8 ms·

Gilead has developed the first drug since penicillin to cure a major disease and people think the price tag is too expensive. In the modern world, it's not ide

Gilead has developed the first drug since penicillin to cure a major disease and people think the price tag is too expensive. In the modern world, it's not ideal to create a drug to cure something. Once people are cured they no longer need your drug. That's why we have so many drugs like Lipitor and Viagra that treat symptoms but do not cure. The "problem" with Sovaldi/Harvoni is that the patient only takes it for ~90 days, and then they're cured. The drugs are cheaper than regular treatment of Hep C - which ends in liver transplant. Do people think the price tag was just random? No, it's because this is a price at which the taxpayer saves money by curing the disease vs. blood transfusions, liver transplants, lost economic value, etc. Not to mention that the waitlist for a liver transplant is getting halved as we cure Hep C. As we slam Gilead the other really evil pharma companies like Pfizer are taking notes and patting themselves on the back for creating drugs whose end goal is to addict the consumer.

swalsh 10y ago
I worked for a company that developed some PA criteria for these drugs, I can assure you a lot of debate went into this criteria.. these two specific drugs are probably the most hotly contested drugs. If we sold them at the 84k price tag to anyone that COULD use it, the entire insurance industry would go bankrupt, literally. Not even an exaggeration. While your logic is sound, the drug is cheaper than a liver transplat... not everyone who has Hep C ends up getting a liver transplant. There's a huge gap between the number of people who COULD use the drug (and have a MUCH better quality of life), and the people who are most qualified for it. The drug companies are not doing the government a favor here... sorry. Another side conversation that's interesting, is who takes the $84k hit. There's sound logic that it's cheaper to give the drug NOW vs paying for surgery LATER... but what if i'm not your insurer when you need it. With obamacare, you can't be denied because of pre-existing conditions... so it's interesting math.
- maxerickson 10y ago
  Do you have a sense of the production costs? If they aren't very high, the US government could start making the company look like jerks by offering $50 billion for the patent. I'm pretty sure they would be able to calculate a nice return based on a payment like that. The math works fine for that, there's ~3 million people just in the US to treat, paying $50 billion would save a substantial amount just treating those patients. Of course, we don't run our government based on math that makes sense, so it's a pipe dream.
  - swalsh 10y ago
    I don't, there's a lot of people in government trying to make change (Bernie Sanders for one!), any public information that is out there, is probably about as twisted as Enrons finance sheets.
  - danielweber 10y ago
    > the US government could start making the company look like jerks by offering $50 billion for the patent Pretend you were in charge of Medicare/Medicaid. The NPV of the lifetime care cost of the HepC symptoms of each HepC patient on your rolls is $X. You want to encourage someone to develop a cure for HepC, so you put out a price bid for what you will pay someone who shows up with a cure. What price do you offer?
    - maxerickson 10y ago
      I offer $Y, the lowest amount I think I can get them to accept.
      - danielweber 10y ago
        In the hypothetical, you are offering a price before anyone has developed it. "You want to encourage someone to develop a cure." What price do you offer for someone who shows up with a cure?
jhall1468 10y ago
> In the modern world, it's not ideal to create a drug to cure something. Once people are cured they no longer need your drug. That's why we have so many drugs like Lipitor and Viagra that treat symptoms but do not cure. I don't think that's a reasonable conclusion at all. One of the main reasons we have so many drugs that treat symptoms is because cures are absurdly difficult to find while treatments can be found accidentally (Viagra was originally intended to treat hypertension). Funding research into cures is funding your own bankruptcy. Pfizer execs would jump a the opportunity for "Pfizer" to be the name of the company that cured cancer. But the reality is, hunting for cures is expensive with little chance of payoff. That's not how you stay in business.
danielweber 10y ago
In the modern world, it's not ideal to create a drug to cure something. The drug companies produce the drugs they can. They are nervous enough about having enough blockbusters in their upcoming pipeline that if they could make something that cures a given cancer, they would. We've eaten the low-hanging fruit. If any of us went back in time a hundred years we could come up with a polio vaccine just by trying a few times to remember what we learned about it in grade school. Modern diseases that don't have a cure in a pill isn't because someone never thought of doing it; it's because it takes hundreds of scientists doing lots of long trials to find something that improves outcomes by 10%.

swalsh 10y ago

I worked for a company that developed some PA criteria for these drugs, I can assure you a lot of debate went into this criteria.. these two specific drugs are probably the most hotly contested drugs. If we sold them at the 84k price tag to anyone that COULD use it, the entire insurance industry would go bankrupt, literally. Not even an exaggeration. While your logic is sound, the drug is cheaper than a liver transplat... not everyone who has Hep C ends up getting a liver transplant. There's a huge gap between the number of people who COULD use the drug (and have a MUCH better quality of life), and the people who are most qualified for it. The drug companies are not doing the government a favor here... sorry. Another side conversation that's interesting, is who takes the $84k hit. There's sound logic that it's cheaper to give the drug NOW vs paying for surgery LATER... but what if i'm not your insurer when you need it. With obamacare, you can't be denied because of pre-existing conditions... so it's interesting math.

maxerickson 10y ago
Do you have a sense of the production costs? If they aren't very high, the US government could start making the company look like jerks by offering $50 billion for the patent. I'm pretty sure they would be able to calculate a nice return based on a payment like that. The math works fine for that, there's ~3 million people just in the US to treat, paying $50 billion would save a substantial amount just treating those patients. Of course, we don't run our government based on math that makes sense, so it's a pipe dream.
- swalsh 10y ago
  I don't, there's a lot of people in government trying to make change (Bernie Sanders for one!), any public information that is out there, is probably about as twisted as Enrons finance sheets.
- danielweber 10y ago
  > the US government could start making the company look like jerks by offering $50 billion for the patent Pretend you were in charge of Medicare/Medicaid. The NPV of the lifetime care cost of the HepC symptoms of each HepC patient on your rolls is $X. You want to encourage someone to develop a cure for HepC, so you put out a price bid for what you will pay someone who shows up with a cure. What price do you offer?
  - maxerickson 10y ago
    I offer $Y, the lowest amount I think I can get them to accept.
    - danielweber 10y ago
      In the hypothetical, you are offering a price before anyone has developed it. "You want to encourage someone to develop a cure." What price do you offer for someone who shows up with a cure?

jhall1468 10y ago

> In the modern world, it's not ideal to create a drug to cure something. Once people are cured they no longer need your drug. That's why we have so many drugs like Lipitor and Viagra that treat symptoms but do not cure. I don't think that's a reasonable conclusion at all. One of the main reasons we have so many drugs that treat symptoms is because cures are absurdly difficult to find while treatments can be found accidentally (Viagra was originally intended to treat hypertension). Funding research into cures is funding your own bankruptcy. Pfizer execs would jump a the opportunity for "Pfizer" to be the name of the company that cured cancer. But the reality is, hunting for cures is expensive with little chance of payoff. That's not how you stay in business.

danielweber 10y ago

In the modern world, it's not ideal to create a drug to cure something. The drug companies produce the drugs they can. They are nervous enough about having enough blockbusters in their upcoming pipeline that if they could make something that cures a given cancer, they would. We've eaten the low-hanging fruit. If any of us went back in time a hundred years we could come up with a polio vaccine just by trying a few times to remember what we learned about it in grade school. Modern diseases that don't have a cure in a pill isn't because someone never thought of doing it; it's because it takes hundreds of scientists doing lots of long trials to find something that improves outcomes by 10%.