Indian Government uses special powers to slash cancer drug price by 97% • Hacker News Board

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

#141

Post by ttt_ » Tue, Mar 13, 2012, 4:25 PM UTC

relix wrote: post #66

ttt_ wrote: post #34

Earlier quoted context omitted.

>> however because of such decisions companies will find it risky to invest in life saving drug research. I disagree. That mentality is precisely the reason that they are overpricing now (and always have done so) as much as they can. People will always need life saving drugs, and ordinary drugs as well. Terminal and cronical patients will always try both traditional and new drugs (or the state will provide it to them…

You're talking about an infinite timeline where they are the sole seller of a drug that is used indefinitely. This is false. When patents expire the drug is also made by generic drug making companies for cheap. So upper bound of getting a ROI is the lifetime of a patent (30 years for drugs iirc, 10 years longer because it takes about 10 years to develop, so still effectively 20 years). For every drug that is successf…

Ok, I might have exagerated.

The thing is, when a company chooses to manufacture pharmaceuticals, it shouldn't just be 'business as usual' for them. They must realize that they have a social responsability to undertake besides making a profit, and that is even without a proper regulamentory agency or something of the sort.

Most countries have some kind of social welfare, so maybe these companies could have differentiated deals with those programs and still price whatever for those can afford it. It would both cover a market they wouldn't otherwise reach and not jeopardize those that imperatively need treatment and can't afford it otherwise.

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

#142

Post by vannevar » Tue, Mar 13, 2012, 4:26 PM UTC

roadnottaken wrote: post #120

vannevar wrote: post #106

Earlier quoted context omitted.

Somewhere out there, a business model is waiting to be found. I hope so, because the current one isn't working for consumers. Even with the billions spent on R&D, it turns out that many of the drugs Big Pharma turns out are no better than placebos. It's not hard to see why: a big company spends X amount on each failure and needs a 10X hit to offset the costs. If one doesn't materialize, it's not hard to rig the stati…

Actually it's almost impossible to rig the statistics. And every drug on the market has shown efficacy compared to placebo in large tests calle phase 3 clinical trials.

Actually it's almost impossible to rig the statistics.

I would argue that it's actually impossible to economically conduct sufficient studies to reliably predict the efficacy and long term safety of drugs in the general population. And you're right, every drug on the market has passed Phase 3 trials because they're cherrypicked. A big drug company knows how many drugs it needs in production to ensure that some percentage of them are statistically likely to get through Phase 3 trials. To believe otherwise is to believe a drug company would bet a multi-billion-dollar enterprise purely on a research gamble. Is it possible for them to lose? Sure, 'statistically likely' isn't a guarantee. But it's much better odds than depending on stumbling into an actual cure.

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

#143

Post by vannevar » Tue, Mar 13, 2012, 4:34 PM UTC

smalltalk wrote: post #134

vannevar wrote: post #106

Earlier quoted context omitted.

Somewhere out there, a business model is waiting to be found. I hope so, because the current one isn't working for consumers. Even with the billions spent on R&D, it turns out that many of the drugs Big Pharma turns out are no better than placebos. It's not hard to see why: a big company spends X amount on each failure and needs a 10X hit to offset the costs. If one doesn't materialize, it's not hard to rig the stati…

Do you not believe these are actually problems for people?

They're a problem for a lot of people. So many in fact that they fall into the range of normal human physiology and behavior. My point is that for most people, the cures that are being vigorously marketed by drug companies are no better than placebos for many of these 'disorders'. These drugs are an artifact of the pharmaceutical industry business model, which the parent comment acknowledges is broken albeit for a different reason.

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

#144

Post by thwest » Tue, Mar 13, 2012, 4:41 PM UTC

JunkDNA wrote: post #133

Alex3917 wrote: post #108

Earlier quoted context omitted.

> Almost all the cost in a drug is the manufacturer recouping R&D costs. Actually that's not true. Big pharma spends twice as much on advertising as they do on R&D: http://www.sciencedaily.com/releases/2008/01/080105140107.ht... They also spend a significant amount of money on government fines due to corrupt practices (i.e. killing people). They are now the single most corrupt industry, paying significantly more fine…

If you took the time to look at the link I posted that talks about the Forbes piece, you'd see that they specifically excluded the cost of marketing from the analysis of how much it costs to put out a new drug. When companies do marketing, they expect it to more than pay for itself, clearly it is, or they wouldn't be spending so much on it. I know people don't like to hear it, but marketing products does lead to more…

Of course one expects marketing mental diseases to be effective! 'Its not your fault, take a pill and it will all go away' certainly has mass emotional appeal. However, the article is not too convincing about the methodology of excluding marketing expenses.

    First - and I know that I'm going to hear about this from some people - you might assume that different companies are putting different things under the banner of R&D for accounting purposes. But there's a limit to how much of that you can do. Remember, there's a separate sales and marketing budget, too, of course, and people never get tired of pointing out that it's even larger than the R&D one. So how inflated can these figures be?

Not particularly powerful evidence here: a vague notion of a limit, and a rhetorical question. Corporate accounting statements are generally only accountable to the board of directors, who might be perfectly happy with pushing the limit on creative accounting while the stock goes up. When aimed at investors other than the board, and especially when used by citizens attempting to assess the social value of institutions, accounting statements are better treated as marketing materials themselves.

We can discuss evidence when the CFOs of these corporations open their daily work to a public VNC session.

