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Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

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Re: Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

#32

I feel kinda bad for the writer, because it's a good question: no, curing patients is not a good business model, just like public transit is not a good business model. What a lot of folks neglect are N+1-order effects, because those are harder to quantify and fail to reach the predetermined decision some executive or board or shareholder has already made. Is curing patients a bad business model? Sure, for the biotech…

I think it's the opposite. I think people are very aware of those effects, and that's actually why they ask the question in the first place.

They ask it "is this good business" not just because they care about the answer itself but because they want to start a debate on how society should promote the invention of cures.

Like I think most people in most industries are passionate people that really want to do good, but they do need to eat too.

Re: Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

#33

I feel kinda bad for the writer, because it's a good question: no, curing patients is not a good business model, just like public transit is not a good business model. What a lot of folks neglect are N+1-order effects, because those are harder to quantify and fail to reach the predetermined decision some executive or board or shareholder has already made. Is curing patients a bad business model? Sure, for the biotech…

If a person dies from a disorder in their 20s, they'll never buy your heart medication in their 70s. Today's patient is tomorrow's patient.

The issue with that logic there is those basic drugs are mostly generic now. That money is less, and goes to the PBM and generic manufacturers in India.

Re: Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

#34
post #26

I feel kinda bad for the writer, because it's a good question: no, curing patients is not a good business model, just like public transit is not a good business model. What a lot of folks neglect are N+1-order effects, because those are harder to quantify and fail to reach the predetermined decision some executive or board or shareholder has already made. Is curing patients a bad business model? Sure, for the biotech…

With public transit, value capture is possible if you have the right business model. Public transit is ultimately real estate development. However, I prefer that the value capture is by the public rather than a private corporation.

Public Transit was very much thrown in there as an example of the kinds of societal-good projects that often are "bad" business models or run at a loss (Japan being a very notable exception, kinda). Thing is, anyone even casually looking at n+1-order effects sees that the value created isn't for the transit system itself, but all the components that make it function (jobs, logistics, and materials for trains, rails, signals, ports, tunnels, etc) and all the effects of easing people movement (more money to spend, more job opportunities, cleaner air, safer streets, etc). Real estate is one such effect, provided communities recognize the benefit of real estate near stations and not let naysayers constrict development around them (like you see in much of America, for some reason).

Re: Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

#35

I feel kinda bad for the writer, because it's a good question: no, curing patients is not a good business model, just like public transit is not a good business model. What a lot of folks neglect are N+1-order effects, because those are harder to quantify and fail to reach the predetermined decision some executive or board or shareholder has already made. Is curing patients a bad business model? Sure, for the biotech…

If a person dies from a disorder in their 20s, they'll never buy your heart medication in their 70s. Today's patient is tomorrow's patient.

The longer someone lives, the more potential value they can contribute to a society. The opportunity cost is something we've figured out from a medical perspective, but shareholders want returns today, not returns fifty years from now.

That is what we need to address.

Re: Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

#36

Earlier quoted context omitted.

yeah but the pharma comapnies are only in the business of selling drugs so they would need to diversify into retirement homes or somnething to profit from actually curing people

I mean, that's one way to look at it I suppose, and it's why you see Healthcare Insurers and Private Equity diversify into elder care for a captive audience. In reality though, I was not-so-subtly trying to suggest that if something is necessary for the public good (curing diseases) but a bad business model, then perhaps Capitalism itself is the wrong vehicle for that segment of industry and a different option - be i…

> In reality though, I was not-so-subtly trying to suggest that if something is necessary for the public good (curing diseases) but a bad business model, then perhaps Capitalism itself is the wrong vehicle for that segment of industry and a different option - be it an incentive structure, government-owned pharmaceutical research, or managed economy - is needed.

I believe the great innovation of capitalism is markets, and the next era of economic and social progress will be driven by mixed capital/social good markets.

For example, what if you tied the tax rate for an industry to a combination of broad social goods (say, homelessness) and industry-specific goods (say the incidence rate of cancer for cancer drug companies), such that if we’re in a the middle of a homelessness crisis and many people have cancer, the tax rate might be 50%, vs if there is virtually no homelessness and we’ve cured cancer, maybe it’s 10%. Obviously there are other market approaches but eventually they would be converted to capital markets, so something like the above makes sense to me as a start.

Re: Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

#37

Earlier quoted context omitted.

If a person dies from a disorder in their 20s, they'll never buy your heart medication in their 70s. Today's patient is tomorrow's patient.

The longer someone lives, the more potential value they can contribute to a society. The opportunity cost is something we've figured out from a medical perspective, but shareholders want returns today, not returns fifty years from now. That is what we need to address.

They could use profit in 50 years, but it will possibly be someone else's profit.

Re: Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

#38

I feel kinda bad for the writer, because it's a good question: no, curing patients is not a good business model, just like public transit is not a good business model. What a lot of folks neglect are N+1-order effects, because those are harder to quantify and fail to reach the predetermined decision some executive or board or shareholder has already made. Is curing patients a bad business model? Sure, for the biotech…

yeah but the pharma comapnies are only in the business of selling drugs so they would need to diversify into retirement homes or somnething to profit from actually curing people

Or some kind of organization, some kind of union of all people, could pool their money and invest in such a thing.

Re: Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

#39

I feel kinda bad for the writer, because it's a good question: no, curing patients is not a good business model, just like public transit is not a good business model. What a lot of folks neglect are N+1-order effects, because those are harder to quantify and fail to reach the predetermined decision some executive or board or shareholder has already made. Is curing patients a bad business model? Sure, for the biotech…

> I feel kinda bad for the writer, because it's a good question: no, curing patients is not a good business model, just like public transit is not a good business model.

Betteridge's law of headlines: "Any headline that ends in a question mark can be answered by the word no."

Re: Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

#40

socialized healthcare please and thank you.

[flagged]

Thats simply not true. To argue to an absurd reduction, if that were true the NHS would preference amputation and wooden limbs over all other treatments for infected limbs. They still preference paths short of amputation.

It's a race to a medium. the problem is the medium is lower than rich people want, and the masses of poorer people who benefit from being lifted above amputation and a wooden leg don't appear in the cashflow as benefactors.

Getting used to a happy medium being lower than many people are used to, is hard.

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