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Goldman Sachs questions whether curing patients is a sustainable business model

arstechnica.com

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Re: Goldman Sachs questions whether curing patients is a sustainable business model

#71

Post by nukeop »

igravious wrote: post #62
cornholio wrote: post #42

Sure it is. Gilead made 100 billion dollars curring Hep-C with seed research investments that were probably much less than 1 billion. So as long as this strong differential and potential for profit exists, drug companies feel competitive pressure to produce better treatments, irrespective of the fact that "milking" the pathology would yield them trillions collectively. It's effectively a "tragedy of the commons" of s…

Is it just me or does anyone else think that "tragedy of the commons" is overused as an explanation? While I'm at it. Also overused (not as an explanation) but just as an expression is, "onboarding". Also, "Dunning-Kruger effect" Sorry for veering off-topic but I was triggered . I imagine a HN Bingo app game where each player is randomly assigned HN-y phrases and expressions from a fixed database at the start of the…

That HN Bingo is a great idea for a browser plugin that adds a board to the HN page and fills it automatically as you browse

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#73

Post by pantalaimon »

pintxo wrote: post #15
dschuetz wrote: post #4

A healthy person is bad for pharmaceutical business and doctors, yet very good for health and life insurances.

Not sure about that. Insurances require a certain level of "damage" probability, else no one would get insurance in the first place. If you could cure any illness with a $5 pill, I'd guess no one would get health insurance. This is somewhat different for life insurances, as you could still be run over by a (self-driving) car and die.

You could still get run over by a car, self driving or not, and not die but just break your legs, so you'd still need insurance.

Actually you need it more than when you'd die if you don't have any dependents.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#74

Post by watwut »

dagw wrote: post #28
watwut wrote: post #7

Earlier quoted context omitted.

That assumes monopoly. Competition should solve that.

The problem is that most normal market forces don't apply. Often neither the patient nor the doctor know the price of the 'product' on offer. And to the extent the doctors do know the price they have an incentive to offer the more expensive drug since they make more money that way. And since the patient is rarely paying the full cost they have no reason to price compare and will simply 'buy' what they're told is the…

Even where patient don't negotiate, insurance company could. I have seen itemized lists of hospital stay where band-aid or temperature measuring costed ridiculous money. Not everything costly is death vs life choice.

I think a lot would be much cheaper, if there would be better price transparency. The bad transparency is not so much about bad feeling of putting price on it, but also that it is profitable. The same entity that hides prices will turn you back if you are not insured without visible bad feeling.

Also, plenty of people are uninsured or under-insured and money they have to pay out of pocked hurt them. They postpone doctor visit till the last possible moment, they take half dosage etc.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#75

Post by ta76567656 »

buvanshak wrote: post #34
PeterStuer wrote: post #24

The 'ideal' drug from a business point of view not only not cures the patient long term, it offer a short term mitigation while increasing the risk on relapse and thus future recurring consumption of the treatment. At the same time it can be IP protected to block alternatives and has an insured third party collective payment coverage to guard against the treated running out of funds to afford the perpetual dependency…

> The 'ideal' drug from a business point of view not only not cures the patient long term... There is another one. Vaccines. Or any preventive medicines that does not actually require people to be sick. You just need to inject massive amount of fear of diseases (Statistics is your friend here) into the populace to create a nice, ever increasing demand of your produce...

I rather enjoy never having gotten smallpox or polio.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#76

Post by bonzini »

dominotw wrote: post #70
kdelok wrote: post #67

Earlier quoted context omitted.

