Dutch join backlash at expensive drugs by making their own • Hacker News Board

Re: Dutch join backlash at expensive drugs by making their own

#41

Post by sykho » Sat, Mar 09, 2019, 2:35 PM UTC

vonmoltke wrote: post #39

sykho wrote: post #37

Earlier quoted context omitted.

In European countries the marketing spend is essentially zero for all companies since they are banned from advertising. As you say, marketing clearly does increase profits for the pharmaceutical companies in the U.S. However, from a societal point of view it seems to me that it is much better for society for there to be no marketing of drugs. My wife is a physician and listening to her and her colleagues they all hat…

> In European countries the marketing spend[ing] is essentially zero for all companies since they are banned from advertising. Companies are prohibited from advertising to doctors? I thought it was just direct-to-consumer.

It appears you are correct. Direct to consumer advertising is heavily regulated but not outright banned. In Germany in 2017 the advertising expenditure was around 1.6 billion euros. In 2017 advertising expenditures in the U.S. were 24 billion dollars. There appears to be a big disparity in advertising amounts in the EU vs. the U.S. Germany’s population is more than 1/5 the population of the U.S. and spends far less than 1/5 of the U.S. advertising budget.

From [1] it appears that U.S. sales for pharmaceuticals are double the figure for the EU. This suggests that advertising, lack of regulatory controls on pricing, and R&D account for this. Since medical costs are exspensive in the U.S. at the point of contact and the U.S. spends twice per capita GDP on healthcare people are indignant at the system and things like direct to consumer advertising is an easy target for our ire.

I don’t know if English is your native language but “marketing spend” is correct and “marketing spending” is not.

[1] https://www.efpia.eu/media/361960/efpia-pharmafigures2018_v0...

Re: Dutch join backlash at expensive drugs by making their own

#42

Post by zaroth » Sat, Mar 09, 2019, 2:42 PM UTC

netjiro wrote: post #22

zaroth wrote: post #12

Earlier quoted context omitted.

I think you have cause and effect reversed. They helped fund the development of the new CF drug by Vertex, which Vertex sells for $300k. Because of the success of the drug, they were able to resell their royalty rights to another investor for $3.3 billion. Funds which they will use to drive massive amounts of additional R&D to make even better treatments at lower costs. In the process they have created therapies whic…

> Funds which they will use to drive massive amounts of additional R&D to make even better treatments at lower costs. This is a _myth_ Big Pharma is an insanely inefficient structure for turning money into useful R&D results. Big Pharma often spends on the order of 25-30% on marketing, vs 15% on R&D. From societal standpoint this is horribly inefficient considering that most medical costs are paid for communal money…

I do not concede the point as it relates to Big Pharma, but in this particular case I was talking specifically about the $3B that was earned by the CF Foundation.

Are you contending that the non-profit CF Foundation is going to take their $3B and not do something useful with it to serve the CF population?

> For well over a decade, CFF has employed a venture philanthropy model that provides upfront funding to pharmaceutical companies to help reduce the financial risk associated with the development of drugs to treat CF. As a result, the organization has a pipeline of drugs in various phases of development and reinvests the funds from any royalties it owns to advance drug discovery and efforts to find a cure.

> The proceeds of the sale will dramatically accelerate and expand the foundation’s research, care, and patient programs and significantly boost its funding of research targeting the genetic cause of CF. The organization also plans to use the funds to strengthen the specialized care and support that people with CF and their families receive at more than one hundred and twenty centers across the country and to expand its resources for people with CF and their families.

Re: Dutch join backlash at expensive drugs by making their own

#43

Post by sonnyblarney » Sat, Mar 09, 2019, 3:28 PM UTC

fouc wrote: post #33

eecc wrote: post #27

Earlier quoted context omitted.

The article reads as follows: “Novartis bought the rights to Lutathera with a $3.9-billion-euro takeover of French company AAA last year.” Where exactly does it say that the patents have remained with the hospital?

Buying the rights means licensing the rights of the patent, otherwise it would've said "Novartis bought the patent to Lutathera"

"Buying the rights means licensing the rights of the patent"

I don't think journalistic language necessarily so accurate.

I don't think we can say for sure what changed hands in the transaction, but it should not matter anyhow.

If they bought everything, then the total lifetime value of the asset would hopefully have been baked into the price.

Re: Dutch join backlash at expensive drugs by making their own

#44

Post by sonnyblarney » Sat, Mar 09, 2019, 3:29 PM UTC

eecc wrote: post #30

aaavl2821 wrote: post #16

Earlier quoted context omitted.

without for profit companies, all that taxpayer funded research would be sitting on a shelf, never becoming medicines to treat patients. In the last 2 years I think every drug that got approved by FDA was developed by a for profit company. Drugs don't emerge fully formed from academia, just waiting for pharma to patent them and jack up the price. Pharma spends more on r&d than academia

Please provide conclusive proof this process is not consequence of neoliberal policies, aimed at defunding public spending and encouraging for-profit spinoffs, aligning the research process to its ideology

If you're going to make such a conspiratorial claim, then the onus is on you to provide the proof.

