Indian Government uses special powers to slash cancer drug price by 97% • Hacker News Board

Re: Indian Government uses special powers to slash cancer drug price by 97%

#91

Post by jbooth » Tue, Mar 13, 2012, 1:58 PM UTC

ekianjo wrote: post #57

JunkDNA wrote: post #36

I worked in the drug R&D business for over 8 years. I still follow the industry closely. Some things always get lost in these discussions. First, manufacturing an existing drug is absurdly cheap. Modern industrial chemistry ensures this for all small molecule drugs (note that this is not the same case for the "biologics" which are often fiendishly difficult to make). Almost all the cost in a drug is the manufacturer…

The reason why the cost of R&D is inflating so much is due to relentless addition of new regulations, new requirements, new safety-related trials demanded by the authorities. Add to that that almost every other country has specific requirements that do not fit with what was developed and proven before, and that's just another 2-3 years clinical trial you need to put up with. This is really getting insane and there is…

Yeah, there are a lot of safety-related things because we keep getting a vioxx every so often that's killing people.

I'm not willing to increase my chance of getting killed by medicine on behalf of someone else's profit margin. They have a big, powerful lobby, they should suggest process improvements. And make some on their end, as well, nobody's charging them billions in fees, they spend that money on the typical big-company waste in the process of complying with those regs.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#92

Post by matwood » Tue, Mar 13, 2012, 1:59 PM UTC

ig1 wrote: post #41

Indyan wrote: post #17

Earlier quoted context omitted.

On principle, you are right. However, Rs 2.8 lakh for 1 month of pills is inordinately expensive. It's something that no one but aristocrats will be able to afford. By the standards of the Indian society, I fall in the upper middle class category, and that amount is almost half of my annual salary (more than half after tax deductions). To get an idea about how expensive it is, just think whether you could afford to b…

Bayer doesn't have a problem with selling cheaper drugs to poor people, they do have a problem when those drugs go onto the grey market and get purchased by those who could afford Bayer's regular price. That's why drug companies don't do differential pricing, because they can't stop the cannibalization of their wealthier markets.

Exactly. It's very similar to how content companies try to control the release of content and pricing around the world (region codes ugh). If any pharm company sells drug A in the US for $100 and sells the same drug in Africa for $1 then it's an obvious arbitration opportunity. They are trying to prevent the 'flat world' from eating sales by simply pricing it the same everywhere.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#93

Post by anamax » Tue, Mar 13, 2012, 2:00 PM UTC

JumpCrisscross wrote: post #7

corin_ wrote: post #5

I think few people would argue that drug companies' prices are reasonable, and when it comes to life vs. death I no longer care much about the "they're a business, they're allowed to make a profit" line - of course it's still true, and of course they are, but there's a (subjective) line between "making a good profit" and killing people through greed. That said, what pricing would be fair? When people claim that these…

This is a difficult decision to rule on, without resorting to petty emotions, without access to the underlying data. One must balance the incentive for drug companies to develop drugs (and get that development financed) with the price inelasticity of the healthcare market. There is marginal cost, the cost to produce one more product independent of development cost, and fully amortised cost, which amortises the develo…

> On the other hand we know that, since most people will pay whatever they able to for healthcare

"we" don't know that. In fact, we know that it's wrong.

When people are spending their own resources, they plan their non-emergency spending.

For example, I'll bet that you don't take the vitamins that you should. You probably also don't exercise as you should. It's money and time that you could easily afford, yet ....

Re: Indian Government uses special powers to slash cancer drug price by 97%

#94

Post by Produce » Tue, Mar 13, 2012, 2:08 PM UTC

leonth wrote: post #77

antihero wrote: post #62

Earlier quoted context omitted.

Why has the cost gone up so much, and what can be done to reduce it?

It does not go down. The more drugs we know, the harder it is to prove that the new drug you propose is better than current therapy. A proposed molecule that does not have significant advantage compared to the current gold standard will never sell. To put it in another way: all the low-hanging fruits are already taken. Add to the fact that science progresses; we now know more about the human body and generally everyt…

>The more drugs we know, the harder it is to prove that the new drug you propose is better than current therapy.

No it's not. Example:

1980: Drug A is invented to treat illness X, proves to be the most effective

1990: Drug B is invented for illness X, effectiveness is tested against Drug A

2000: Drug C is invented for illness X, effectiveness is tested against Drug B

2010: Drug D is invented for illness X, effectiveness is tested against Drug C

In other words, always compare effectiveness to the current few best treatments. Nothing spirals, nothing becomes harder to prove.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#95

Post by ThomPete » Tue, Mar 13, 2012, 2:10 PM UTC

nikcub wrote: post #86

ThomPete wrote: post #29

The reason why it's expensive to develop drugs is in large parts because of the process involved to get the approval. Couldn't you turn this on it's head? What if the companies could expense the cost of getting the approval. I.e. the tax payers pay for drugtesting and approval process. Wouldn't this make sense? Since it's in the publics interest to get safe medicin, shouldn't they/we pay for that part.

because drugs are a hit based business. a large number don't get through the approval process. your proposal would socialize and subsidize the downsides of an already very profitable drug industry while privatizing the upside

But the downsides are largely due to government demands of safe drugs no?

