Live data from Hacker News

Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

theatlantic.com

91–100 of 176 posts

Re: Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

#91

Earlier quoted context omitted.

According to Ben Goldcare (Bad Science, Bad Pharma) the companies spend around 12% of their budgets on R&D and 30% on marketing ... so the R&D is the easy part to be funded - just outlaw the direct marketing to consumers and doctors and the companies can spend 3 times as much on R&D with no problems.

No problems? Why wouldn't your genius idea work in every sector of the economy? Surely Apple and Samsung could sell more, better phones if they didn't conduct market research or run ads...

humor.

That said you'll notice Samsung doesn't advertise it's chips or raw display panels, because they are not actually sold to the people watching The Daily Show.

Re: Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

#92
post #85

Earlier quoted context omitted.

From that list 48.17% of all health care R&D spend is by US based companies. Sounds like the US is subsidizing the world to me.

It should also be mentioned (since we are talking about statistics here), that 1/3 of the total US medical research spending is from taxes (congress) and has been consistently been so for 20-30 years. That money has no connections with the current health care system, or insurance companies and is just pure tax money sent into research. From those 1/3, about 95% of all core research is supported, and around 80% of all…

If true these stat provide a compelling point of argument for expanded government research funding and less protection for the private insurance system. Do you have a source for it?

Re: Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

#93
post #4

This is basically the paradox of US healthcare innovation. Canada can tell its pharmaceutical companies, "yeah, that cool drug you just invented, we're not gonna pay you what you want for that." And what option does the pharmaceutical company have? Convince healthcare providers to charge retail prices to their patients as an out-of-pocket expense, or... reduce prices accordingly. Because healthcare payments are not f…

So the problem is that healthcare innovation is a public good, which like all public goods is underprovisioned if you don't take steps. We approached this one by converting it to a private good within the U.S. But that's not the only solution.

A natural entity to pay for drug development is health insurance companies, who would save a lot of money if drugs were patent-free. But they don't in fact fund patent-free drugs, since their competitors could free-load.

Bernie Sanders proposed a solution: tax the insurers so none can freeload, and use the money for drug development, and keep everything patent-free. The insurers could come out ahead. (Iirc he had a slightly more complex arrangement that didn't require the government to decide who would be funded.)

It's worth noting that patents don't only reward inventors, they also increase their costs. The book The Gridlock Economy talks about this, and mentions one biotech firm that thought it had a cure for Alzheimer's. It infringed on thirty patents, and each patent-holder thought it had the most important part and charged accordingly. They had to abandon the whole thing.

Re: Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

#94
post #85

Earlier quoted context omitted.

It should also be mentioned (since we are talking about statistics here), that 1/3 of the total US medical research spending is from taxes (congress) and has been consistently been so for 20-30 years. That money has no connections with the current health care system, or insurance companies and is just pure tax money sent into research. From those 1/3, about 95% of all core research is supported, and around 80% of all…

If true these stat provide a compelling point of argument for expanded government research funding and less protection for the private insurance system. Do you have a source for it?

I'd be interested as well, because if he's trying to label all NIH-bound funds as imperative to this process, I think he's overstating his case.

Yes, academic institutions do a lot of low level work that pharma companies build on top of, but you'd be surprised how often potential new molecular entities (truly new drugs) do not originate from government sponsored academic sources.

(However, the tools, understanding and/or methodologies that made that new NME possible did likely come from those labs!)

Re: Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

#95

Earlier quoted context omitted.

I think when the UK paid 1/20th of the cost to R&D Trident 2, but got 1/5 of the orders, I'd say yeah that was pretty heavily subsidized by the US to have an ally country with stealth-nuclear capabilities. I also think you have absolutely no clue who international politics works by your blatant naivety. There's a lot more at stake than "access to oil". FYI Iraq showed oil reserves far superior to that of Saudi Arabia…

It sucked to be bombed for three months but now that I realize it made an improvement on your quality of life I feel much better!

Not to be an ass, but Iraq was leading to either another war with Iran, or a war with Saudi Arabia as the Ba'athist party was at odds with both, or just another genocide. The Iraq-Iran war caused (depending on the figures) over a million deaths and at least a trillion dollars in economic damage. The extreme high estimate for the Invasion of Iraq sits at 100,000, and 1/100th the civilian casualties of the Iraq-Iran war.

Personally it didn't improve my quality of life one bit, I had friends and family get deployed over there and I would have preferred they weren't for their and my own sake. I was opposed to the war, I was calling the WMD claims bullshit from the start. I know why the war happened, but I'd have rather our people have been kept out of it and just let Saddam and Ahmadinejad fucktard it out by killing hundreds of thousands of their own people.

