Maybe the Indian generic companies should worry a little more about the frogs and flies in their manufacturing facilities. And maybe they shouldn't delete test results.
Welcome to the global race to the bottom. I doubt that a little pressure from multinational pharma companies will do much to reverse the overall trend.
Than do that, but don't stop others. Have your originals, let those that need it have their generics. Just because you shop at waitrose doesn't give you the right to stop people shopping at Aldi!
The implications of dirty drug synthesis and medication compounding processes are dangerous and real.
Deleted testing results are a red flag; however, keep in mind that lack of evidence to the contrary is not evidence of the positive. I see this more as regulation being used to limit international competition than anything promoting general human welfare.
They definitely are real, but I'm not sure that the case is so clear-cut against generics. Would you rather save the lives of 100,000 people and cause 2,000 of them meningitis, or have 100,000 people die because they can't get cheap medication?
bullshit. grandiose statement, but once your precious baby gets born with no legs your stance will be a tad different.
pharma topics are so hilariously ill suited for public discussion, so many half truths and misconceptions. like grandma discussing JS frameworks - or vaccinations.
fun fact: pharma offers tiered pricing, matching economic structures. HIV treatments in Africa are basically free.
india plays fast and loose with pharma patents, something not even china has done. so, if even the copy-happy chinese understand the benefits of a regulated pharma market, maybe there is something to it, no?
the pharma/biotech industry has saved more lives than any uber, airbnb, slack, whatever tech unicorn. the one industry that comes close is big-agriculture with GMOs and fertilizers - and guess what, the same awesome discussion happens there.
> pharma topics are so hilariously ill suited for public discussion, so many half truths and misconceptions
If the reason they're so ill suited for public discussion is the half truths and misconceptions, statements like this one aren't doing anything to help:
> once your precious baby gets born with no legs your stance will be a tad different
Whilst I agree with you. I would like to point out that babies being born with no legs (generally with appendages missing) is in fact known to be one of the great screwups of pharmacology (though anyone reporting it today would undoubtedly hold the pharma industry responsible. In my opinion that is not a reasonable position to take. It was almost unheard of to do separate pregnancy testing (it's still not common at all), therefore blaming someone for not doing them is not fair).
It is even a truism to say that medicine for pregnant women (when not relating to the pregnancy itself) is far behind "normal" medicine, as for most treatments it is not known what effect they'll have on the embryo, or if there will be interactions between the pregnancy and the treatment. Of course there is also a number of treatments that can't be used because they're known to be harmful, but not nearly as many. This crisis is one of the main reasons for this.
But what caused babies with no legs: The softenon/thalomide disaster.
The scary part is that it was a problem relating to the chirality of the molecule used. Very few chemical tests of the molecule would have even revealed that there were two kinds of the molecule, and there was no good reason to assume one would cause deformed babies. In other words: this was extremely likely (and sadly) an honest mistake. 20000 deformed babies were born, about half survived (I went to school with a very cute and smart one). One enantiomer causes babies with missing appendages, one does not. Both help against a number of cancers, various serious diseases and there is some use as a sedative and it helps against morning sickness during pregnancy.
Getting the chirality right is bloody hard, even for people with advanced chemistry degrees (especially getting to the required purity).
This disaster is also well known for being one of the main reasons our current pharma regime is what it is.
also to note that some agencies caught it (US, Austria) and some (Germany) did not.
growing up with Germans of that generation makes it likely to encounter the effects of less regulated pharma first hand. the US was protected from it, which might explain the more prevalent ignorance here.
like good fire protection lulling you into the belief that fire never happens. so lets splash around in gasoline, because freedom and conspiracies by big firefighters.
> like good fire protection lulling you into the belief that fire never happens. so lets splash around in gasoline, because freedom and conspiracies by big firefighters.
The conventional wisdom here seems to be that the more important an industry is, the less people in it deserve to make money. Helping people should be its own reward or something like that.
No, but it boils down to that. Copy one company's hook-up app that cost nothing to develop, and you're the bad guy. Copy one company's drug that cost billions to develop, and you're a hero. The more important the end product, the less people are okay with the makers getting rich with it.
Your comparison is absurd. The hook-up app doesn't save people's lives. How would you feel if this was the difference between life and death for you or your loved ones?
Science is hard, making these drugs is hard. It's after years and years, decades even, of research that we determine what might work as a drug... whether it is safe or not, double-checking, triple-checking its efficacy after it has been made, etc. etc.
To do this it costs lab space, it costs machines that easily go in the millions, it costs sweat and tears of scientists, it takes the lives of many generations of scientists sometimes. The stakes are already high for those who take on these projects. Already, we have a problem with PhDs in the health sciences field making shit money. You want to further discourage them into going in this field by denying them what little they get now? So that they rather make easy money serving you ads based on the information they've gotten from observing your habits?
Come on. The scientists are not seeing the lion's share of the money from sky-high drug prices (and besides that, you can see some plainly opportunistic moves like recategorizing drugs to raise the fees that don't have anything whatsoever to do with new research).
Pharma and biotech companies do develop some drugs themselves, but the majority model is for a start-up to form around a single drug, and if it looks promising a big player buys them up to finish testing and then market it. If the drug looks promising the company is killed.
Venture capital is basically doing the job of drug discovery.
In my circle of friends at least, PhDs working on various technologies had their names on patents. When big companies bought these patents, they actually received good money. Not retirement money of course, but a few good tens of thousands.
Assuming your premise regarding low salaries is correct (I have no idea), the choice between a small set of people making better money and a much larger group not dying is, morally speaking, fairly straightforward.
But I suspect the reality is different. I can imagine a couple of reasons for low salaries: Big Pharma would like nothing more than pay its personnel decently, but they're barely breaking even. Alternatively, the ratio between PhDs and jobs available doesn't work in the favour of PhDs. In which case, Big Pharma making even more money would translate into additional mansions for C-level executives, not better salaries for PhDs.
The logical conclusion of your line of reasoning is that people who make hook-up apps (and their investors) deserve to get rich while people who make (and invest in) life-saving drugs don't.
When someone tells you that you're comparing apples and oranges, your conclusion is "ah, but you think apples are better". You could similarly argue for applying the same punishment to a man stealing bread to feed his family as to a Bernie Maddoff, on the principle that bakers deserve to get rich.
That said, yes, I think the health sector should be state-run and not operate with a profit motive, but whether or not you agree or with this idea doesn't change the fact that your comparison is flawed.
This is funny because I am literally on the phone with my bank to get them to lift the block on the charge for indian provigil. I didn't realize this was a big thing, but I am excited to try the provigil. I did ask my doctor for it for what its worth, but he said its too expensive to prescribe to me. I don't have insurance...
I don't think it's legal to import prescription drugs from overseas, FYI. So it might not be a good idea to discuss the transaction with your CC provider.
> I don't think it's legal to import prescription drugs from overseas, FYI. So it might not be a good idea to discuss the transaction with your CC provider.
Doctors can import prescriptions drugs from other countries if they wish too, with a special import form to justify the exception.
