Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

How expensive do prescription drugs need to be to fund research?

theatlantic.com

Post reply on HN
Print view View original

71–80 of 131 posts

Re: How expensive do prescription drugs need to be to fund research?

#71

Post by 0815test »

amelius wrote: post #63
entee wrote: post #6

This is such a complicated issue, I'd highly recommend the following as a primer: https://www.forbes.com/sites/matthewherper/2015/10/13/four-r... Also Derek Lowe is invariably awesome in this space, one highlight: https://blogs.sciencemag.org/pipeline/archives/2019/02/05/ta... Drugs occasionally need to be expensive, particularly on-patent drugs, to make the endeavor worthwhile. That said, it's a two-way street. Maki…

I suspect things could be much simpler if universities or government institutions developed drugs instead.

They do. But they focus on the earliest stages of drug development, mostly involving proofs of concept. That doesn't solve the problem of actually getting the drug approved so that it can be used by patients - which is where the costs skyrocket.

Re: How expensive do prescription drugs need to be to fund research?

#72

Post by michaelscott »

0815test wrote: post #71
amelius wrote: post #63

Earlier quoted context omitted.

I suspect things could be much simpler if universities or government institutions developed drugs instead.

They do. But they focus on the earliest stages of drug development, mostly involving proofs of concept. That doesn't solve the problem of actually getting the drug approved so that it can be used by patients - which is where the costs skyrocket.

As a non-American, why do costs skyrocket in the approval phase? Is it that the drugs have to go through multiple rounds of clinical testing over years? I struggle to understand the astronomical price tags, but I'm assuming it's something bureaucratic?

Re: How expensive do prescription drugs need to be to fund research?

#73

Post by amelius »

0815test wrote: post #71
amelius wrote: post #63

Earlier quoted context omitted.

I suspect things could be much simpler if universities or government institutions developed drugs instead.

They do. But they focus on the earliest stages of drug development, mostly involving proofs of concept. That doesn't solve the problem of actually getting the drug approved so that it can be used by patients - which is where the costs skyrocket.

> They do. But they focus on the earliest stages of drug development, mostly involving proofs of concept.

If that is true, then how can BigPharma patent the drugs?

Re: How expensive do prescription drugs need to be to fund research?

#74

Post by scotty79 »

When the question is stated like that it becomes really questionable whether cost of drugs should have anything to do with drug research cost.

Those two things look like they should be completely separate, done by separate entities with separate funding.

Re: How expensive do prescription drugs need to be to fund research?

#75

Post by Brakenshire »

michaelscott wrote: post #72
0815test wrote: post #71

Earlier quoted context omitted.

They do. But they focus on the earliest stages of drug development, mostly involving proofs of concept. That doesn't solve the problem of actually getting the drug approved so that it can be used by patients - which is where the costs skyrocket.

As a non-American, why do costs skyrocket in the approval phase? Is it that the drugs have to go through multiple rounds of clinical testing over years? I struggle to understand the astronomical price tags, but I'm assuming it's something bureaucratic?

I think it’s just because of the degree of failure. Going through the rounds of clinical trials might cost £15m, which isn’t much amortized over drug sales, but you might go through 50 candidate drugs that fail (and possibly at the last stage of clinical trials after the money has been spent) before you get one success. Public or academic research bodies don’t have the capital or the appetite for risk to go through that process.

I think there are quite a few drugs which work exactly as intended, except for the small detail that they turn out to be toxic to humans. One of the big outcomes I’m hoping for from stem cells is to be able to test heart or liver toxicity before human trials, weed out a whole subset of failures before substantial money is spent, and make the whole process of drug discovery inherently more efficient.

Re: How expensive do prescription drugs need to be to fund research?

#76

Post by RHSeeger »

Nf508 wrote: post #64

Interestingly in the case of the the Abiraterone example used in the article, none of the R&D was even done by JNJ. The original work was done at The Institute of Cancer Research, an academic/charity drug discovery institute. JNJ actually only market this drug because of acquisitions rather than R&D efforts. Which is the way that a lot of pharma is going these days, letting smaller biotechs take the high risk of deve…

I don't buy that argument. It's like saying I should sell something I bought at the store for free, because I didn't pay the cost to make it directly (someone else did, and I paid them).

