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This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

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Re: This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

#51
post #3

Based on previous "investigations", basically nothing will happen to the company and things will continue as usual. The $5-per-pill price URL Pharma set for Colcrys surprised the FDA Find the people that were surprised and terminate them immediately. The "FDA" wasn't surprised, it was a few idiots left in charge. What if they just do a compromise of $2.50 a pill, is that really going to help anyone when it was 10 cen…

"It's okay for the CEO to buy their 2nd or 3rd house with the profits while patients suffer?"

To be fair, patients can continue to take the drug in it's herbal supplement form the same way people have been taking it forever. Or they can take tart cherry juice, which also works; a one month subscription for home delivery of tart cherry juice is only $60 on cheribundi.com

Re: This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

#52
The FDA has a somewhat scary recourse here:

Makena (aka 17P), a compound used to control preterm labor got similar treatment. KV Pharmaceutical announced plans to multiply the price by x100 and set off a storm.[1]

The FDA has simply decided not to enforce the monopoly that KV legally acquired.

Beth Martino, a spokeswoman for the FDA, called the Makena controversy a "unique situation." Martino stressed that the drug agency's enforcement actions are discretionary, and that it has chosen at this time not to take action against other suppliers in order to "support access to this important drug." [2]

[1] It appears they spent something between $250,000 and $1m acquiring rights and commissioning studies for the FDA approval or existing practices. They appear to be set to reap 18 times that in monopoly rent.

[2] http://www.stltoday.com/business/local/article_26f67c9a-5ae9...

Re: This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

#53
There is some large cost of doing this drug research, with benefits that will accrue to all the people taking colchicine for decades into the future. The problem here is that congress has decided, through the Orphan Drug Act, to place that cost just on the patients who take the drug in the next 3 years (the length of URL Pharma's monopoly).

This is stupid. It's not the fault of the FDA (they're following the law) and it's certainly not the fault of the manufacturer. It's congress.

Re: This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

#54
post #21
post #15

The problem doesn't end there. Once these drugs' exclusive rights expire and "generic brand" prescriptions are allowed to compete, most insured patients will still prefer the "name brand" as they are only charged co-pay. Some insurance providers may place restrictions on which drugs are eligible for treatment but this is not the case with traditional U.S. sponsored Medicare/Medicaid (patients are free to choose betwe…

In Australia, most people have to pay for drugs. There are subsidies available. If a drug company wants the subsidy, it has to offer a fair price. If they don't offer a fair price, then they don't get subsidized, and nobody buys it. So, patients pay (a bit), so they avoid unnecessary treatment. But they don't have to pay to much. And if the drug companies try to play funny-buggers, they get shut out. Also, the subsid…

> Also, the subsidy process is completely hands-off (it's run by an untouchable board of experts), so while it's a little inefficient (untouchable experts are always inefficient) it's incorruptible.

If they're actually incorruptible, that process can not be used in the US.

Disagree? Then produce a couple of incorruptible groups of experts with comparable powers in related areas.

Hope is not a plan.

As far as the US is concerned, it doesn't matter what works elsewhere, what matters is what will work here.

Re: This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

#55
post #36
post #28

Earlier quoted context omitted.

This is just unbelievably incorrect, absurd, and just shows complete ignorance of the healthcare industry. Profits for healthcare companies are the same as those in any other industry. A quick check on Yahoo Finance will let you compare their respective financial statements. The culprit is in the endless rules and regulations that drive up costs to make the pills, preventing competitors from coming in to drive down t…

I don't think you understood what he was saying. In effect the FDA set a ~1 billion dollar bounty from doing 2 study's on this drug. What was not said is there are limited resources in the industry so while this company went after this fairly safe and profitable drug plenty of other companies went after other drugs and there is no incentive to research the same drug as another company. This is a land grab plain and s…

It seemed pretty clear that in addition to the FDA he was attacking the company for behaving like a profit seeking entity (which it, of course, is). He questioned whether it is "ok" for them to charge the particular price they wanted and questioned how many homes the CEO should be able to own while there are still suffering people in the world.

We can argue that this particular bit of regulation is wonderful or evil all we want, but to think that any for-profit organization is going to act in your best interest rather than it's own, or that it's even possible to regulate a company or person into doing so, is just plain naive.

Re: This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

#56

> One can't fault the FDA for the price increases for Makeda and Colcrys; the agency is doing what it's supposed to do, clearing out old drugs and improving the standards of the national Pharmacopoeia. (Disclosure: I worked as a speechwriter for FDA in early 2010 but had no involvement in the colchicine or 17OHP issues.) I think anyone will agree that FDA's intentions are good. But sadly, what really matters are cons…

"I think anyone will agree that FDA's intentions are good."