I don't know if you're actually Iraqi, or just trying to make a point, if you are I'm sorry for my callousness, but I honestly don't think my friend should have had to be in a Hummer that got hit by an IED because the Iraqi government had a history of going apeshit with mustard gas on civilian populations, just because my government didn't want some retard fiesta in the Middle East to put us into a great depression when the oil industry and all derivative industries halt.

Re: Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

#96
post #31

Earlier quoted context omitted.

> What if the European countries had to had to pay for their own defense? The European countries pay big bucks for their own defense, thank you very much. And the US doesn't provide any defense at all. It merely uses its pressure to get the European countries to participate in its inane crusades and wars, from Korea to Iraq, which are for it's own interests. Plus, defense against what? The only thing that brings any…

I think when the UK paid 1/20th of the cost to R&D Trident 2, but got 1/5 of the orders, I'd say yeah that was pretty heavily subsidized by the US to have an ally country with stealth-nuclear capabilities. I also think you have absolutely no clue who international politics works by your blatant naivety. There's a lot more at stake than "access to oil". FYI Iraq showed oil reserves far superior to that of Saudi Arabia…

>I think when the UK paid 1/20th of the cost to R&D Trident 2, but got 1/5 of the orders, I'd say yeah that was pretty heavily subsidized by the US to have an ally country with stealth-nuclear capabilities.

"Subsidized to have an ally country" is completely different to "subsidized" (as in, "we did them a favor"). Plus, did they get those 1/5 of the orders for free? If not, I can't see how the fact that they paid 1/20th of the cost of the R&D comes into play at all. Do you expect them to pay the R&D on top of the price they buy the stuff?

Plus, the UK is not "Europe". Heck, they're considered mostly US lackeys down in the "continent", what with Blair and all.

>I also think you have absolutely no clue who international politics works by your blatant naivety.

I don't think Americans not in the government have any clue of international policy. For one, their access to good information is extremely limited, and most of their coverage (from news to books) comes from officially sanctioned party lines (with some faux-heretics thrown in for good measure). Even the american leftists have very mediocre analysis and take for granted a lot of ideology.

>There's a lot more at stake than "access to oil". (...) The War in Iraq was less about getting our hands on Iraqi oil, but getting their Regimes hands off of Iraqi oil.

So the well known situation with Saudi Arabia aside, that people in Europe (where we actually read newspapers and discuss international politics all the time, and not just what our government wants to bring into the spotlight to prepare the public consensus for some aggressive foreign policy) know even in High School, you wrote all that just to come around to that it's all about "access to oil"?

>Had they been left alone since before the first gulf war, allowed to buy Russian hardware and build a military superior to that of Saudi Arabia, the region would be under their thumb and so would a massive chunk of the western worlds oil supply for military purposes. Not to mention they would have been well within the budget range to develop nuclear weapons without ever having to test like North Korea

And that makes the business of a sovereign country something the US has any say in it because?

>The US also didn't sit around and leave Europe high and dry in conflicts like the Kosovo War, because following your logic why should the US be dragged into a purely European conflict.

The US shouldn't have been involved at all in the Kossovo war. They just wanted to establish Kosovo as a protectorate, and have a solid base in the Balkans. If the European people had their say (instead of our governments) they would have told the US to go and shove their participation in this conflict.

>So when NATO countries have a vested interest in keeping a country down (Iraq) because it developing a military will support an old adversary (Russia), you can bet they'll tell the public whatever they fucking want to justify a situation like the Cold War never gets the opportunity to arise.

We really hope something like the Cold War does arise. The Cold War was an era where none of the two bloody superpowers could do as it pleased. The so-called "balance of terror" worked in the favor of smaller countries (hence the tons of sovereignty and anti-colonial fights all around the third world). Now we just have one global cop, which does as it pleases, invaded who they like, takes care of its interests by stepping down on sovereign countries and such. Let's hope China can play the counter-balance in the future. (Sure, China has it's flaws. But the counter-balance does have to be totally progressive or democratic. Just as the US is not. It just have to be there, and stand as a limit to the other's power0.

>It's a sad state of affairs that crippling the development of foreign countries is in our own best interest, but personally I enjoy my way of life

Sure. Who wouldn't, if his country fucked up the world for him to enjoy cheap gas, financial domination, et al?

Re: Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

#97
post #31

Earlier quoted context omitted.

