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

timesofindia.indiatimes.com

171–180 of 227 posts

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

#171

Earlier quoted context omitted.

But most of those R&D costs are for getting "FDA" approval. I don't see why India (or anyone, really) should pay for lining the pockets of the USA's inefficient and corrupt bureaucratic machinery. Or I could be wrong and those $12B really goes into equipment and lab workers wages, but you won't blame me for finding it real hard to believe until I see at least a rough breakdown of how those costs are summed up. From t…

The majority of the money goes into Phase III clinical trials. Don't bash the FDA - they're the most evidence based, scientifically minded regulatory body in our government. Preclinical and Phase I - II trials aren't too expensive, in the order of millions of dollars. But also remember, for every ~10,000 candidates that enter preclinical trials, about 1-2 will actually pass FDA approval. The billion number isn't just…

> If "the most rigorous evidence requirement in the world" is your example of "inefficient and corrupt", than I guess we'll just disagree.

That is exactly where so much of the inefficiency comes from! How rigorous does an evidentiary requirement have to be before it costs more than it's worth? If getting FDA approval for a new drug cost, say, $100 billion, would the added safety be worth holding back all the drugs that wouldn't be profitable enough to offset that huge up-front cost? A truly efficient FDA would take into account not just the harm of being too lax, but also the harm of being too strict.

(There's an even starker example of this in the Nuclear Regulatory Commission. Their regulations are so strict and red-tapey that the economics of nuclear energy in the US are inferior to those of coal, which is much more dirty and dangerous. Caution has costs.)

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

#172
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…

Most private research dollars go into patent work-around drugs--drugs that have the same basic function as another, but successfully work around its patent (and get their own patent in the process). E.g. duplicated effort with occasional serendipity leading to something new.

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

#173
post #137

This may end up hurting India not helping. In order to get a drug approved in India, you need to run clinical trial on Indians. You also need to go to through the regulatory process, which isn't cheap. If drug companies fear that the millions they spend on getting a drug approved in India won't be recouped because the gov't issues a compulsory license, then they simply won't do it. I mean think about it... if introdu…

The really simple argument is that at the previous price very, very few people in India could afford it. So in the end it is more than likely that the revenue that is gained is higher than it would have been at the very high price.

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

#174

Earlier quoted context omitted.

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 perce…

Do you have any evidence for that? I don't have any background in pharma, but my background in stats tells me that the odds of passing a controlled study with a placebo would be so low as to be economically infeasible.

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

#175

Earlier quoted context omitted.

The reason the EPS hasn't taken a hit is because these companies aren't stupid. If they can't bring in more money by selling new products, they cut costs instead. Pharmas have been laying off huge numbers of research scientists and slashing their sales forces in record numbers. If you follow the industry, it seems like a major Pharma site is closing completely every few months. In the short-term, this props up the nu…

Should doctors really be finding out about drugs from salespeople? It seems to me that this is a large part of the problem and perverts the incentives in the industry not to produce what people need but what they can sell. There has got to be a more efficient way for doctors to discover what drugs are useful to the patients they treat. Heck, look at the tech startup industry. Very few if any of us learn about new sta…

Why was this downvoted?

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

#176

"The Bayer price of Rs 34,11,898 per year ($69,000) is more than 41 times the projected average per capita income for India in 2012, shattering any measure of affordability." This is good enough for any govt to act so and rightly done as well! Also "6% royalty on net sales every quarter to Bayer" that isnt all unfair

Bayer is in it to make money, so presumably the reason the Indian government forced this deal is that Bayer would lose money under it. So no, it isn't fair.

Keep in mind that the government did NOT force Bayer to manufacture the drug, only to license it. I don't believe Bayer had any interest in pursuing the Indian market whatsoever since it was priced well beyond what the average person could afford.

On the question of fairness: Is it fair for people to die because they can't afford a life-saving drug? I'm sure that's what it boiled down to for the Indian government.

According to my math if Bayer priced the drug over here the same way they did in India relative to average per-capita income the drug would cost around $1.5 million per year. Would that change your perspective?

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

#177
This is a late stage cancer drug, delays death by 6 months to 5 years for liver and kidney cancer patient. Even after 97% reduction most Indian households may not be able to afford it .

Government wants to buy it and distribute through government and aided hospitals, that is the principal reason behind it.

According to statistics there about 200 Indians using it, even if can save a additional thousand lives it is worth passing this compulsory licensing

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

#178
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…

@JunkDNA, you seem to know Pharma R&D & patents.

An excellent read on another case coming up before the Indian Supreme Court, regarding Swiss drug co. Novartis's blockbuster anti-cancer drug Gleevec.

http://www.nytimes.com/2012/03/07/business/global/indias-sup...

I think that judgement might be more important, as the NYT article points out how the US govt is trying to influence the outcome. http://keionline.org/sites/default/files/tpp-10feb2011-us-te...

What are your thoughts on Gleevec ?

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

#179

Earlier quoted context omitted.

Why would we want to sustain the current model again? What's to say that whatever new model crops up in its place won't be better? I can't really think of any industry that had their business model collapse that didn't come out of it better than they had been. Individual players, technologies and processes may disappear, but it's not like demand will, and so long as there is demand, there is a potential market.

I agree, but the risk is this: the current model produces the majority of the world's NME's (new molecular entities, or truly new drugs that aren't just old drug + ibuprofen and a new name). We can sit here and talk about what's wrong with the system, but it ignores that this is the most successful system in the history of medicine for producing truly effective pharmaceuticals. But ultimately I agree, we may be in fo…

Does the current model produce the majority of the world's NMEs or does the current model simply bring them to market. From another comment on this topic, it sounds as though most novel research happens not in the labs of companies like Glaxo-Welcome or Pfizer, but in university research labs for a couple of million dollars.

If this is the case, I imagine that any disruptions will occur at the C-suite level mostly, paving the way for entirely new ways of looking at the problem of bringing a new drug to market.

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

#180
post #168

Does anyone else find it appalling that the American government and American companies have the gall to complain about intellectual property violations in developing countries like China and India? Until the late 1800s, American IP law explicitly excluded foreigners from IP rights. That's right, forget about lax enforcement (like you often see in developing nations nowadays) - you could violate foreign IP rights in p…

No one else finds it appalling that things in the 1800s are not the same as in the 2000s. It is a bit appalling that you expect nothing to change in 200 years though.

Read my comment here: http://hackerne.ws/item?id=3699868

It has nothing to do with the year, it has to do with the position of the US (as developing or developed) changing its viewpoint vis-à-vis IP rights.

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