$1,000-a-day miracle drug shocks U.S. health care system

[Hayabusa Rider]

Solution to what?

What I quoted.

 

[Capt Caveman]

what makes it cost 1000$ a day?

Billions of dollars in development costs, cost of failed compounds/drugs, cost to fund further research/development and a return to investors.

One of my prior Pharma companies developed a drug for Hep C, the cost to develop the drug was in the billions and took close to ten years to develop and get approved. A single clinical trial can cost up to $100 million.

 

[Eug]

$84000 for a full course of treatment indeed is very expensive. That said, if they had priced it at say $500 a day, I'd guess that people wouldn't be complaining as much.

It should be noted that many anti-cancer drugs for example go for around $5000 a month, but patients often take them for a year or more, so again they're spending north of $50000 for that single drug.

This issue has been around a long time, but arguably its worse with the cancer drugs because they take them for a year or whatever, and then die a couple of years later after spending big bux on the various drugs and treatments required.

 

[imagoon]

Then they get a nice tariff on their other drugs. Its pretty simple and worked for a hundred years till government started bowing to business instead of keeping them on a leash.

Every incentive and punishment scheme is defeat able. That doesnt make them effective.


Are you the kind of guy that argues slippery slope on every topic?

Nope. I live in the real world. The tax gets passed to the consumer and provides no benefit for anyone involved except for lining politician pockets.

It also only "works" when it is an import tariff where there is an effective domestic competitor. Since there is none, the tariff only hurts the people that need the drug and accomplishes nothing. In this case if the other drugs get taxed, they can stop selling the ones they are not able to sell and just raise the price of the ones they hold patents on to cover the lost revenue.

Do you seriously expect them to pay the tariffs out of their profits?

 

[Capt Caveman]

So basically our plan is to see what Canada can negotiate the price to be, then buy it online?








What I don't get is why new drugs are released first in America anyway. It seems like it makes way more sense to release new drugs into parts of the world where patients have less legal protections, and then only release in America at the very end of the line when the legal liability is minimal and all the kinks are worked out.

Most other countries want the drug released in the US due to the strict FDA regulations required to get a drug approved. Though some countries will require specific/additional studies/trials, many use the data used in the FDA approval process in their approval process.

 

[Eug]

It should be noted that in Canada a lot those uber expensive drugs are cheaper. Still expensive, but less expensive than in the US.

I mention Canada and not Egypt because Canada is also a first world country, with similar or better outcomes for medical treatment as compared to the US.

Why do they charge more in the US? Because they can.

 

[ThatsABigOne]

You sure? antibiotics should do nothing against HepC (which is viral.)

Forgot to mention that I took a lot of other things along with antibiotics. As another poster mentioned, it is highly probable that my immune system was able to fight it off. I will never know.

 

[Eug]

Forgot to mention that I took a lot of other things along with antibiotics. As another poster mentioned, it is highly probable that my immune system was able to fight it off. I will never know.

Did you have chronic Hepatitis C? Or were you newly infected from a blood transfusion or something with out significant chronic liver disease? Not the same thing.

 

[Hayabusa Rider]

It should be noted that in Canada a lot those uber expensive drugs are cheaper. Still expensive, but less expensive than in the US.

I mention Canada and not Egypt because Canada is also a first world country, with similar or better outcomes for medical treatment as compared to the US.

Why do they charge more in the US? Because they can.

Yes they can. I have a question for you. If a drug costs a billion dollars to make (and in this case it's probably more) and you have a million people who will be treated with it (as an example), how much needs to be made per person to break even?

Edit: I haven't included the costs of failed investigations, which probably amounts to a very very great sum, but let's leave that out.

 

[poofyhairguy]

Most other countries want the drug released in the US due to the strict FDA regulations required to get a drug approved. Though some countries will require specific/additional studies/trials, many use the data used in the FDA approval process in their approval process.

Sure I get why a France or even a Mexico would have this standard. But if I am running some big pharma company worth billions you think I could find some banana republic that is willing to be guinea pigs for cheap healthcare and lined pockets.

