11 ms·
Foreigners turn to India in search of cut-price, life-saving cures
- hudibras 11y agoThe economist Dean Baker has been vocal for years about the benefits of free trade on medicine. [0] (of many) But while the powers-that-be are fine with free trade for cars, cheap clothing, electronics, etc. or exporting American manufacturing jobs overseas, it's a different tune all the sudden when you try to do the same thing to powerful industries, like doctors or lawyers. [0]http://www.cato.org/publications/cato-online-forum/doctors-drugs-promoting-growth-equality-through-free-trade http://www.cato.org/publications/cato-online-forum/doctors-d...
- jpatokal 11y agoAre you claiming that the American car lobby is not powerful? You might need a history refresher on how (for example) "voluntary export restraints" came to be a thing: https://en.wikipedia.org/wiki/Voluntary_export_restraints#1981_Automobile_VER https://en.wikipedia.org/wiki/Voluntary_export_restraints#19... But they've been fighting that battle for close to 50 years and losing.
- horsecaptin 11y agoDon't have to go all the way to India if you live in the US. Mexico is close by. And soon, Cuba will be even closer for some.
- puissance 11y agoPeople wer exporting them from Canada, but big pharma lobbied for bans (http://news.healingwell.com/index.php?p=news1&id=526618 http://news.healingwell.com/index.php?p=news1&id=526618). Anywhere close to US mainland, especially Mexico, I am afraid, will meet with the same fate. Cuba's a different story as they just tell US lawmakers to fuck off.
- dineshp2 11y agoI find the concept of intellectual property and patents ridiculous. What would be the benefit of granting IP over an invention or innovation to a corporation or a group of individuals versus releasing the knowledge under the public domain? Except the corporation or inventor(s) making money off of it, I can't think of anything significant. Instead, if the knowledge is made freely available under the public domain, the limitation becomes how well the innovation is used for the benefit of humanity instead of the limitation being access to the invention itself and IP. Maybe the existence of IP and patents was important to get to the present as a way of rewarding innovation, but it's high time to look for a better model. I know this is a very complex issue for which there are no simple answers or solutions, but a good starting point might be to think about a society where the motivation for innovation is not financial reward. Taking the example of patented drugs, how is it justified to keep access to life saving drugs beyond the reach of most people(including people in developed nations)?
- forrestthewoods 11y ago> how is it justified to keep access to life saving drugs beyond the reach of most people Trivially. By asserting that without intellectual property protection those drugs wouldn't have been invented. I'm not arguing if that's true or not. But it's certainly how people justify it. I'm going to copy and paste one of my favorite comments on copyright. From Judge Richard Posner. It's bit a of a wall of text; sorry. It's worth reading in it's entirety. "A distinguishing characteristic of intellectual property is its "public good" aspect. While the cost of creating a work subject to copyright protection—for example, a book, movie, song, ballet, lithograph, map, business directory, or computer software program—is often high, the cost of reproducing the work, whether by the creator or by those to whom he has made it available, is often low. And once copies are available to others, it is often inexpensive for these users to make additional copies. If the copies made by the creator of the work are priced at or close to marginal cost, others may be discouraged from making copies, but the creator’s total revenues may not be sufficient to cover the cost of creating the work. Copyright protection—the right of the copyright’s owner to prevent others from making copies—trades off the costs of limiting access to a work against the benefits of providing incentives to create the work in the first place. STRIKING THE CORRECT BALANCE BETWEEN ACCESS AND INCENTIVES IS THE CENTRAL PROBLEM IN COPYRIGHT LAW. [empaphsis added] For copyright law to promote economic efficiency, its principal legal doctrines must, at least approximately, maximize the benefits from creating additional works minus both the losses from limiting access and the costs of administering copyright protection." http://cyber.law.harvard.edu/IPCoop/89land1.html http://cyber.law.harvard.edu/IPCoop/89land1.html
- DanBlake 11y agoIm curious what is stopping some other countries (even micro-nations) from instituting a policy that forfeits all patents on medication. Lets say you take the country of Saint Lucia- Could they not spur the economy (among the lowest in the world by GDP) by saying any company can manufacture any existing drug and sell it? I feel like the medical tourism for that could be extreme, especially since there is still many treatments india still does respect the patent for. If the country put it in their constitution that all drugs should be a human right, could a legal action be taken against the country itself? I imagine the only recourse would be the pharma companies trying to force legislation in other countries to bring sanctions, but I think that would be a hard sell.
