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With no prospects for profits, big pharma neglects new infectious diseases

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Re: With no prospects for profits, big pharma neglects new infectious diseases

#101

Post by vikramkr »

WalterBright wrote: post #5

In the 1960s big increases in regulations on new drug development led to big cost increases, and hence less interest in non-blockbuster treatments.

It's also lead to unprecedented investment and development of drugs for rare diseases. Some 45% of drugs approved last year are for rare diseases.

The key with those is that high pricing let's those rare disease drugs be blockbusters - you can still make enough money in a disease with only a few thousand patients in the US if you're able to charge whatever you want.

We've seen less interest in drugs that can't be blockbusters because the costs have gone up, yes, but we also haven't had another thalidomide yet

Re: With no prospects for profits, big pharma neglects new infectious diseases

#103

Post by vikramkr »

barry-cotter wrote: post #64
refurb wrote: post #9

Earlier quoted context omitted.

Sure, but as a result we don't have problems like thalidomide popping up every decade or so. There are benefits (and drawbacks) to having a much more stringent approval process. And probably worth adding that in public health emergencies, the FDA is more than willing to pull back on regulations in the interest of the public good.

You can have a stringent safety process without having any efficacy process. The FDA has no incentive to approve drugs but plenty to deny them so delay is the order of the day. Delay in approving new effective drugs costs lives. The FDA has not shown any willingness to pull back on regulations during the current COVID crisis, nor have they historically shown any such willingness. Politicians have forced them to. They…

I'm not clear on whether you're arguing that the FDA should not be requiring efficacy? The FDA makes exceptions on cases of urgent need, and not having efficacy as a bar would reduce the reward for innovation - why would you spend all the time and effort to development a treatment for a disease if vitamins with no efficacy are already filling the market? False hope is dangerous, and healthcare is uniquely suited to attracting snake oil salesmen with cure-alls because of how serious health needs are - these regulations are written in blood

Re: With no prospects for profits, big pharma neglects new infectious diseases

#104

Post by vikramkr »

WalterBright wrote: post #69
jokowueu wrote: post #62

Earlier quoted context omitted.

It's was never approved because of one person that was continually harrased if it wasn't for her it would have been approved . There were only 11 people responsible to review these new drugs . For crying out loud pcp was approved as an analgesic after using it on a few prisoners . FDA's stringent approval process is required

> FDA's stringent approval process is required The downside of that is greatly reduced new drug development due to the expense, much more expensive drugs, and years of delay for the ones that are worked on. If you have a less popular disease, or can't wait years, you're out of luck.

Drug companies can charge whatever they want for less popular diseases. 45% of new approvals last year were for rare diseases. In the industry, rare diseases are sought out as ideal targets because of some regulatory advantages and market power. And there has been an obscene amount of money pouring into biotech and drug development over the past few years - probably one of the most active bull markets the industry has ever seen, with huge numbers of drugs in clinical trials and all sorts of fundamental new technologies under development. Industry's doing fine under the current regulatory regime, with this being one of the best times in history for development of rare disease drugs

Re: With no prospects for profits, big pharma neglects new infectious diseases

#105

Post by AmpsterMan »

dTal wrote: post #80
cjfd wrote: post #63

Earlier quoted context omitted.

Actually, there is a market solution to this problem. I cannot claim to have thought this up, it was discussed in an episode of econtalk. Don't remember the person that was interviewed. The idea is that big pharma companies have to publicly post a price for each of their patents. If anyone is prepared to pay that price they get the patent for that price. Next there needs to be a tax that is a percentage of the price…

Why would there be lots more innovation with a low tax? In the limit, that's the system we have now (0% patent tax, companies are free to price their patents however they want).

The assumption there is that the current system is already highly innovative in the U.S., which is generally accepted as true.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#106

Post by [deleted] »

VvR-Ox wrote: post #65

1:0 for Capitalism vs. Humanity. Exactly this is why the motivation to do at least some things should not be bound to earning profit. There is common goods that we need to share, global issues that need to be addressed together and we need to find ways to achieve this if we want to develop further as a civilization. Money must not be the sole reason why we do things or we will fail with this "strategy" and we need to…

[deleted]

Re: With no prospects for profits, big pharma neglects new infectious diseases

#108

Post by vikramkr »

zachguo wrote: post #47

Since COVID-19 is targeting elders, I can imagine there are evil capitalists or bureaucrats who view this pandemic as a gigantic economic stimulus for the next decade. Sorry for my evil thought.

The performance and volatility of the markets over the past few days do not agree with the idea that capitalists and bureaucrats view this as an economic stimulus - having your workforce quarantined and your imports restricted are not good for business

Re: With no prospects for profits, big pharma neglects new infectious diseases

#109

Post by dTal »

AmpsterMan wrote: post #105
dTal wrote: post #80

Earlier quoted context omitted.

Why would there be lots more innovation with a low tax? In the limit, that's the system we have now (0% patent tax, companies are free to price their patents however they want).

The assumption there is that the current system is already highly innovative in the U.S., which is generally accepted as true.

But the premise of this entire thread is that "With no prospects for profits, big pharma neglects new infectious diseases".

Re: With no prospects for profits, big pharma neglects new infectious diseases

#110

Post by Frost1x »

jyrkesh wrote: post #60
_bxg1 wrote: post #11

Earlier quoted context omitted.

> Basically, rather than paying for drugs on a per unit basis, you pay a lump sum for access to the drug. Hmm... a system where uncommon but extreme spikes in the cost of care are artificially distributed so that an entire society can bear them as a group... that sounds oddly familiar...

The fact that there's a feasible market incentive for drug R&D suggests to me that that an actual competitive approach to health care would stimulate this sort of behavior on a more widespread basis.

Perhaps that market incentive only exists when competition is a small/limited factor (say near monopolistic cases)?

There are a lot of businesses I'd happily set up if I knew I'd have limited to no competition. When competition is more fierce, it disincentivizes me to even try.

If I was guaranteed the lionshare of say, local coffee goers across a large area and didn't have to worry about Starbucks, Peet's, etc. I'm pretty sure I could make it successful and my life would be pretty easy, all things considered.

A lot of rural ISPs can operate this way because it's not viable to compete with their infrastructure foothold in a lot of cases and barriers to entry are high/capital intensive (similar to pharma).

I work in a research environment and there are a lot of funding opportunities/solicitations out there that fit our internal capabilities that we don't even bother writing proposals up for because we know how competitive and unlikely it is to be successful compared to certain other opportunities. Instead, we choose our battles where we suspect we have a higher probability of success: less competitive options. This leads to higher ROI for our time. It works fairly well and I imagine most businesses try to operate under a similar perspective (or more dubiously where they also try to actively stifle their competition).

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