How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India • Hacker News Board

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#171

Post by necessity » Mon, May 09, 2016, 5:09 AM UTC

nickpsecurity wrote: post #116

cheriot wrote: post #114

Eminent domain is not just for land. In extreme cases like this where a profit motive is the only thing keeping us from curing huge numbers of people, the US government should write a single check, take the rights, and start handing out pills. As far as the company is concerned, that could even be a preferable outcome. Cash now and the marketing benefits to promote its other drugs. Edit: Just a reminder that eminent…

We could do that. On other hand, we could just pay them the expected market value of the drug when they first invent it then give it to public for almost nothing. "You can cure cancer with those three drugs? Was going to make tens of billions? Here you go: guarantee of tens of billions of subsidies over next 20 years in exchange for the patent and license for anyone to produce it generically." Boom! Tens of thousands…

When you say "we pay the market value" and "give to the public for almost nothing", "we" and "the public" are the same group and therefore it makes no sense to make the distinction.

Unless by "we" you mean "the wealthy" and "the public" you mean "the poor", in which case the increased tax that has to be set up for that will just be reverted into the cost of the service/good provided by the wealthy, the wages of their employers, or turn into capital flight, and so forth. In short, you're basically taking money from other areas of people's lives and making them put it into health care. Which could be achieved by themselves by saving, if that's what they wanted to do.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#172

Post by nickpsecurity » Mon, May 09, 2016, 5:10 AM UTC

rtkwe wrote: post #144

nickpsecurity wrote: post #132

Earlier quoted context omitted.

Wait, this was apparently misreported to me although it still says wonders about the situation. It was a threatened mass suicide that led to concessions. Over a dozen did jump to death. And the worst part of what I originally received.... curtailing the suicides by installing safety nets instead of better working conditions... did happen. So, yes, that's unusually bad with not many in the U.S. that can compare. I'll…

I doubt it'll happen in the US because we don't really have workers dormitories for people to jump from and in the US very few people jump for suicides (~2%) vs guns (~56%), suffocation/hanging (~25%) or poisoning (~11%). source: http://lostallhope.com/suicide-statistics/us-methods-suicide

Ok, that makes more sense. So, I modify the question to be U.S. workers threatening mass suicide by gun or whatever with a good number at one plant over time. Then, the plant starts taking preventative measures against various suicide equipment instead of investing in working conditions.

This actually has more odds of happening.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#173

Post by nickpsecurity » Mon, May 09, 2016, 5:12 AM UTC

necessity wrote: post #171

nickpsecurity wrote: post #116

Earlier quoted context omitted.

We could do that. On other hand, we could just pay them the expected market value of the drug when they first invent it then give it to public for almost nothing. "You can cure cancer with those three drugs? Was going to make tens of billions? Here you go: guarantee of tens of billions of subsidies over next 20 years in exchange for the patent and license for anyone to produce it generically." Boom! Tens of thousands…

When you say "we pay the market value" and "give to the public for almost nothing", "we" and "the public" are the same group and therefore it makes no sense to make the distinction. Unless by "we" you mean "the wealthy" and "the public" you mean "the poor", in which case the increased tax that has to be set up for that will just be reverted into the cost of the service/good provided by the wealthy, the wages of their…

I live in the U.S. if I didn't mention it. Here, we differentiate between the rights of the public as a whole and private individuals. Businesses and I.P. tend to be a form of private property. So, "we" the public can't take what "we" consider private. That's a contradiction.

In this specific case, it's the public paying money to private parties for their property to move into public hands. Then, that public property is manufactured to be distributed to the many, private parties in need that constitute the general public.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#174

Post by rayiner » Mon, May 09, 2016, 5:14 AM UTC

pgodzin wrote: post #152

rayiner wrote: post #139

Earlier quoted context omitted.

> Yes, the company that actively prevents people from obtaining life-saving medicine for billions extra in profit is more reprehensible than the company that makes no pretenses about having anything to do with life and death. So the moral impact of a company's actions depends not on the net good done by that company, but on the "pretenses" it does or does not put on? It's morally better to waste natural resources on…

> And if it's morally reprehensible to not save a life when you have the power to do so, aren't all of Apple's customers morally reprehensible for buying iPhones? That money could literally save the life of someone in the world that lacks basic necessities. No, the decision to make billions extra in profits on top of the billions they would already be making at the cost of millions of lives is still definitely more r…

Apple made $18 billion in profits last quarter. For half of that, they could have saved 2.7 million people from dying of malaria. In one quarter alone.[1] Apple's customers spent about $45 billion on iPhones last quarter. If they had gotten Android phones for half the price (which still provide essential information and communications), they could have saved 5 million children by investing in children's health programs.[2]

If it's reprehensible to have the means to save a life and not do so, then Apple and its customers are reprehensible. This is the natural consequence of your reasoning. The only distinction you can make between Gilead and Apple is that Gilead invented the means of saving lives, while Apple would have to pay someone else to do so. But how on earth does that count against Gilead? Why is Gilead evil for making profits when they could save lives by giving away Sovaldi, when Apple could just as easily save lives by buying Sovaldi for those who need it?

