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

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

#231

Post by Mvandenbergh »

markvdb wrote: post #198

This is yet another perverse collision of care and market regulation. Other examples abound. Why do we accept this? Do we even dare think of alternatives? What if western governments stop enforcing drug development intellectual rights? Not going to happen before hell freezes over, but let's have a short thought experiment. Quality health care for all would probably blossom thanks to more access to affordable drugs th…

>Quality health care for all would probably blossom thanks to more access to affordable drugs than ever. Drug development would probably slow down significantly without compensating measures. But would that be so bad? Medical research is increasingly a game of diminishing returns...

If that's true then this problem will resolve itself in a decade or so when these drugs go off patent.

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

#232

Post by dang »

ptaipale wrote: post #142

I actually wouldn't expect that Indian prisons provide any effective medication against hepatitis C. You might get it if you buy it yourself, and bribe the prison staff to allow you to have it. Sorry: this is not based on any real experience or references, just the overall assessment of how India stands currently.

We detached this subthread from https://news.ycombinator.com/item?id=11657665 and marked it off-topic.

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

#233

Post by te_chris »

lucaspiller wrote: post #224
mikekchar wrote: post #212

Earlier quoted context omitted.

I don't think you could get that to fly politically. While it is true that drugs require high prices to recoup research cost and that drug patents allow drug companies to charge those high prices, they don't just recoup prices. They charge as much as they can. From the point of view of trying to save as many people as possible for the money, that sucks, but from the point of view of encouraging investment in drug com…

> They charge as much as they can How does it work in European countries where health care is (mostly) paid for by the government? Do these companies still charge the same prices as in the US?

Back in NZ, we have PHARMAC, which is basically a centralised drug buyer for the country. It works remarkably well at keeping drug prices low https://www.pharmac.govt.nz/ - though tends to miss some niche stuff.

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

#234

Post by junofan »

airless_bar wrote: post #223
adrianN wrote: post #205

Earlier quoted context omitted.

I wouldn't call cancer, heart disease, alzheimer's, ageing etc "the rarest disease puzzles", yet I'm not satisfied with the status quo of medical care for these problems.

Mainstream access to all existing drugs would still be a hugely more favorable outcome than the "chance" of new drugs at outrageous prices.

Don't we get cheap drugs when patents expire? Are you saying we should invalidate all existing drug patents today and cease R&D rather than wait for patents to expire?

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

#235

Post by ikeboy »

ubernostrum wrote: post #195
ikeboy wrote: post #57

Earlier quoted context omitted.

How is giving people jobs exploiting them again?

I think a way to state this that you can't semantically object to is: We live in a society in which those who control large corporations argue that it is virtuous to relocate significant portions of the business to locations which are cheaper due to more lax or nonexistent laws protecting workers and/or the environment, and thus consumers back in the US receive the same quality of product but at a lower price thanks…

>We live in a society in which those who control large corporations argue that it is virtuous to relocate significant portions of the business to locations which are cheaper due to more lax or nonexistent laws protecting workers and/or the environment, and thus consumers back in the US receive the same quality of product but at a lower price thanks to the location-based saving.

I don't think this is entirely fair. Some of the lower cost can surely be attributed to lower cost of living in those locations, not necessarily due to more lenient laws.

In that case, it isn't comparable to arbitrage over IP.

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

#236

Post by pramttl »

I was once prescribed 4 tablets of Albandazole (a drug for worms treatment) just before my health insurance was active on file. The drug was costing over 700$ without insurance and my health center asked if I would like to wait for my student health insurance to show up as active. I said, yes (ofcourse) shocked at the price of the drug (being an international student in US from India). Even after my insurance I paid 35$ co-pay. The same drug costs Salary ratio: ~5:1 (Software engineer, Google based on Glassdoor); Albendazole drug cost ratio: ~700:1

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

#237

Post by chris_wot »

necessity wrote: post #162
corvallis wrote: post #122

Something to keep in mind is the population that typically has chronic Hep C requiring this drug. It's IV drug users who share needles. Think they have $84K? Nope. Think they have insurance? Nope. Guess who pays for it. Oh that's right, it's Medicaid! It's you, the taxpayers. Where is there a large concentration of people that have Hep C? Prisons. Guess who pays for it then? Still you! The prison systems are obligate…

The drug from the original company is expensive everywhere, what India has is generics, which in their turn might lower the price of the original drug because of the competition. It also lowers the incentive of selling the original drug there at all (and consequently allowing the government to press for agreements). I have some unpopular opinions regarding the subject...

