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I'm conflicted about this article. On the one hand, the pharmaceutical companies gouging ordinary Americans is abominable. Doing something to circumvent their g
by surrealvortex 10y ago
I'm conflicted about this article. On the one hand, the pharmaceutical companies gouging ordinary Americans is abominable. Doing something to circumvent their greed is something to support.
On the other hand, if enough people exploit loopholes like this, and the pharma company actually felt a significant drain in revenue, they may decide not to license the manufacture of these drugs in India at lower prices. If $84,000 seems unreasonably high in the US, imagine how out of reach it will be in India, where the cost of living is much lower.
- hueving 10y agoRight now US citizens are basically subsidizing other countries when it comes to drug revenue via price gouging. I would rather it be done via some other more explicit mechanism (e.g. India government subsidies) rather than at the expense of poor healthcare availability to people in the US.
- sandworm101 10y agoConsidering that Americans consume 75% of the world's prescription drugs, and I think it safe to assume an equivalent amount of non-prescription drugs, I don't think any of this makes much difference. The US is a very strange and unique drug market. Citation: "5 percent of the United States is the world's population and consumes 75 percent of the the world's prescription drugs." https://www.drugabuse.gov/related-topics/trends-statistics/infographics/popping-pills-prescription-drug-abuse-in-america https://www.drugabuse.gov/related-topics/trends-statistics/i... (And by "Americans" I and the gov included all those people in the US market who are not "US citizens". Ie me.)
- adrianN 10y agoThat statistic seems a little misleading to me, because very large parts of the world don't consume any prescription drugs at all, because they're too poor to go to the doctor.
- bpodgursky 10y agoYeah, but that's not going to happen. If a big pharm company doesn't provide India-priced versions of drugs, the Indian government just declares the patent invalid and lets generics produce it for free (yes, this happens).
- gruez 10y agoSounds like a good decision by india
- deleted 10y ago[deleted]
- Houshalter 10y agoYes but not a good decision for everyone else. Someone has to pay for the development of these drugs.
- creshal 10y agoIndia wouldn't be able to either way.
- evgen 10y agoYeah, until the US decides that it will retaliate by, for example, adding a 100% import duty to all goods produced in India and no longer supplying visas to Indian citizens.
- dba7dba 10y agoI don't think such retaliation will ever happen. Many lobbyists will be waiting in the hallway of US Senate before ink of the signature dries.
- gradstudent 10y agoThat sounds terrific?
- rdtsc 10y ago> Right now US citizens are basically subsidizing other countries when it comes to drug revenue via price gouging. I am ok with that. They can take even more taxes out every month if it means people get access to better healthcare.
- jessriedel 10y agoDoes it bother you that Europe and the rest of the developing world also free-ride subtantially?
- rdtsc 10y agoNot particularly. By the way pharmaceutical companies also free ride on public universities. Research is often done there. Even if it is from grants, it often means professors end up working and spending their time for pharma companies instead of doing other things like teaching students. Moreover, if our goal is to win hearts and minds and I don't know, promote Democracy (at least that is what the propaganda tells us), isn't providing health saving medication or building hospitals or schools working towards that goal better than say overthrowing their government or threatening to invade. Going back to Western Europe, I hear it is already possibly to go to Germany (or was it Norway) and attend a 4 year university there for free. Isn't that free riding So they can have our pills and we can go there and not pay $200k in student loans. Globalization and free markets, we learned that was a good thing, right ...
- refurb 10y agoBy the way pharmaceutical companies also free ride on public universities. Free ride? You think pharmaceutical companies just come along and pluck the best drugs for free? No, they out-license it from the university and pay royalties. How else would Northwestern University build a brand new chemistry building from their Lyrica royalties?
- Daishiman 10y agoWell, it's evidently cheaper for them to get it from a public resource than actually, you know, developing it from their own labs. So nice for them to be able to pick and choose the successful research while not having to absorb all the other, less interesting research funded with public money.
- lostlogin 10y agoDon't worry, with the Trans Pacific Partnership Agreement (TPPA) we are all signing up for we have agreed to be gouged deeply. New Zealand.
- rayiner 10y agoWhat exactly is "gouging?" The average wedding in the U.S. is almost $30,000. Average new car price is $33,000. Is $84,000 one-time an unreasonable price for a complete cure to a chronic disease?
- coralreef 10y agoBut you can choose to have a cheap wedding, and choose to buy a used car.
- selectodude 10y agoYou can also choose to not share dirty needles.
- remicade 10y agoThat's not the only way to get it bud.
- vdance 10y agoare there really people this naive lingering on this forum?
- bdcravens 10y agoThe #1 killer in the US is heart disease, but insurance companies cover those medicines quite readily, despite the fact that one can choose not to eat fast food or smoke.
