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A million-dollar drug

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Re: A million-dollar drug

#111

Post by School-Cotton »

apsec112 wrote: post #9

This seems bizarre to me: Van Deventer says the company never considered lowering the price. "Why would we? Pricing shouldn't be a political decision. It should be a rational decision based on merits and value." If no one will pay $1 million, your revenue is $0. Assuming the drug costs much less than $1 million to make, surely any revenue number is better than $0?

Because if you signal to health systems that you're not serious about your pricing, why should they pay you fairly in the future, rather than just stubbornly waiting for you to give up and sell at a loss?

It's basically the same reason most businesses throw product away rather than just distributing it for free.

Re: A million-dollar drug

#112

Post by School-Cotton »

ericflo wrote: post #76
rayiner wrote: post #47

Earlier quoted context omitted.

It's bad to analyze this issue through the medium of a long-form article, which wraps the story up in emotional narrative. Here is a better write-up in the MIT Technology review: https://www.technologyreview.com/s/601165/the-worlds-most-ex... . The gist of the problem is this: > The Amsterdam company spent more than $100 million testing the drug and carving a path through Europe’s medical rules and regulations, which…

> Viewing this after-the-fact leads one astray, into thinking there is some problem with the system > The answer is probably that this drug doesn't make economic sense You don't see it? The problem with the system is that we let economics drive these decisions.

Okay. Let's say you were the dictator of the world. What model not involving "economics" would you propose for deciding how many resources to assign to which medical research projects?

Re: A million-dollar drug

#113

Post by eloff »

School-Cotton wrote: post #110

> "Why would we? Pricing shouldn't be a political decision. It should be a rational decision based on merits and values," he said. "Hundreds of millions of investor money has gone into the company, and if there is no return for those investments, there will be no new drugs because nobody's going to do that in the future, right?" As terrible as it sounds, this logic seems sound to me. If we think having this type of d…

Yeah, people just look at the price and think that's terrible, but it's a business not a charity. It's up to the government to step up if people really deem this to be a problem worth solving. With their tax dollars. I bet a lot of critics would go quiet at the point they actually have to pony up.

Re: A million-dollar drug

#114

Post by School-Cotton »

ddingus wrote: post #77
lisper wrote: post #53

Earlier quoted context omitted.

> You can play this moral dilemma forever. Yes, of course. That's the whole point. It's a very hard problem. > In reality, there is no dilemma. The people who can help are morally obligated to help in non-theoretical situations. Really? How much money have you donated to help provide clean drinking water to poor children in third world countries? > If a child is drowning, and by jumping in I have to ruin my $5,000 wa…

Seriously? Tell me how a person watches a child drown. Sorry fam, next week I plan on donating to save 100 kids living in worse places than your dead kid lived in... Actually facing a scenario like that, and the people involved plays out very differently.

There is no argument here other than an appeal to emotion.

Yes, it's true that no normal person would actually avoid jumping into a pool to save a drowning child, even at the cost of $5000 that could save 100 other people. That is the entire point -- human moral faculties are not based on logic, and overweight the interests of people you can see, or whom you can help in obvious, concrete ways, relative to diffuse total global happiness. But the fact that humans are wired to think in a particular way doesn't prove that it's rational or correct.

Re: A million-dollar drug

#115

Post by GeekyBear »

Getting a drug approved for use is an expensive proposition, but that doesn't mean that it is impossible for a nonprofit organization to step in and get the job done when the target treatment group is too small or too poor to make it worthwhile for those with a profit motive.

The Drugs for Neglected Diseases Initiative, a nonprofit which grew out of Doctors Without Borders, just received approval for a pill that successfully treats African Sleeping Sickness.

>Ultimately, the drive for approval cost $63 million and involved clinical trials including 750 patients in Congo and the Central African Republic. Two million villagers were screened.

The costs were paid by seven European countries, the Bill and Melinda Gates Foundation, Doctors Without Borders and other donors.

https://www.nytimes.com/2018/11/16/health/sleeping-sickness-...

Re: A million-dollar drug

#116

Post by School-Cotton »

miguelrochefort wrote: post #3
charlesism wrote: post #2

"Well, one pharma company has the patent, and we need to let them charge what they think the market will bear. Sorry LPLD carriers, you have to die now." Apparently, this is the best the world can manage in 2018.

I don't understand how anyone can think patents are a good idea.

Reading the article has convinced me that drug patents in particular are a great idea. Isn't it wonderful that we live in a world where futuristic new treatments like this can be developed?

Yes it's true that people can't get the drug now, but at least someday it might be available.

Without patents, who would you find to work for free developing something like this?

Re: A million-dollar drug

#117

Post by School-Cotton »

longerthoughts wrote: post #25
carbocation wrote: post #6

Earlier quoted context omitted.

What if governments paid for the clinical trials?

The government does frequently fund the discovery of new drugs. The problem is that the return on that investment is usually abysmal and the taxpayer ends up not only paying to fund the drug’s discovery, but also paying absurdly high prices to buy it from pharmaceutical companies who passed some or all of their risk onto taxpayers. One example: https://abcnews.go.com/WNT/YourMoney/story?id=129651

If you read the article, the drug was in fact discovered at UBC, which is a publicly funded university.

But it turns out that discovering the drug wasn't the expensive part. The expensive part was privately funded.

Re: A million-dollar drug

#118

Post by School-Cotton »

worldsayshi wrote: post #13
miguelrochefort wrote: post #3

Earlier quoted context omitted.

I don't understand how anyone can think patents are a good idea.

There should at the very least be a law that states that a patented technology should be made available in reasonable ways to make the patent valid.

Would you rather have this drug exist and be patented, or never have existed at all?

Re: A million-dollar drug

#119

Post by rileymat2 »

JamesBarney wrote: post #56
rayiner wrote: post #47

Earlier quoted context omitted.

It's bad to analyze this issue through the medium of a long-form article, which wraps the story up in emotional narrative. Here is a better write-up in the MIT Technology review: https://www.technologyreview.com/s/601165/the-worlds-most-ex... . The gist of the problem is this: > The Amsterdam company spent more than $100 million testing the drug and carving a path through Europe’s medical rules and regulations, which…

But of that 100 million dollars the bulk was safety testing due to regulation. So you're right it doesn't make economics sense but for a specific reason. As a society we have to strike a balance between safety and efficiency. And I don't think we've struck the right balance. Many times erroring too much on the side of safety, especially with rarer and more fatal diseases without good current treatments.

"But of that 100 million dollars the bulk was safety testing due to regulation."

How do you differentiate the cost of safety testing that should be done and the cost of safety testing due to regulation?

Re: A million-dollar drug

#120

Post by School-Cotton »

belltaco wrote: post #31
lisper wrote: post #20

Earlier quoted context omitted.

The last sentence of the article sums it up pretty well: "If it's not commercially viable to produce a certain therapy, unfortunately, in our Western society, it does not happen." And it is far from clear that this is not as it should be, because it's not just LPLD carriers about whom tear-terking stories can be told. $1M can be deployed in other ways that could potentially save more lives. Instead of "Sorry LPLD car…

>If it's not commercially viable to produce a certain therapy, unfortunately, in our Western society, it does not happen. Are there new and innovative drugs for rare conditions coming from non-Western societies?

Excellent point. Everybody in this thread who thinks that the most outrageously expensive branches of medical research will continue to happen without a profit motive would do well to think about how many examples of that we have, empirically.
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