That's the whole idea of patents, isn't it? Just like you can't import medicine that infringes patents you also cannot parallel import iPhones or start making jeans and attach a Levi's tag to it...
edit @aikah: ok, point taken. You recall the issues Apple and Samsung had with the one phone looking like the other? Fighting on the streets and in court to prove that the edges were different or the home button is not the same? Patents are valid for phones, then why not for medicine? Because lives are involved? That seems a slippery argument - next animal life is endangered or quality of living is impacted: where does it stop?
It's not possible to start making exceptions, because there is always someone with a tear-jerking story who is impacted by not being excepted too...
> That's the whole idea of patents, isn't it? Just like you can't import medicine that infringes patents you also cannot parallel import iPhones or start making jeans and attach a Levi's tag to it...
That's not a good analogy. one could make an phone that has the exact same specs as the iphone or jeans that is the exact replica of a Levi's ,without the brand and the logo on it and it would not be an iPHone or a Levi's Jean.
it might not be legal but it wouldn't be shocking. The fact that you can't reproduce a formula ... TO SAVE LIVES ... is shocking.
US government prefers people dying because they can't afford meds rather than violating something that has nothing to do with the free market, ie , patents. We're not talking about phones or clothes here , we're talking about medication people's life depend on.
>That's not a good analogy. one could make an phone that has the exact same specs as the iphone or jeans that is the exact replica of a Levi's ,without the brand and the logo on it and it would not be an iPHone or a Levi's Jean.
I'm not sure this is true. You'd likely fall afoul of one of Apple's design patents (like the famous "rounded corners" patent).
This is one reason why it's worth it to take the time to use Bitcoin to buy from the clearnet sellers: it is less risky both for you and them, and leaves less obvious traces. (Managing CC payments is the single biggest risk & difficulty for them. They hate it and all want to move to Bitcoin as fast as possible.)
Serious question for anyone opposes this. What incentive would pharma companies have to publish their secret formulas if Indian generics simply take the IP and drastically undercut prices, preventing the pharma companies from making any profit on the billions they invested in their research? What would compel these pharma companies to invest in any further research?
I don't understand what you're implying. A drug requires billions in investment. Why would a company invest billions into a new drug if they can't make that money back?
I am still finding it hard to understand this argument. Why do you think pharma companies like Novartis will continue to be profitable if all of their patents and future patents are ignored? Why would any pharma company invest billions into new research when their IP could just be stolen by an Indian generic and sold for pennies on the dollar?
Because they're still making billions? But hey, we're not making as many billions as we could. Let's just shut it all down for good. Your reasoning is stupid.
The drugs that make them billions are things like Xanax, Prozac and Viagra.
We need to incentivize research into important medicine (ie antibiotics, or something to actually cure AIDS and malaria for good), which is hard because as soon as they develop something actually useful, people refuse to honor their patents.
He's implying that they already make their money back, and that billions in investment does pay off, even with the existence of Indian generics - and that will continue to hold true in the future.
Ofcourse from the big pharmacy side, the generics represents lost opportunities, they want to make more money.
> I don't understand what you're implying. A drug requires billions in investment. Why would a company invest billions into a new drug if they can't make that money back?
Well pharma companies tend to spend so much money because they are run very inefficiently in the first place. Plus there's the cost of lobbying...
They make billions regardless of India's patent laws. Why should India let its people die so some company executives somewhere can make a few more billion?
I think you are focusing on the successful pharma products.
When a company begins an expensive research project, they don't know beforehand if it will be profitable or not.
If little-to-medium pharma were compensated generously for the risks they take, they would make more research in new drugs, but because the risk is not compensated, only big pharma can afford the research.
I don't see how that changes the fact that these companies have profits in the billions, are still not satisfied, and are willing to contribute to the murder of millions to increase their profits. India should have some fucking balls and stand up for its people and repeal these patent laws designed to make a couple of people rich while murdering so many.
I don't see how enforcing patents is equivalent to murder.
It's not like if it weren't for the evil pharma companies, everyone would have access to advanced medicine. Quite the contrary, in fact.
We are not talking about software here. Developing medications requires huge investments in developed countries, and no one will develop in the other countries because there is no patent protection in those countries.
I'm not sure why you need to get hypothetical here. Clearly, they currently have sufficient incentive since they're currently investing in research. They are trying to get a likely small amount of additional money (the people in India who could actually afford their prices) in return for an immense cost human cost.(The people who would lose access because of their prices) Why would anyone not oppose this?
You don't need to "reverse engineer" anything. The large majority of the drugs of the market are in the category of small molecules and they are well known and described everywhere. Any organic chemist from any university can draft a synthesis path.
the only thing holding the system in place are the patents, not the knowledge.
Go back to get a Master's in Organic Chemistry like everyone else :) You can find books and online resources, but for actual hands-on practice you need to have labs at hand. (Disclosure: I'm an Organic Chemist).
They're investing in research on the expectation that their patents will be honored. If patents are ignored, what do you think this will do to any future research that requires tons in capital expenditures?
Their patents continue to be honored in the US. I don't think we have any right to ask India to honor US patents unless they are exporting the products to the US.
This is money grab. There is no way to justify it. If they think the money isn't there, they are more than welcome to stop the research.
qwerty's question isn't hypothetical. Pharma research indeed is a high stakes game.
What's more appropriate to ask though is how do developing/under-developed countries compete with the money spending power of west. Are the poor people forever destined to look for aid from the west? If they ain't creating all the drugs, they ain't creating all the horrible diseases either. Many tribes were perfectly happy and healthy until the intruders affected their ecosystem.
>Clearly, they currently have sufficient incentive since they're currently investing in research
Drug research takes a long time. The drugs that cause this debate are drugs that the pharmaceutical companies decided to research decades ago, when they seriously expected people would respect intellectual property rights more than human lives.
Now that they know better, they will probably go invent a new Viagra or something instead of inventing something useful which can be prematurely generified for the common good.
And that's okay. I'll take millions of Indian lives now than thousands of American's and hundreds of Indians in ten years - when a new drug that can save some lives potentially comes onto the market, a new drug not many people can afford.
I'm not sure where you are getting those numbers. It's very difficult to calculate the costs in human lives of all the drugs that won't be invented in the future.
Lots of people are already dying of antibiotic resistant bacteria, for example, and that's a problem likely to get worse over time.
The average Indian cannot afford to take a 1USD per tablet drug once a day. So if that's how all the new drugs are going to be priced - significantly higher than generics, then I say India should go ahead and make generic versions of those drugs, even if it will in future break international law. Who are you to say they should sacrifice their lives so you can have access to better drugs 10 years later that they can't afford anyway?
India can make generic versions of old drugs. For people who can't afford 1USD a day, having access to bleeding edge medicine isn't going to make as much of a difference as having access to nurses and penicillin. edit: and sanitation, and health education, and so on.
EDIT: Not to mention having their own research and development. I bet it's cheaper to research stuff in India, but evil selfish pharma companies don't want to invest in research in countries with poor intellectual properties protection.
