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With no prospects for profits, big pharma neglects new infectious diseases

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Re: With no prospects for profits, big pharma neglects new infectious diseases

#51

Post by _lqaf »

refurb wrote: post #4

What's needed is a new payment model for anti-infectives. This already happens at a small scale with grants from institutions like BARDA. The DOD of also does this for vaccines for biological weapons like anthrax where there is a high likelihood the drug will never be used, but a vaccine is needed because if there is an outbreak, the consequences are severe. Basically, rather than paying for drugs on a per unit basis…

What's needed is for the NIH to get in to the drug manufacturing business, start making generics and vaccines itself.

A huge amount of their research already is directly responsible for private industry profits; they can be happy with that freebie. But for things like vaccines in emergencies and insulin, if this be socialism; let's make the most of it.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#52

Post by newyankee »

refurb wrote: post #33
markdown wrote: post #24

Earlier quoted context omitted.

The infrastructure and expertise exists in India, and they'll gladly manufacture drugs at a cost that the developing world can afford.

Depends on the drug. Small molecules, sure? Complex biologics? Even other large pharma companies can have challenges making those.

Could you give an example of what makes complex biologics difficult, is it the actual process or just the fact that IP is not shared easily and the hurdles to get licensing in place.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#53

Post by _lqaf »

m0zg wrote: post #38
drocer88 wrote: post #35

Earlier quoted context omitted.

This recent drug does better than 3-6 months: Nivolumab . One-Third of Patients With Advanced Melanoma Survive at Least 5 Years After Nivolumab Treatment. ( https://www.ascopost.com/issues/may-10-2016/one-third-of-pat... Here's another recent success : https://hcp.lutathera.com/ --- https://www.nejm.org/doi/full/10.1056/NEJMoa1607427 At the data-cutoff date for the primary analysis, the estimated rate of progression-…

$150K+/yr. OOF. On the positive side, 20 years from now these drugs will be dollar a bucket as generics. Thank god for capitalism.

No, it won't. Look at inulin prices. Or pharma-bro's Daraprim.

That's what capitalism does to generics.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#54

Post by aschatten »

block_dagger wrote: post #3

With the amount of economic upheaval from the coronavirus scare, I fail to see how there are no prospects for profit.

It's very hard to incorporate events like this into a financial model. With chronic disease like diabetes or cancer they can get a pretty good forecast of demand, so it's translates into a clearer understanding of ROI with higher confidence: more they invest the more they get plus some error, but even the error won't offset the forecast by much. With epidemics, not only you need to predict when, but also what kind of virus it's gonna be. The reward is great, but so is the risk. Would you invest $100 to almost surely get back ($130 +/- $5), or $1000 with a potential outcome of $10000, but very low confidence that it is going to happen at all before you run out of money.

Similar to financial crisis, if the next one could be predicted, it wouldn't happen.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#55

Post by anewhope »

lazyier wrote: post #28
perl4ever wrote: post #20

I thought the "party line" was that private industry doesn't accomplish much if anything, so isn't "big pharma" irrelevant? It makes more sense to demand higher taxes and more basic research.

The problem is that regulation is so expensive there isn't any financial motivation in researching does that are unlikely to generate massive revenue. The reason for this is FDA is fundamentally extremely conservative. The people that run the regulatory system are just faceless bureaucrats and are risk adverse. Their pay is based on seniority and there isn't any financial motivation for them to take risks or stand ou…

I’m not an expert, but I’ve worked with the FDA. In my experience they’re pretty reasonable and motivated by mission. I suspect it’s simply really hard and risky to come up with new therapeutics and make sure they work in a reasonable amount of time. Diminishing returns.

I don’t know anything about the generic drug marketplace. I’d guess the issues are more complicated than what you describe. The FDA’s mandate is safety, not anticompetitive practices.

