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Hepatitis C kills more Americans than all other infectious diseases combined

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Re: Hepatitis C kills more Americans than all other infectious diseases combined

#51

Post by troydavis »

nickthemagicman wrote: post #38
georgeplusplus wrote: post #31

Earlier quoted context omitted.

What’s the alternative? This gets tiresome asking because the typically argument is to say “This is crAzYyyy!!!! “ without offering any real solution or input. gilead the makers of Harvoni literally made a cure for a previously uncureable disease, You literally have no respect on a tech site of all places, for all the RnD that went into doing that.

It's straight up price gouging though these companies are doing. As usual the answer probably lies somewhere in the middle.

> It's straight up price gouging though these companies are doing.

I'm not sure the margins support that allegation. Sovaldi is manufactured by Gilead (which also makes a Harvoni generic). They don't break out drug-specific margin, but http://truecostofhealthcare.org/wp-content/uploads/2014/12/G... and https://www.investors.com/news/technology/can-gilead-withsta... have some food for thought.

A couple things stand out:

1. Their profit margin varies year to year, but in the peak period from 2012-2019 it was 35-55%, averaging ~40-45%. While that's industry-leading for pharma, it's nowhere near high enough to say that their products could be, say, 75% (or even 50%) cheaper. A 20% reduction (very roughly cutting margins in half) wouldn't make it meaningfully more affordable and I don't think most people would describe that as gouging.

2. Apparently it actually cures the disease for many people, so this is a once-and-done treatment. Compared to nearly all other healthcare interventions, curing a life-threating chronic degenerative condition at this price is cheap. (Cost per death prevented of other interventions: https://journalofscientificinnovationinmedicine.org/articles..., https://twitter.com/troyd/status/1195811217056485377)

3. After they cured so many people, there was a much smaller market (success!). Revenue and margin both dropped a lot: https://www.macrotrends.net/stocks/charts/GILD/gilead-scienc...

4. "Gilead Sciences was also unique in that it was the only pharmaceutical company I examined that spent less money on marketing than they spent on research. Gilead’s marketing budget was only 15% of their total revenue."

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#52

Post by [deleted] »

georgeplusplus wrote: post #31
save_ferris wrote: post #5

Earlier quoted context omitted.

That is so depressing to read. US pharma companies are completely out of control, there’s absolutely no reason a 12 week treatment should cost around the mean annual US income. Can’t imagine having to decide to risk my entire financial future to deal with Hep C.

What’s the alternative? This gets tiresome asking because the typically argument is to say “This is crAzYyyy!!!! “ without offering any real solution or input. gilead the makers of Harvoni literally made a cure for a previously uncureable disease, You literally have no respect on a tech site of all places, for all the RnD that went into doing that.

[deleted]

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#54

Post by _jal »

georgeplusplus wrote: post #31
save_ferris wrote: post #5

Earlier quoted context omitted.

That is so depressing to read. US pharma companies are completely out of control, there’s absolutely no reason a 12 week treatment should cost around the mean annual US income. Can’t imagine having to decide to risk my entire financial future to deal with Hep C.

What’s the alternative? This gets tiresome asking because the typically argument is to say “This is crAzYyyy!!!! “ without offering any real solution or input. gilead the makers of Harvoni literally made a cure for a previously uncureable disease, You literally have no respect on a tech site of all places, for all the RnD that went into doing that.

What gets tiresome is this tactic of declaring that since one does not have a fully documented 5-year plan in a binder, one is not allowed to bullshit bullshit.

That's bullshit.

It is perfectly acceptable to know something is wrong without wishing to extemporaneously perform for you.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#55

Post by big_chungus »

shaftoe wrote: post #12

I get their point about stigma, but as someone who has never injected drugs, I'm having a hard time caring about getting screened for this. How do they intend to actually roll out a massive testing operation (everyone under 80) when likely most people hear the details and respond with "meh, not me"?

Seconded. I have zero risk factors: no tattoos, sex, drugs, cuts on suspicious objects, etc. There is no reason for me to get tested to avoid someone else being uncomfortable. The value of the comfortability of a random stranger to any one is near-zero.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#56

Post by Cyph0n »

ameister14 wrote: post #32
lawn wrote: post #14

Earlier quoted context omitted.