Did you know if a pharma company takes an old drug and a new chemical to it to change its effects slightly, the patent is renewed, and that way it it never actually becomes 'old' enough? India will go on and ignore these patents to make generic drugs. Millions of indians have access to affordable medicine today. We can worry about the future benefits when you successfully petition oil companies to stop drilling for oil and invest in renewables instead. The Indian pharmaceutical industry is vibrant and thriving, that is why it has the capacity to reproduce generic versions of patented drugs at will.
You can live a perfectly fine, if frugal, life in India on USD $2 a day, but not if you have to pay for USD $1 tablets.
>The Indian pharmaceutical industry is vibrant and thriving, that is why it has the capacity to reproduce generic versions of patented drugs at will.
I thought any lab could do that. Isn't the research part the most difficult and expensive part?
>if a pharma company takes an old drug and a new chemical to it to change its effects slightly, the patent is renewed, and that way it it never actually becomes 'old' enough
I've heard about this happening with 'me-too' drugs and bullshit antidepressants. Does it happen as well with essential life saving medicine?
I thought any lab could do that. Isn't the research part the most difficult and expensive part?
"The Pharmaceutical industry in India is the world's third-largest in terms of volume and stands 14th in terms of value."
"Indian companies carved a niche in both the Indian and world markets with their expertise in reverse-engineering new processes for manufacturing drugs at low costs."[2]
There is skill involved in reverse-engineering new processes for manufacturing drugs.
Does it happen with essential life saving medicine?
Yes.
"...Glivec, a medicine for chronic myeloid leukemia"[1]
"The Supreme Court defended India’s right to deny patents to incremental improvements. It ruled that Glivec was merely a new form of an older drug and did not constitute a patentable invention. “This is a huge relief,” said Unni Karunakara, the president of Médecins Sans Frontières, which cares for patients in poor countries. Novartis is less pleased, declaring that the ruling “discourages future innovation in India."
Did you previously think pharmaceutical companies care about people's lives more than profit? I'm sorry to disappoint.
Very little; which is why pharma research is such a problematic industry. We need to seriously rethink the way we develop drugs:
1. Research does not get funded unless there is a commercial market for the drug. This leads to overfunding of maintenance treatments of chronic diseases like diabetes, because they are widespread and never really go away. Meanwhile, the system does not incentivize investment in things like antibiotics (because the next wide-spectrum antibiotic that gets developed will likely be force-licensed for public health interests).
2. For the vast majority of life-threatening diseases that anyone is likely to catch, the most effective drugs are already off-patent. Unless you can significantly improve outcomes, how can you compete with a generic that works 95% as well as your new drug?
3. The only country currently willing to pay sticker price for pharmaceuticals is the US. Every other country negotiates prices down to a fraction of what the US pays. The idea of a month worth of pills costing $400 is unheard of outside the US. So US citizens are either directly subsidizing the cheap drugs for the rest of the world, or we're getting taken for a ride.
4. The majority of the cost of developing a drug comes in the clinical trial phases. This cost is the same for any drug -- and most of this is marketing budget. Studies are designed to have specific outcomes so they can be listed as bullet points on information sheets given to doctors -- doctors are smart, but they're busy, so if you can do a study saying that "outcomes in high-risk patients were improved by 30% over the leading treatment", the doctors will never look to see what high-risk patients means, whether the study was done correctly, or even what an improved outcome looks like for those patients. Never mind you may have done the study 8 times and this outcome was only observed once.
Pharma is broken. Our current pharma industry is geared towards "lifecycle" drugs that alleviate symptoms rather than fixing any underlying problems.
Timely. I'm reading "The Truth About the Drug Companies" by
Marcia Angell. Per Wikipedia, Dr. Angell is "the first woman to serve as editor-in-chief of the New England Journal of Medicine. She is currently a Senior Lecturer in the Department of Global Health and Social Medicine at Harvard Medical School in Boston, Massachusetts". So, a good person to write a book on the issue.
Just one more example of how drug companies are taking their customers for a ride. Knowing that a drug has a finite patent life, a drug company will stagger the release of two drugs that are pharmacologically similar by patent-wise different. The drug company will introduce an "improved" drug (which we'll refer to as "nu") just as the old drug's (which we'll refer to as "pro", as in before) patent is about to expire. This is accompanied by pricing tactics such as raising the price of the "pro" drug above the "nu" drug so as to incentivize patients to switch, paying generic-producing companies not to make it, and giving hospitals preferential pricing on the "nu" drug so that it is prescribed at hospitals but then patients pay the higher rate when they go home. One of the most insidious effects of this strategy is that, the drug company is either purposely pricing people out of medicine they need or knowingly selling an inferior product for a decade or more.
"How is the pharmaceutical industry responding to its difficulties? One could hope drug companies would decide to make some changes—trim their prices ..." It seems this, extrapolation, or "logical next step" well encapsulates what the writer knows on the topic of pharma. On what planet would one derive this conclusion from the precursor of lessening profits?
This is hardly new. The Clintons threatened to impose trade sanctions on South Africa if they distributed HIV treatments to the poor, and that was twenty years ago.
Of course they are. In the United States you also can't import cheap generic from Canada. Most intellectual property law is recognized and enforced internationally. Everyone on this board has a career because of IP law.
We have a globally broken system in that America subsidizes the world medicinally. American companies research and develop many (not all) drugs. Americans then pay out their asshole for those drugs. Other countries then get to make those drugs for "free". Not free free. But they get to ignore the R&D costs.
Eventually the camel's back will break. Research costs will become too high for 300m out of 7b to pay for. Then we can figure out a new system that works better. This is probably a good thing. I don't know what the system looks like though. No one does.
Americans then pay out their asshole for those drugs. Other countries
then get to make those drugs for "free". Not free free. But they get to
ignore the R&D costs.
Eventually the camel's back will break. Research costs will become too
high for 300m out of 7b to pay for.
This "Drug industry scare card" is easily refuted [0] (check the table).
But as the table below shows, drug companies spend far more on
marketing drugs - in some cases twice as much - than on developing
them. And besides, profit margins take into account R&D costs.
Few people dispute that it costs a billion dollars or so to bring a new drug to market. That's a heavy cost foreign manufacturers don't have to pay.
The fact that marketing is a higher spend is irrelevant. It's like free2play on mobile. You spend a bunch of money developing something. If you can spend $.90 in user acquisition to earn back $1.00 then you throw every single dollar you can muster so long as the benefit is higher than the cost. It's a diminishing returns equation so you do as long as you can. The highest grossing games have marketing campaigns on the order of $100,000,000. Basically the same thing here. Take out as many loans as you can so long as it works.
I'm not saying you're wrong, but it struck me as funny to see a much-criticised practice in the pharmaceutical industry being defended by comparing it to F2P mobile games, which are also widely reviled.
Hah. I'm no fan of the f2p mobile gaming industry myself. But the math is very straight forward there. It exists for non-f2p games as well but it's less obvious and clear.
