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Hospitals and universities repurposing drugs at lower cost

kcl.ac.uk

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Re: Hospitals and universities repurposing drugs at lower cost

#71

Post by tekla »

amanaplanacanal wrote: post #13
boxed wrote: post #5

Earlier quoted context omitted.

That seems wild. Do you have a citation to back that up? And in what country/countries?

I'm in the US, and there are a couple of wrinkles to this: insurance typically won't cover off label use, so patients end up paying the full cost of the medication, and if there is a big enough market, I believe companies can patent the new use even if the patents for the original use have run out. Doctors here are allowed to prescribe them though.

> insurance typically won't cover off label use

That's a lie, I get off-label drugs prescribed monthly covered.

Re: Hospitals and universities repurposing drugs at lower cost

#72

Post by danans »

ck2 wrote: post #9

the thing is while something is better than nothing, new drug development is critical there is absolutely no cure for certain types of long-covid and me-cfs right now no repurposing any drug is going to cure it, they've tried everything after six years it will take a decade to have anything even in the pipeline and won't emerge from the USA because all medical and science research investment by the government has bee…

> the thing is while something is better than nothing, new drug development is critical

> there is absolutely no cure for certain types of long-covid and me-cfs right now

> no repurposing any drug is going to cure it, they've tried everything after six years

Then repurposing should free up resources for new drug development for those conditions that it can't address.

Sounds like a win-win, unless the goal is somehow not to most efficiently allocate resources to maximize health outcomes. But at least in the US, that's clearly not the goal.

Re: Hospitals and universities repurposing drugs at lower cost

#73

Post by Jblx2 »

dpark wrote: post #56
Aurornis wrote: post #35

Earlier quoted context omitted.

> insurance typically won't cover off label use I’m in the US. This is not true. Insurance will have prior authorization rules for certain drugs that are expensive that require the doctor to submit documentation of the condition, but in most cases the common medication is simply covered if prescribed. The insurance company does not receive documentation of every condition for every prescription to determine if the pr…

So much weirdly confident misinformation here. When LLMs do this we can it hallucination.

Can't tell if this comment is agreeing with Aurornis or calling them out.

Re: Hospitals and universities repurposing drugs at lower cost

#76

Post by parineum »

photochemsyn wrote: post #68

If every drug created with taxpayer dollars at government-funded research institutions was open-sourced, there would be a collapse in monopoly control of drug manufacturing and that would lower prices significantly. The question is then, if corporations can no longer acquire IP rights to drugs created by taxpayer-funded research programs and transferred to their exclusive control (eg if Bayh-Dole is repealed in the U…

This all assumes that the government will do an equal or better job spending money than companies that rely on spending that money well to exist.

What will actually happen is that the government department of repurposing drugs will be efficient once and then get their budget reduced and never be efficient again. Next time they'll make sure to spend every last cent and not worry about the over budget boondoggle that's three years late because their job isn't to get stuff done, it's to make sure politicians can say their doing something on the campaign trail.

Re: Hospitals and universities repurposing drugs at lower cost

#77

Post by dabinat »

I’m currently on Spravato, which is fully emblematic of how broken the incentives in the US healthcare system are.

Spravato is esketamine - a modified version of ketamine. Ketamine is made up of mirror image molecules and esketamine is the right-handed molecule. They did this because ketamine is off-patent so they needed to modify it in order to patent it, however there is evidence that esketamine is a less effective treatment than ketamine.

It’s very cheap for me but my insurance company pays about $17k a month for this treatment. Ketamine would be a more effective treatment that would be super cheap for them, but they don’t do it because it’s not FDA-approved. So they’re paying a fortune for a less effective treatment.

It would be in the insurance companies’ interests to band together to fund the research so they can save huge amounts of money in the long term but they do not do this.

Re: Hospitals and universities repurposing drugs at lower cost

#78

Post by NoMoreNicksLeft »

mothballed wrote: post #62
simiones wrote: post #60

Earlier quoted context omitted.

The maximum libertarian alternative to patents isn't free-for-all copying, it's trade secret formulas - e.g. Coca Cola. Drug patents actually exist as a compromise given the clear need for the state to force companies to publish their drug formulas for research. Allowing companies to just keep their drugs secret would be even more capitalistic, and would increase drug prices even more.

They keep their processes secret instead under the current system, achieving a "trade-secret" like result for some drugs. For some drugs it achieves the same thing because finding a practical economic synthesis is the hard part rather than coming upon a small bit of chemical that is proven to be effective. For others it wouldn't matter whether you kept it secret or not, someone would isolate and characterize it and r…

Is the patent not for the synthesis route itself, rather than the drug? Someone can't just plop down a chemical formula on a piece of paper and patent that, can they?

Re: Hospitals and universities repurposing drugs at lower cost

#79

Post by parineum »

vjvjvjvjghv wrote: post #46
wk_end wrote: post #25

Earlier quoted context omitted.

> This is interesting because the USA claims to pursue a maximum capitalistic society No it doesn't. This is silly. Drug prices in the US are high for non-generic drugs because patent law gives the patent holder an artificial government-granted monopoly, which is blatantly not "pure" or "maximum capitalistic". Generic drugs - where the free market does apply - in the US are as cheap or cheaper than in other countries…

"Drug prices in the US are high for non-generic drugs because patent law gives the patent holder an artificial government-granted monopoly, which is blatantly not "pure" or "maximum capitalistic"." This is very much capitalistic. It's not competitive markets (which are good for consumers) but capitalists hate competition once they have made it to the top.

Capitalism doesn't serve capitalists. It's built to create an environment where the capitalist, doing what they do best, also serves the community.

Monopolies are anti-capitalism, despite it being something that capital strives for.

This is like being upset that bug spray doesn't actually spray bugs, in fact, it actually deters them.

Re: Hospitals and universities repurposing drugs at lower cost

#80

Post by photochemsyn »

parineum wrote: post #76
photochemsyn wrote: post #68

If every drug created with taxpayer dollars at government-funded research institutions was open-sourced, there would be a collapse in monopoly control of drug manufacturing and that would lower prices significantly. The question is then, if corporations can no longer acquire IP rights to drugs created by taxpayer-funded research programs and transferred to their exclusive control (eg if Bayh-Dole is repealed in the U…

This all assumes that the government will do an equal or better job spending money than companies that rely on spending that money well to exist. What will actually happen is that the government department of repurposing drugs will be efficient once and then get their budget reduced and never be efficient again. Next time they'll make sure to spend every last cent and not worry about the over budget boondoggle that's…

Notice I was sure to include ‘revival of corporate R & D divisions’ in the argument? Bell Labs is the archetype - if corporations can do a better job of applied R & D, let them. If corporations are upset about publicly funded research generating open-source discoveries that upset the monopolistic apple cart, that’s not an argument about improving efficiency - that’s an argument about maximizing profits and investor return, not for efficient new drug discovery or old drug repurposing.

The real question is, what is the metric of ‘success’ - improved public health for the entire population at low cost, or bloated returns for pharmaceutical investors?

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