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

theatlantic.com

111–120 of 176 posts

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

#111
This article does not say why the Gleevec patent was rejected, maybe it was not the purpose of the article. Indian companies did not invest in clinical trials, even in the discovery of the molecule. They are just using the disclosures. Even if there is compulsory licencing there should be a cost, about 20 million dollars would be okay based on the average research cost and population of India. I dont believe in compulsory licencing but believe in price control. Let those patent holder companies have exclusive rights but govt should have the right to determine the price based on the purchasing power of the people. The better option of course is govt or the insurance companies negotiate with patent holder. But in India there is no health insurance run by govt that addresses the real price of drugs. Most of the insurance for poor is like a fixed amount like Rs. 30 thousand which does not even cover 10 days in hospital. The price control is supposed to make the cost of healthcare down, but there is no control of the cost of surgical procedures.

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

#112

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…

"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. T…

Saudis spend the most money on hardware, yes. But the hardware is left unused, and the sole reason for it is as a token in lieu of payments for US and allies.

The Saudi Arabian army does not project any power in the region, and is not a player. Saudi Arabia is not even able to support its allies in Lebanon against Iran-backed military players.

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

#113
post #94

Earlier quoted context omitted.

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 an…

One can read the data in different ways, and I don't think anyone doubt that pharma companies do contribute to the investments into new medical innovations. One interpretation that I listen/read about is that NiH and pharma operate on different levels, and thus sadly, NiH's contribution tend to be forgotten because they aren't the people with that pop out the pills bought in the store, even if the pills would not have existed if it hadn't been for the NiH funded research that made the new innovation possible.

Then we add patents and insurance companies into the mix, and some people want to paint a picture how innovation gets created. My comment was thus mostly to inform that the largest single funder to medical research is not some for-profit company like Pfizer, but rather tax supported NiH.

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

#114
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…

US firms are investing less in R&D relatively to their rank http://en.wikipedia.org/wiki/Pharmaceutical_industry#Market_... than their French/UK (publicly-funded healthcare) counterparts. The US are not "subsidizing it for poor countries" more than other rich countries. The truth in the case you're making is not specific to healthcare and is that "research (private and public) of rich countries that can afford it" be…

Whether the US is subsidizing healthcare for other countries is not a function of the amount of research US companies or the government produces. Instead, it depends on the amount of revenue that those companies derive from the US health consumers. I don't have any numbers in front of me but if it turns out that the vast majority of profits for these companies comes from the US, due to our clusterfuck of a healthcare system, and if those extra profits offset the lower revenue from charging other countries less, then that looks like an indirect US subsidy to me (sorry for the unwieldy sentence).

If you're not American, I don't see what there is to take offense at. That's just the shitty (for us) way that it is. Due to structural problems, greed, boondoggles, lack of political will, lobbying/corruption, the US simply can't have low drug prices compared to other rich and poor countries. On the other hand, the US enjoys relatively low prices for electronics and other consumer goods (as our Australian friends can attest to). You win some and you lose some.

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

#115
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…

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.

Haven't seen Goldacre's stuff, but I had heard (can't find a source right now) that it's actually closer to 80-85% of pharma companies costs are advertising and marketing. Can't think of a better place to cut costs, really.

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

#116
post #96

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. "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/…

Thanks for the point by point there, but you basically just confirmed my initial opinion that you really have no clue beyond your own media-infused bias of the situation. I don't think we have to introduce your head to your ass, because I think they're well acquainted with each other. Boo hoo, US evil, blah blah.

That's a complete non-answer, which is usually done by a person with the same issue you're accusing the parent of.

Trident is a sore point for the UK for several reasons:-

> It's not an independent nuclear deterrent, we're on a US leash even if we try to sell it otherwise.

> They're based in Scotland, a country within the UK which has fairly low support for nuclear weapons, which the primary elected party are dead against having them, going as far to make it a platform for the independence vote in 2014.

> We need to buy them and pay for upkeep. Theres talk of £100bn costs to renew the things, and I believe the lions share of that goes right back to the US.

I can't tell you whether or not it was subsidised, but I doubt it was when you get down to it and the comparison you are making isn't completely apt.

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

#117
post #51

Earlier quoted context omitted.

How exactly is extracting the maximum possible revenue from people for giving them something that saves their lives NOT evil?

As far as I know, companies are supposed to make profit,they are not charities. Especially if you are so large that you sell shares in company, then you have a LEGAL obligation to the shareholders to always take decisions that maximise profit over everything else(unless you can show that selling your product cheaper is going to bring more money to the company in the long run). This is not "evil" - this is just how th…

Especially if you are so large that you sell shares in company, then you have a LEGAL obligation to the shareholders to always take decisions that maximise profit over everything else

I wish people would quit saying that. IANAL, but I never have found anything that definitively says that. It would seem that in the case of company sale or takeover, yes, the board has to "maximize shareholder value". But in day-to-day operations there is nothing stopping a company from saying, "we're not going to be assholes" at the expense of maximizing shareholder value. Shareholders don't like it? Sell your shares.

As one example, I refer you to Costco, with profits capped at 15%, to the chagrin of some on Wall Street.

As for the Jobs/Apple example, I sure hate to play the [citation needed] card, but I don't think he exactly said that Apple legally had its hands tied.

EDIT: found my own citation. Jobs said nothing of the sort. http://www.nytimes.com/2012/01/22/business/apple-america-and...

The article even quotes someone from the Labor Department as saying that companies used to use US workers at the expense of "maximizing shareholder value", without anyone going to jail, but they don't now.

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

#118

Earlier quoted context omitted.

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 wa…

I'm from Belgrade, Serbia.

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

#119

Earlier quoted context omitted.

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 wa…

Your view of Iraq's military capabilities and of it's military potential in 2000 is badly wrong. Iraq, by 2000, was a shell of its former self militarily speaking. The sanctions, no fly zones, and complete domination of its military in the early 90s ensured this.

Saudi Arabia, after the first Gulf War, was not in any way threatened by Iraq. Saudi Arabia supported Iraq in its war with Iran.

It is most interesting that you point out Iraq's usage of mustard gas. Said usage occurred during the Iran/Iraq war. The usage was supported by the U.S. until it was applied to Iraqi Kurds. Then there was some moral posturing but the weapons, support, and money kept flowing to Iraq so that they could continue the fight with Iran.

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

#120

Earlier quoted context omitted.

Thanks for the point by point there, but you basically just confirmed my initial opinion that you really have no clue beyond your own media-infused bias of the situation. I don't think we have to introduce your head to your ass, because I think they're well acquainted with each other. Boo hoo, US evil, blah blah.

That's a complete non-answer, which is usually done by a person with the same issue you're accusing the parent of. Trident is a sore point for the UK for several reasons:- > It's not an independent nuclear deterrent, we're on a US leash even if we try to sell it otherwise. > They're based in Scotland, a country within the UK which has fairly low support for nuclear weapons, which the primary elected party are dead ag…

The prospect of getting rid of Trident is the #1 reason why I'm going to vote for independence next year.
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