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Drugs for the People: Rethinking the global pharmaceutical supply chain

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Re: Drugs for the People: Rethinking the global pharmaceutical supply chain

#11

Post by Nbox9 »

DoreenMichele wrote: post #6

Evergreening props up pharmaceutical profits but prevents lower-income populations from ever benefitting from the drugs. It keeps enormous swaths of the global population, without insurance or financial resources, from accessing lifesaving treatments. It seems the pharmaceutical industry has largely forgotten why it makes drugs in the first place: to save lives. No, not really. They are in it to make money. We used t…

> But if you make some prosaic observation about this overall pattern

If you outlined a pattern in your comment I failed to deduce it. Something about negative externalities of increased drug consumption? I’m sure there is a point there that deserves a better argument.

Re: Drugs for the People: Rethinking the global pharmaceutical supply chain

#12

Post by Nbox9 »

Is it viable for every country to produce all of it’s own basic necessities — food, medicine, energy, fresh water, building materials? Is it desirable?

I believe that the US being a net exporter of food, and a net importer of medicine is an acceptable situation. I think that to frame out ‘reliance’ on India and China for medicine ignores China’s ‘reliance’ on the US for soybeans, or India’s reliance on US warships in the Indian Ocean for strategic defense. We are codependent, and that codependency is going to keep us all from killing each other again.

Re: Drugs for the People: Rethinking the global pharmaceutical supply chain

#13

Post by newyankee »

GiorgioG wrote: post #5
Vaslo wrote: post #3

For a tl;dr, an article by a left leaning magazine saying that drug companies should make drugs and not be allowed to charge exorbitant prices or the government should get involved. Between that and the Trump bashing, shockingly original.

I don't care what side of the political aisle you side with: It's insane that pharma companies and the healthcare system in general can hold people hostage. A friend of mine has Leukemia and takes Gleevec. Thankfully he has a good job because it costs something like $14,000/month. Yep, you read that right, $14,000. Yes it's covered by insurance. But that's not some magical money tree paying for it, we're collectively…

The primary incumbents interested in keeping the status quo are not merely US companies though, quite a few EU companies especially Swiss figure in the list too. This is a field where developed countries do not want to give any perceived advantage over up and coming countries.

For better or worse, only country that can break the monopoly is China imo. I hope they follow a different model of rewarding useful research.

Re: Drugs for the People: Rethinking the global pharmaceutical supply chain

#14

Post by DoreenMichele »

Nbox9 wrote: post #11
DoreenMichele wrote: post #6

Evergreening props up pharmaceutical profits but prevents lower-income populations from ever benefitting from the drugs. It keeps enormous swaths of the global population, without insurance or financial resources, from accessing lifesaving treatments. It seems the pharmaceutical industry has largely forgotten why it makes drugs in the first place: to save lives. No, not really. They are in it to make money. We used t…

> But if you make some prosaic observation about this overall pattern If you outlined a pattern in your comment I failed to deduce it. Something about negative externalities of increased drug consumption? I’m sure there is a point there that deserves a better argument.

These days, we conflate medical care and health care. Basic health care is stuff like eating right, exercising, good hygiene, etc. We overprescribe drugs in part because things have swung too far in a commercial direction. A drug is a solution we can sell. A walk for your health is not.

And then we wring our hands when this leads to the kind of situation described in the article. But I know from long experience that no one will take you seriously if you try to talk about non drug solutions.

Re: Drugs for the People: Rethinking the global pharmaceutical supply chain

#15

Post by bigdogc »

big pharma does not equal generic drug manufacture. HCQ is available by at least 8 different manufacturers in America.

As a drug wholesaler, this drug increased from ~20$ for a 100ct bottle to ~$100 for a 100ct bottle. At its height of popularity in late April, all supply chain went to McKesson/Cardinal/Amerisource with daily allocations to smaller independent/regional wholesalers. State boards of Pharmacy specifically changed law to make sure this drug was given to those that actually needed it for RA.

The author does make great points on big pharma and absurdity of patents/costs, but HCQ is not a great way to illustrate that point.

Lastly, HCQ was so overproduced that by the end of July 100ct bottles were selling to smaller regional wholesalers off contract at $3-5 per 100 ct bottle. Patients can probably buy this cash pay from an independent pharmacy for $10 now.

Re: Drugs for the People: Rethinking the global pharmaceutical supply chain

#16

Post by roenxi »

henrikschroder wrote: post #10
ineedasername wrote: post #7

Earlier quoted context omitted.

It's difficult to say whether other countries are just dealing with the financial side of this better or if the US is basically subsidizing the low prices elsewhere by paying the exorbitant prices here.

> or if the US is basically subsidizing the low prices elsewhere by paying the exorbitant prices here. Nope, you're just being taken for a ride because they can. Remember that the biggest line item for pharmaceutical companies is their advertising budget, not their research budget. Also, this kind of thinking is some weird sort of Stockholm Syndrome, you're basically trying to frame being taken advantage of as some s…

> the biggest line item for pharmaceutical companies is their advertising budget

There seems to be some tension between that and a $14,000/month leukemia drug. The drug companies shouldn't really need to advertise life saving medication.

The world is full of surprises, but I assume the advertising budget is more for the less important medications where people have to be more active in seeking them out.

Re: Drugs for the People: Rethinking the global pharmaceutical supply chain

#17

Post by jandrewrogers »

henrikschroder wrote: post #10
ineedasername wrote: post #7

Earlier quoted context omitted.