Actually, India basically refuses to recognise patents for a wide variety of pharmaceutical products. For a long time they refused to recognise patents for drugs that combat AIDS and a thriving market for generics sprung up.

There was a lot of posturing and complaining by pharmaceutical companies in the U.S. and the U.S. Government tried to heavy the Indian Government, but to no avail.

When it became apparent that the Indians weren't going to budge, and with a growing realisation that other nations would ether do the same thing or import their drugs from India, the companies agreed to drastically reduce their prices on "humanitarian" grounds. Now they still make massive profits, just they are less massive than they once were.

This is now happening with academic research.

Nobody will shed any tears because greedy multinationals make a lower profit to ensure less people die from disease. Nobody will weep over Elsevier's reduced earning if it frees up necessary information and research findings so science can progress for the benefit of all mankind.

The entrenched interests of rich, arrogant corporate executives and business owners in first world nations are finally being disrupted by poorer nations who don't care about this group of people. But that's what happens when you gain an attitude on I weaning entitlement - you eventually overreach so far you come undone, and nobody feels any sympathy when it happens.

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

#238

Post by chris_wot »

lucaspiller wrote: post #224
mikekchar wrote: post #212

Earlier quoted context omitted.

I don't think you could get that to fly politically. While it is true that drugs require high prices to recoup research cost and that drug patents allow drug companies to charge those high prices, they don't just recoup prices. They charge as much as they can. From the point of view of trying to save as many people as possible for the money, that sucks, but from the point of view of encouraging investment in drug com…

> They charge as much as they can How does it work in European countries where health care is (mostly) paid for by the government? Do these companies still charge the same prices as in the US?

The Australian Federal government has a Pharmaceutical Benefits Scheme, and U.S. pharmaceutical companies have been trying to undermine it for years.

Sadly for these companies, and fortunate for the vast majority of Australians, it is so popular and successful that any attempt to undermine it puts the government at risk of being turfed out in the next general election.

The Abbott government tried to force through a hair-brained GP co-payment and it was so unpopular that even when it was scrapped they eventually had to replace the Treasurer and Prime Minister for fear of being routed in the next general election.

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

#239

Post by philh »

forgotpwagain wrote: post #54
netheril96 wrote: post #33

Earlier quoted context omitted.

> while they invest x for R&D and actual manufacturing, they earn back at least 100*x in profits. If that is true, VC's money will be flooding over pharmaceuticals instead of Silicon valley. This "100x" number probably fails to account for the vast number of failed trials that is all cost and no profit.

Typically quoted values are (in the current market), approx. $2-3B per product brought to market. Drug development is incredibly difficult -- for very good reasons. The FDA has to be risk-averse in order to protect the health of the public and to prevent harm to be done.

More cynically, the FDA has to be risk-averse because people get much more upset over "this person died because the FDA approved a bad drug" than over "this person died because the FDA didn't approve the drug that would have saved her".

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

#240

Post by bandrami »

junofan wrote: post #234
airless_bar wrote: post #223

Earlier quoted context omitted.

Mainstream access to all existing drugs would still be a hugely more favorable outcome than the "chance" of new drugs at outrageous prices.

Don't we get cheap drugs when patents expire? Are you saying we should invalidate all existing drug patents today and cease R&D rather than wait for patents to expire?

No, the manufacturers apply for a new patent for using the drug to treat a different condition, which still keeps generics out of the market.
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