It seems like that is a really good way for one of these countries with no real economic advantages or resources to stand out from the crowd. Make your nation the nation of medical innovation, where all these rich westerners fly to and drop tons of tourist money to take your experimental drugs.

 

[Eug]

Yes they can. I have a question for you. If a drug costs a billion dollars to make (and in this case it's probably more) and you have a million people who will be treated with it (as an example), how much needs to be made per person to break even?

Not sure what your point is. Taking your math at its simplest, what needs to be made per person is $1000. That means at a price of $84000, there is an $83000 profit.

Which is my point. A lot of times they can price things a lot lower and still make a lot of profit off of it, even after consider all other development, manufacturing, distribution, marketing costs, etc.

I'm not saying it costs the company $1000 per patient to break even. It's probably much higher than that. But $84000 seems excessive. In fact, it's >$160000 for harder to treat strains.

 

[Hayabusa Rider]

Sure I get why a France or even a Mexico would have this standard. But if I am running some big pharma company worth billions you think I could find some banana republic that is willing to be guinea pigs for cheap healthcare and lined pockets.

It seems like that is a really good way for one of these countries with no real economic advantages or resources to stand out from the crowd. Make your nation the nation of medical innovation, where all these rich westerners fly to and drop tons of tourist money to take your experimental drugs.

The problem is that only tourists could get treatment and that would be with an unproven drug as far as efficacy or safety goes. Can you imagine what would happen if it were to be learned that pharmaceutical companies were using Nigeria as a test bed? They'd be gone in a heartbeat.

 

[poofyhairguy]

Yes they can. I have a question for you. If a drug costs a billion dollars to make (and in this case it's probably more) and you have a million people who will be treated with it (as an example), how much needs to be made per person to break even?

I have a question for you:

Why in America do we have to care if these companies make a profit, while the rest of the world only cares about what they will pay for the drug?

We need to stop subsidizing medicine for the whole planet. If that slows down innovation so be it, it is not like the public payer systems (Medicare/Medicaid/Obamacare/VA) we have can or want to take on the cost of all these new wonderdrugs.

 

[ThatsABigOne]

Did you have chronic Hepatitis C? Or were you newly infected from a blood transfusion or something with out significant chronic liver disease? Not the same thing.

I was most likely infected from the blood transfusion. I would have to dig into my medical record papers to find out what it is to confirm 100%. I 2 years old when I was diagnosed, so obviously I didn't understand anything.

 

[Bill Brasky]

So instead of paying $84,000 for treatment here, buy a ticket to Egypt ($1500), stay for 3 months in a nice apartment ($3000), and get fully treated ($900). Pocket the $78,600 difference and enjoy your vacation.

Yes. I would do this 100%.

 

[Capt Caveman]

Sure I get why a France or even a Mexico would have this standard. But if I am running some big pharma company worth billions you think I could find some banana republic that is willing to be guinea pigs for cheap healthcare and lined pockets.

It seems like that is a really good way for one of these countries with no real economic advantages or resources to stand out from the crowd. Make your nation the nation of medical innovation, where all these rich westerners fly to and drop tons of tourist money to take your experimental drugs.

That may sound good for the country but if you're the Pharma company and you haven't completed all of the necessary FDA studies/trials/research and people start dying from your drug or it doesn't work as intended this data will be used in the FDA approval process. And due to the inability to control who takes the drug, you may never know if the side effect/negative impact was due to the drug or from some other prevailing health issue.

 

[Eug]

I was most likely infected from the blood transfusion. I would have to dig into my medical record papers to find out what it is to confirm 100%. I 2 years old when I was diagnosed, so obviously I didn't understand anything.

Yeah, so what this drug is treating is a completely different scenario.

These are people with chronic liver disease from chronic Hepatitis C infection. They will have life long infection with Hepatitis C without further treatment, and that "life" may not actually be that "long" depending on how bad their livers are.

 

[uclaLabrat]

The old antiviral treatment is about 70% effective in curing it, so there's still that.

And one of the side-effects of those treatments is being knocked on your ass from flu symptoms for the whole 3-6 months due to the interferon. Interferon kinda works, but is almost unbearable. This drug almost always works, and has much reduced side effects.

 

[ThatsABigOne]

Yeah, so what this drug is treating is a completely different scenario.

