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

timesofindia.indiatimes.com

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

#201

Post by Produce »

carbocation wrote: post #129
Produce wrote: post #105

Earlier quoted context omitted.

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…

Every time I read a post like yours, I think "Do you really want to treat HIV with a placebo?" But I know that's an uncharitable reading of your position. Which diseases do you propose be treated with placebo primarily?

All I said was try a placebo and see if it works as part of the standard routine. Obviously with a potentially fatal illness you want to use everything in your disposal to stop it. Why would you not use your last resort for something that serious? But then that includes using both physical and psychological treatments. If someone has HIV then the boost that positive thinking delivers to the immune system (http://legacy.lclark.edu/dept/chron/positives03.html) combined with anti-virals could save a life. If it's something like, say, depression or migraines or the flu, then a placebo may well cure it and there's no need to prescribe drugs which have nasty side effects or are addictive. If you can get something for free, why would you not do it?

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

#202

Post by Produce »

tomjen3 wrote: post #125
Produce wrote: post #100

Earlier quoted context omitted.

Human lives are at stake, there's nothing more cut and dry than that. We need to stop trying to make our reality fit our models and start adapting our models to fit reality. This whole business is backwards.

You have made a series of statements, but they don't follow logically at all. Yes human lives are at stake (but then they always are), yes our models should follow reality as closely as we can if they are to give any useful predictions. But what do you mean the business is backwards? Surely they are trying to make money.

>Yes human lives are at stake (but then they always are), yes our models should follow reality as closely as we can if they are to give any useful predictions.

I would argue that our models do not follow reality closely enough given that there are people who cannot afford to have their lives saved. If our model yields such results then it ought to be rebuilt or refactored.

>But what do you mean the business is backwards? Surely they are trying to make money.

As in peoples' business, what they do. To rephrase, the business of how we handle healthcare research is backwards. The part of society responsible for that should not be in the mindset of making money but that of saving lives.

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

#203

Post by ori_b »

jerf wrote: post #199
ori_b wrote: post #169

Earlier quoted context omitted.

A workable model may be industry/research partnerships with universities, with heavy government subsidies.

That's generally not a model that results in decreased costs, not to mention that we're in a situation now and for the forseeable future where people really need to stop thinking of the government as a free money fountain. We already can't fund our current commitments, adding yet more billions onto the already huge pile is not necessarily a good idea. (And don't even think of trying to sell me on it being a net money…

The money needs to come from somewhere. I'd rather not have the costs concentrated on the sick. We do have plenty of money to fund everything we need if we pull our military out of most foreign countries. I believe that Nasa's annual budget, for example, is roughly the same cost as 1 day in Iraq [citation needed].

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

#204

Post by jerf »

ori_b wrote: post #203
jerf wrote: post #199

Earlier quoted context omitted.

That's generally not a model that results in decreased costs, not to mention that we're in a situation now and for the forseeable future where people really need to stop thinking of the government as a free money fountain. We already can't fund our current commitments, adding yet more billions onto the already huge pile is not necessarily a good idea. (And don't even think of trying to sell me on it being a net money…

The money needs to come from somewhere. I'd rather not have the costs concentrated on the sick. We do have plenty of money to fund everything we need if we pull our military out of most foreign countries. I believe that Nasa's annual budget, for example, is roughly the same cost as 1 day in Iraq [citation needed].

In 2011, we spent 700 billion on the defense department, and we spent 1,205 billion dollars more than we took in. It's time to stop thinking of the government as a free money fountain.

I'd suggest it's much cheaper to look into how we could reduce the regulations making it so expensive, rather than throw government money at a problem of the government's creation. At the point where we are seriously talking about the entire edifice collapsing one must take seriously the question whether the costs of our regulatory regime have managed to exceed the benefits. Right now we have a terribly irrational balance between those who are hurt taking insufficiently vetted drugs vs. those who are hurt by not having drugs available for years that turn out safe. The former are visible and the latter invisible, but they are still real. A classic recipe for irrationality.

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

#205

Post by Aloisius »

Aloisius wrote: post #150
dlytle wrote: post #118

Earlier quoted context omitted.

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…

Yes indeed I often forget to take it during the weekends. I have no compulsion to take it when my prescription runs out (I often delay going to the doctor to get a refill and go a week without, especially if focus is not absolutely necessary).

I didn't realize this was unusual.

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

#206

Post by ori_b »

jerf wrote: post #204
ori_b wrote: post #203

Earlier quoted context omitted.

The money needs to come from somewhere. I'd rather not have the costs concentrated on the sick. We do have plenty of money to fund everything we need if we pull our military out of most foreign countries. I believe that Nasa's annual budget, for example, is roughly the same cost as 1 day in Iraq [citation needed].

In 2011, we spent 700 billion on the defense department, and we spent 1,205 billion dollars more than we took in. It's time to stop thinking of the government as a free money fountain. I'd suggest it's much cheaper to look into how we could reduce the regulations making it so expensive, rather than throw government money at a problem of the government's creation. At the point where we are seriously talking about the…

I'd suggest it's much cheaper to look into how we could reduce the regulations making it so expensive

That part's pretty easy. Reduce the guarantees we require demonstrating the safety and effectiveness of new drugs.

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

#208

Post by ekianjo »

jbooth wrote: post #91
ekianjo wrote: post #57

Earlier quoted context omitted.

The reason why the cost of R&D is inflating so much is due to relentless addition of new regulations, new requirements, new safety-related trials demanded by the authorities. Add to that that almost every other country has specific requirements that do not fit with what was developed and proven before, and that's just another 2-3 years clinical trial you need to put up with. This is really getting insane and there is…

Yeah, there are a lot of safety-related things because we keep getting a vioxx every so often that's killing people. I'm not willing to increase my chance of getting killed by medicine on behalf of someone else's profit margin. They have a big, powerful lobby, they should suggest process improvements. And make some on their end, as well, nobody's charging them billions in fees, they spend that money on the typical bi…

Note that we still got a Vioxx on the market even though we had those tons of regulations in place. There was a similar scandal in France recently with another drug called Mediator. Truth is, regulations do not replace ethics - Corporations knowlingly allowing patients to be hurt should be punished accordingly - there is no need to inflate regulations further and further, this has never solved the problem, just like regulations in the financial industry will not make crooks disappear.

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

#209

Post by streptomycin »

pjscott wrote: post #171
betterth wrote: post #90

Earlier quoted context omitted.

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 th…

But they already do this. When they design clinical trials, they take type 1 and type 2 errors into account. Even if you wanted to accept a ton more error, which would mean a lot more bad drugs on the market and a lot more good drugs off the market, it's still not going to be cutting costs by orders of magnitude or something.

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

#210

Post by streptomycin »

vannevar wrote: post #142
roadnottaken wrote: post #120

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…

That's not true. Drug companies can't just cherry pick trials to report to the FDA. The FDA is involved from very early on in the process. Furthermore, if the drug company is doing suspicious things like shutting down trials, the FDA will be even more strict in their requirements for approval.
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