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

#145

Post by pullo » Tue, Mar 13, 2012, 4:58 PM UTC

JunkDNA wrote: 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…

May be the real solution is a combination of tiered pricing and cut of all sales revenues by generics. The cost of this decision for Bayer is yet to be seen. Considering the number of users is only a few hundred at the current price point, Bayer should be ok. But, it will be interesting to see a breakdown of r&d costs of bayer in total. Considering India is one of the most popular destinations for clinical trials by drug firms, I cant shrug off a karma play here. http://www.scidev.net/en/health/clinical-ethics/news/fines-e...

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

#146

Post by RexRollman » Tue, Mar 13, 2012, 5:02 PM UTC

x3c wrote: post #55

I propose the following solution. R&D stays in private sector. All successful drugs are bought by the government at the cost of R&D and a sizable profit. The government, then, distributes it. Government can control the distribution and Pvt. markets can control the invention. Government can then tie up with other govts. and allow sales of the said medicine in those countries. It's not an ideal solution, but it has bes…

That's funny, because I was thinking it should be the opposite: R&D by government scientists so that discoveries can be made available to the public as cheaply as possible.

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

#147

Post by Symmetry » Tue, Mar 13, 2012, 5:23 PM UTC

refurb wrote: post #138

Duff wrote: post #76

Earlier quoted context omitted.

At this point, isn't the pharmaceutical industry playing games with supply by limiting the production of many medicines? Even a common OTC drug like guaifenesin that has been around since the 50's is difficult to find by itself, except in the newly patented time-release formulation (ie. Mucinex). (Although it is an ingredient in many cold medicines.)

The margins on generic drugs are razor thin. Most of the recent drug shortages are due to a lack of starting materials or manufacturing problems. Both of these can be traced back to the fact that there is very little money to be made in generic drugs. They are basically commodities.

Other sources of shortages are due to the fact that the government issues drug companies production quotas for some drugs, which the drug companies aren't allowed to go over even if their competition has problems. My understanding of how this works is that the DEA tells companies A, B, and C that they can each make 20 units of Drug X. Then the FDA tells company C that their Drug X isn't up to snuff and they can't make any more this year. The 40 units that companies A and B make isn't enough to cover demand, but they can't increase their production to 30 units because the DEA has already filed their paperwork.

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

#148

Post by intended » Tue, Mar 13, 2012, 5:29 PM UTC

refurb wrote: post #140

lysol wrote: post #80

Earlier quoted context omitted.

Got any examples? The trial process for new medications isn't perfect, but without citing specific failures in the process it becomes to easy to discount the parts of the process that do work.

Weight loss drugs. Three new products were rejected by the FDA last year. Sure these drugs had risks, but what's the cost of obesity in terms of medical costs? At this point in time the FDA has incredibly high standards of safety for weight loss drugs and not without reason. But what are the costs of the 40% of obese Americans who will get diabetes, cardiovascular disease, etc, etc?

Wait - so you want to take the at risk group and give them a drug that failed human safety tests?

EDIT: I am trying to say that while obesity is 'bad', giving them a drug that adds to their risk levels is not a solution.

If you are still pro your position, bear in mind that you are now throwing dice and hoping that: (people who improve) >= (people who suffer + nothing happens).

Are you qualified to play dice with peoples lives?

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

#149

Post by Symmetry » Tue, Mar 13, 2012, 5:31 PM UTC

Produce wrote: post #105

nikcub wrote: post #99

Earlier quoted context omitted.

for some reason the placebo effect is getting stronger and more drugs are failing in stage II and III against sugar: http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo...

I'm honestly gobsmacked that our model of health and physiology is so primitive that it doesn't use the most widely available treatment as a first line approach, which, as you point out, is the placebo effect. Why are so many resources being wasted on developing new chemicals when the brain can seemingly perform the same functions with nothing? I get that for a lot of things you need a physical intervention, but shou…

The placebo effect only really changes self-reported symptoms. It makes people feel much better and that shouldn't be discounted, but it doesn't change things you can make objective measurements of - like whether the patient is alive or dead.

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

#150

Post by Aloisius » Tue, Mar 13, 2012, 5:34 PM UTC

dlytle wrote: post #118

betterth wrote: post #113

Earlier quoted context omitted.

Funny thing about meth is that it's not that dangerous -- it's almost identical to adderral. The methyl group (meth-amphetamine vs amphetamine) really only improves the ability of the drug to cross the blood-brain barrier. It's basically a form of adderal with a slightly stronger bioavailability curve. The reason why meth is a public health issue while addy arguably is not is mainly because requiring a Doctor rx, usi…

As an Adderall user, I can back this up. The symptoms of use are very similar to meth. Ever seen that "meth jingle" ad? The whole "pulling hairs out of your face, cleaning everything, etc" pitch is spot on to Adderall side effects. The difference is that Adderall side effects are dramatically more mild due to (as betterth said) a properly calibrated and reliable dose. Also, with Adderall, you can't afford to just tak…

Uh, having taken adderall nearly every day for 20 years, I can say that I have absolutely no temptation to take another when the first wears off. In fact, I tend to forget without an alarm and then wonder why I can't focus.

Nor have I ever had any compulsion to clean everything in sight or pluck every hair from my face. It certainly makes cleaning easier, but I certainly don't feel the need to do it anymore on or off of it.

You appear to have become addicted.