These are people with chronic liver disease from chronic Hepatitis C infection. They will have life long infection with Hepatitis C without further treatment, and that "life" may not actually be that "long" depending on how bad their livers are.

Yes, I understand. I was just chiming in regarding one poster how he was amazed that HCV is curable. It is curable, but there are chances that current drugs are ineffective against it.

 

[poofyhairguy]

That may sound good for the country but if you're the Pharma company and you haven't completed all of the necessary FDA studies/trials/research and people start dying from your drug or it doesn't work as intended this data will be used in the FDA approval process. And due to the inability to control who takes the drug, you may never know if the side effect/negative impact was due to the drug or from some other prevailing health issue.

All great points, that makes sense.

 

[Capt Caveman]

And one of the side-effects of those treatments is being knocked on your ass from flu symptoms for the whole 3-6 months due to the interferon. Interferon kinda works, but is almost unbearable. This drug almost always works, and has much reduced side effects.

Correct, older treatments have been cocktails of many drugs which have some rough side-effects causing some people to stop the treatment b/c they can't tolerate it.

 

[techs]

And what is your solution? Hint, you haven't one.

Yes, I don't.

It's a tough problem. If you limit what drug companies can charge you open a can of worms since they use what they make on the successful drugs to pay for the unsuccessful ones.

On the other hand many of the drugs are actually developed by small companies and purchased by the big companies since they have the testing and marketing ability the small companies don't.

 

[SaurusX]

Answer: go to Egypt and buy a 90-pill bottle for $900. The insurance company would probably pay for your ticket.

 

[Hayabusa Rider]

Not sure what your point is. Taking your math at its simplest, what needs to be made per person is $1000. That means at a price of $84000, there is an $83000 profit.

Which is my point. A lot of times they can price things a lot lower and still make a lot of profit off of it, even after consider all other development, manufacturing, distribution, marketing costs, etc.

The point is that you need to do the math. There will be profit, but it's not going to be at the level you describe. Company financials are readily availible so you can see that on a billion dollar investment an 83 billion dollar profit is not happening.

No, I'm trying to get a point across you made about drug pricing in general. There is a fixed minimum pay back. That does not provide for payroll, nor for future investments. It doesn't do anything.

So in my hypothetical, with a billion being a very very realistic number, what if your nation or others pay less than what it costs to run the business if making a drug? Those costs don't go away by fiat, they either get passed on or the company goes belly up. There is no third option the way things are done now. So the "wealthy" pay up. No, not automatically, because other first world nations don't pay based on business considerations. They offer of course. The "wealthy" get a discount. The really poor? Well the price is heavily subsidized by the company, not Canada or France. Of course that subsidy goes so far with economics in play so who is left? The "wealthy" in the US. Techs is the "wealthy" although he might say otherwise. I too am. For that matter those at "poverty level" are by comparison rich by standards applying to half the world.

We get to eat it. Ok, so us relative billionares don't like it and complain about people who are wealthy by their standards, the drug companies in this case. They want "free" or nearly so. So suppose the US decides to cut sharply what it pays for medication, tired of being the cash cow. Well certainly you've eliminated profit, but you've also eliminated R&D. New drugs are now not done. Instead that goes out the window and you have frozen the state of medicines. The drug companies won't be able to abuse profits for advertising of course and personally I think way too much has been spent on things bean counters and market analysts value, but R&D WILL be slashed.

That's how things must be considering the limited mentalities and imagination of those in the business world and in government.

Everyone bitches, but I have yet to see one workable alternative presented by another, and "well just let the people in DC" isn't the best one. They can't get a budget passed, or the NSA out of our knickers.

 

[uclaLabrat]

It should be noted that in Canada a lot those uber expensive drugs are cheaper. Still expensive, but less expensive than in the US.

I mention Canada and not Egypt because Canada is also a first world country, with similar or better outcomes for medical treatment as compared to the US.

Why do they charge more in the US? Because they can.

And a lot of that is due to our healthcare system. Canada has single payer, we don't. Another huge factor is we have the ability to pay. The biggest issue is we don't have good measures for price control in the US, outside of medicare.