The prices of the drug includes the cost of development. So if you remove that cost you would decrease the price.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#96

Post by Produce » Tue, Mar 13, 2012, 2:13 PM UTC

w1ntermute wrote: post #69

Does anyone else find it appalling that the American government and American companies have the gall to complain about intellectual property violations in developing countries like China and India? Until the late 1800s, American IP law explicitly excluded foreigners from IP rights. That's right, forget about lax enforcement (like you often see in developing nations nowadays) - you could violate foreign IP rights in p…

All of what you described falls under the "history is written by the victors" sentiment.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#97

Post by Judson » Tue, Mar 13, 2012, 2:14 PM UTC

Duff wrote: post #76

JunkDNA wrote: post #36

I worked in the drug R&D business for over 8 years. I still follow the industry closely. Some things always get lost in these discussions. First, manufacturing an existing drug is absurdly cheap. Modern industrial chemistry ensures this for all small molecule drugs (note that this is not the same case for the "biologics" which are often fiendishly difficult to make). Almost all the cost in a drug is the manufacturer…

At this point, isn't the pharmaceutical industry playing games with supply by limiting the production of many medicines? Even a common OTC drug like guaifenesin that has been around since the 50's is difficult to find by itself, except in the newly patented time-release formulation (ie. Mucinex). (Although it is an ingredient in many cold medicines.)

Maybe I'm not talking about guaifenesin by itself, but there seems to always be a drug store generic of Mucinex beside it on the shelves.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#98

Post by ThomPete » Tue, Mar 13, 2012, 2:15 PM UTC

crusso wrote: post #75

ThomPete wrote: post #33

Earlier quoted context omitted.

I am not sure I follow? It would force the governments to develop better and cheaper systems themselves to make sure that they can test for cheap. Surely the current scenario isn't working is it?

> Surely the current scenario isn't working is it? How so? Are not drug companies finding drugs that people desire a great deal for their life saving and other efficacious properties? I'm guessing that you don't like that newer drugs are too expensive. What would be your definition of "too expensive" and what would be your proof that such a situation exists?

Wow that was a lot of assumptions :)

The current scenario isn't working IMO if the majority of the cost comes from the approval process.

Drugs for me er fairly cheap as I come from Denmark.

With regards to proof. The article we are debating here is proof that since the production of a drug is extremely cheap the development of it is extremely expensive.

Surely that cost can be cut.

Re: Indian Government uses special powers to slash cancer drug price by 97%

#99

Post by nikcub » Tue, Mar 13, 2012, 2:17 PM UTC

Produce wrote: post #94

leonth wrote: post #77

Earlier quoted context omitted.

It does not go down. The more drugs we know, the harder it is to prove that the new drug you propose is better than current therapy. A proposed molecule that does not have significant advantage compared to the current gold standard will never sell. To put it in another way: all the low-hanging fruits are already taken. Add to the fact that science progresses; we now know more about the human body and generally everyt…

>The more drugs we know, the harder it is to prove that the new drug you propose is better than current therapy. No it's not. Example: 1980: Drug A is invented to treat illness X, proves to be the most effective 1990: Drug B is invented for illness X, effectiveness is tested against Drug A 2000: Drug C is invented for illness X, effectiveness is tested against Drug B 2010: Drug D is invented for illness X, effectiven…

for some reason the placebo effect is getting stronger and more drugs are failing in stage II and III against sugar:

http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo...

Re: Indian Government uses special powers to slash cancer drug price by 97%

#100

Post by Produce » Tue, Mar 13, 2012, 2:18 PM UTC

crusso wrote: post #79

arkitaip wrote: post #3

Bayer shareholders should hold the senior management accountable for not caring enough to bring the drug to more than 2% of the Indian market.

And if they lower the price drastically in India and then are accused of gouging their customers in other countries? When they lower the price of the drug in India, a gray market arises that resells the drugs to other countries. The presence of the gray market creates yet more opportunities for scam artists to sell fake versions of the drug, creating yet more victims. My point is that this isn't as cut and dry of an…

Human lives are at stake, there's nothing more cut and dry than that. We need to stop trying to make our reality fit our models and start adapting our models to fit reality. This whole business is backwards.