It's difficult to say whether other countries are just dealing with the financial side of this better or if the US is basically subsidizing the low prices elsewhere by paying the exorbitant prices here.

> or if the US is basically subsidizing the low prices elsewhere by paying the exorbitant prices here. Nope, you're just being taken for a ride because they can. Remember that the biggest line item for pharmaceutical companies is their advertising budget, not their research budget. Also, this kind of thinking is some weird sort of Stockholm Syndrome, you're basically trying to frame being taken advantage of as some s…

The reason their advertising budget is so high is that they have a small number of years within which to recover a billion dollars in development costs. They have to find customers fast for new drugs, they have no time to waste, and that requires aggressive marketing. Companies don’t advertise for laughs since it costs money, it has a concrete ROI.

It is a matter of incentives. If you want them to spend less on advertising, you’d have to provide them with a much longer time to recover development costs. Which also has significant downsides.

Re: Drugs for the People: Rethinking the global pharmaceutical supply chain

#18

Post by GiorgioG »

jandrewrogers wrote: post #17
henrikschroder wrote: post #10

Earlier quoted context omitted.

> or if the US is basically subsidizing the low prices elsewhere by paying the exorbitant prices here. Nope, you're just being taken for a ride because they can. Remember that the biggest line item for pharmaceutical companies is their advertising budget, not their research budget. Also, this kind of thinking is some weird sort of Stockholm Syndrome, you're basically trying to frame being taken advantage of as some s…

The reason their advertising budget is so high is that they have a small number of years within which to recover a billion dollars in development costs. They have to find customers fast for new drugs, they have no time to waste, and that requires aggressive marketing. Companies don’t advertise for laughs since it costs money, it has a concrete ROI. It is a matter of incentives. If you want them to spend less on adver…

I'm just going to leave this here: http://www.drugood.com/2018/07/15/gleevecs-cost-and-price/

Gleevec did not take many years at all for Novartis to recover its trivial relative costs and generate billions of dollars of profit for nearly 2 decades. The problem is when you have a disease and there's only one treatment around, you'll literally pay whatever it costs - because not having it means you're dead.

These companies then turn around and extract as much money as they possibly can. They're monopolies, pure and simple.

I've seen this with my son's diabetes as well. The costs continue to rise (insulin, Dexcom sensors/transmitters, etc.) I've turned down jobs because their health benefits only covered a lousier insulin pump / glucose monitor due to an exclusive agreement with their chosen health insurer.

The problem is if you or a loved one isn't sick, this doesn't affect you one damn bit. My dad (an italian-born immigrant) has always complained to me about our healthcare system (and he had a great healthcare plan as a GM employee.) I didn't really paid it much attention because I was young and healthy. Now, quite a bit older and with family members with a variety of health issues, I realized that he (in my opinion) was right.

Re: Drugs for the People: Rethinking the global pharmaceutical supply chain

#19

Post by jandrewrogers »

GiorgioG wrote: post #18
jandrewrogers wrote: post #17

Earlier quoted context omitted.

The reason their advertising budget is so high is that they have a small number of years within which to recover a billion dollars in development costs. They have to find customers fast for new drugs, they have no time to waste, and that requires aggressive marketing. Companies don’t advertise for laughs since it costs money, it has a concrete ROI. It is a matter of incentives. If you want them to spend less on adver…

I'm just going to leave this here: http://www.drugood.com/2018/07/15/gleevecs-cost-and-price/ Gleevec did not take many years at all for Novartis to recover its trivial relative costs and generate billions of dollars of profit for nearly 2 decades. The problem is when you have a disease and there's only one treatment around, you'll literally pay whatever it costs - because not having it means you're dead. These compa…

Yet Novartis only has 15% margins. Not shabby but not exactly living large, and much worse than tech companies. You aren’t going to move the needle on drug costs by making those margins 0%, and no amount of wishing will change that. That’s math. I guess you could pay people less at Novartis but it probably won’t have the desired effect.

These things cost a certain amount of money to produce. What you are complaining about is how that cost is distributed among the people that might consume it. However, the implications of redistributing that cost are not particularly palatable either. Ultimately, someone has to pay for development and there are only so many places you can hide the necessary revenue that no one wants to pay. These costs don’t automagically disappear through political sleight of hand.

Re: Drugs for the People: Rethinking the global pharmaceutical supply chain

#20

Post by solstice »

Nbox9 wrote: post #12

Is it viable for every country to produce all of it’s own basic necessities — food, medicine, energy, fresh water, building materials? Is it desirable? I believe that the US being a net exporter of food, and a net importer of medicine is an acceptable situation. I think that to frame out ‘reliance’ on India and China for medicine ignores China’s ‘reliance’ on the US for soybeans, or India’s reliance on US warships in…

I fully agree with your last sentence. But I think that nobody is seriously arguing that the US or European countries should become autarchies and produce _everything_ themselves again. (That whole "decoupling from China" is considered unfeasible and highly disruptive/dangerous at least by EU officials that I have personally heard from.) Instead, certain products and production capacities should be preserved at a minimum level. This is economically unprofitable but can save your country's collective butt in an emergency if it's properly managed and production can be ramped up quickly by getting a network of companies to switch their production (eg masks). I would expect my government to think about these long-odds, high risk events and take measures to prevent them or at least mitigate them. More traditional examples of this kind of thinking are strategic stockpiles of oil, food etc. If the covid-19 pandemic has shown one thing, it's that just in time manufacturing and globalized highly-optimized supply chains can fail spectacularly.
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