[1] It costs about $3,300 to save a life from malaria: http://www.techinsider.io/the-worlds-best-charity-can-save-a....

[2] It costs $4,200 to save a child by investing in childhood health: https://www.sciencedaily.com/releases/2015/07/150703072652.h....

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#175

Post by Houshalter » Mon, May 09, 2016, 5:16 AM UTC

WalterBright wrote: post #170

Houshalter wrote: post #158

Earlier quoted context omitted.

I think the government should put a value on every life (or quality adjusted life year, whatever), and offer to pay that much for any drug that saves lives. From that perspective, $84k per life saved doesn't sound that unreasonable, and creates a huge incentive to develop similar drugs in the future. But I don't think valuing every life at $84k would be sustainable. And why should the drug company itself get to deter…

> And why should the drug company itself get to determine the price, with no upper bound? Because they took the financial risk to develop the drug.

Sure. But if they demanded a trillion dollars per pill, the government shouldn't have to pay for it. It would bankrupt the country. They shouldn't be able to set a price and force the government to pay it.

The only reason we have this crazy system is because people refuse to put an economic value on life.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#176

Post by gaius » Mon, May 09, 2016, 5:16 AM UTC

x5n1 wrote: post #168

gaius wrote: post #157

Earlier quoted context omitted.

Do they hand out sainthoods with PhDs now? A scientist working in the commercial sector has the same motivations as anyone else.

Then why not make any scientist who discovers any very important drug or therapy into a billionaire. If they are motivated the same way corporations are, then that should super motivate them produce more drugs faster. In fact why don't universities work the same way?

Scientists at pharma companies who make breakthrough discoveries are well rewarded in stock and bonuses.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#177

Post by necessity » Mon, May 09, 2016, 5:17 AM UTC

rayiner wrote: post #69

andrewchambers wrote: post #63

Earlier quoted context omitted.

It sounds more like a lack of real competition.

You can't have "real competition" in the drug industry. While the status of patents is debatable in software (where actual copying is rare), the generics manufacturers are always directly copying from the drug inventors. They don't have the capability to do their own R&D, or often even to develop a lot of the ancillary protocols themselves. So you either have a regulated market, or massive free-riding, neither of whi…

How much time does it take to analyze the original and copy it, set up for mass production, advertise, etc? Then, how much time until demand shifts from the original to the generic in each market (India, US, etc)?

According to the OP the company was making "billions every quarter" on sales in the US. Considering the research often costs "billions", they should make a profit in the first quarter by selling in multiple markets if it takes around a month until the demand shifts to the generic.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#178

Post by WalterBright » Mon, May 09, 2016, 5:17 AM UTC

Keep in mind that the potential for huge profits was what motivated private investors to fund development for a cure. Without that, Hep C would still be a death sentence, regardless of how much money you had.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#179

Post by lostlogin » Mon, May 09, 2016, 5:17 AM UTC

refurb wrote: post #143

cheriot wrote: post #114

Eminent domain is not just for land. In extreme cases like this where a profit motive is the only thing keeping us from curing huge numbers of people, the US government should write a single check, take the rights, and start handing out pills. As far as the company is concerned, that could even be a preferable outcome. Cash now and the marketing benefits to promote its other drugs. Edit: Just a reminder that eminent…

Let's walk through this. Drug develop is mostly funded with private money. Yes, the NIH funds basic research that often support drug research, but private companies fund most of the bill. It's in the hundreds of billions each year. Now why would they do that? Well, they expect that they'll give a company $500M and it will turn into $2B or $3B. However, most of those companies will fail and the $500M will turn into $0…

As someone who works at a university and does work for drug trials, I don't agree that they are fully privately funded. They use university staff much of the time, and those staff are not paid market rate. They get equipment hire at academic rates rather than commercial rates too. Just thought I'd add my 2c.

Re: How I Got the $84k Hepatitis C Drug for $1500 by Buying It from India

#180

Post by lostlogin » Mon, May 09, 2016, 5:20 AM UTC

forrestthewoods wrote: post #109

GreaterFool wrote: post #103

Earlier quoted context omitted.

I have a private global (excluding USA) medical insurance that covers costs (no in-patient) up to 1M and it costs me $1k/year. I've been hearing about Obamacare for years and always thought "well, it's good that more people will have insurance". But when my colleagues in US told me what their deductibles on a good insurance plan are ( thousands of dollars. my deductibles are $375) I was floored. The whole medical sys…

America subsidizes the health care of the entire world. Because such a large portion of health profit comes from the US. If the US ceased to exist then global prices would increase and global research would decrease.

I'd argue that US practice damages healthcare systems everywhere with the defensive practice of ordering every test and scanning every system to avoid liability. It contaminates thought processes where a 1 minutes pause would generate some level headed thought.