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> When it costs billions to develop a new drug due to onerous testing regulations, that's what happens. This does not explain the increase in cost of insulin, which was invented in 1923.
You can buy the formulation that was invented in 1923 for cheap. It's newer formulations that are expensive, and those are still protected by patents.
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You're way overthinking this. What needs to happen is, again and again with health care issues, transparency. Manufacturers should be required to declare and with audits prove how much they're spending to manufacture everything. Then everyone can see the price they're being charged and figure in their head what sort of markup they are being charged. Then we can start to push back on the companies need to recoup prima…
Should anyone buying that insulin have to divulge how much money they make a year and what other things they spend their money on, so that the manufacturer can figure out how much to charge?
A reasonable percentage can be arbitrated once the process is in public view.
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If you are rich, get cancer and can pick any country to get treatment in, which country do you go to? Obviously it would depend on the specific cancer, but I think the US would be the best bet in aggregate.
And if you're not rich, and get cancer, which country do you go to? I bet in aggregate it is never the US.
It may very well be quite true that the price of insulin is too high but price controls really are not that great. If the price now is to high, $100 probably still is too high. Also, in the more general case (not for insulin, obviously) pharma does need to recover its research costs and who is going to say what is a good price and what not. You know, capitalism actually kind of works and price controls just don't. Th…
except it doesn't in this case. Manufacturers keep the price artificially high by continually patenting more and more esoteric parts of the manufacturing of this drug. They then cross license the patents to each other, preventing any third party from joining the marketplace. Insulin is NOT rocket science, and it's necessary for some people to live. It's almost as simple to make as beer. It is unreasonable that people…
I agree, though, that it should also become harder to get patents. If a useful invention depends on more than one or, at most, two patents the patents mainly serve as friction to innovation. A corrollary of this is that software patents should not exist. Perhaps there could also be a process where it is asserted that a medicine can only depend on one patent. Whenever it depends on more than one it should be adjudicated which of them is the innovative one and the other ones should not apply. This will solve the cross licensing problem that you notice.
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You can buy the formulation that was invented in 1923 for cheap. It's newer formulations that are expensive, and those are still protected by patents.
The NHS pays £14 - £28 a vial for those newer formulations.
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Except the market has succeeded fantastically. In my lifetime alone, AIDS and HepC went from death sentences to chronic conditions. Many forms of leukemia went from fatal to highly treatable. Meanwhile, what has the government done? The trip from DC to New York on Amtrak is slower today than it was in 1960. In 1980, DC’s Metro had self driving trains. They had to shut that down in 2009 due to lack of maintenance and…
> The trip from DC to New York on Amtrak is slower today than it was in 1960. serious question - does a profitable private passenger railroad company that actually owns/maintains tracks, stations, etc exist without subsidies anywhere at all in the world? And Amtrak itself is nominally public-private and was formed in reaction to purely private railroads collapsing.. > In 1980, DC’s Metro had self driving trains. They…
Hong Kong, Japan. But my point is narrower than that. I’m not saying governments in general cannot run decent train service. I’m saying Americans cannot. We’re culturally defective in that respect.
> even if the trains were self driving, for the 10y or so I lived there before this, there was still a conductor, so not sure if this is really a good argument..
They had a conductor for safety. But the self driving trains made the ride very smooth and allowed tighter headways. Even after 10 years, Metro conductors cannot properly stop at stations. To avoid overshooting the platform, they stop way short, and then jerkily inch into position. When I was growing up, headways on the orange line were 6 minutes and the WMATA trip planner was accurate. Today, it’s 8 minutes, because they can’t sustain the 6 minute headways. And they had to revise the trip planner a few years ago to increase the predicted travel time between stations. If you look at Metro advertising from the 1980s, station to station trip times today are 30-50% longer.
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> When it costs billions to develop a new drug due to onerous testing regulations, that's what happens. This does not explain the increase in cost of insulin, which was invented in 1923.
You can buy the formulation that was invented in 1923 for cheap. It's newer formulations that are expensive, and those are still protected by patents.
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This whole cost plus percentage model doesn’t work — it encourages people to drive up costs to increase profit. I see no reason that pharma manufacturing can’t be done just regular contract manufacturing. The Zika vaccine is a prime example. The US developed the ZIPV vaccine at public expense, and then, for some mind boggling reason, they offered an exclusive license to Sanofi. Imagine if Apple outsourced iPhone manu…
> for some mind boggling reason, What, never seen corruption at work? Somebody at Sanofi, or connected to them, was connected elsewhere, and hey, there's your license :) (No, no cash payment.... but my kid really wanted to get into Harvard, maybe a limited endowment/scholarship? You know somebody, right?) We humans are predictable.
[1]Episode 105 of a podcast called the Accad and Koka Report.
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Comments like this always make me sad. Not just because I disagree with them (I do!) or that I think they are claiming certainty about facts in dispute (I think they are ! [1, 2] ) but because they make no mention of trade-offs. We can vehemently disagree about these things, get our information from different sources, and advocate for different policies, but hopefully we can all agree that there _would_ be tradeoffs?…
whenever anyone casts doubt on the idea that healthcare (or pharma) could be cheaper (and implicitly that the tradeoffs would be worth it) my simple response is: then please tell me how does every other western nation accomplish it? overall healthcare goals are met and for less money (in aggregate and individually) all around the world. in which way is america exceptional except insofar as exactly that here business…
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When it costs billions to develop a new drug due to onerous testing regulations, that's what happens. Ultimately returns in every industry tend towards zero. If we made it cheaper to develop new drugs it would extend the lifespan of the industry somewhat but not indefinitely. At some point diminishing returns take over and investment must go down.
The testing regulations are not onerous. They are necessary to ensure that new medications are both safe and effective. I often see vague complaints about the regulations, but no one seems to have specific suggestions about how to lower drug development costs while still protecting patients.
Tons of drugs have been approved, only to be later pulled off the shelves. So despite the massive cost, delays, etc. the process has failed at least 35 (!) times:
https://prescriptiondrugs.procon.org/fda-approved-prescripti...