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Open Letter from Gilead CEO: Remdesivir Pricing

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Re: Open Letter from Gilead CEO: Remdesivir Pricing

#91

Post by kgwgk »

kenhwang wrote: post #82
kgwgk wrote: post #77

Earlier quoted context omitted.

> It's not like the inefficiencies are limited to only US companies because they can charge more. US companies cannot really charge more than European companies [+]. They all charge more in the US and less elsewhere. [+] In general, there are also cases where the same drug is marketed by a US company in the US and a non-US company in the rest of the world.

The US companies inherently had a home field advantage. Yet non-US companies were willing to jump through the hoops to follow the US drug funding model. If their original funding and development mechanism were sufficient or better, why go through the trouble? Why did all of them do it?

I don’t understand what are you referring to. Big pharma companies are multinationals that will adapt to the regulatory requirements and commercial practices of the different markets where they want to operate. Why would European companies renounce to be present in the principal drug market?

Re: Open Letter from Gilead CEO: Remdesivir Pricing

#92

Post by pintxo »

RobertoG wrote: post #58
mathieuh wrote: post #35

Earlier quoted context omitted.

The most relevant industry to this board (IT) usually provide private healthcare though. I’ve had BUPA from work since I graduated. Granted this is across only two jobs but when I’ve been applying for jobs in the past private health has always been one of the perks Maybe it’s different in the start up world but larger companies all seem to offer private health insurance.

When comparing healthcare costs between USA and Europe, everybody speak about the public systems vs. USA, but I would like to see the cost per person of the private plans in Europe against the cost per person in the USA. For what I read about USA, in HN and in other places, I suspect Americans would be surprised too. Those private plans have a very hard competitor in the public system, so, somehow, at least in my are…

in Germany, private plans are often 1/2 of the public plan. But only at young age, prices will go up with age and switching back in the public system is legally blocked (for most cases).

Also private plans are mostly only available above a certain income level. So the demographics are skewed towards better educated, richer and thereby healthier people in the privat plans.

Re: Open Letter from Gilead CEO: Remdesivir Pricing

#93

Post by kgwgk »

nix23 wrote: post #66
flumpcakes wrote: post #22

Earlier quoted context omitted.

Very few people have private health care in Europe, at least in the UK - they are either comparatively very rich or have a job that provides it (again, very rare and probably a job that pays very well to begin with). You will see a lot of buying power from free health care providers as they represent tens-hundreds of millions of people - they will most likely pass on a price gouging drug in favour for others. They wo…

>Very few people have private health care in Europe, at least in the UK In Europe at least in Switzerland quite many have private health care (the price difference is quite small because the obligatory insurance is tremendously high already), and if you think 'we' are rich..you are wrong.

The obligatory insurance is also private.

Re: Open Letter from Gilead CEO: Remdesivir Pricing

#94

Post by danaris »

kenhwang wrote: post #68
flumpcakes wrote: post #57

Earlier quoted context omitted.

You're subsidising paying other Americans extremely high salaries. You're also subsidising share holders and C-level people's luxury lifestyle. The same drug wouldn't cost $2b to create in any other country. It's not Europe's fault you treat basic healthcare like any other business to make money from.

If that were actually the case, Europe should've had a huge competitive advantage in drug development and priced the majority American drug companies out of business. Isn't anywhere close to happening, is it?

The barrier to entry to the pharmaceutical business is fairly high. Not only is it a pretty heavily regulated field (for damn good reasons), the equipment needed to start a drug company is significant and expensive, and the time between first investment and first payoff can be very long.

Re: Open Letter from Gilead CEO: Remdesivir Pricing

#95

Post by candiodari »

kenhwang wrote: post #89
DanBC wrote: post #69

Earlier quoted context omitted.

> Then the drug companies just offload the rest of the R&D cost onto the US consumer. But, almost the entire cost of a drug is in the R&D. How much do drug companies spend on advertising in EU vs US?

Usually the marketing spend ranges from half to double the spend compared to R&D. However, advertising (specifically the direct to consumer variety that's uniquely allowed in the US) only consists of ~10% of the marketing budget. Over half the marketing budget is free samples and a quarter is physician outreach/training, which happens in both the EU and US. So there's potential for ~3-7% cost improvement if direct-to…

Those are the numbers that always make one wonder. If you look at margins of pharma companies, you see the potential for price improvement: from 2% to about 20%.

And this is not what anyone of the people complaining are looking for. That would make somewhat optimistically make Remdesivir $350 per vial, and that pricing would cause ... exactly the same outrage.