One surprising takeaway from working with our regulatory consultants is that apparently many actors try to game the crap out of the FDA’s processes. The FDA is really the only wall between shenanigans and consumers.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#56

Post by m0zg »

_lqaf wrote: post #53
m0zg wrote: post #38

Earlier quoted context omitted.

$150K+/yr. OOF. On the positive side, 20 years from now these drugs will be dollar a bucket as generics. Thank god for capitalism.

No, it won't. Look at inulin prices. Or pharma-bro's Daraprim. That's what capitalism does to generics.

Not really. Regarding insulin, that's what _the lack of capitalism_ does to generics. You can't import insulin into the US, and that's why it's so expensive here.

Daraprim wasn't generic until literally 5 days ago: https://www.biospace.com/article/fda-approves-first-generic-...

Re: With no prospects for profits, big pharma neglects new infectious diseases

#57

Post by hnzix »

_bxg1 wrote: post #11
refurb wrote: post #4

What's needed is a new payment model for anti-infectives. This already happens at a small scale with grants from institutions like BARDA. The DOD of also does this for vaccines for biological weapons like anthrax where there is a high likelihood the drug will never be used, but a vaccine is needed because if there is an outbreak, the consequences are severe. Basically, rather than paying for drugs on a per unit basis…

> Basically, rather than paying for drugs on a per unit basis, you pay a lump sum for access to the drug. Hmm... a system where uncommon but extreme spikes in the cost of care are artificially distributed so that an entire society can bear them as a group... that sounds oddly familiar...

Please put the invisible hands of the market over your ears and wait for the drugs to trickle down.

Jokes aside - while people are justifiably pointing out the community healthcare angle, arguably this problem is exacerbated by the American FDA drug approval model, ie no corporation will fund clinical trials unless they're guaranteed a profit monopoly.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#58

Post by DrScump »

refurb wrote: post #31
dehrmann wrote: post #22

Earlier quoted context omitted.

Testicular cancer is now very treatable, but before Cisplatin, the prognosis was pretty grim. I guess to grandparent's comment, we absolutely do develop chemotherapy drugs, and many don't just buy you six months, they're life-saving.

I unfortunately can't find it, but there was an interesting chart that showed overall survival in metastatic colorectal cancer. It covered the last 30 years. Each new therapy improved survival by only 6-12 months, but each new drug was more effective than the last. Over those 30 years, the median survival went from 6 months to over 5 years. People shouldn't discount incremental improvements because that's often how m…

Cell type is much more relevant to curability than location.

Re: With no prospects for profits, big pharma neglects new infectious diseases

#59

Post by beardedman »

What a pile of sensationalist rubbish.

In 2018 we had an estimated 400k people dying of Malaria [1] & around 600k (est.) people dying of cancer in the US alone. [2] Compare that to the 3110 deaths that have happened in the last 3 or so months for COVID-19. [3]

I think a little perspective would go a long way here.

[1] https://www.who.int/news-room/feature-stories/detail/world-m...

[2] https://www.cancer.org/research/cancer-facts-statistics/all-...

[3] https://www.who.int/dg/speeches/detail/who-director-general-...

Re: With no prospects for profits, big pharma neglects new infectious diseases

#60

Post by jyrkesh »

_bxg1 wrote: post #11
refurb wrote: post #4

What's needed is a new payment model for anti-infectives. This already happens at a small scale with grants from institutions like BARDA. The DOD of also does this for vaccines for biological weapons like anthrax where there is a high likelihood the drug will never be used, but a vaccine is needed because if there is an outbreak, the consequences are severe. Basically, rather than paying for drugs on a per unit basis…

> Basically, rather than paying for drugs on a per unit basis, you pay a lump sum for access to the drug. Hmm... a system where uncommon but extreme spikes in the cost of care are artificially distributed so that an entire society can bear them as a group... that sounds oddly familiar...

The fact that there's a feasible market incentive for drug R&D suggests to me that that an actual competitive approach to health care would stimulate this sort of behavior on a more widespread basis.
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