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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

#61

Post by georgeplusplus »

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…

Wrong. Gilead made Harvoni. Pharmasset made Sovaldi.

Is there something that’s supposed to be inherently evil in acquiring a company anyway?

Because pharmasset, the smaller company, had forecasted a price of 36000$ for Solvadi. With Gilead buying it out, it was able to reach a third of that price point and that’s a win to me.

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

#62

Post by hep_c_throwaway »

Using a throwaway for obvious reasons.

Like many of you, I'm a young and healthy guy. I haven't taken a sick day in years. Since I'm young and healthy, I didn't see the need to take an annual physical exam. Scheduling doctor's appointments is such a hassle. I'm sure many of you feel the same.

So when I was diagnosed with Hepatitis C, it came as a complete shock to me. The shock was due to two reasons:

1. I wasn't involved in any of the "high risk" activities associated with Hepatitis C, which are intravenous drug use and tattoos.

2. I regularly went to the doctor's when I was a child, so there was at least 20 blood tests done back then. None of tests caught the Hepatitis C back then.

Since Hepatitis C is a chronic condition for most people, if I didn't catch mine early, it would have been found much later in life when all of the damaged has been done. I only caught my Hepatitis C because I wanted to an elective cosmetic medical procedure. It was my own vanity, plus pure luck, that caught it.

When I was a child, I was covered under the government's and my parents' health care plans. When I entered college, I was enrolled under the mandatory student health care plan. After I entered the work force, I was covered under my employer's health care plan. All this health care was fully paid for, either through tax dollars, or my parent's contributions, or my own contributions, and I stupidly chose not to utilize it, because I was young and healthy.

If you don't want to end up like me, then please heed my advice: all of you are under-utilizing the medical services that you have already paid for. You should research what kind of screening and preventive care is included in the health care plan that you purchased and then take full advantage of them. It's better for you since you live longer. It's better for your insurance company since screening and preventive care is much cheaper than paying for treatments down the road. It's better for your government since they get to collect more tax dollars over your longer lifespan. And it's better for me since I make a living using the software and services that you guys provide.

I can stick around and do a AMA if you guys have any questions for me.

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

#63

Post by troydavis »

lukeschlather wrote: post #59
troydavis wrote: post #51

Earlier quoted context omitted.

> 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 hap…

> The whole funding model is fundamentally broken.

That's a totally reasonable point (and perhaps worth starting a separate top-level reply about), but it's not at all what the GP comment was arguing.

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

#64

Post by Tharkun »

idclip wrote: post #3
yakz wrote: post #2

Antiviral drugs for hepatitis C are very effective, but they come at a steep cost. Just one Sovaldi pill costs $1,000. A full 12-week course of treatment with this drug costs $84,000. The price of other hepatitis C drugs is also high: Harvoni costs $94,500 for a 12-week treatment Mavyret costs $39,600 for a 12-week treatment Zepatier costs $54,600 for a 12-week treatment Technivie costs $76,653 for a 12-week treatmen…

Jesus how much did these drugs cost to develop? Are these numbers justified?

Drug development is incredibly costly. It's also something of a long term gamble. It can take 10-20 years to develop a new drug. A lot of that time is spent testing safety and waiting for approval. As a drug company, you need to have several new drugs in your pipeline at any given point, or you'll be seriously fucked if one (or more) of your products don't pan out. It's basically a high-risk-high-reward type of gambling situation.

Imagine having thousands of people on payroll, some working on drug design, some designing experiments to test the drugs, some doing the legal paperwork to get drugs approved etc, and suddenly the patent for your best selling drug expires and your latest drug doesn't work. You're pretty much boned.

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

#65

Post by [deleted] »

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…

[deleted]

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

#66

Post by dfsegoat »

idclip wrote: post #3
yakz wrote: post #2

Antiviral drugs for hepatitis C are very effective, but they come at a steep cost. Just one Sovaldi pill costs $1,000. A full 12-week course of treatment with this drug costs $84,000. The price of other hepatitis C drugs is also high: Harvoni costs $94,500 for a 12-week treatment Mavyret costs $39,600 for a 12-week treatment Zepatier costs $54,600 for a 12-week treatment Technivie costs $76,653 for a 12-week treatmen…

Jesus how much did these drugs cost to develop? Are these numbers justified?

The development costs per a Forbes analysis are as follows:

> "The median per-drug R&D spending of companies that developed more than six drugs – that’s only 8 companies – was $5.8 billion."

...so that is $5-6B USD per drug DEVELOPED in large companies.

Gilead - maker of Sovaldi/Harvoni for HepC treatment - has been on a development tear of late, and almost certainly falls into that range IMO [2].

For companies that produce fewer drugs - the estimates are between $700M-$1B per drug.

Note these are prices for drug R&D only ("development") - there is no guarantee those drugs developed make it to market ("approval") - Over 90% do not.

edit: source links

1 - https://www.forbes.com/sites/matthewherper/2017/10/16/the-co...

2 - https://en.wikipedia.org/wiki/Gilead_Sciences#2010_to_2019

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

#67

Post by ameister14 »

Cyph0n wrote: post #56
ameister14 wrote: post #32

Earlier quoted context omitted.

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.

Even if that's the case, unless your deductible is $40k, which I have never seen before, the insurance would still cover the majority of the cost. Plus if you have chronic Hep C, you're likely spending thousands a year as it is and will continue to do so indefinitely.

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

#68

Post by twoodfin »

chmod775 wrote: post #25
ohyes wrote: post #4

Earlier quoted context omitted.

It’s priced based on ability to pay. US it will be 100,000 other countries it will be less.

In many other countries getting treated for hepatitis C won't cost you a dime besides your regular health insurance payment. Prices are often negotiated by health insurers and are pretty much guaranteed to be lower for that reason. Depending on what system you are in, you might never even learn what your treatment cost. Not that you should care.

That depends on the treatment and politicians’ willingness to pay for it. Take cystic fibrosis in England: Until this year, modern, highly effective (and, yes, expensive) treatments available for years in the US—covered at low out-of-pocket cost by insurers there—were unavailable through the NHS.

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

#69

Post by big_chungus »

Retric wrote: post #45
lotsofpulp wrote: post #40

Earlier quoted context omitted.

I wonder how many people that complain about healthcare costs would be willing to pay higher taxes for taxpayer funded research for medications and education to increase supply of doctors.

Presumably, R&D costs should be shared across all countries rather than individual countries footing the bills. Alternatively a cost benefit from such R&D spending such that US R&D subsidies resulted in free drugs for the US market would be acceptable. Instead, the US both has the largest R&D subsides and the largest drug prices.

This requires some IP protection. Even if it's weaker than in America, at least some. Many nations adopt the stance that if it wasn't invented in their nation, screw the other guy, they're taking the IP. Many first-world nations, including Europe and Canada, do this and use the threat thereof to force down prices because their socialized medicine does not provide sufficient funds.

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

#70

Post by kenneth »

chmod775 wrote: post #34
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…

> All that said, if it's life saving you might be surprised what people can and will do, savings notwithstanding. Withholding a life-saving treatment has to be criminal in some way. I just can't imagine a hospital sending people home to die because they can't pay.

Except it isn't. You can debate the moral questions behind drug pricing. But it's entirely legal for pharma companies to set the price for the drugs to maximize their profits. It's logical.
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