Flu vaccines aren't useless, but they also aren't 100% effective. The CDC reckoned they reduce the risk by about 40-60%. Flu is a variable pathogen, which means that it evolves to look different from an immune perspective over time. It follows clustered patterns, where the flu strain will look pretty similar (and vaccines will be more effective), then it "jumps" to a new cluster every few years or so (and the vaccine…

> CDC reckoned they reduce the risk by about 40-60%. curious, Do you have a link to this by any chance? According to this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693492/ After looking at "328 households with 1441 members, including 839 children," for an entire year (2011) these authors determined that there was a difference of 4/10ths of one percentage point between those who received flu vaccine and those who…

That's a 0.4/8.9 reduction, about 5%. However, flu vaccine isn't useful to the general population. In many countries is usually administered to people that are most likely to develop complications such as pulmonitis.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#77

Post by moccachino »

dominotw wrote: post #70
kdelok wrote: post #67

Earlier quoted context omitted.

Flu vaccines aren't useless, but they also aren't 100% effective. The CDC reckoned they reduce the risk by about 40-60%. Flu is a variable pathogen, which means that it evolves to look different from an immune perspective over time. It follows clustered patterns, where the flu strain will look pretty similar (and vaccines will be more effective), then it "jumps" to a new cluster every few years or so (and the vaccine…

> CDC reckoned they reduce the risk by about 40-60%. curious, Do you have a link to this by any chance? According to this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693492/ After looking at "328 households with 1441 members, including 839 children," for an entire year (2011) these authors determined that there was a difference of 4/10ths of one percentage point between those who received flu vaccine and those who…

Going from 8.9% to 8.5% is a 5% reduction in flu cases. If this translates to 5% fewer sick days during the flu-period and a 5% reduction in doctor visits that are due to flu symptoms (some people go to the doctor for everything), that can absolutely be a reason for the government to want people to get their flu shots.

Personally I have never had a flu shot and am not inclined to start doing so, but I know people who have and according to them, if they do get the flu it affects them less in the years they get their shots vs. when they don't. So assuming that the flu vaccine is harmless and the cost is not too great, it can make sense to get it even if the effectiveness rate is low.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#78

Post by ramblerman »

brann0 wrote: post #54
PeterStuer wrote: post #24

The 'ideal' drug from a business point of view not only not cures the patient long term, it offer a short term mitigation while increasing the risk on relapse and thus future recurring consumption of the treatment. At the same time it can be IP protected to block alternatives and has an insured third party collective payment coverage to guard against the treated running out of funds to afford the perpetual dependency…

So we agree medicine cannot be managed as a business, right? It's ok if healthcare losses money, in fact it should be ok for all public sevices to operate and not being profitable.

You are jumping from one extreme to the other. Creating a public institution with no pressure to make profit is a disaster waiting to happen.

You can certainly keep a 'competitive' environment which is regulated with incentives. And I do agree healthcare needs this, and shouldn't live purely by the free market.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#79

Post by amelius »

cousin_it wrote: post #56
gpvos wrote: post #39

The story goes that in China, doctors used to be paid for keeping you healthy. When you got sick, they didn't get any money anymore. This sounds to me like a system with the proper incentives.

Healthy people are less willing to pay :-(

But they pay for insurance.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#80

Post by mtgx »

PeterStuer wrote: post #24

The 'ideal' drug from a business point of view not only not cures the patient long term, it offer a short term mitigation while increasing the risk on relapse and thus future recurring consumption of the treatment. At the same time it can be IP protected to block alternatives and has an insured third party collective payment coverage to guard against the treated running out of funds to afford the perpetual dependency…

In a private healthcare system, where the government doesn't directly pay for its own citizens' healthcare issues, the government also lacks an incentive to keep its population healthy - which can go from allowing food companies to put as much sugar as they want not just in sweets, but in meat, sauces, and so on, to allowing companies to pollute the air as much as they want.

In a private healthcare system the insurers are also incentivized to pay for as few treatments as possible, hospitals are incentivized to make patients pay as much as possible for all the tests or unnecessary surgeries they make them have, and Big Pharma, as you said, is incentivized to make drugs that don't actually cure people and to price the drugs based on "value provided to the citizen". So if it's something like cancer, the value is a lot, even if the drug costs little to make.

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