NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska • Hacker News Board

Re: NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska

#21

Post by SketchySeaBeast » Thu, Feb 27, 2020, 7:02 PM UTC

aantix wrote: post #13

frandroid wrote: post #7

Earlier quoted context omitted.

Or you know, we can determine that the cost of keeping people healthy is a social good and invest in that. I don't think we need market indicators to show that we don't want people to die. And we know that that market signal distorts the needs addressed so that chronic alleviation things get more attention than one-time cures...

There are smart people that want to earn more than a "social good" paycheck, whatever amount you peg that at. That's the issue with your "social good" approach, is that by capping the upside, you're capping the control one can exercise over their own livelihoods. The smart scientist wanted to send their kid to a more expensive Montessori preschool instead of a neighborhood preschool? Too bad. You are capped at the so…

That seems to suggest that somehow everyone's earnings is unlimited assuming they do extra work and train in whatever vocation they want, when we all know that isn't the case. Why is it that the markets cap is more virtuous than one that's good for society?

Re: NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska

#22

Post by TsomArp » Thu, Feb 27, 2020, 7:08 PM UTC

RcouF1uZ4gsC wrote: post #5

> Remdesivir, developed by Gilead Sciences Inc., This is the same Gilead Sciences that developed a cure for Hepatitis C, but was crucified in the press because of the high upfront cost. I want pharma to makes lots of money so they care hire lots of smart people. I want developing cures for viruses and diseases to be at least as a good a career path for smart kids in the future as working for a Silicon Valley company…

If 90% of the people in the world die because they cannot pay this vaccine, do you think they can keep making money with only the 10%?

Re: NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska

#23

Post by LASR » Thu, Feb 27, 2020, 7:09 PM UTC

refurb wrote: post #19

pradn wrote: post #10

Earlier quoted context omitted.

There's a difference between ensuring companies creating beneficial products are financially rewarded and asking the customers to pay the full cost. The government can step in to pay for serious illnesses so we don't let people die from newly cured diseases. This already happens with Medicare/Medicaid, and it is tough to ask state governments to spend millions to cure a handful of people, but the alternative is cappi…

What? If the people who do the basic research patent their work, sure they get financially rewarded for it. Go talk to the chemist at Northwestern who discovered Lyrica. Or the CF Foundation who made billions from Kalydeco.

Not if the funding to do the research is from public money.

Re: NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska

#24

Post by [deleted] » Thu, Feb 27, 2020, 7:11 PM UTC

pradn wrote: post #10

RcouF1uZ4gsC wrote: post #5

> Remdesivir, developed by Gilead Sciences Inc., This is the same Gilead Sciences that developed a cure for Hepatitis C, but was crucified in the press because of the high upfront cost. I want pharma to makes lots of money so they care hire lots of smart people. I want developing cures for viruses and diseases to be at least as a good a career path for smart kids in the future as working for a Silicon Valley company…

There's a difference between ensuring companies creating beneficial products are financially rewarded and asking the customers to pay the full cost. The government can step in to pay for serious illnesses so we don't let people die from newly cured diseases. This already happens with Medicare/Medicaid, and it is tough to ask state governments to spend millions to cure a handful of people, but the alternative is cappi…

[deleted]

Re: NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska

#25

Post by abstractbarista » Thu, Feb 27, 2020, 7:13 PM UTC

SketchySeaBeast wrote: post #21

aantix wrote: post #13

Earlier quoted context omitted.

There are smart people that want to earn more than a "social good" paycheck, whatever amount you peg that at. That's the issue with your "social good" approach, is that by capping the upside, you're capping the control one can exercise over their own livelihoods. The smart scientist wanted to send their kid to a more expensive Montessori preschool instead of a neighborhood preschool? Too bad. You are capped at the so…

That seems to suggest that somehow everyone's earnings is unlimited assuming they do extra work and train in whatever vocation they want, when we all know that isn't the case. Why is it that the markets cap is more virtuous than one that's good for society?

It actually is the case. Trick is that it's strongly modulated by randomness (luck).

Re: NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska

#26

Post by dekhn » Thu, Feb 27, 2020, 7:19 PM UTC

RcouF1uZ4gsC wrote: post #5

> Remdesivir, developed by Gilead Sciences Inc., This is the same Gilead Sciences that developed a cure for Hepatitis C, but was crucified in the press because of the high upfront cost. I want pharma to makes lots of money so they care hire lots of smart people. I want developing cures for viruses and diseases to be at least as a good a career path for smart kids in the future as working for a Silicon Valley company…

Good jobs in pharma pay pretty well and are nearly competitive with SV (I've worked for Genentech, Google, and a small biotech startup). Pharma has no lack of smart people, but modern pharma is really just a rent-seeking entity (goal is to maximize profit on fairly small stable of well-defined drugs) while maintaining a portfolio of investments in smaller pharma and biotech companies who do most of the innovation, while pharma handles ads, sales, distribution, manufacturing, etc.

