Are these price tags inherent in the treatment itself, or is this a "bleeding edge prices" issue that will ultimately subside with time and patient volume?
Gene Therapy Was Hailed as a Revolution – Then Came the Bill
41–50 of 91 posts
Re: Gene Therapy Was Hailed as a Revolution – Then Came the Bill
#42Earlier quoted context omitted.
It's ethical, because as a society we need to look at the long term rather than any specific treatment. It's better for us if private investors invest money into lifesaving treatments, because it means that more of them will be available earlier to people. If investors go and invest in something else then nobody's getting the benefit of the medicine. Let's say we have a disease that kills 1000 people per year. Let's…
I mean if we're only looking at made up numbers anyway isn't the 3rd scenario preferable? Almost the same number of people died, but there was no 20 year long period where people were paying extortionate rates for a medicine, and it took 30 years before the diseases was effectively cured, as opposed to the 20 years it took before a government funded cure came along. You might even argue that the money saved by not ha…
It's preferable until it's your own head on chopping block.
Re: Gene Therapy Was Hailed as a Revolution – Then Came the Bill
#43Earlier quoted context omitted.
Playing devil's advocate: there may be an argument that such care would not have been developed without the free-market monetary incentive. (Maybe not; maybe it would have been developed thanks to some government-funded grant. The point is: it's worth understanding what's possible and impossible in our current system.)
I work for a government driven genome research company in the UK, there are many others like this across Europe. Gov funding isn't such a problem in Europe where healthcare is a government issue.
Could you link to drugs that you have developed and how much they cost?
Re: Gene Therapy Was Hailed as a Revolution – Then Came the Bill
#44Earlier quoted context omitted.
Or for insurance companies to form an association that comes up with policies that would benefit all of them if they all did them, and then requires all member companies to implement them. Not sure exactly what carrot or stick they could use to ensure that any remaining insurance companies have an incentive to join the association rather than trying to free-ride off what they're doing, but one might be able to come u…
This Wikipedia page might offer some ideas: https://en.wikipedia.org/wiki/Cartel
Or this one: https://en.wikipedia.org/wiki/Central_bank
Re: Gene Therapy Was Hailed as a Revolution – Then Came the Bill
#45Not to be too snarky but to the question in the article, “The question for health systems: how much are one-time therapies worth?”, you mean like vaccines? Presumably, it should cost a similar amount.
Good analogy.
To the article's point, there is currently a dynamic where long term/chronic prescriptions such as anti-depression drugs "win out" relative to antibiotics & vaccines, which have the same pricing issue. It's mitigated by the large out-of-patent portfolio and (especially for vaccines) the large potential volume, but the problem is there.
To some extent, this is a problem economist don't like. The pricing system shouldn't matter too much. If X has Y value and A cost, those (alongside competition, which should be driving price to A)... If the value/efficacy is identical, those are supposed to be the main determinates of price.
Non-academic pricers understand that these pricing paradigms are big determinates though, in practice. Membership vs pay-as-you-go. Software & updates vs SAAS. These change demand & pricing dynamics enormously.
A one-time pill, with measured effectiveness against depression on par with one-a-day alternatives is very unlikely to make as much money, in practice... blackboard reasoning be damned.
Re: Gene Therapy Was Hailed as a Revolution – Then Came the Bill
#46Earlier quoted context omitted.
I mean if we're only looking at made up numbers anyway isn't the 3rd scenario preferable? Almost the same number of people died, but there was no 20 year long period where people were paying extortionate rates for a medicine, and it took 30 years before the diseases was effectively cured, as opposed to the 20 years it took before a government funded cure came along. You might even argue that the money saved by not ha…
It's preferable until it's your own head on chopping block.
...and you also happen to have money.
Re: Gene Therapy Was Hailed as a Revolution – Then Came the Bill
#47Earlier quoted context omitted.
Parent is asking how it can be ethical to place such a large price tag on a lifesaving therapy if the materials themselves are cheap. It's one thing for AMD or Intel to recoup engineering costs with outlandish per-chip costs as compared to the cost of manufacturing itself. However, serious ethical questions about profit margins and recouping R&D appear once someone's life is directly tied to usage. That being said, o…
It's ethical, because as a society we need to look at the long term rather than any specific treatment. It's better for us if private investors invest money into lifesaving treatments, because it means that more of them will be available earlier to people. If investors go and invest in something else then nobody's getting the benefit of the medicine. Let's say we have a disease that kills 1000 people per year. Let's…
I like your comment, it explains a lot. It seems that the system was built the way, that makes a drug research to grow a pie, while in an ideal world where everyone is happy and everything is fair, drug research would shrink the pie: it is the goal of medicine to eliminate all diseases. It means, that all that system is working on self-destruction, but we allow them to get excessive profits now, to make it work.
There is only one detail I cannot understand. Why competition doesn't work? Why some new investors (who are not invested in drugs yet) do not invest in the research of new drug that heals all the diseases, to sell this drug for $1 -- they would destroy existing system, but they would get all the market at once. (Or in a smaller scale they might make a drug that treats some disease once and for all, and shrink not the pie overall, but some part of it).
Re: Gene Therapy Was Hailed as a Revolution – Then Came the Bill
#48Earlier quoted context omitted.
But due to insurance churn, you don’t want to be footing the bill for your competitor down the road. As an insurance manager, your unit of analysis is not healthcare system or society, but your quarterly bottom line.
Sounds like a great argument for Medicare for All, the NHS, or other nationalized systems.
It’s Called “reinsurance” and it’s already implemented in many states for cases such as these (million dollar payouts) since post-ACA an insurer could go bankrupt on a single customer with a pre-existing condition.
Re: Gene Therapy Was Hailed as a Revolution – Then Came the Bill
#49Earlier quoted context omitted.
Sounds like a great argument for Medicare for All, the NHS, or other nationalized systems.
It’s Called “reinsurance” and it’s already implemented in many states for cases such as these (million dollar payouts) since post-ACA an insurer could go bankrupt on a single customer with a pre-existing condition. https://en.m.wikipedia.org/wiki/Reinsurance
Privatize the gains, socialize the losses!
Re: Gene Therapy Was Hailed as a Revolution – Then Came the Bill
#50Earlier quoted context omitted.
Sounds like a great argument for Medicare for All, the NHS, or other nationalized systems.
Or for insurance companies to form an association that comes up with policies that would benefit all of them if they all did them, and then requires all member companies to implement them. Not sure exactly what carrot or stick they could use to ensure that any remaining insurance companies have an incentive to join the association rather than trying to free-ride off what they're doing, but one might be able to come u…
Look folks, I'm open to any and all ideas, as long as it's not a decently funded public system.