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"Outrageously" priced weight-loss drugs could bankrupt US health care

arstechnica.com

51–60 of 102 posts

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#51
post #18
post #10

Earlier quoted context omitted.

> I'd argue that there's a moral imperative to bootleg the drug and distribute it to those who would benefit from it at a fair price. Why not do away with patents and IP altogether if the standard is that as soon as someone makes something needed it can be stolen?

I'm not sure what the right solution is, but making 160x the manufacturing cost seems a bit obscene. Not sure what the total cost of R&D was, but at that rate of return those R&D costs have to be recovered relatively quickly and then it becomes a pure profit machine.

Do you similarly object to the insane gross margins on software?

Like in software, pretty sure the main expense is R&D.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#52
post #10

> A study by researchers at Yale estimated that drugs like Wegovy can be profitably manufactured for less than $5 per month. Serious question: Why not just bootleg the stuff? It's a very small protein, easy to make, and "research chemical" companies that sell structurally similar bodybuilding drugs and nootropics are a dime a dozen. Search online for "BPC-157" (a protein drug of only slightly inferior complexity) and…

> I'd argue that there's a moral imperative to bootleg the drug and distribute it to those who would benefit from it at a fair price. Why not do away with patents and IP altogether if the standard is that as soon as someone makes something needed it can be stolen?

>Why not do away with patents and IP altogether if the standard is that as soon as someone makes something needed it can be stolen?

laughs in anarchist don’t threaten me with a good time!

We also need to differentiate “theft” (actually taking a tangible thing) from “ripping off” (stealing an idea and making that thing yourself).

Theft is bad (depending in who you steal from and why), ripping off is only bad if you believe current economic models/practices are good. But

I’m only talking about conceptually since this doesn’t account for the consumer’s safety. In practice one downside to unregulated markets is they get exploited by bad actors for profit by making inferior products that harm consumers, unlike regulated markets that get exploited by bad actors for profit through regulatory capture.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#53

The USA should nationalize the health care industry and all the pharmaceutical companies. Illness should not be a source of profit.

I think there should be more competition, and one source of competition should be public health care and maybe publicly subsidized medical supply corporations or nonprofits. I don't know that nationalizing existing private companies is really necessary.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#54

The USA should nationalize the health care industry and all the pharmaceutical companies. Illness should not be a source of profit.

> Illness should not be a source of profit.

Exactly.

Let's take this further. Nobody should be making money off other people's suffering.

So.

Let's also zero out doctor's and nurse's salaries.

Hospital administrator's salaries.

This would also apply to all charities that try to alleviate any suffering. No administrator should make any money off other people's suffering.

The only profitable enterprise should be showing ads!

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#56

The USA should nationalize the health care industry and all the pharmaceutical companies. Illness should not be a source of profit.

Going to leave a link here to a reddit thread I ran across recently for the curious.

https://old.reddit.com/r/unitedkingdom/comments/1cn8dy8/what...

Look at how many times NHS is referenced and how it is viewed by those utilizing the system. In my opinion, socialized medicine tends to fail as the overall demand for healthcare will usually exceed the available supply in most societies.

I'm sure there are counterexamples to be provided; however, I think the benefits of a capitalist healthcare system are underappreciated.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#57
The Government could manufacture the drug itself under 28 USC 1498.[1] "Reasonable and entire compensation" to the patent holder is required, but previous cases indicate that does not authorize a huge markup.

The last time using 28 USC 1498 was proposed in the pharma sector, it involved ciprofloxin. The pharma industry panicked. Suddenly, ciprofloxin became much cheaper.

[1] https://www.law.cornell.edu/uscode/text/28/1498

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#58
post #40

Earlier quoted context omitted.

They already are. Weight loss clinics will send the Rx to a compounding pharmacy.

What is compounding? What raw ingredients do they start with? How is it possible?

They are compounding the useful, active ingredient which they are purchasing from some mass manufacturer with some pointless thing they happen to have on hand and that provides a legal fig leaf that the medicine was tailored specifically for you.

The reason compounding pharmacies are very useful in the US is not because the process of compounding is useful; it's that they have carveouts in regulations that make it hard for the FDA to control them. When there is a drug that is useful and safe, but not approved by the FDA for the purpose you want to use it, you can often get it from a compounding pharmacy.

Semaglutide is a GLP-1 agonist. There are many other GLP-1 agonists, of varying efficacy and side effects, and many of them which a compounding pharmacy can purchase in bulk at very reasonable prices. However, only Semaglutide has been FDA approved for the indication of weight loss, and being the sole approved product means they can milk their patent-granted monopoly for a ridiculous amount of money. Simply because without FDA approval, you cannot get the other similar drugs for the purpose of weight loss. Unless you go to a compounding pharmacy, which, for dumb historical reasons, happen to have loopholes in FDA regulation, so long as they are artisanally producing compounded drugs tailored to a specific individual.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#59

Earlier quoted context omitted.

Why not make an exception for life-saving patents/inventions? The irony that, were it not priced outrageously, it could save the health care industry billions as these people with obesity will otherwise require epesneive treatments if the remain obese.

> it could save the health care industry billions as these people with obesity will otherwise require epesneive treatments if the remain obese. "Could" is doing a lot of work there. We don't really know what to expect for these patients 20 or 40 years out. Long-term outcomes and population-scale polypharmacy risks are not really clear, and won't be for decades. These drugs enable a valuable intervention for individua…

Exactly. I’m old enough to remember the Fen-Phen fallout.

A truly harmless weight-loss drug is the white whale of the pharmaceutical (assuming it can be profitable enough to offset the losses that would go along with the decrease in needed treatment for problems ancillary to obesity). These drugs, so far, seem pretty good but some of the side effects should take the shine off for people who thing this is ”The Cure” for obesity.

Re: "Outrageously" priced weight-loss drugs could bankrupt US health care

#60
post #39

My hot take on these GLP-1 drugs is that they won't work long term for most people. If the plan is to give the drug to as many obese people as possible and take a victory lap, thats going to fail. I don't think its resonable for most people to continue taking GLP-1 antagonists all their lives. Its been widely shown that most people rapdily gain back ~2/3 of their weight after stopping semaglutide. This means that the…

While I 100% agree that GLP-1 antagonists won’t lead most to making actual changes to their behaviors with food outside of forcing them to not over-eat when actively taking the drug, I am not so sure about your hot take here. A woman I know has been on this stuff for a couple years now and while she has plateaued for about 6 months, her current weight is now in a healthier spot. It’s crazy what losing some weight can…

I agree that obesity can be a chronic condition for many people, especially when combined with societal pressures causing mental harm.

> And now for the bad news, her insurance no longer covers it.

This is one of the reasons why I think these GLP-1 drugs are going to be classified by insurance as a temporary tool to help people improve their health. Rather than a long term medical necessity like insulin.

> I think we need more time to see

I agree with this statement, we definitely need more time. We don't fully understand the long term effects of GLP-1 in large populations.

I'm in the camp of, if its possible to use GLP-1 as a ramp to building sustainable habits and then wean off the drug, then as many people as possible should be weaned off.

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