Creating cures for diseases is a systemically complex problem and it's not clear that "more smart people" really is the answer, versus "do a better job". In many ways, the smartest folks in the room are the least capable at moving drug discovery forward- smart people want to work on cool new problems, explore nifty theories, but don't want to deal with the day-to-day challenges of reliably identifying new drugs.

I left drug discovery because the systemic challenges were too great; it's not like you can be smart or work hard and solve a problem. You have to play a very long game, do a bunch of tedious and boring things, and master politics to get a drug to market.

One thing to note is that some drugs really do cost a lot to R&D and to manufacture, and I think those drugs should reflect those costs; but many companies overprice their drugs to maintain absurdly high profit margins. That doesnt' translate into larger investments in future drugs.

Gilead has been very good at this, but after working for a biotech startup that had a deal with Gilead to work on NASH, I've become extremely skeptical. This is a "disease" where nobody can agree that it's actually a disease, and worse, it could be far more easily treated using simple obesity reduction techniques, instead of spending billions to create a drug that helps people who are extremely sick.

Re: NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska

#27

Post by dekhn » Thu, Feb 27, 2020, 7:20 PM UTC

refurb wrote: post #19

pradn wrote: post #10

Earlier quoted context omitted.

There's a difference between ensuring companies creating beneficial products are financially rewarded and asking the customers to pay the full cost. The government can step in to pay for serious illnesses so we don't let people die from newly cured diseases. This already happens with Medicare/Medicaid, and it is tough to ask state governments to spend millions to cure a handful of people, but the alternative is cappi…

What? If the people who do the basic research patent their work, sure they get financially rewarded for it. Go talk to the chemist at Northwestern who discovered Lyrica. Or the CF Foundation who made billions from Kalydeco.

It really depends on a lot of factors. Not every scientist who has their name on a patent that led to a billion dollar drug saw much money from it.

the university sees much of the upside.

Re: NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska

#28

Post by SketchySeaBeast » Thu, Feb 27, 2020, 7:24 PM UTC

abstractbarista wrote: post #25

SketchySeaBeast wrote: post #21

Earlier quoted context omitted.

That seems to suggest that somehow everyone's earnings is unlimited assuming they do extra work and train in whatever vocation they want, when we all know that isn't the case. Why is it that the markets cap is more virtuous than one that's good for society?

It actually is the case. Trick is that it's strongly modulated by randomness (luck).

There are no billionaire janitors, drycleaners, or chefs. I don't think there are even any billionaire software developers, doctors, or lawyers. There ARE billionaire business owners of all those things, but for the vocations themselves, it doesn't matter how good at that particular thing you are, you can't earn unlimited wealth strictly off those vocation specific skills and hard work unless you pivot and move your time and effort into something else.

Re: NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska

#29

Post by gdubs » Thu, Feb 27, 2020, 7:25 PM UTC

RcouF1uZ4gsC wrote: post #5

> Remdesivir, developed by Gilead Sciences Inc., This is the same Gilead Sciences that developed a cure for Hepatitis C, but was crucified in the press because of the high upfront cost. I want pharma to makes lots of money so they care hire lots of smart people. I want developing cures for viruses and diseases to be at least as a good a career path for smart kids in the future as working for a Silicon Valley company…

The implication here is that reforming prices would destroy innovation in pharmaceuticals, but marketing costs dwarf R&D expenditures. These companies also benefit from huge, decades long investments by government in basic research.

Edit: It’s also worth pointing out that it’s not the scientists and researchers who are raking it in — it’s executive managers. It’s not about punishing value creators, it’s about stemming value extraction, aka rent-seeking, aka what makes markets not free according to Adam Smith.

Re: NIH trial of remdesivir for COVID-19 begins in hospitalized adults in Nebraska

#30

Post by gdubs » Thu, Feb 27, 2020, 7:26 PM UTC

aantix wrote: post #13

frandroid wrote: post #7

Earlier quoted context omitted.

Or you know, we can determine that the cost of keeping people healthy is a social good and invest in that. I don't think we need market indicators to show that we don't want people to die. And we know that that market signal distorts the needs addressed so that chronic alleviation things get more attention than one-time cures...

There are smart people that want to earn more than a "social good" paycheck, whatever amount you peg that at. That's the issue with your "social good" approach, is that by capping the upside, you're capping the control one can exercise over their own livelihoods. The smart scientist wanted to send their kid to a more expensive Montessori preschool instead of a neighborhood preschool? Too bad. You are capped at the so…

No one’s talking about pegging the salaries of the researchers who are in a completely different class than executive management. It’s a Straw Man argument.