> What if the European countries had to had to pay for their own defense? The European countries pay big bucks for their own defense, thank you very much. And the US doesn't provide any defense at all. It merely uses its pressure to get the European countries to participate in its inane crusades and wars, from Korea to Iraq, which are for it's own interests. Plus, defense against what? The only thing that brings any…

I think when the UK paid 1/20th of the cost to R&D Trident 2, but got 1/5 of the orders, I'd say yeah that was pretty heavily subsidized by the US to have an ally country with stealth-nuclear capabilities. I also think you have absolutely no clue who international politics works by your blatant naivety. There's a lot more at stake than "access to oil". FYI Iraq showed oil reserves far superior to that of Saudi Arabia…

"Saudi Arabia has a military far exceeding most European states"

Speaking about knowledge of international politics, this statement is simplistic and arguably wrong. Saudi Arabia does have one of the largest military budgets in the world, but that does not translate to better or more military. It translates to buying more equipment and giving more money to the weapons industry in the US, the UK and other countries. The US is the main beneficiary, so it is kind of like protection money.

In particular, Saudi Arabia is far from the biggest military force in the Middle East in practice. Israel, Egypt, Iran, and Saddam-era Iraq are/were all far stronger. The last fact is the reason that Saudi Arabia and Kuwait invited the US and the coalition when Saddam invaded Kuwait, despite the loss of face. And it is the reason the US is military active in the Gulf region: Saudi Arabia is nowhere near Iran military speaking..

Re: Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

#98
post #4

This is basically the paradox of US healthcare innovation. Canada can tell its pharmaceutical companies, "yeah, that cool drug you just invented, we're not gonna pay you what you want for that." And what option does the pharmaceutical company have? Convince healthcare providers to charge retail prices to their patients as an out-of-pocket expense, or... reduce prices accordingly. Because healthcare payments are not f…

Has nothing to do with "innovation", since nearly all healthcare research is paid for by the U.S. government anyway, and it's much less money than you think.

The claimed expenses for "research" are mostly about bringing slight variations of drugs to market in order to extend patent protections - that is, they are rent-seeking.

> "More than four fifths of all funds for basic research to discover new drugs and vaccines come from public sources."

http://www.bmj.com/content/345/bmj.e4348?ijkey=Y1g4ZVUImIbtX...

The story of healthcare costs in the U.S. is entirely to do with profits for drug companies and hospitals, and has almost nothing to do with "innovation".

Re: Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

#99
post #34
post #27

Earlier quoted context omitted.

Please provide some data to back that up because it is a common belief that the high cost of producing a new drug is offset by the US consumer.

What high cost? US companies pay more money for advertising than for creating the drug. Add other regulation and inefficiencies, and subsidized research would work with 1/10 the money. Not to mention that because of the commercialization of medicine, tons of research is for BS like Viagra and other such drugs (like the tons of stupid feel-good "energy" drugs, so that your boss can squeeze even more overtime out of yo…

>What high cost? US companies pay more money for advertising than for creating the drug.

Misleading stat that doesn't look at the full cost of bringing a NME to market.

You're looking at a yearly budget for a company while ignoring reality: drug development isn't yearly, it takes about 8-12 years total. To analyze something on an 8 year cycle using 1 years worth of data is at best ignorant and at worst, intentionally dishonest.

They'll spend almost $1,000,000,000 USD to whittle 10,000 drug candidates into what is hopefully a single FDA approved new molecular entity.

>That's how you get the US sucking donkey's balls in infant mortality rates. As if it was some third world country.

Did you hear that loud crack? It was you smashing your head against correlation/causation. You might want to have that fallacy checked out. Looks bad, man.

Re: Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

#100

Earlier quoted context omitted.

I think when the UK paid 1/20th of the cost to R&D Trident 2, but got 1/5 of the orders, I'd say yeah that was pretty heavily subsidized by the US to have an ally country with stealth-nuclear capabilities. I also think you have absolutely no clue who international politics works by your blatant naivety. There's a lot more at stake than "access to oil". FYI Iraq showed oil reserves far superior to that of Saudi Arabia…

That's one of the more rational explanations of the causes of the Iraq war that I've heard....

The Iran-Iraq war caused around a million deaths and a trillion in economic damage in the region. If Iraq went against Saudi Arabia, and started bombing the crude oil transports again, we'd be potentially looking at a Great Depression in the US and globally as it would shut down the massive oil refineries in the US gulf, and associated oil-derivative industries like having massive effects on US shipping.

Personally I don't think my friend should have had to be in a Hummer that got hit by an IED (he's fine, well tinnitus but I got that from a Motorhead concert) because Saddam liked bombing civilians with mustard gas, but given my work is solely dependent on petroleum products I kind of like having a job right now.

Post reply on HN