- codegeek 10y agoChoose not to share ? A lot of times it is difficult to tell and if you have dishonest nurses like the one below [0], what do you then ? Victim blaming is easy but people can get infected not due to their own fault. [0] http://www.nj.com/healthfit/index.ssf/2015/10/eeuw_nurse_in_trouble_for_using_just_one_syringe_a.html http://www.nj.com/healthfit/index.ssf/2015/10/eeuw_nurse_in_...
- ptaipale 10y ago
- HillRat 10y agoCompulsory licensing under TRIPS means that India can allow manufacturing without running afoul of international trade law, though if enough non-Indians started doing this it could cause some headaches due to the "predominantly for domestic use" clause. But in reality there's no way that pharma companies can stop developing countries from manufacturing critical medicines.
- voodootrucker 10y agoSo it's fair for a multi-billion dollar company to exploit the "global market" by farming work out to 3rd world countries... But not for a customer who is literally dying to take advantage of that same "global market" to save himself? Like everything else in the global economy, laws are only enforced to protect the strong against the weak, and yet we wonder how all the wealth is accumulating in the hands of the few.
- rdtsc 10y ago> So it's fair for a multi-billion dollar company to exploit the "global market" by farming work out to 3rd world countries... That makes sense. It is interesting that when usually there are "anti-globalization" protests shown in the media, the protesters are presented as fringe idiots, violent, with facemasks and so on. Sort of implying "look at these crazies not wanting countries get close to each other, trade and be friends". The truth is globalization is overloaded to apply only to large companies. And usually the more they "globalize" -- the more they create inequality and pain for those at the bottom. So then they also end up increasing border controls, formulate various laws and agreements and ram those through each country's legislature to protect segmentation and control of market.
- icebraining 10y agoAll evidence I've seen points to a massive reduction of poverty "at the bottom" (the actual bottom, not developed world's bottom) as globalization has increased in the last few decades. On what do you base the claim that it has increased pain?
- surrealvortex 10y agoI didn't take a position one way or the other in my comment. But if anything, I definitely did not support the company. I was more concerned about the billions of people in other countries who will suffer because they will lose access to medicine even more. Some of the comments below pointed out that India had the ability to break patents if the government considered the drugs overpriced, so I'm not sure that's a very valid concern anymore.
- 10y ago
- gozur88 10y agoIndia can break patents on drugs it considers too expensive. The real danger is if this sort of thing makes drugs unprofitable pharma companies won't spend any money researching drugs to treat uncommon conditions, and the drug will never exist to start with. We'll get endless varieties of new opioids, blood pressure pills, pecker perkers, and not much else.
- danjoc 10y agoI always hear this argument, but never any evidence to back it up. Is it simply regurgitating econ 101? There must be some economic incentive? Any time people die from a disease, that alone creates an incentive for those left living to find a cure. What econ doesn't teach is that people are not perfectly rational creatures. Just like we will find people who will write code for free, who will make music for free, there will always be people who are searching for cures for the sake of searching for cures. I don't buy the argument that only Big Pharma who can deliver cures. As the article pointed out, Gilead didn't develop the cure. They bought the company that did.
- refurb 10y agoI don't think anyone is arguing only Big Pharma creates new cures. In fact, most big pharma companies acquire smaller companies for their drugs. That said, I don't disagree that money is the only motivator. However, good intentions aren't enough to develop a new drug. It takes a hell of a lot of money as well. If you don't create incentives for private investment, then you need to get that money somewhere else.
- gozur88 10y ago>There must be some economic incentive? Any time people die from a disease, that alone creates an incentive for those left living to find a cure. No matter how altruistic you are, as a private company you can't put billions of dollars toward a drug that's going to lose money. >I don't buy the argument that only Big Pharma who can deliver cures. As the article pointed out, Gilead didn't develop the cure. They bought the company that did. ... which they would not have done without the expectation of a profit.
- codegeek 10y ago"and the pharma company actually felt a significant drain in revenue, they may decide not to license the manufacture of these drugs in India at lower prices" But thats the thing. There will be no drain in revenue as they make money in the US by selling for $84K while they make money from the sales in India as well due to licensing agreement (albeit a bit less revenue). Overall, still a pretty good deal for these pharma companies if you ask me otherwise why would they even do such a deal with India ?
- surrealvortex 10y agoWell, my point was that if everyone decided to source it through India, they will no longer sell anything for $84k. Even if 10% of people did that, their profits will slip enough for them to notice and take action.
- sandworm101 10y ago"..not to license the manufacture of these drugs in India" And then India can purchase/void their domestic patent, allowing generic brands to fill the market the original creator decided to abandon.
- kangar00 10y agoI agree the real problem is the high cost. It can be solved by extending patents in return for lower prices. Then the government must enforce patents internationally by putting pressure on countries that ignore patents. Another concern is poor quality from knockoff manufacturers. You can partially solve that by lowering costs because the original product becomes more competitive. You can also try to apply pressure on countries that don't honor patents. You can complain about the cost, but you can't just make pharma companies sell their products for less because you believe they are too expensive. You need to give them a reason to believe that they can continue to sell a good product and make money off of the research investment they put in. You also need to give them incentive not to make small changes to drugs to renew patents when the original version of the drug might be a better version. Granted, it is sick when people make an excessive amount of money at the expense of those most in need. But, most of the bad that happens in pharma is due to suboptimal patents and suboptimal patent enforcement.