I don't see how Pharmaceutical companies can exist without IP protections, unless you're willing to publicly fund the entire development cycle.
For the vast majority of drugs the cost of producing the tablet you take is just a few cents, which is dwarfed by the amortized cost of the R&D. Nobody is going to spend on R&D if competitors can skip that part and go right to production.
The main structural problem is the blanket protection from the market that the people/govt offer to the pharma companies. Many shills continue to argue that this is necessary for pharma to make progress.
The problem is that this a quantitative question -- how much protection in $$ should pharma companies receive that would still not get in the way of real progress? -- is given a blanket non-quantitative answer by fiat. The answer is neither known for certain nor a constant of nature, it changes with time and situation. Any mechanism addressing this problem should have a fast feedback loop and pretty much the only scalable mechanism that we have for such feedback on economic affairs is the market.
Rather than subverting the market, one should actively involve it to create an efficient market where the people/govt and the pharma companies negotiate the level of protection that they can both agree on.
Patents are a mechanism that largely nukes this negotiation completely in favor of the pharma companies.
A parting thought borrowed from Upton Sinclair : if the justification for patent protection is high dev costs, it only ensures that the dev costs will be kept high to enjoy the (dis-proportionate) protection.
Can you name some drugs whose IP has been immediately broken by other countries? From what I have read India is breaking IP laws for life saving medicines and / or trivial modifications to existing products.
Lots of programmings jobs could easily exist without any IP protection at all (if you're writing the server-side code for a Web-based product, nobody ever gets the opportunity to pirate the code) so you're going a little bit too far.
Then again, as long as the big pharmaceuticals still have a profit margin of 25% or so I don't think they are the victims here... Point is that there are two sides to this coin: the pharmaceuticals charging way too much for their medicine and the Indian companies copy-catting/piggy backing on the US R&D
> Everyone on this board has a career because of IP law.
I don't know about that. I think more people here have a career thanks to open source. It has proven that it's a lot more effective than the barriers to knowledge.
Prices have increased more than tenfold between 2000 (average price $5,000-$10,000 per year) and today (average price of new cancer drugs exceeds $120,000 per year).
Novartis, the company that makes the leukemia drug Gleevec, keeps raising the drug’s price, even though the drug has already delivered billions in profit to the company. In 2001 Novartis charged $4,540, in 2014 dollars, for a month of treatment; now it charges $8,488. In its pricing, Novartis is just keeping up with other companies as they charge more and more for their drugs. They know we can’t say no.
Lauren Baumann is one of the lucky ones. Though she has cancer, chronic myeloid leukemia, it is manageable, as long as she takes a daily pill called Gleevec. Gleevec is considered a wonder drug, turning Lauren's leukemia from a death sentence to a disease she and thousands of others can live with. The problem is, even with health insurance and a full-time job, Lauren can't afford the monthly co-pay for Gleevec. It can be as high as $2,000 a month — twice the average mortgage payment in the U.S.
"I feel like you get punished," says Baumann. "I didn't ask to get cancer; I didn't ask to get sick. I was 26 and I was perfectly healthy."
This is essentially extortion due to price inelasticity of demand. $9,000-$12,500/month to survive, for the rest of your natural life! Patients+insurers have to pay whatever price the companies ask. For something as crucial as a life-saving drug, maybe the prices shouldn't be set only by market forces? Maybe generics should be allowed for import after patents expire the first time around?
(There are analyses of drug discovery costs around, and even after all those costs and reliance on basic research funded by taxpayer money, pharma companies make a very healthy profit. Much of the money goes into marketing, which we wouldn't need so much of in a system similar to the NHS which approves drugs for dispensing countrywide.)
Please sign the above Change.org petition (first link) and spread it! I normally don't make appeals, but this is one truly egregious case of unethical profiting.
An international panel of 115 doctors co-authored a paper decrying these ridiculous prices and offering 7 solutions, including allowing Medicare to negotiate drug prices once again (which they now aren't allowed to!):
> maybe the prices shouldn't be set only by market forces??
It's (arguably) not the market here that's the problem, but the patent. The patent means that generic manufacturers can't get in on the market and create a commodity out of it with a race to the bottom on price. The problem isn't the market, but the absolute lack of a market created by the exclusivity of a patent.
We need to find a way as a society that these companies can profit off the research and development of these drugs while still allowing generic manufacturers to do what they do best: create a real, competitive market to produce the drug in bulk.
Unfortunately I don't think there's any clear answers here.
Government funding the research + selling the drugs at cost would benefit mankind overall... but then politicians would decide how many $ to spend researching which drug per year, which has it's own downsides..
The problem, yet again, is quarterly earnings reports.
It takes sometimes billions to find the next new drug. In order to keep showing quarter after quarter of sustained growth that investors demand, they have to continue raising prices.
Fixing patents, wouldn't necessarily fix this problem.
> It takes sometimes billions to find the next new drug. In order to keep showing quarter after quarter of sustained growth that investors demand, they have to continue raising prices.
you don't raise prices on drugs that easily, Prices changes are heavily regulated as well.
> Patients have to pay whatever price the companies ask.
hello ? Prices are regulated by governments in most countries. You should start acting to make your government stop inflation on drug prices. Pharma companies can only abuse the system if you let them.
But where do most new drugs come from? (Not a rhetorical question, but serious).
If the US system of insane drug prices leads to 10x the drugs of a system of capped drug prices, I could see an argument to be made that insane drug prices are saving lives.
> But where do most new drugs come from? (Not a rhetorical question, but serious).
US market because that's the largest pharma market in the world, and it's the most friendly to businesses as well (since you can do direct to consumer advertising for pharma drugs, which is forbidden is about every other country). It's kind of natural that this is the market with the most innovation, but also where prices go the craziest, because of the way the insurance system is structured,
I'm a bit nervous about doing this. At the moment, I've got the possibility of paying $2k/month or dying. If we mess with a system that's clearly working, will I continue to have the choice of paying $2k/month?
For Gleevec, almost surely yes. But what about other undiscovered drugs?
> maybe the prices shouldn't be set only by market forces??
It's far from being a market-forces driven market. Pharma pricing is a heavily regulated market involving parties which are not the end consumer (Pricing Authorities, FDA, Pharma Companies, Insurance Companies, and sometimes Patient Advocate Groups).
That has about NOTHING to do with Free Market ideals.
In the end, patients either get the drugs or they don't.
If pharmas set a certain pricing, the patients+insurers/Medicare feel the effect of that pricing, and respond accordingly. Patients have no choice but to take the price, and demand that insurers provide coverage for all cancer drugs. Insurers then spread the costs across their pool of insurees, resulting in skyrocketing premiums.
Did you know that Medicare isn't allowed to negotiate the prices of drugs, as part of regulatory concessions to pharma companies made in 2003?[1] What happens when Medicare (unlike other insurers) is forced to always pay what drug companies demand?