I don't entirely, though I'm not claiming malice either. The purpose of drug testing is to make drugs safe. The FDA has mistaken goals for means, and now they are testing drugs for the purposes of testing drugs.

If an untested drug has been used for decades by millions of people to treat a chronic condition that requires each of them to themselves consume the drug for decades at a time, that by itself puts such a sharp, strong bound on the maximum damage the drug may be doing that it is well in excess of what any study could possibly hope to establish. The improved methodology the study may have is simply swamped by the statistical power of a sample five or six orders of magnitude larger (measured in man-years) we have in the real world. In fact you just don't get any statistically more powerful than a "sample" of 100%.

Even if the study managed to produce some small negative side effect there is no chance in hell that it will exceed the positive value of a drug for gout.

I've actually seen this before. Several children's drugs have been "unrecommended" by the FDA for toddlers, not because they could produce a shred of evidence that they were dangerous but because the studies-for-the-sake-of-studies had not been done. Again, decades of use by millions of people dominates what any study could produce.

(By the way, when I say "dominates what a study would produce" I emphatically do not mean "is perfectly safe". I mean precisely that a study will not be able to find the small damage. Drugs have after all gotten all the way through our stringent approval process and then had to be pulled because it turns out they were still dangerous. If the process couldn't catch the several diet drugs that turn out to give you a heart attack, it isn't going to pick up on something that could escape hundreds of millions of man-years of usage. Studies do not have infinite resolution.)

It's a continuing degradation in the standards of science, as the disease of scientific form replacing scientific substance marches on. That's why I don't claim "malice" in my first paragraph. Malice is not required, merely the raising of form above substance. I do not call "intention to have good form even at the cost of substance" good intentions.

Re: This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

#57

I think maybe its about time we set up something life the NSF to conduct these trial for the FDA (in the particular case of orphaned and old drugs) and generally does a much better job of dealing with the mess that drug trails have come to be. At some point, this knowledge becomes a public good and the conflict of interest presented by those seeking to win approval also being the ones who stand to win a "get a monopo…

Oh sure another taxpayer funded job-killing GOVERNMENT agency. Don't you understand that the private sector, in combination with absurd patent/monopoly incentivization, is the ideal solution to all human need?

I can imagine privately owned roads. Toll booths every few miles sound far fetched? Try looking at midevil europe, and that would be the US you would have.

We've already did the private fire departments with medallions. Doesn't exactly work out when the non-medallioned house next door is on fire.

Or, we've read the articles about the for-profit prison systems. And they were even buying a judge to sentence juve offenders to the max.

Yes, private stuff does make sense. So does public.

Re: This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

#58

Earlier quoted context omitted.

Oh sure another taxpayer funded job-killing GOVERNMENT agency. Don't you understand that the private sector, in combination with absurd patent/monopoly incentivization, is the ideal solution to all human need?

I can imagine privately owned roads. Toll booths every few miles sound far fetched? Try looking at midevil europe, and that would be the US you would have. We've already did the private fire departments with medallions. Doesn't exactly work out when the non-medallioned house next door is on fire. Or, we've read the articles about the for-profit prison systems. And they were even buying a judge to sentence juve offend…

I think reader5000 was being sarcastic...

Re: This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

#59
Drugs are broken in the US. The FDA testing of a drug costs a huge pile of money (I was in Clinical Trials for a while). Most protocols don't work out so your success rate is somewhere around the success of rolling out software. The ones that do, take a long time and allow for a very limited monopoly period. So, you spend a lot of money on advertising to maximize. Plus, the FDA does weird crap and drug producers up the price. It is a very weird cycle. Including, spending a lot of time on stuff that is more lifestyle than cures. Never mind the liability laws, since almost every drug made will react badly with someone.

It is a damn mess, that should have been the first thing addressed in health care legislation, because it is an input cost to health care. I sometimes wonder if separating the research from the producer and guaranteeing royalty for a number of years after approval would have been a good way to go. Much like not allowing film companies to control the theaters back in the day.

Re: This pill used to cost me 10c/pill, now it's $5/pill. I take it 3x day.

#60
Some good discussion from a blogger in the drug discovery industry:

http://pipeline.corante.com/archives/2011/03/11/makenas_pric...

http://pipeline.corante.com/archives/2011/03/24/more_on_kv_a...

http://pipeline.corante.com/archives/2011/03/30/kv_pharmaceu...

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