns by corporations and wealthy individuals—it allowed the creation of SuperPACs, for instance.

Re: How expensive do prescription drugs need to be to fund research?

#107

Post by testpostpls »

ljcn wrote: post #69
thatoneuser wrote: post #55

Earlier quoted context omitted.

Interesting about the volume being higher. In most logistical systems that would drive avg price down.

Perhaps the total volume is higher, but this doesn't lead to downwards price pressure since there are many small(ish) buyers. The opposite is often said for the NHS in the UK - certainly a smaller buyer than the US aggregate, but maybe a larger player than any one of them?

Blue Cross Blue Shield buys for 100 million patients. How much bigger does it need to get to save money?

Re: How expensive do prescription drugs need to be to fund research?

#108

Post by DanBC »

refurb wrote: post #48
shkkmo wrote: post #40

Earlier 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.

In your parent post you mention outcomes, and that's a really important thing you're missing when you talk about "rationing".

If a scan is more likely to cause harm than to treat illness is it really being rationed, or do single payer systems have an easier time not providing harmful over-testing and over-treatment options?

Re: How expensive do prescription drugs need to be to fund research?

#109

Post by vonmoltke »

thewhitetulip wrote: post #51

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?

> I saw a show earlier this week, an insulin shot costs 2$ in rest of the world and 100+$ in the US.

"Insulin" is not a singular thing. For various reasons, lower-cost insulins are difficult to impossible to find in the US, which is a problem.

Also, some insulins are $2/dose in some parts of the world. Most insulins in the developed world are significantly more expensive than that (to whomever is paying for it), though still significantly less than what they cost in the US.

Re: How expensive do prescription drugs need to be to fund research?

#110

Post by vonmoltke »

kingkawn wrote: post #62
refurb wrote: post #45

Earlier quoted context omitted.

Drug costs are ~10% of all healthcare spending in the US. Even if the gov't created all the drugs and made them "free", we'd still be spending double the next closest developed country. Drug spending might be very visible to the public, but it's not a major contributor to healthcare costs.

Last I saw healthcare accounts for just under 20% of the US GDP. So then we’re talking about a market that’s just under 2% of the GDP if your 10% number holds. At these scales nothing is trivial.

It's trivial with respect to moving the needle on the overall problem, particularly since that number needs to be broken down by how much is spent on really expensive drugs versus how much is spent on affordable, generic maintenance medications.
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