The research had to be done, and JNJ bought the company that did it. The price they had to pay was impacted by the cost of the research.

Re: How expensive do prescription drugs need to be to fund research?

#77

Post by rygxqpbsngav »

thewhitetulip wrote: post #51

I saw a show earlier this week, an insulin shot costs 2$ in rest of the world and 100+$ in the US. Isn't this loot?

Makes sense.

Thanks to the advances in medical research in US, and the approach they take (i.e. divide divide and divide and dig to the nanoscopic level of human body to give a disease it's own name. ) There are more bespoke diseases in US than anywhere in the world. Drug industry has to keep itself busy to invent drugs just to affect that single bespoke disease.

Re: How expensive do prescription drugs need to be to fund research?

#78

Post by bildung »

m0zg wrote: post #53
refurb wrote: post #47

Earlier quoted context omitted.

Really? So a country with a per capita income of $5,000 should pay the same as what a country with a $50,000 per capita income? That would be a terrible outcome.

You should extend this line of reasoning to other goods. Pay 10x for your food, too, so someone else could get theirs for less. Pay $50 per gallon of gas, stuff like that. The op's POV might seem cruel, but only if you're in an ivory tower. There are _plenty_ of people right here in the US who can't afford drugs because we insist that they should be 10x the price in the US than everywhere else. In fact, I'd say those…

> There are _plenty_ of people right here in the US who can't afford drugs because we insist that they should be 10x the price in the US than everywhere else.

The very article explains this isn't true, as drug price doesn't really correlate with R&D costs.

> There's also another negative side effect: due to what amounts to dumping, other countries essentially don't have any pharma research of their own

That's wrong, too. According to [0], U.S. pharma companies globally spent about 70 billions, of which about 11 billions were spent in Western Europe, so net amount was at most (assuming nothing was spent outside the US and Western Europe) 59 billion dollars.

By comparison, according to [1], R&D spend from national companies from Germany, Switzerland, UK and France were about 20 billion USD.

So the population adjusted R&D spend relation is lower than 1:2 between Western Europe and the US.

[0] = https://www.healthaffairs.org/do/10.1377/hblog20170307.05903...

[1] = https://www.vfa.de/download/the-pharmaceutical-industry-in-g...

Re: How expensive do prescription drugs need to be to fund research?

#79

Post by Brakenshire »

scotty79 wrote: post #74

When the question is stated like that it becomes really questionable whether cost of drugs should have anything to do with drug research cost. Those two things look like they should be completely separate, done by separate entities with separate funding.

I think the reason you want them connected is the ability to channel private capital towards achieving medical progress.

If there is a disease which costs the general population tens of billions of dollars a year, either in providing healthcare or in an inability to carry on a normal life, work, look after yourself and so on, then there is an inherent and huge pot of money which can go to solving the problem. If you sever the connection, you rely solely on funding achieved through political processes. Which given the level of expensive failure inherent to the process, tabloid campaigns, lack of public understanding, and short termism from politicians, does not seem like something we should rely on.

For instance, can you imagine what the reaction would have been if the hundreds of millions spent on alpha-beta clearance for Alzheimers had been spent by public bodies? Future funding would depend on a battle waged on twitter, opinion pages and talk radio.

Re: How expensive do prescription drugs need to be to fund research?

#80

Post by ourmandave »

refurb wrote: post #44
apo wrote: post #16

Patent expirations don't factor into this article very much, but there's this: The simple explanation for excessive drug prices is monopoly pricing. Through patent protection and FDA marketing exclusivity, the U.S. government grants pharmaceutical companies a monopoly on brand-name drugs. But monopolies are a recipe for excessive prices. A company will raise prices until its profits start to drop. That monopoly is ve…

Indeed. Companies have a limited time to recoup costs. Once the patent runs out, that $10,000 drug turns into a $500 drug. Forever. That benefit can't be ignored.

Well, except for Daraprim which has been off patent for 62 years.

It went from $13.50 to $750 overnight because it only has one producer that decided to raise the price 5500%.

https://www.vox.com/2015/9/22/9373557/daraprim-competitor-tu...

And there's no generic insulin sold in the US, even though it was discovered 90+ years ago.

https://www.npr.org/2015/03/22/394634923/90-years-after-its-...

Post reply on HN