Further, in the case of Gleevec, the basic drug molecule was discovered by a university researcher, who went to Novartis to get it to invest in trials. So the costs aren't even fully borne by Novartis.
The system is broken and some possible solutions (proposed by researchers including those who discovered the drugs) should be evaluated. But strong lobbying from pharma is hard to get around.
[1] ...the 2003 Medicare Prescription Drug, Improvement, and Modernization Act contains legislation that forbids Medicare from negotiating drug prices. These policies have created an opportunity for drug companies, rendering them the sole decision makers on the price of cancer drugs.http://www.mayoclinicproceedings.org/article/S0025-6196%2815...
Big pharma compoanies like Pfizer and Novartis generate lower net profit margins than Google and Apple. They're making less than 20 cents for every $1 in revenue. These are all public companies and you can look for their financial statements online.
Drug trials are expensive and the ROI is not stellar at all. Without the prospect of copyrighting the result there would be way less efficient yet safe drugs for all of us. As a fact pharma companies - despite the conspiracy - are nowhere the biggest or richest companies of the world (Pfizer roughly #48). So why did you decide that actually pharma companies - and not for example YOU - should sponsor the treatment of the poor of this world? Do you equally expect Nestle to feed the hungry for free because it produces food?
This is about IP. Not about a limited resource like food. And is very easy to understand economically: is the same reason why in Finland and other countries traffic tickets amounts are based on the income of the driver, following the same logic costs of drugs should be tied to the ability of a country to pay them.
TL;DR you can't pretend asking $1.000 to an American is the same as asking $1.000 from a Nigerian
Read my post again. I am not saying the needy should pay the same as the rich - I am saying there is no reason why only the pharma companies should pay the bill for the needy.
Drug companies do a great job at developing drugs, but then turn around and spend twice as much marketing them. Doesn't it seem like it would be a better system if government(s) set up drug development bounties, and pay the bounty in exchange for the patents? Drugs immediately gain generic availability, and the drug companies no longer need to sell their shit with Super Bowl commercials in order to make a profit.
Drug companies do spend a lot of money on marketing, but not every drug is the same. The ones you see on Superbowl commercials are usually drugs you don't need, like mild pain killers and allergy medications. My suspicion is the only reason these kinds of drugs aren't OTC is this way the drug company can get your insurance to pay.
I doubt they spend much marketing drugs to treat cancer or AIDS.
The science that these drugs are based on was given to the public domain for free by scientists all around the world throughout history. Lets see if these greedy companies are willing to pay those scientists whose results they freely use.
Knowledge that helps save lives should not be under copyright (nor should it be a for-profit enterprise, but that is a separate argument).
The free market has been pretty efficient at inventing lifesaving gadgets and processes. They are protected by patent and copyright. Its arguable they wouldn't exist otherwise.
Its a lazy view that 'everything we need should be free' that ignores basic facts about invention and innovation.
If we're being generous - your argument is weak. Most governments heavily subsidize core scientific research through public funds. It is decidedly NOT a free market. The free market has always been horrible at anything to do with public good.
>Its a lazy view that 'everything we need should be free' that ignores basic facts about invention and innovation
"Knowledge that helps save lives should not be under copyright (nor should it be a for-profit enterprise, but that is a separate argument).
"
That's what I was getting at. Devices and processes are what patents are for, for a reason. Scientific research - ok, that's a different beast. I probably changed the subject there, sorry.
>The science that these drugs are based on was given to the public domain for free by scientists all around the world throughout history. Lets see if these greedy companies are willing to pay those scientists whose results they freely use.
The scientists are normally working for hire, which means everything they discover belongs to the company or university that employs them, and universities do maintain and aggressively defend large patent portfolios. Very little of this is "given to the public domain for free".
Also, drug targets are a dime a dozen. That's the easy part. What's difficult and expensive is getting a drug through the regulatory process. If drug companies aren't going to see a profit that will all have to be publicly funded.
US Pharmaceutical companies don't give a damn about their own compatriots, so why wouldn't they try to monopolize the world?
Back in 2010-2011, a few friends of mine showed me how an online pharmacy works, I couldn't believe it - vast majority of people ordering Indian generics are Americans. The reasons? - Costs. Theyve told me it sometimes takes multiple resends of medicines for them to get through the border. Don't know how well US clamped down on it in the past several years.
"SWISS PHARMACEUTICAL COMPANY NOVARTIS first took the Indian government to court in 2006 over its patent law because Novartis wanted a more extensive granting of patent protection for its products than offered by Indian law. The company had been refused a patent in India on a cancer drug it produces. In a first case before the High Court in Chennai, Novartis claimed that the Act did not meet rules set down by the World Trade Organization and was in violation of the Indian constitution. Novartis lost this case in 2007, but launched a subsequent appeal before the Indian Supreme Court in a bid to weaken the interpretation of the law and empty it of substance. All of Novartis’s claims were rejected by the Supreme Court in a landmark decision announced on 1 April, 2013."
So much for world trade organization benefiting the world through more competition and a lowering of prices. Fuckers.
There should be a global consortium for socialized medicine. It's insanely problematic to have for profit companies demanding the right to kill the poor.
I heard a country in europe stopped drugs import from india on quality concerns. Is that true? Is that the real reason or is there more behind that decision?
I have many friends working in Indian pharma companies, working mostly on generics. There have been some instances where USFDA has forced shutdown of the entire plants, due to non-compliance of the USFDA norms (1).
But most of the time, they ban some Indian generics, and let the same Indian company manufacture certain generics that USFDA/US needs. My friends say, generics are subjected to such stringent testing by USFDA that even the branded drugs are not.
148 comments
[ 2.8 ms ] story [ 190 ms ] threadTitle typo: should be `generic`.
Welcome to the global race to the bottom. I doubt that a little pressure from multinational pharma companies will do much to reverse the overall trend.
http://www.bloomberg.com/news/articles/2014-12-03/indian-lab...
Good. An imperfect (with the odd frog), but cheap, system that can save thousands of lives is perfectly acceptable to me.
The implications of dirty drug synthesis and medication compounding processes are dangerous and real.
Deleted testing results are a red flag; however, keep in mind that lack of evidence to the contrary is not evidence of the positive. I see this more as regulation being used to limit international competition than anything promoting general human welfare.
pharma topics are so hilariously ill suited for public discussion, so many half truths and misconceptions. like grandma discussing JS frameworks - or vaccinations.
fun fact: pharma offers tiered pricing, matching economic structures. HIV treatments in Africa are basically free.
india plays fast and loose with pharma patents, something not even china has done. so, if even the copy-happy chinese understand the benefits of a regulated pharma market, maybe there is something to it, no?
the pharma/biotech industry has saved more lives than any uber, airbnb, slack, whatever tech unicorn. the one industry that comes close is big-agriculture with GMOs and fertilizers - and guess what, the same awesome discussion happens there.
