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Turing CEO Defends $750 Pill in Reddit AMA

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Re: Turing CEO Defends $750 Pill in Reddit AMA

#31

Earlier quoted context omitted.

> As much as I hate socialism, the only solution appears to be Single Payer. The problem is, "How do we establish a market that provides medication to patients who may not be able to afford it while still generating enough profit to allow research and development of new drugs 10 years from now?" Establishing a monopsony doesn't actually solve this problem. It changes the flow of money slightly[0], but it doesn't actu…

If the US bargained with drug companies on more even footing with other countries, we might not get stuck footing such a disproportionate fraction of the bill (R&D and otherwise). > Health insurance in the US already is much more like a monopsony than most people realize. Dead wrong, Medicare part D is hobbled so that the US is not even close to being a half-monopsony, let alone a full monopsony, in the drug market.…

> If the US bargained with drug companies on more even footing with other countries, we might not get stuck footing such a disproportionate fraction of the bill (R&D and otherwise).

That's an odd way to phrase it, because it implies that the amount of research being done globally is constant. But it isn't; it's driven by the available funds.

This actually proves my point: a disproportionate amount of the research that happens globally happens in the US[0], and that's because there's enough profit in the US market for companies to conduct that research. If that profit is reduced, then yes, it's possible that the short-term prices would decrease, but at the cost of delaying further discoveries and advances in medicine.

That's not an easy tradeoff to make, precisely because it's unclear which choice benefits patients more. It's a much easier choice for a country that has a small population, or for a country that doesn't contribute that much to the global R&D (because the impact would be smaller), but the US is in neither of those two categories.

> Dead wrong, Medicare part D is hobbled so that the US is not even close to being a half-monopsony (let alone a full monopsony) in the drug market.

I'm actually not referring to Medicare Part D with that footnote, but that's a separate discussion.

[0] The US's share has dropped in the last decade or so, but only because China and India have become even more lucrative.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#32
post #16
post #14

Earlier quoted context omitted.

What does this have to do with socialism? How does drug companies charging for an arm and a leg or insurance companies paying for it and raising premiums relate to socialism?

Single-payer is socialized medicine.

It's all socialized medicine. We all have the same bodies. The only question is whether we get what we pay for. In the US, we don't.

The idea that "insurance" is somehow applicable to a scenario where essentially every participant will need to file multiple expensive claims is extremely silly.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#33
post #27

Earlier quoted context omitted.

> As much as I hate socialism, the only solution appears to be Single Payer. The problem is, "How do we establish a market that provides medication to patients who may not be able to afford it while still generating enough profit to allow research and development of new drugs 10 years from now?" Establishing a monopsony doesn't actually solve this problem. It changes the flow of money slightly[0], but it doesn't actu…

Why do we have to establish a market?

By definition, it's a market if there are two or more entities exchanging scarce goods or services. Medical care is a scarce good, medical research is a scarce good, and money is a scarce good, so it's a market, no matter how we structure it.

If one (or both) of those parties is a sovereign state, or if we set arbitrary restrictions on the price and/or quantities traded, that doesn't change the fact that it's a market.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#34
post #22
post #21

Earlier quoted context omitted.

> As much as I hate socialism I think it's funny that people think insurance isn't a (distorted) form of socialism. It's small-scale socialism - you pay into a pool, and those who need resources get it. If you really hated socialism, you wouldn't have any insurance at all.

The only funny thing here is that most people who hate socialism just do so because they don't want to pay taxes.

I only want to pay insurance tax.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#35

What a slimy piece of crap: "People hate because they think I'm charging people $750 per pill even though it costs patients less than $10 out of their pocket" No. People hate because you ARE charging $750 per pill. They may only have to pay $10 out of pocket immediately, but one way or another, through co-pays, deductibles, premiums, opportunity cost when employers pay premiums, patients ARE paying $750 per pill. I h…

Maybe we need a charity that builds a research war chest to threaten companies like this with redevelopment. It costs a lot to replicate a pill and go through the FDA hoops, and once a private company does, the price just gets competed down to the point where it doesn't cover the redevelopment costs.

Instead, a charity doesn't have to take profit into consideration and can just threaten: drop your price or we'll persue independent redevelopment. With only the credible threat of spending on independent redevelopment, they could devalue a lot of these orphan drugs, and then buy up the rights/trade secrets to them for open release.