The actual issue is "too many" medicines. More and more effective and specialized medicine. But, of course, that you can just sidestep as an individual (you'll have to have your doctor on board, but that may be doable). It boils down to the same thing: if you're willing to forego the most expensive treatments and best possible outcomes you can avoid a lot of the financial problem. There's just zero willingness to do that.

Best possible treatments, no matter the human effort required to do that, at zero cost to anyone (not carried by the actual patients, not collectively carried by insurance, not carried by government, not by church, institutions or charitable giving). And we're not willing to give anywhere (for instance, cheaper drug trials, something the government could simply decide to provide at frankly minimal costs). This is not happening.

There just doesn't seem to be any solution here that I can see.

Re: Open Letter from Gilead CEO: Remdesivir Pricing

#96

Post by danaris »

apsec112 wrote: post #56

This isn't just paying for the R&D on remdesivir itself. It's paying for all of the other antivirals which were developed and then failed clinical trials, and all the other antivirals that turned out to be largely useless because (like SARS, MERS, and Ebola) there was never a large-scale outbreak. If you require remdesivir to be sold at cost, then any company developing antivirals will reason out: Scenario A: There's…

You know what government is really good for?

Expensive projects for the public good with no mandate to turn a profit.

If you're part of a government agency whose entire purpose is to develop and research new drugs, you're not going to be unduly risk averse. You're going to be doing your job, trying new things, working on getting new, effective, efficient treatments and cures developed, tested, and released to the public.

Personally, I don't know to what extent I believe that pharmaceutical companies have actively suppressed research on cures for diseases, in favour of life-long treatments, but the incentives definitely support the theory. Publicly-run pharmaceutical research would also be much more likely to do a proper, thorough investigation of the kinds of treatments that can come out of well-known natural/easily-synthesized substances (as opposed to the existing pharmaceutical industry, which is incentivized to do research into things that require more specialized expertise & equipment, so the people who want the drugs must but them from them).

Re: Open Letter from Gilead CEO: Remdesivir Pricing

#97

Post by Pick-A-Hill2019 »

This Open Letter is bullshit (purely personal opinion obviously). I note they are transparent about the pricing in specific markets but that the CEO fails to be so transparent about the pricing for generics in other markets. I’m aware of the studies regarding its effectiveness but hate hand-wavy B.S. like this so here's some snippets taken from Gilead's own website.

"All descriptive printed matter, including advertising and promotional material, relating to the use of the remdesivir clearly and conspicuously shall state that: :the remdesivir have not been approved [sic] :the remdesivir have been authorized by FDA under an EUA [sic]" page 6 https://www.gilead.com/-/media/files/pdfs/remdesivir/eua-fda...

and "Remdesivir is an investigational drug that has not been approved by the FDA for any use." https://www.gilead.com/remdesivir

I was in two minds about correcting the grammar but since they are all snips from the links decided to leave as is.

[Edit to clarify] My main point was that if they were pricing generics at a reasonable price they would have been trumpeting in the same press release as this. eg. if one is so reasonable that they openly discuss it then why not the pricing of generics.

Re: Open Letter from Gilead CEO: Remdesivir Pricing

#98

Post by jjeaff »

sub7 wrote: post #88

I do in $20 or less what costs $800 there. Americans pay probably $200 of that $800 and think "oh insurance covered it" when really they just payed 10x the price. The US is so full of morons they must love being ripped off or something.

Few pay that much. It's the insurance companies who for some reason can't negotiate better. But also, note that you get it for $20 because americans are subsidizing you.

Re: Open Letter from Gilead CEO: Remdesivir Pricing

#99

Post by jjeaff »

cjhopman wrote: post #84
jjeaff wrote: post #54

When you need a whole letter to explain the new price, you know it's going to be loaded with crap and the price will be excessive. This one doesn't disappoint.

That's bullshit. Companies have "whole letter"s for pretty much everything they do. Gilead had a "whole letter" when they said they'd provide 1.5 million doses for free. Was that also loaded with crap and the "$0" price excessive?

That's fine if you want to make a PR splash with a donation.

But don't do the same while you are gouging consumers. In other words, don't piss on me and call it rain.

Re: Open Letter from Gilead CEO: Remdesivir Pricing

#100

Post by nix23 »

kgwgk wrote: post #93
nix23 wrote: post #66

Earlier quoted context omitted.

>Very few people have private health care in Europe, at least in the UK In Europe at least in Switzerland quite many have private health care (the price difference is quite small because the obligatory insurance is tremendously high already), and if you think 'we' are rich..you are wrong.

The obligatory insurance is also private.

From private company yes, but with private we mean the 'luxury' addon...the obligatory is regulated by the state, but administered by private company's.
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