I think the answer is probably a little bit more grey FYI.

Re: Dutch join backlash at expensive drugs by making their own

#45

Post by marcosdumay » Sat, Mar 09, 2019, 3:46 PM UTC

rocqua wrote: post #3

Yes, less payout on rare disease drugs is less of an incentive to research them. But: * Drug companies have profit margins of 15% on average indicating there is room. * many recent 'orphan drugs' were not newly developed, but off-label uses registered with the FDA for a whole new patent. * these drugs rely heavily on research done by universities through public funding. It stands to reason the public should get to be…

> Yes, less payout on rare disease drugs is less of an incentive to research them.

What is just one more reason for the government to bear that risk, from research up to distribution.

Re: Dutch join backlash at expensive drugs by making their own

#46

Post by simonsaidit » Sat, Mar 09, 2019, 3:52 PM UTC

In Denmark I recently saw a discussion between politicians and the just resigned head doctor of a major hospital where he said he no longer could bear the responsibility of “optimizing” and that there was not enough money in the coming years no mattter how much money the politicians were promising in their soon to be election campaigning.. and his belief was we had to decide what we can afford as a country in regard to medicine. Meaning we had to choose who should live or die or die sooner as medicine treatment prices were too high and new treatments are coming all the time.

Re: Dutch join backlash at expensive drugs by making their own

#47

Post by nabla9 » Sat, Mar 09, 2019, 3:54 PM UTC

aaavl2821 wrote: post #19

rocqua wrote: post #3

Yes, less payout on rare disease drugs is less of an incentive to research them. But: * Drug companies have profit margins of 15% on average indicating there is room. * many recent 'orphan drugs' were not newly developed, but off-label uses registered with the FDA for a whole new patent. * these drugs rely heavily on research done by universities through public funding. It stands to reason the public should get to be…

Drug companies increasingly fund r&d with their balance sheet, not with internal r&d. So the money they pay for new drugs is not reflected in the profit and loss statement. There are maybe 15 pharma companies that commercialize a large portion of the drugs developed in the world. The vast vast majority of drug companies never make a penny in profit. They sell their products or companies to bigger, commercial companie…

> the top 15 pharma companies spend $75B in r&d

Large sum of that money is wasted because incentives are perverse.

Developing new molecular entities (NME) that do the same thing as already approved new chemical entity (NCE) just for competitive reasons is wasted R&D from the public health perspective.

Evergreening and pay-for-delay costs additional billons for pharma companies and it's just zero-sum game between manufacturers.

Re: Dutch join backlash at expensive drugs by making their own

#48

Post by forinti » Sat, Mar 09, 2019, 3:59 PM UTC

This reminded me of an incident in which the Netherlands intercepted generic drugs en route to Brazil from India.

https://www.kff.org/news-summary/india-brazil-launch-trade-d...

Re: Dutch join backlash at expensive drugs by making their own

#49

Post by tirrit » Sat, Mar 09, 2019, 4:16 PM UTC

tomcam wrote: post #17

username223 wrote: post #13

Earlier quoted context omitted.

> Universities and R&D companies have a codependent relationship and this is generally regarded as a good thing. Is it? At best, I'd say it's seen as a "necessary evil," where "evil" is much more certain than "necessary."

It stinks, I agree. What economic/social arrangement has done a better job in drug innovation?

Has there ever been made an effort with any other approach/arrangement, in modern times?

Any sources on this, anyone?

Re: Dutch join backlash at expensive drugs by making their own

#50

Post by jknz » Sat, Mar 09, 2019, 4:22 PM UTC

simonsaidit wrote: post #46

In Denmark I recently saw a discussion between politicians and the just resigned head doctor of a major hospital where he said he no longer could bear the responsibility of “optimizing” and that there was not enough money in the coming years no mattter how much money the politicians were promising in their soon to be election campaigning.. and his belief was we had to decide what we can afford as a country in regard…

I am wondering if any cost-analysis studies have been done to assess the trade-off between lengthy end-of-life terminal care and the corresponding cost. Doctors seem to make such decisions all the time; but we may have at some point to discuss collectively how much of the public money involved in end-of-life terminal care (last two months, say) for elderly should be used instead for better care earlier in life.

In countries where such care is provided by private insurance and not the state, I am wondering why this trade-off is not given as a choice to the consumer. Many people might be OK to get smaller premiums and better coverage throughout their life by explicitly rejecting coverage of end-of-life care.