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Indian Government uses special powers to slash cancer drug price by 97%

timesofindia.indiatimes.com

151–160 of 227 posts

Re: Indian Government uses special powers to slash cancer drug price by 97%

#152
post #141
post #66

Earlier quoted context omitted.

You're talking about an infinite timeline where they are the sole seller of a drug that is used indefinitely. This is false. When patents expire the drug is also made by generic drug making companies for cheap. So upper bound of getting a ROI is the lifetime of a patent (30 years for drugs iirc, 10 years longer because it takes about 10 years to develop, so still effectively 20 years). For every drug that is successf…

Ok, I might have exagerated. The thing is, when a company chooses to manufacture pharmaceuticals, it shouldn't just be 'business as usual' for them. They must realize that they have a social responsability to undertake besides making a profit, and that is even without a proper regulamentory agency or something of the sort. Most countries have some kind of social welfare, so maybe these companies could have differenti…

But surely the social responsibility to help people isn't just limited to pharmaceutical companies? I mean, if you tell rich people that they don't have any responsibility to help sick people in India until they invest in a medicine company, and then suddenly they have to spend huge amounts of their investment helping those people then I think that's a bit unfair, and more importantly saying that will cause a lot of people to avoid investing in medicine.

Ultimately, matters of social responsibility ought to be governed by the government, using taxation to spread the burden equally among everyone who can pay.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#154
post #36

I worked in the drug R&D business for over 8 years. I still follow the industry closely. Some things always get lost in these discussions. First, manufacturing an existing drug is absurdly cheap. Modern industrial chemistry ensures this for all small molecule drugs (note that this is not the same case for the "biologics" which are often fiendishly difficult to make). Almost all the cost in a drug is the manufacturer…

Where does all the R&D money go? Somehow I get the impression that developing a new drug involves way too many people and processes and that disintermediation and automation along the R&D chain could greatly simplify and cheapen the process.

First of all, you need the brains to develop the drug. I can't imagine that this involves a team much larger than a pre-series A startup.

Does the development process for creating a new drug promote failing fast?

Does keeping the entire R&D process in house help or hinder?

How far can a team get before it needs to try a drug on humans and how much does it cost to get that far?

Are there any startups that just manage a portfolio of patients with symptoms/diseases/disorders and automatically pair those patients with drugs that might benefit them?

Should the process allow the patient to "price" his or her own life/health, whereby patients can opt in to Phase 1 trials for a lot more money than Phase 2 for example and name their own price in the process?

How much of the money spent is actually (time*wages) for a lot of people for an unnecessarily long process? Is burn rate a consideration when creating a new drug? How long does it take to get a drug to market? Can price be reduced by half by reducing the time it takes by half? Do a lot of people in the process spend their time waiting?

Is drug development in the US far more expensive than elsewhere because the entire healthcare system here is more expensive (vicious cost cycle / positive feedback loop)

Anyways, just tossing some ideas out there because I get the suspicion that pharma R&D is ridiculously archaic.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#155
post #56

Earlier quoted context omitted.

> You don't need to be an industry expert to grok that those numbers are wildly unsustainable. Tell you what. When these companies stop being the most profitable in America, or even just when their EPS starts declining, I'll believe you.

The reason the EPS hasn't taken a hit is because these companies aren't stupid. If they can't bring in more money by selling new products, they cut costs instead. Pharmas have been laying off huge numbers of research scientists and slashing their sales forces in record numbers. If you follow the industry, it seems like a major Pharma site is closing completely every few months. In the short-term, this props up the nu…

Should doctors really be finding out about drugs from salespeople?

It seems to me that this is a large part of the problem and perverts the incentives in the industry not to produce what people need but what they can sell.

There has got to be a more efficient way for doctors to discover what drugs are useful to the patients they treat.

Heck, look at the tech startup industry. Very few if any of us learn about new startups from traveling salespeople. We learn about them from websites like Hacker News, TechCrunch, TechMeme, etc.

Do we have doctor bloggers that make an effort to learn about new drugs and discover what is and isn't worthwhile?

I would imagine that the very reliance on salespeople actually makes it harder to bring good, useful drugs to market because the industry generates its own noise for doctors that they themselves need to cut through.

Every pharma salesperson I've ever known has been for all intents and purposes indistinguishable from viagra spam emails in my inbox, except for they have a pulse and "pay" for readership through expensive dinners and other niceties.