/sigh
If the reason they're so ill suited for public discussion is the half truths and misconceptions, statements like this one aren't doing anything to help:
> once your precious baby gets born with no legs your stance will be a tad different
It is even a truism to say that medicine for pregnant women (when not relating to the pregnancy itself) is far behind "normal" medicine, as for most treatments it is not known what effect they'll have on the embryo, or if there will be interactions between the pregnancy and the treatment. Of course there is also a number of treatments that can't be used because they're known to be harmful, but not nearly as many. This crisis is one of the main reasons for this.
But what caused babies with no legs: The softenon/thalomide disaster.
Here's the full story: https://en.wikipedia.org/wiki/Thalidomide#Birth_defects_cris... More photos illustrating exactly what went wrong can be found here: https://en.wikipedia.org/wiki/Phocomelia
The scary part is that it was a problem relating to the chirality of the molecule used. Very few chemical tests of the molecule would have even revealed that there were two kinds of the molecule, and there was no good reason to assume one would cause deformed babies. In other words: this was extremely likely (and sadly) an honest mistake. 20000 deformed babies were born, about half survived (I went to school with a very cute and smart one). One enantiomer causes babies with missing appendages, one does not. Both help against a number of cancers, various serious diseases and there is some use as a sedative and it helps against morning sickness during pregnancy.
Getting the chirality right is bloody hard, even for people with advanced chemistry degrees (especially getting to the required purity).
This disaster is also well known for being one of the main reasons our current pharma regime is what it is.
growing up with Germans of that generation makes it likely to encounter the effects of less regulated pharma first hand. the US was protected from it, which might explain the more prevalent ignorance here.
like good fire protection lulling you into the belief that fire never happens. so lets splash around in gasoline, because freedom and conspiracies by big firefighters.
Really made me think of the Zoolander movie : https://www.youtube.com/watch?v=ZnZ2XdqGZWU#t=2m16s
To do this it costs lab space, it costs machines that easily go in the millions, it costs sweat and tears of scientists, it takes the lives of many generations of scientists sometimes. The stakes are already high for those who take on these projects. Already, we have a problem with PhDs in the health sciences field making shit money. You want to further discourage them into going in this field by denying them what little they get now? So that they rather make easy money serving you ads based on the information they've gotten from observing your habits?
exactly the same as in tech - founders reap the big rewards, individual coders less so.
http://pipeline.corante.com/archives/2010/11/04/where_drugs_...
58% from pharmaceutical companies.
18% from biotech companies..
16% from universities, transferred to biotech.
8% from universities, transferred to pharma.
Pharma and biotech companies do develop some drugs themselves, but the majority model is for a start-up to form around a single drug, and if it looks promising a big player buys them up to finish testing and then market it. If the drug looks promising the company is killed.
Venture capital is basically doing the job of drug discovery.
But I suspect the reality is different. I can imagine a couple of reasons for low salaries: Big Pharma would like nothing more than pay its personnel decently, but they're barely breaking even. Alternatively, the ratio between PhDs and jobs available doesn't work in the favour of PhDs. In which case, Big Pharma making even more money would translate into additional mansions for C-level executives, not better salaries for PhDs.
Which explanation do you feel is the most likely?
That said, yes, I think the health sector should be state-run and not operate with a profit motive, but whether or not you agree or with this idea doesn't change the fact that your comparison is flawed.
Doctors can import prescriptions drugs from other countries if they wish too, with a special import form to justify the exception.
(See our other backwards drug laws for more confirmation of this)
edit @aikah: ok, point taken. You recall the issues Apple and Samsung had with the one phone looking like the other? Fighting on the streets and in court to prove that the edges were different or the home button is not the same? Patents are valid for phones, then why not for medicine? Because lives are involved? That seems a slippery argument - next animal life is endangered or quality of living is impacted: where does it stop?
It's not possible to start making exceptions, because there is always someone with a tear-jerking story who is impacted by not being excepted too...
That's not a good analogy. one could make an phone that has the exact same specs as the iphone or jeans that is the exact replica of a Levi's ,without the brand and the logo on it and it would not be an iPHone or a Levi's Jean.
it might not be legal but it wouldn't be shocking. The fact that you can't reproduce a formula ... TO SAVE LIVES ... is shocking.
US government prefers people dying because they can't afford meds rather than violating something that has nothing to do with the free market, ie , patents. We're not talking about phones or clothes here , we're talking about medication people's life depend on.
I'm not sure this is true. You'd likely fall afoul of one of Apple's design patents (like the famous "rounded corners" patent).
We need to incentivize research into important medicine (ie antibiotics, or something to actually cure AIDS and malaria for good), which is hard because as soon as they develop something actually useful, people refuse to honor their patents.
That means research into important drugs like antibiotics, HIV and malaria medicine is underfunded.
Ofcourse from the big pharmacy side, the generics represents lost opportunities, they want to make more money.
Well pharma companies tend to spend so much money because they are run very inefficiently in the first place. Plus there's the cost of lobbying...
When a company begins an expensive research project, they don't know beforehand if it will be profitable or not.
If little-to-medium pharma were compensated generously for the risks they take, they would make more research in new drugs, but because the risk is not compensated, only big pharma can afford the research.
It's not like if it weren't for the evil pharma companies, everyone would have access to advanced medicine. Quite the contrary, in fact.
We are not talking about software here. Developing medications requires huge investments in developed countries, and no one will develop in the other countries because there is no patent protection in those countries.
the only thing holding the system in place are the patents, not the knowledge.
This is money grab. There is no way to justify it. If they think the money isn't there, they are more than welcome to stop the research.
What's more appropriate to ask though is how do developing/under-developed countries compete with the money spending power of west. Are the poor people forever destined to look for aid from the west? If they ain't creating all the drugs, they ain't creating all the horrible diseases either. Many tribes were perfectly happy and healthy until the intruders affected their ecosystem.
No. That's just your american white guilt playing up.
Drug research takes a long time. The drugs that cause this debate are drugs that the pharmaceutical companies decided to research decades ago, when they seriously expected people would respect intellectual property rights more than human lives.
Now that they know better, they will probably go invent a new Viagra or something instead of inventing something useful which can be prematurely generified for the common good.
Lots of people are already dying of antibiotic resistant bacteria, for example, and that's a problem likely to get worse over time.
EDIT: Not to mention having their own research and development. I bet it's cheaper to research stuff in India, but evil selfish pharma companies don't want to invest in research in countries with poor intellectual properties protection.
You can live a perfectly fine, if frugal, life in India on USD $2 a day, but not if you have to pay for USD $1 tablets.
I thought any lab could do that. Isn't the research part the most difficult and expensive part?
>if a pharma company takes an old drug and a new chemical to it to change its effects slightly, the patent is renewed, and that way it it never actually becomes 'old' enough
I've heard about this happening with 'me-too' drugs and bullshit antidepressants. Does it happen as well with essential life saving medicine?
"The Pharmaceutical industry in India is the world's third-largest in terms of volume and stands 14th in terms of value."
"Indian companies carved a niche in both the Indian and world markets with their expertise in reverse-engineering new processes for manufacturing drugs at low costs."[2]
There is skill involved in reverse-engineering new processes for manufacturing drugs.