Ability to pay? Is that a joke? Considering that 40% of Americans can't cover a $400 emergency expense[0], what makes you think they can pay $84,000 for a 12-week treatment? [0]: https://money.cnn.com/2018/05/22/pf/emergency-expenses-house...

Most Americans wouldn't end up paying the 84k. Their insurance would pay for most of that, and negotiate it down further - the other day I was picking up a drug that without insurance would cost over $1,000. I paid $34.

It depends on your plan. If you’re on a HDHP, chances are that prescriptions are not covered until you hit your deductible.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#57

Post by zwily »

baq wrote: post #41
georgeplusplus wrote: post #31

Earlier quoted context omitted.

What’s the alternative? This gets tiresome asking because the typically argument is to say “This is crAzYyyy!!!! “ without offering any real solution or input. gilead the makers of Harvoni literally made a cure for a previously uncureable disease, You literally have no respect on a tech site of all places, for all the RnD that went into doing that.

Basically any other country than US is a better alternative for the patient financially.

How many of these “miracle cures” are developed in the US?

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#58

Post by nkozyra »

wadkar wrote: post #37
nkozyra wrote: post #21

Earlier quoted context omitted.

As with most commercial goods there's a market identified and the goods priced accordingly to maximize profit. This means that somebody is priced out no matter what. Given the state of American healthcare it's easier to reconcile if you remove the emotional part and view a drug treatment as, say, a television. If I make a 50" television and price it at $500, I accept that some people will not buy it and target my tel…

Taking the television example a bit far - one can imagine that one company makes radio, other makes ~telephones~ cellphones, oven, etc. These are all electronic gadgets that are used for different purposes. However, most if not the entirety of drugs is to cure disease and save lives (or significantly improve the quality of live). There is one market as opposed to a market each for the types of gadgets. Which is why s…

> The free market economy doesn’t work in this case.

While I think this is self evident, it depends on your definition of "working."

If we - a I personally think we should - attach a social caveat to capitalism that requires we do what we can for people less fortunate, it fails miserably because we lack a mechanism for fostering unfettered profit while ensuring healthcare is available to all in a reasonable form. No such mechanism may exist, but I think the problem is we keep trying to shoehorn half measures into the current system and expecting a miracle.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#59

Post by lukeschlather »

troydavis wrote: post #51
nickthemagicman wrote: post #38

Earlier quoted context omitted.

It's straight up price gouging though these companies are doing. As usual the answer probably lies somewhere in the middle.

> It's straight up price gouging though these companies are doing. I'm not sure the margins support that allegation. Sovaldi is manufactured by Gilead (which also makes a Harvoni generic). They don't break out drug-specific margin, but http://truecostofhealthcare.org/wp-content/uploads/2014/12/G... and https://www.investors.com/news/technology/can-gilead-withsta... have some food for thought. A couple things stand ou…

> 3. After they cured so many people, there was a much smaller market (success!). Revenue and margin both dropped a lot: https://www.macrotrends.net/stocks/charts/GILD/gilead-scienc....

This seems like a pretty clear example of why looking at revenue and margin like this is not a good way to manage this. Our goal here is clearly to eliminate the market for this product, and everyone ought to chip in to make that happen, not just the people who currently are at risk. The whole funding model is fundamentally broken.

Re: Hepatitis C kills more Americans than all other infectious diseases combined

#60

Post by troydavis »

tyingq wrote: post #48
georgeplusplus wrote: post #31

Earlier quoted context omitted.

What’s the alternative? This gets tiresome asking because the typically argument is to say “This is crAzYyyy!!!! “ without offering any real solution or input. gilead the makers of Harvoni literally made a cure for a previously uncureable disease, You literally have no respect on a tech site of all places, for all the RnD that went into doing that.

"gilead the makers of Harvoni literally made a cure for a previously uncureable disease" No, they acquired Pharmasset, the company that made the cure, for $11.2B. That was a pretty low-risk move. It was already an obvious money maker. "for all the RnD that went into doing that" In the 18 months following Sovaldi’s approval, Medicare alone spent $8.2 billion on the drugs...that doesn't include private insurance paymen…

> Pricing after that was just how much profit they wanted to make.

While that's by definition true of any pricing decision, there's a lot more to the story: https://news.ycombinator.com/item?id=21883254#21884030

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