- benjamo 11y agoSuch a country wouldn't get admission to the WTO and would have a very hard time trading with the other countries in it. It would also amount to state endorsed IP theft.
- x5n1 11y agoTheft is such a strong word. If you control the language, you control the world.
- linuxkerneldev 11y ago> Such a country wouldn't get admission to the WTO As opposed to what we do when we invade and bomb/drone other countries? As opposed to what we did when we engineer coups in resource rich countries? Come on. Let me guess, you're buying into the idea that generics hurt RnD. Let me assure you, having worked briefly in a pharma RnD lab, the bulk of big pharmas expenditures are on marketing and bribes, NOT RnD. Here's a recent headline: http://www.statnews.com/pharmalot/2016/02/22/novartis-south-korea-bribes-doctors/ http://www.statnews.com/pharmalot/2016/02/22/novartis-south-... You'll find similar bribery cases with GSK, Pfizer, etc.
- awongh 11y agoFeels like there should be some kind of website or service that tracks these drug price arbitrage / differences.
- abpavel 11y agoThe problem is not in patents or capitalism, but in perpetual extension of intellectual property in a Disney-like fashion. The point of "Cyclical" is that there is a cycle - a life-cycle of development, then intellectual monopoly and finally general availability. Sovaldi's patent should have expired in 2012, and Martin Shreli's Daraprim's patent should have expired in 1973. Perpetual extension simply abuses the system, and the stories like in the original article are just a reflection of system's abuse, not the flaw of the idea of protecting intellectual property in the first place.
- adventured 11y agoNot to mention the FDA holding back generic drug approvals. They've got a backlog of generics awaiting approval that is over 4,000 now (they like to white lie and say they've "acted" on many of those, which of course isn't the same thing as an approval).
- afarrell 11y agoWow. How hasn't AARP raised hell about this? Maybe they aren't the most powerful lobbying organization in America after all.
- maxerickson 11y agoThere's no patent keeping other companies from producing Daraprim equivalents for sale in the US, it's just that no generic maker had bothered to setup an FDA approved production process. There's a few thousand people using it in the US, so there isn't a huge market for it. Medicare is a big enough consumer that it should probably be running a program where it shares risk with generic makers that are willing to produce drugs that don't cost a lot, as long as the company maintains quality. Basically, make sure that line start up and regulatory costs aren't preventing $1 pills for rare conditions coming to market.
- chimeracoder 11y ago> Medicare is a big enough consumer that it should probably be running a program where it shares risk with generic makers Perhaps, but Medicare has literally no incentive to do this. It's one thing to posit that a monopsony or oligopsony could result in driving prices down. And in a closed system, that might be what happens[0]. But at the end of the day, Medicare has no mandate to ensure sustainability of reimbursement and payment rates. Since they can't raise revenues (taxes) without Congress, they balance the budget by driving reimbursements (for service providers) down below cost. Pharmaceutical companies are actually affected by this too, but because the big-ticket items are under monopoly protection (via drug patents), unlike care delivery, Medicare still has to pay sticker price for those. The people who end up being hurt by this, by the way, are not Medicare patients, but uninsured patients and privately-insured patients. [0] But not always - like a monopoly, a monopsony can choose price or quantity, but not both.
- vinodkd 11y agoI know the article and the discussion is about access to drugs, but I must call out that part of the success of medical tourism in India is the lack of stranglehold control over medical care by insurance companies. In India, I can: - Get an estimate for service before it happens, and plan for it therefore. - Pay for the service at the time of discharge with/without insurance - decide by myself if i want to get a specific procedure done or not - no fuss of "does the insurance cover it?". Of course, this is one area where the costs of service being inherently low helps. - get all my medical records in my hand These are basic patient freedoms, IMO, that the insurance industry in the US has taken away. I dont know the history of how it came to be this way in the US, but as it stands, the situation is very geared towards getting mystery service - you dont know what you're allowed until you're refused, you dont know how much the service cost you until months later and even then in multiple bills from various hosiptals, doctors practices and specialists, and you have to ask for your records because you cannot keep them safe! I have all my records from every treatment in India, but not one coherent,collated record of my last physical checkup in the US. There's something broken there.
