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Indian Government uses special powers to slash cancer drug price by 97%

timesofindia.indiatimes.com

41–50 of 227 posts

Re: Indian Government uses special powers to slash cancer drug price by 97%

#41
post #17
post #9

Earlier quoted context omitted.

Truth is, clinical trials are mind-bogglingly expensive and takes years for turnover. Also some newer drugs (I'm not sure about Nexavar) are rightfully expensive to manufacture due to requirements in equipment, sterile conditions, etc. If I were to say anything negative about this it would be that this sets a bad precedent for any new drugs coming to India -- knowing that the government can effectively void out drug…

On principle, you are right. However, Rs 2.8 lakh for 1 month of pills is inordinately expensive. It's something that no one but aristocrats will be able to afford. By the standards of the Indian society, I fall in the upper middle class category, and that amount is almost half of my annual salary (more than half after tax deductions). To get an idea about how expensive it is, just think whether you could afford to b…

Bayer doesn't have a problem with selling cheaper drugs to poor people, they do have a problem when those drugs go onto the grey market and get purchased by those who could afford Bayer's regular price.

That's why drug companies don't do differential pricing, because they can't stop the cannibalization of their wealthier markets.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#43
post #36

I worked in the drug R&D business for over 8 years. I still follow the industry closely. Some things always get lost in these discussions. First, manufacturing an existing drug is absurdly cheap. Modern industrial chemistry ensures this for all small molecule drugs (note that this is not the same case for the "biologics" which are often fiendishly difficult to make). Almost all the cost in a drug is the manufacturer…

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Re: Indian Government uses special powers to slash cancer drug price by 97%

#44

Earlier quoted context omitted.

Those costs could be covered by the government in this case and they should increase the investment to match all money lost on dead end R&D and add standard going rate profits on top - on the grounds that it is a market failure of public good - R&D. Also the costs will be covered in the richer markets. I'm no fan of government interventions but the fact that we are having a debate around intellectual property shows h…

Covering bad R&D deadens the incentive for firms to do R&D efficiently - it's structurally identical to the implicit guarantees that are proving so problematic in finance.

I'm not saying cover bad R&D - I'm saying cover bad R&D costs for companies that did the good R&D you want to use - because that costs would usually be covered by the profits from good R&D - this is how you structure investing - you make several risky shots so that the one that succeeds pays for the failures - it's a good way to determine "the proper" amount of profit, if you just repay the investment in profitable R&D you will actually lower the investments in the sector.

Anyway the point is moot because R&D costs will probably be paid in the US and other richer markets, India could simply take a free ride. If everyone wanted to do this then you would need to find a way to compensate R&D investments.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#45
post #37

Earlier quoted context omitted.

I am not sure I follow? It would force the governments to develop better and cheaper systems themselves to make sure that they can test for cheap. Surely the current scenario isn't working is it?

What I was trying to say: When the goverments pays for testing how will you stop brute force testing? > It would force the governments to develop better and cheaper systems themselves to make sure that they can test for cheap. I doute they cool do that. > Surely the current scenario isn't working is it? Well like most things it kind of works but is not very effective. I agree its not very good right know but I don't…

I would stop brute force testing simply by putting a limit on it.

As far as I know there are some pretty standard procedures you have to go through. Surely it must be possible to somehow validate and verify whether someone is trying to take advantage.

You can't hinder some taking advantage of it, but you don't have to IMO.

>I doute they cool do that.

Of course they can, just like then can improve many other areas in public service.

>I agree its not very good right know but I don't know how to change it.

Well I for one think its more fair to accept some fraud to make it cheaper for everyone else if possible of course.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#46

The reason why it's expensive to develop drugs is in large parts because of the process involved to get the approval. Couldn't you turn this on it's head? What if the companies could expense the cost of getting the approval. I.e. the tax payers pay for drugtesting and approval process. Wouldn't this make sense? Since it's in the publics interest to get safe medicin, shouldn't they/we pay for that part.

Did I say something that was factually wrong?

Re: Indian Government uses special powers to slash cancer drug price by 97%

#47
post #40
post #21

Earlier quoted context omitted.

I am referring to FDA trials, in the US, which can take over a decade and cost 8- or 9-figure dollar sums. These are required before the drug even comes to market.

US clinical trials often involve a second, parallel clinical trial in India, because it's easy to find lots of poor patients in desperate need of treatment. I think that, at least in some cases, this probably works out well for everyone except the control group. But if poor Indian patients are going to test these drugs, the GP can certainly argue that poor Indian patients should be able to afford them.

I think the recruitment rules are just more lax in India, than in the US.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#48

Earlier quoted context omitted.

Covering bad R&D deadens the incentive for firms to do R&D efficiently - it's structurally identical to the implicit guarantees that are proving so problematic in finance.

I'm not saying cover bad R&D - I'm saying cover bad R&D costs for companies that did the good R&D you want to use - because that costs would usually be covered by the profits from good R&D - this is how you structure investing - you make several risky shots so that the one that succeeds pays for the failures - it's a good way to determine "the proper" amount of profit, if you just repay the investment in profitable R…

Then we get into the case of having to monitor companies to make sure their bad R&D budget isn't being inflated to give them additional profit.

Better to just negotiate cleanly with the company for the drug you want, and sell it all on your own market like the NHS does.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#49
post #20
post #5

I think few people would argue that drug companies' prices are reasonable, and when it comes to life vs. death I no longer care much about the "they're a business, they're allowed to make a profit" line - of course it's still true, and of course they are, but there's a (subjective) line between "making a good profit" and killing people through greed. That said, what pricing would be fair? When people claim that these…

Perhaps the FDA should bankroll clinical trials, subject to a pre-agreed price and a reasonable case that the trial will work out. Monopoly sellers and monopoly buyers is fairer than a monopoly seller.

In this situation who decides what drugs go into clinical trials? The drug companies are in a much better position to know which drugs are worthwhile, but if they don't pay the price they have to reason not to throw everything at the wall to see what sticks.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#50
Special powers? They mean by force or arms. There is nothing special about theft except when a government does it they are pretty much immune to counter actions.

This is little different that Greece having passed laws allowing them to retroactively change bond agreements and then implement said changes they claimed were now legal under their laws.

Now if India decided to pay a reasonable fee to Bayer for the ability to have a national drug company manufacture them then I would see little issue here.

Instead they are simply passing the costs to other countries. As in, let those "rich" countries pay for the development of medicines and countries like India will simply steal what they want with impunity. How different is that from what the Chinese do to manufacturers of cars, electronics, and other technology not developed at home.

The cost is simply borne by people they don't have to see or care about. Yes I know the drugs are expensive but development of new medicines is not a cheap endeavor. To have government arbitrarily decide who can charge what and when will simply trade a few lives today for a potentially larger number in the future, that larger number arises because potential treatments may be deemed to risky to research under the threat of confiscation.

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