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Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

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Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#111

Post by DanBC »

lukasm wrote: post #22
kar1181 wrote: post #12

Having lived in both the UK and US I find the cost of medicines very hard to understand here. For example in the UK I can buy a ventolin inhaler for £10 over the counter (if I went to the Doctor it would be free). But in the US, an inhaler costs me $60 (with insurance). Why is it that much more expensive here?

In UK government has almost a monopoly for buying drugs, so they have a leverage in negotiation and there is a lower overhead with paper work. Americans subsidize drugs for the rest of the world.

> Americans subsidize drugs for the rest of the world.

This keeps being said, but I've never seen any support for it.

It's probably true to say that Americans subsidise the massive advertising budgets.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#112

Post by ceejayoz »

microcolonel wrote: post #86
ceejayoz wrote: post #36

Earlier quoted context omitted.

That's a strawman. Yes, most patients likely retained their access to the drug. The issue is more that we all wind up paying higher premiums so Shkreli can line his pockets with inflated proceeds and no alternatives.

I doubt much money is spent on Daraprim overall. $75k is apparently the overall cost of a course of treatment to insurers, in addition to the two or three other drugs prescribed to reduce the side effects of the drug. It is apparently not in common use, Health Canada says that hospitals simply don't buy it anymore as of 2013, well before the price increase. I suspect that if there's an entire first-world nation which…

Wikipedia says it's on the WHO Model List of Essential Medicines, and while the number in the US on it may be low, it's not like this can't be done with other medications.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#113

Post by Neliquat »

mikeash wrote: post #82
microcolonel wrote: post #78

Earlier quoted context omitted.

He outright offered to send the drug at no cost to patients whose insurers did not cover it.

Before or after his name got dragged through the mud?

Its pretty standard for most life saving drugs to be subsidized. Watch the end of many pharma ads in the us. Not saying he is a saint, but in this case you are ascribing malice where there is none.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#114

Post by ebalit »

kgwgk wrote: post #69
FireBeyond wrote: post #37

Earlier quoted context omitted.

Yeah. That's not so accurate. Top 10 pharma companies, 5/10 are US (2 UK, 2 Swiss, 1 French). 4 of the top 6 for profit margins (from 43%(!) to 19%) are US (Merck is the only outlier, 9th, at 10%). 4 of the top 5 for Sales and Marketing Spend (both on raw dollars and as a percentage of revenue) are US. 3 of the bottom 5 for R&D spend (as a percentage of revenue) are US. I think I see a little fat that can be trimmed…

For all those companies the largest and more profitable market is the US, the country of domicile doesn't have much relevance for this discussion.

It's not the case for Sanofi if I understand the table on page 5 of this document correctly:

http://www.eucope.org/lib/downloads/basic_facts_about_the_eu...

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#115

Post by kgwgk »

ebalit wrote: post #114
kgwgk wrote: post #69

Earlier quoted context omitted.

For all those companies the largest and more profitable market is the US, the country of domicile doesn't have much relevance for this discussion.

It's not the case for Sanofi if I understand the table on page 5 of this document correctly: http://www.eucope.org/lib/downloads/basic_facts_about_the_eu...

These figures are pretty old. See for example: http://en.sanofi.com/Images/40647_GlobalGBUs_NewGeo_2015.xls

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#116

Post by mikeash »

Neliquat wrote: post #113
mikeash wrote: post #82

Earlier quoted context omitted.

Before or after his name got dragged through the mud?

Its pretty standard for most life saving drugs to be subsidized. Watch the end of many pharma ads in the us. Not saying he is a saint, but in this case you are ascribing malice where there is none.

I know the guy jacked up the prices for these drugs enormously, and the stuff I found about people getting it for free if their insurance doesn't cover it is after the controversy got rolling, so I don't think I'm ascribing malice so much as describing it.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#117

Post by e40 »

refurb wrote: post #97
e40 wrote: post #80

Earlier quoted context omitted.

We have evidence that the FDA errs too conservatively and doesn't approve (or delays) drugs that would have turned out totally safe and helped people. I'd like to see evidence for that. My impression, from all that I've read on the subject, the truth is quite the opposite. The FDA's funding has steadily been cut over the years and the restrictions on drug trials have been more lax over time. For example, drug trials…

completely run by the companies themselves That's an odd criticism. Who would run the trial if not for the sponsor?