The entire drug information dissemination machine is broken.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#156
post #36

I worked in the drug R&D business for over 8 years. I still follow the industry closely. Some things always get lost in these discussions. First, manufacturing an existing drug is absurdly cheap. Modern industrial chemistry ensures this for all small molecule drugs (note that this is not the same case for the "biologics" which are often fiendishly difficult to make). Almost all the cost in a drug is the manufacturer…

Where does all the R&D money go? Somehow I get the impression that developing a new drug involves way too many people and processes and that disintermediation and automation along the R&D chain could greatly simplify and cheapen the process. First of all, you need the brains to develop the drug. I can't imagine that this involves a team much larger than a pre-series A startup. Does the development process for creatin…

I don't have exact numbers on this, but it seems like a lot of the early stage research happens in very small teams at universities and biotech companies.

Then large companies like Bayer acquire the research and spend millions on getting it through FDA process.

I know advancements are being made in automation for various research activities and I'm sure there will continue being a lot of advancements there. (The need for automation is fully recognized at the industry level)

Re: Indian Government uses special powers to slash cancer drug price by 97%

#157
post #78

Earlier quoted context omitted.

I really don't see your point. Microsoft's basic business model hasn't changed, their products are just evolving. Drug companies make new drugs and refine old ones all the time. Other than whining by obviously-biased spokespeople for the drug industry, I have no reason to believe their business model can't be sustained indefinitely under the current regulatory regimes.

Did you read his post about the patent cliff? The majority of blockbuster drugs are about to go off of patent protection. This is where the majority (if not all) of the profit in the industry comes from, as well as a huge chunk of the rests of their costs. It's an interesting time in the industry but the patent cliff is real and the industry is going to change quite a bit more in the next few years. The model is abso…

Why would we want to sustain the current model again? What's to say that whatever new model crops up in its place won't be better?

I can't really think of any industry that had their business model collapse that didn't come out of it better than they had been.

Individual players, technologies and processes may disappear, but it's not like demand will, and so long as there is demand, there is a potential market.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#158
post #144

Earlier quoted context omitted.

If you took the time to look at the link I posted that talks about the Forbes piece, you'd see that they specifically excluded the cost of marketing from the analysis of how much it costs to put out a new drug. When companies do marketing, they expect it to more than pay for itself, clearly it is, or they wouldn't be spending so much on it. I know people don't like to hear it, but marketing products does lead to more…

Of course one expects marketing mental diseases to be effective! 'Its not your fault, take a pill and it will all go away' certainly has mass emotional appeal. However, the article is not too convincing about the methodology of excluding marketing expenses. First - and I know that I'm going to hear about this from some people - you might assume that different companies are putting different things under the banner of…

Mental disease drugs are only a part of industry. The drugs for physical problems are still marketed heavily too.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#159
post #140

Earlier quoted context omitted.

Weight loss drugs. Three new products were rejected by the FDA last year. Sure these drugs had risks, but what's the cost of obesity in terms of medical costs? At this point in time the FDA has incredibly high standards of safety for weight loss drugs and not without reason. But what are the costs of the 40% of obese Americans who will get diabetes, cardiovascular disease, etc, etc?

Wait - so you want to take the at risk group and give them a drug that failed human safety tests? EDIT: I am trying to say that while obesity is 'bad', giving them a drug that adds to their risk levels is not a solution. If you are still pro your position, bear in mind that you are now throwing dice and hoping that: (people who improve) >= (people who suffer + nothing happens). Are you qualified to play dice with peo…

He's not advocating giving drugs to anyone, what he advocates is letting the at risk group decide whether or not they want to roll the dice with their own lives. You advocate forbidding this to happen. In other words you're hoping that: (people who suffer + nothing happens) > (people who improve). If you're wrong, then preventing the release of the drug is literally killing people.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#160
post #140
post #80

Earlier quoted context omitted.

Got any examples? The trial process for new medications isn't perfect, but without citing specific failures in the process it becomes to easy to discount the parts of the process that do work.

Weight loss drugs. Three new products were rejected by the FDA last year. Sure these drugs had risks, but what's the cost of obesity in terms of medical costs? At this point in time the FDA has incredibly high standards of safety for weight loss drugs and not without reason. But what are the costs of the 40% of obese Americans who will get diabetes, cardiovascular disease, etc, etc?

Public health wise, the US could achieve similar effects by ending corn subsidies and reduce obesity across the country.
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