Competing businesses can't do this, because they can't pose a credible threat, because following through wouldn't make business sense. A charity can have non-business aims.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#36

What a slimy piece of crap: "People hate because they think I'm charging people $750 per pill even though it costs patients less than $10 out of their pocket" No. People hate because you ARE charging $750 per pill. They may only have to pay $10 out of pocket immediately, but one way or another, through co-pays, deductibles, premiums, opportunity cost when employers pay premiums, patients ARE paying $750 per pill. I h…

What he thinks is that people are going to be outraged over this and new regulations will drive down the stock price of other pharmaceuticals which he has shorted, and if that fails he will still make some money off the pills.

It's an excellent bet even if it is extremely immoral.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#37
post #12

The problem with healthcare in America is insurance. When you are insured and insurance is paying for everything patients don't care how much anything costs. (See Tragedy of the Commons). And the drug companies charge $250 to $750 a pill or $14,000 for a years worth of drugs (recent cholesterol drugs Repatha and Praluent) to $250,000 (cancer drugs) and the drug companies justify it by saying insurance pays for it any…

> As much as I hate socialism, the only solution appears to be Single Payer. The problem is, "How do we establish a market that provides medication to patients who may not be able to afford it while still generating enough profit to allow research and development of new drugs 10 years from now?" Establishing a monopsony doesn't actually solve this problem. It changes the flow of money slightly[0], but it doesn't actu…

We don't need pharma to pay for R&D. Total pharma R&D on drug development comes to a paltry $26 billion a year. This could easily be paid for by the government. We already have the infrastructure, we just need to fund it.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#38
post #12

The problem with healthcare in America is insurance. When you are insured and insurance is paying for everything patients don't care how much anything costs. (See Tragedy of the Commons). And the drug companies charge $250 to $750 a pill or $14,000 for a years worth of drugs (recent cholesterol drugs Repatha and Praluent) to $250,000 (cancer drugs) and the drug companies justify it by saying insurance pays for it any…

> As much as I hate socialism, the only solution appears to be Single Payer. The problem is, "How do we establish a market that provides medication to patients who may not be able to afford it while still generating enough profit to allow research and development of new drugs 10 years from now?" Establishing a monopsony doesn't actually solve this problem. It changes the flow of money slightly[0], but it doesn't actu…

The R&D costs argument is a diversion. Profit margins for Pharma companies are consistently 3-5x of more competitive industries (e.g. car makers [1], [2]). Health is a failed market full of rentier corporations.

It's hard to argue against them because they are doing good (inventing life saving medicines) but the opportunity cost of money paid out as profits instead of reinvested into research must be huge.

[1] https://ycharts.com/companies/VLKPY/gross_profit_margin https://ycharts.com/companies/BAMXY/gross_profit_margin

[2] https://ycharts.com/companies/PFE/gross_profit_margin

Re: Turing CEO Defends $750 Pill in Reddit AMA

#39
post #12

The problem with healthcare in America is insurance. When you are insured and insurance is paying for everything patients don't care how much anything costs. (See Tragedy of the Commons). And the drug companies charge $250 to $750 a pill or $14,000 for a years worth of drugs (recent cholesterol drugs Repatha and Praluent) to $250,000 (cancer drugs) and the drug companies justify it by saying insurance pays for it any…

> When you are insured and insurance is paying for everything patients don't care how much anything costs. (See Tragedy of the Commons).

Obamacare is the free market answer.

It encourages HDHP plans which forces the individuals to pay for those pills. Now that consumers are fronting the costs below $1300 or so, they really do care about huge pill costs like this now.

Before, consumers may have not cared. But now, people do care and people will pay attention.

Re: Turing CEO Defends $750 Pill in Reddit AMA

#40
post #12

The problem with healthcare in America is insurance. When you are insured and insurance is paying for everything patients don't care how much anything costs. (See Tragedy of the Commons). And the drug companies charge $250 to $750 a pill or $14,000 for a years worth of drugs (recent cholesterol drugs Repatha and Praluent) to $250,000 (cancer drugs) and the drug companies justify it by saying insurance pays for it any…

A competitor has stated that they are going to make an equivalent available for $1:

http://www.nbcnews.com/health/health-news/competitor-offer-1...

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