It certainly could be the case that disinterested 3rd parties could be involved, at some level, to remove the possibility of bias.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#118

Post by refurb »

criddell wrote: post #104
refurb wrote: post #100

Earlier quoted context omitted.

And what do you think the impact on biotech VC money will be? Would you invest in a company if the gov't could confiscate the intellectual property?

I think the impact would be similar to the impact eminent domains laws have on real estate investment. What do you think the impact of withholding drugs from those that can't afford them could be?

Eminent domain in real estate means the property owner gets reimbursed for the fair value of the property taken. If the gov't is willing to fork over a few billion dollars to drug manufacturers, then yeah , no impact to VC investment.

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#119

Post by allenz »

koolba wrote: post #98
drewrv wrote: post #94

Earlier quoted context omitted.

Pricing based on value provided to the customer makes a lot of sense for phones and web apps and cheetos. But how much do you value being alive? The "value" of a lifesaving drug is essentially unbounded, most people will pay anything to stay alive. That's one of the reasons healthcare is an edge case where the typical rules of capitalism don't work. So yes, it is unfair to have some industries price their products ba…

> Pricing based on value provided to the customer makes a lot of sense for phones and web apps and cheetos. > But how much do you value being alive? The "value" of a lifesaving drug is essentially unbounded, most people will pay anything to stay alive. That's one of the reasons healthcare is an edge case where the typical rules of capitalism don't work. > So yes, it is unfair to have some industries price their produ…

Everyone knows single-payer would be great, but practically speaking we don't have the votes :(

I'd also propose a ban on drug marketing, which would reduce about half the costs.[1]

I don't think that excluding monopoly drugs will work. First, the industry has made significant progress in the past two decades, so for most major diseases, the leading treatment was patented within the last 20 years. Second, drug companies have little incentive to make direct competitors, and R&D effort is better allocated in areas with unmet medical need. Third, unpatented cures are already cheap, so by market size, almost all drugs are monopolies.

Over a third of the $333B pharmaceutical market[2] can be attributed to:

- Antibody drugs, $100B revenue and growing, almost all after 1997. E.g. Herceptin for HER2+ breast cancer, Humira for arthritis, Avastin for many cancers.[3,4]

- The cure for Hepatitis C is patented until 2028, and currently has $20B revenue.[5,6]

Disclaimer: I've worked in the industry.

[1] http://blogs.sciencemag.org/pipeline/archives/2013/05/23/ano...

[2] http://trade.gov/topmarkets/pdf/Pharmaceuticals_Executive_Su...

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622599/

[4] http://www.prnewswire.com/news-releases/antibodies-market-no...

[5] http://www.pharmacompass.com/patent-expiry-expiration/sofosb...

[6] http://www.pharmacompass.com/radio-compass-blog/top-drugs-by...

Re: Trump Sends Pharma Stocks Down with New Tweet on Drug Prices

#120

Post by huxley »

refurb wrote: post #99
drewrv wrote: post #94

Earlier quoted context omitted.

Pricing based on value provided to the customer makes a lot of sense for phones and web apps and cheetos. But how much do you value being alive? The "value" of a lifesaving drug is essentially unbounded, most people will pay anything to stay alive. That's one of the reasons healthcare is an edge case where the typical rules of capitalism don't work. So yes, it is unfair to have some industries price their products ba…

Go talk to the NHS. They value a year of healthy human life at 30,000 GBPs. And if you take your idea to the extreme, then every person should have access to every type of medical care regardless of the value offered?

Most people won't know what you're referencing.

https://www.channel4.com/news/drugs-life-breast-cancer-nice-...

https://www.nice.org.uk/news/article/kadcyla-too-expensive-f...

NICE (National Institute for Health and Care Excellence) sets the guidance on the QALY (Quality Adjusted Life Year) at between 20000-50000GBP for a year's worth of a single drug treatment.

Of the drugs that they approve for coverage the annual regimen has to be under a threshold of 50000GBP or it may not be covered by the NHS.

But that 20000-50000GBP is per drug per person, someone could be on multiple drugs and treatments simultaneously for much more than that and they'll be covered.

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