Does it happen with essential life saving medicine?
Yes.
"...Glivec, a medicine for chronic myeloid leukemia"[1]
"The Supreme Court defended India’s right to deny patents to incremental improvements. It ruled that Glivec was merely a new form of an older drug and did not constitute a patentable invention. “This is a huge relief,” said Unni Karunakara, the president of Médecins Sans Frontières, which cares for patients in poor countries. Novartis is less pleased, declaring that the ruling “discourages future innovation in India."
Did you previously think pharmaceutical companies care about people's lives more than profit? I'm sorry to disappoint.
[1] http://webcache.googleusercontent.com/search?client=safari&r...
[2] https://en.wikipedia.org/wiki/Pharmaceutical_industry_in_Ind...
1. Research does not get funded unless there is a commercial market for the drug. This leads to overfunding of maintenance treatments of chronic diseases like diabetes, because they are widespread and never really go away. Meanwhile, the system does not incentivize investment in things like antibiotics (because the next wide-spectrum antibiotic that gets developed will likely be force-licensed for public health interests).
2. For the vast majority of life-threatening diseases that anyone is likely to catch, the most effective drugs are already off-patent. Unless you can significantly improve outcomes, how can you compete with a generic that works 95% as well as your new drug?
3. The only country currently willing to pay sticker price for pharmaceuticals is the US. Every other country negotiates prices down to a fraction of what the US pays. The idea of a month worth of pills costing $400 is unheard of outside the US. So US citizens are either directly subsidizing the cheap drugs for the rest of the world, or we're getting taken for a ride.
4. The majority of the cost of developing a drug comes in the clinical trial phases. This cost is the same for any drug -- and most of this is marketing budget. Studies are designed to have specific outcomes so they can be listed as bullet points on information sheets given to doctors -- doctors are smart, but they're busy, so if you can do a study saying that "outcomes in high-risk patients were improved by 30% over the leading treatment", the doctors will never look to see what high-risk patients means, whether the study was done correctly, or even what an improved outcome looks like for those patients. Never mind you may have done the study 8 times and this outcome was only observed once.
Pharma is broken. Our current pharma industry is geared towards "lifecycle" drugs that alleviate symptoms rather than fixing any underlying problems.
TPP bill [0] which is being negotiated in secret will result in more sustained damage [1].
Since R&D will be the single most critical argument, this table [2] could highlight it's fallacies.
[0] https://www.eff.org/issues/tpp
[1] http://www.doctorswithoutborders.org/news-stories/briefing-d...
[2] http://i.imgur.com/3kmBKcS.png
Just one more example of how drug companies are taking their customers for a ride. Knowing that a drug has a finite patent life, a drug company will stagger the release of two drugs that are pharmacologically similar by patent-wise different. The drug company will introduce an "improved" drug (which we'll refer to as "nu") just as the old drug's (which we'll refer to as "pro", as in before) patent is about to expire. This is accompanied by pricing tactics such as raising the price of the "pro" drug above the "nu" drug so as to incentivize patients to switch, paying generic-producing companies not to make it, and giving hospitals preferential pricing on the "nu" drug so that it is prescribed at hospitals but then patients pay the higher rate when they go home. One of the most insidious effects of this strategy is that, the drug company is either purposely pricing people out of medicine they need or knowingly selling an inferior product for a decade or more.
Highly recommend reading this book if interested on this subject: http://www.nybooks.com/articles/archives/2004/jul/15/the-tru...
/s
We have a globally broken system in that America subsidizes the world medicinally. American companies research and develop many (not all) drugs. Americans then pay out their asshole for those drugs. Other countries then get to make those drugs for "free". Not free free. But they get to ignore the R&D costs.
Eventually the camel's back will break. Research costs will become too high for 300m out of 7b to pay for. Then we can figure out a new system that works better. This is probably a good thing. I don't know what the system looks like though. No one does.
The pharmaceutical industry pays for clinical trials, marketing, and bribing doctors and government officials all over the world.
Bribing goes both ways. Politicians and Doctors actively WANT to be bribed as well, let's not pretend they are victims.
The fact that marketing is a higher spend is irrelevant. It's like free2play on mobile. You spend a bunch of money developing something. If you can spend $.90 in user acquisition to earn back $1.00 then you throw every single dollar you can muster so long as the benefit is higher than the cost. It's a diminishing returns equation so you do as long as you can. The highest grossing games have marketing campaigns on the order of $100,000,000. Basically the same thing here. Take out as many loans as you can so long as it works.
For the vast majority of drugs the cost of producing the tablet you take is just a few cents, which is dwarfed by the amortized cost of the R&D. Nobody is going to spend on R&D if competitors can skip that part and go right to production.
The main structural problem is the blanket protection from the market that the people/govt offer to the pharma companies. Many shills continue to argue that this is necessary for pharma to make progress.
The problem is that this a quantitative question -- how much protection in $$ should pharma companies receive that would still not get in the way of real progress? -- is given a blanket non-quantitative answer by fiat. The answer is neither known for certain nor a constant of nature, it changes with time and situation. Any mechanism addressing this problem should have a fast feedback loop and pretty much the only scalable mechanism that we have for such feedback on economic affairs is the market.
Rather than subverting the market, one should actively involve it to create an efficient market where the people/govt and the pharma companies negotiate the level of protection that they can both agree on.
Patents are a mechanism that largely nukes this negotiation completely in favor of the pharma companies.
A parting thought borrowed from Upton Sinclair : if the justification for patent protection is high dev costs, it only ensures that the dev costs will be kept high to enjoy the (dis-proportionate) protection.
I don't know about that. I think more people here have a career thanks to open source. It has proven that it's a lot more effective than the barriers to knowledge.
https://www.change.org/p/secretary-of-health-and-human-servi...
Prices have increased more than tenfold between 2000 (average price $5,000-$10,000 per year) and today (average price of new cancer drugs exceeds $120,000 per year).
http://www.nytimes.com/2015/01/15/opinion/why-drugs-cost-so-...
Novartis, the company that makes the leukemia drug Gleevec, keeps raising the drug’s price, even though the drug has already delivered billions in profit to the company. In 2001 Novartis charged $4,540, in 2014 dollars, for a month of treatment; now it charges $8,488. In its pricing, Novartis is just keeping up with other companies as they charge more and more for their drugs. They know we can’t say no.
http://www.nbcnews.com/health/cancer/utterly-broken-drug-mar...
Lauren Baumann is one of the lucky ones. Though she has cancer, chronic myeloid leukemia, it is manageable, as long as she takes a daily pill called Gleevec. Gleevec is considered a wonder drug, turning Lauren's leukemia from a death sentence to a disease she and thousands of others can live with. The problem is, even with health insurance and a full-time job, Lauren can't afford the monthly co-pay for Gleevec. It can be as high as $2,000 a month — twice the average mortgage payment in the U.S.
"I feel like you get punished," says Baumann. "I didn't ask to get cancer; I didn't ask to get sick. I was 26 and I was perfectly healthy."