- bobby_9x 11y agoThis is why we need to completely get rid of health insurance in the US. If Hospitals could only charge the actual value for their services, and not the inflated insurance prices, the prices would be much lower. One of my friends is a Doctor. He told me that they need to over-charge for services because of the insurance companies. If they charge $20 (the actual cost of the service), they might get $4 back from the insurance company. If they charge $100, they might get the $20 from the insurance company for the service. We need to cut out the middle man. It's basic economics. The drug issue in the US is mostly the fault of the government. It takes hundreds of millions of dollars and 10+ years to get FDA approval. This stifles innovation and creates an environment where there are only a few players (IE: a monopoly). The result is ridiculous prices due to no competition.
- ocean3 11y agoIf they charge $100, they might get the $20 from the insurance company - the remaining 80 goes to the insurance company?
- discardorama 11y agoAnecdata, size 2, from India: My uncle (who had a device implanted 4 years ago to regulate his heartbeat) went into the ER one of the premium hospitals in our city (Fortis). He was having some weird symptoms, and his blood sugar was off. They strongly recommended that they upgrade his device to a pacemaker! (A highly expensive procedure). When my cousins refused, the hospital pumped him full of insulin and discharged him. He came home and relapsed again. This time he was taken to another hospital, and the problem was some infection in his kidney. Another cousin: had a severe pain in his stomach area. Went to a hospital, they injected him with a painkiller and let him go. Pain continued: he went to another, same deal. Finally he got to a third hospital, and they diagnosed the problem: kidney stone. There's caveat emptor for Indian hospitals. Be careful.
- vinodkd 11y agoThis is true. The big "chain" hospitals do have pushy tactics, doctors with lab prescription quotas etc. Similarly, but at the other end of the spectrum, there are hospitals in smaller towns that mistreat you or send you off with painkillers. Clearly, your mileage will vary, so you have to do research, ie, talk to people you trust, much like everything else in India :)
- lake99 11y agoI've had good experience with big "chain" hospitals, be it Apollo, Columbia Asia, Wockhardt, or whatever else. I never found them pushy. One of the docs from there quit and opened his own clinic. He doesn't even charge me for consultation. Don't know why. Of course, doing your own research is critically important. Many doctors are dangerously ignorant of anything that doesn't come under their specialty.
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- kamaal 11y ago>>There's caveat emptor for Indian hospitals. Be careful. Yes, as an Indian I can confirm this. Medical Malpractice is a big think in India. What makes it possible is doctors can get away from it. Any kind of criticism is not tolerated by the medical fraternity. Remember that program by Aamir Khan in Satyamev Jayate. There was a tremendous backlash from doctors as though it was their birth right to cheat. A few things that ordinary Indians have to undergo everyday. 1. Doctors running polyclinics in areas they have no specialization in. 2. Polyclinics running mini-labs. To sustain which, doctors order pointless tests(especially blood work) which might not even be needed. 3. Commission deals with local pharmacy stores, so that they prescribe brands only available at that pharmacy in exchange for a commission. 4. Prolonging treatment to maximize net consultation fees. Prescribing drugs/tests to boost their commission. 5. Tests claimed to be done, which aren't. Also known as the 'basin test'. Collect the patients blood and throw it in the basic, cook up artificial numbers to make it look normal. 6. A while back I visited a hospital with my mom for arthritis. To my surprise they ordered an X-ray. Nurse tells us X-ray is the regular routine no matter what patient walks into the department. The Orthopedic apparently thinks its the best way for him to recover his money invested on a X-ray machine. Same goes for colonoscopy/MRI/CAT scan and other complicated tests. 7. In government hospitals nurses routinely ask for bribes from poor patients. Administering euthanasia for burn victims especially from poor families who can't afford long term health care in return for a bribe is common. The list can go on and on... I know a colleague who was verbally abused by a doctor for being 'a little intelligent', it was almost like he was furious the patient was resisting being cheated. Foreign nationals may not face all this as they go to top line hospitals. But the ordinary Indian continues to suffer at these people's hand.
- discardorama 11y agoAnecdata, size 2, from India: My uncle (who had a device implanted 4 years ago to regulate his heartbeat) went into the ER one of the premium hospitals in our city (Fortis). He was having some weird symptoms, and his blood sugar was off. They strongly recommended that they upgrade his device to a pacemaker! (A highly expensive procedure). When my cousins refused, the hospital pumped him full of insulin and discharged him. He came home and relapsed again. This time he was taken to another hospital, and the problem was some infection in his kidney. Another cousin: had a severe pain in his stomach area. Went to a hospital, they injected him with a painkiller and let him go. Pain continued: he went to another, same deal. Finally he got to a third hospital, and they diagnosed the problem: kidney stone. There's caveat emptor for Indian hospitals. Be careful.