- surrealvortex 10y agoCurious about the last part. How does that work? If they make small changes and get patents based on the new formula, won't other companies be allowed to use the original formula? I'm guessing somehow both formulae are covered by the renewed patent, but that is wrong on so many levels.
- tracker1 10y agoBut stronger patent protection won't improve pricing... competition will. I think we should reduce extension patents to 5 years, and possibly even have compulsory licensing fees ($10 per day, per prescription for the first year, $8 for the second ... 6... 4... down to $2, then $1) for prescription drug patents starting at 5 years. And the penalty for an insufficient patent application for a third party to properly apply within the first 8 years would mean a loss of said patent.
- refurb 10y agoWhat about drugs that cost more than $10 per day to produce? Hell that's only $3650 per year. How many manufacturing plans can sustain themselves on that sort of revenue, particularly if they are creating a drug for a disease that only affects 1000 patients in the world? One of the reasons why generic drugs prices jumped so much in the last few years, if because manufacturers said "screw this" and just stopped making the drugs because the margins were so low.
- Zigurd 10y agoLots of research in the US is university and government lab-based. Even if private sector drug development were cut back, it would not end useful drug development. I suspect the way government and university research is monetized could be improved so that more competition would exist.
- rayiner 10y agoLet's say we shut down Silicon Valley and had the government do computer research. You think that would be efficient and effective? At the end of the day, you need to give smart people a reason to make their lives' work saving lives instead of selling financial products or advertising algorithms. That's not going to happen if going into drug development means topping out at GS-15 in a government lab.
- Daishiman 10y agoHow funny that you mention that, given that the Internet, the very backbone upon so much of the economy moves around, started and developmed mostly as... a military project. Supported by universities and public research.
- maxerickson 10y agoThe market paid Cisco and the like to develop the ever advancing hardware that powers the internet as it exists today.
- Daishiman 10y agoSure they did, because corporations are much better at iterative product improvements than at radical, high-risk research projects with no short-term returns. So?
- Daishiman 10y agoSure they did, because corporations are much better at iterative product improvements than at radical, high-risk research projects with no short-term returns. So?
- zaroth 10y agoI think you should be conflicted for a slightly different reason :-) Should Americans pay for a disproportionate share of pharma revenue? I for one am so happy for all the medical research that we fund in this country, it is probably the best thing we can possibly do for the world. Of all the American foreign aid and foreign intervention, very little else will compare to the amazing impact of widespread access to Harvoni/Sovaldi in India. That is truly an amazing gift that America is giving to India, and it's made possible exactly by extreme price discrimination. This is an amazing miracle cure for a deadly disease. My understanding is that it cost a lot of money to develop, and took a lot highly skilled work, and involved a fair measure of risk of total loss. We want wins like this to be rewarded. We want a significant fraction of the dollars this drug earns to ultimately be re-invested in more of this kind of R&D. We definitely want more drugs like Harvoni/Solvaldi coming to market. So the conflict I have is, when manufacturing is not the bottleneck, you want to get this cure out to people everywhere, but at the same time you can't afford to pay for it all to happen in one year. So you see cases like OP where they won't pay for the treatment until you are showing symptoms. But the cure is so easy, nobody wants to wait for symptoms, and how can you blame them?
- GreaterFool 10y agoI have a private global (excluding USA) medical insurance that covers costs (no in-patient) up to 1M and it costs me $1k/year. I've been hearing about Obamacare for years and always thought "well, it's good that more people will have insurance". But when my colleagues in US told me what their deductibles on a good insurance plan are (thousands of dollars. my deductibles are $375) I was floored. The whole medical system in US is broken. This morning I had a strange thought... I need to prepare for trips to US the same way I'd prepare for going to a third-world country: by buying a special medical insurance! It's one of the important TODO items when going to certain countries. Fun fact: I can get a medical insurance that covers US with deductibles in low hundreds of dollars by doubling my not-so-high premium. As an expat. How crazy it is that I can get a better deal on insurance in US than local people?
- forrestthewoods 10y agoAmerica subsidizes the health care of the entire world. Because such a large portion of health profit comes from the US. If the US ceased to exist then global prices would increase and global research would decrease.
- CaptSpify 10y ago> America subsidizes the health care of the entire world. Howso?
- forrestthewoods 10y agoBecause profit is disproportionately earned in America. Europe, Canada, and the whole world enjoy lower prices because we pay higher prices.
- ptaipale 10y agoI don't need to agree or to disagree, but I need to ask: why downvote the parent without offering any replies? (Upvoted, just out of the feeling of irritation at this.)