This is essentially extortion due to price inelasticity of demand. $9,000-$12,500/month to survive, for the rest of your natural life! Patients+insurers have to pay whatever price the companies ask. For something as crucial as a life-saving drug, maybe the prices shouldn't be set only by market forces? Maybe generics should be allowed for import after patents expire the first time around?
(There are analyses of drug discovery costs around, and even after all those costs and reliance on basic research funded by taxpayer money, pharma companies make a very healthy profit. Much of the money goes into marketing, which we wouldn't need so much of in a system similar to the NHS which approves drugs for dispensing countrywide.)
Please sign the above Change.org petition (first link) and spread it! I normally don't make appeals, but this is one truly egregious case of unethical profiting.
An international panel of 115 doctors co-authored a paper decrying these ridiculous prices and offering 7 solutions, including allowing Medicare to negotiate drug prices once again (which they now aren't allowed to!):
http://www.forbes.com/sites/matthewherper/2015/07/23/155-ang...
It's (arguably) not the market here that's the problem, but the patent. The patent means that generic manufacturers can't get in on the market and create a commodity out of it with a race to the bottom on price. The problem isn't the market, but the absolute lack of a market created by the exclusivity of a patent.
We need to find a way as a society that these companies can profit off the research and development of these drugs while still allowing generic manufacturers to do what they do best: create a real, competitive market to produce the drug in bulk.
Unfortunately I don't think there's any clear answers here.
Wasnt that how NASA was supposed to work ? Oh wait, we know how it went...
It takes sometimes billions to find the next new drug. In order to keep showing quarter after quarter of sustained growth that investors demand, they have to continue raising prices.
Fixing patents, wouldn't necessarily fix this problem.
you don't raise prices on drugs that easily, Prices changes are heavily regulated as well.
hello ? Prices are regulated by governments in most countries. You should start acting to make your government stop inflation on drug prices. Pharma companies can only abuse the system if you let them.
If the US system of insane drug prices leads to 10x the drugs of a system of capped drug prices, I could see an argument to be made that insane drug prices are saving lives.
US market because that's the largest pharma market in the world, and it's the most friendly to businesses as well (since you can do direct to consumer advertising for pharma drugs, which is forbidden is about every other country). It's kind of natural that this is the market with the most innovation, but also where prices go the craziest, because of the way the insurance system is structured,
For Gleevec, almost surely yes. But what about other undiscovered drugs?
It's far from being a market-forces driven market. Pharma pricing is a heavily regulated market involving parties which are not the end consumer (Pricing Authorities, FDA, Pharma Companies, Insurance Companies, and sometimes Patient Advocate Groups).
That has about NOTHING to do with Free Market ideals.
If pharmas set a certain pricing, the patients+insurers/Medicare feel the effect of that pricing, and respond accordingly. Patients have no choice but to take the price, and demand that insurers provide coverage for all cancer drugs. Insurers then spread the costs across their pool of insurees, resulting in skyrocketing premiums.
Did you know that Medicare isn't allowed to negotiate the prices of drugs, as part of regulatory concessions to pharma companies made in 2003?[1] What happens when Medicare (unlike other insurers) is forced to always pay what drug companies demand?
Further, in the case of Gleevec, the basic drug molecule was discovered by a university researcher, who went to Novartis to get it to invest in trials. So the costs aren't even fully borne by Novartis.
The system is broken and some possible solutions (proposed by researchers including those who discovered the drugs) should be evaluated. But strong lobbying from pharma is hard to get around.
[1] ...the 2003 Medicare Prescription Drug, Improvement, and Modernization Act contains legislation that forbids Medicare from negotiating drug prices. These policies have created an opportunity for drug companies, rendering them the sole decision makers on the price of cancer drugs. http://www.mayoclinicproceedings.org/article/S0025-6196%2815...
Make this a vote by the people instead of relying on your leaders to make such changes. Referendums can be used for important measures.
Drug trials are expensive and the ROI is not stellar at all. Without the prospect of copyrighting the result there would be way less efficient yet safe drugs for all of us. As a fact pharma companies - despite the conspiracy - are nowhere the biggest or richest companies of the world (Pfizer roughly #48). So why did you decide that actually pharma companies - and not for example YOU - should sponsor the treatment of the poor of this world? Do you equally expect Nestle to feed the hungry for free because it produces food?
TL;DR you can't pretend asking $1.000 to an American is the same as asking $1.000 from a Nigerian
In case people don't know - another way to start your last sentence is: In summary...
I doubt they spend much marketing drugs to treat cancer or AIDS.
Knowledge that helps save lives should not be under copyright (nor should it be a for-profit enterprise, but that is a separate argument).
Its a lazy view that 'everything we need should be free' that ignores basic facts about invention and innovation.
>Its a lazy view that 'everything we need should be free' that ignores basic facts about invention and innovation
Nobody said that.
That's what I was getting at. Devices and processes are what patents are for, for a reason. Scientific research - ok, that's a different beast. I probably changed the subject there, sorry.
The scientists are normally working for hire, which means everything they discover belongs to the company or university that employs them, and universities do maintain and aggressively defend large patent portfolios. Very little of this is "given to the public domain for free".
Also, drug targets are a dime a dozen. That's the easy part. What's difficult and expensive is getting a drug through the regulatory process. If drug companies aren't going to see a profit that will all have to be publicly funded.
Back in 2010-2011, a few friends of mine showed me how an online pharmacy works, I couldn't believe it - vast majority of people ordering Indian generics are Americans. The reasons? - Costs. Theyve told me it sometimes takes multiple resends of medicines for them to get through the border. Don't know how well US clamped down on it in the past several years.
"SWISS PHARMACEUTICAL COMPANY NOVARTIS first took the Indian government to court in 2006 over its patent law because Novartis wanted a more extensive granting of patent protection for its products than offered by Indian law. The company had been refused a patent in India on a cancer drug it produces. In a first case before the High Court in Chennai, Novartis claimed that the Act did not meet rules set down by the World Trade Organization and was in violation of the Indian constitution. Novartis lost this case in 2007, but launched a subsequent appeal before the Indian Supreme Court in a bid to weaken the interpretation of the law and empty it of substance. All of Novartis’s claims were rejected by the Supreme Court in a landmark decision announced on 1 April, 2013."
So much for world trade organization benefiting the world through more competition and a lowering of prices. Fuckers.
http://www.ft.com/cms/s/0/4ded8ca4-3b8a-11e5-bbd1-b37bc06f59...
That follows similar concerns in the US.
http://mobile.nytimes.com/2014/02/15/world/asia/medicines-ma...
http://mobile.reuters.com/article/idUSBREA2H06Y20140318
(I've given up guessing what a clean URL should be. Now I'm just going to post whatever stupid URL a site gives me.)
But most of the time, they ban some Indian generics, and let the same Indian company manufacture certain generics that USFDA/US needs. My friends say, generics are subjected to such stringent testing by USFDA that even the branded drugs are not.
1. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/uc...