4 ms·

1) An article discussing the prices of drugs that doesn't talk about the costs of RnD and the FDA approval process is pointless. 2) We're in a free market, com

1) An article discussing the prices of drugs that doesn't talk about the costs of RnD and the FDA approval process is pointless. 2) We're in a free market, companies can charge a billion dollars a pill if they want to.

mtgx 10y ago
The U.S. pharmaceuticals market is far from a free market. And it's actually the main cause of the high drug prices in the U.S.: http://abcnews.go.com/Health/us-drug-prices-remain-high-generic-competitors-study/story?id=41589653 http://abcnews.go.com/Health/us-drug-prices-remain-high-gene... Companies wouldn't be able to "charge a billion dollars" or even increase the existing prices by 5,000% overnight, as it happened for several different drugs last year, if the generics and drug importation markets were much more "free".
- kolinko 10y ago
  But then they wouldn't be able to do research either.
HarryHirsch 10y ago
How does FDA testing even affect drug prices? They demand proof of safety and efficacy. As far as safety goes, the interests of pharma and the FDA coincide. You really don't want to find out that your compounds causes adverse effects once it has hit the market, it's a guaranteed win for the lawyers. People in the field will remember the Vioxx lawsuits. They were expensive to defend and a PR disaster as well, because it became known that Merck had a list of people it wanted silenced. And if the FDA won't confirm efficacy for you you can be sure that your health insurance will be asking for proof before they pay. The only reason that Gilead can charge as much for their Hep C drug is that it is still cheaper than a liver transplant, and it is proven to work!
- Anderkent 10y ago
  There's lots of drugs that everyone knows are safe and effective, but no one wants to shell out the money to get them approved. Just because the FDA says it provides proof of safety and efficacy doesn't mean that's what actually happens. But, even more, your argument as presented is self defeating. If the companies already have to do enough research into the drug to make it safe (because 'You really don't want to find out that your compounds causes adverse effects once it has hit the market, it's a guaranteed win for the lawyers'), and that it works ('your health insurance will be asking for proof before they pay'), then why do we need another organisation that requires a different set of tests?
  - rincebrain 10y ago
    I'd be curious to see even a partial list of those "safe and effective" meds that nobody wants to pay to run through the approval process. From my perspective, it seems like a substance that's already through the R&D pipeline would be relatively cheap to turn into something for sale, compared to developing new drugs "from scratch".
    - Anderkent 10y ago
      Ok, simplest example - antixilotics (https://en.wikipedia.org/wiki/Anxiolytic https://en.wikipedia.org/wiki/Anxiolytic): Selank https://en.wikipedia.org/wiki/Selank https://en.wikipedia.org/wiki/Selank Afobazole https://en.wikipedia.org/wiki/Fabomotizole https://en.wikipedia.org/wiki/Fabomotizole Emoxypine https://en.wikipedia.org/wiki/Emoxypine https://en.wikipedia.org/wiki/Emoxypine Picamilon https://en.wikipedia.org/wiki/Picamilon https://en.wikipedia.org/wiki/Picamilon There's an entire category of anti-anxiety drugs developed in Russia that are not licensed in the US, because it's not worth the price for anyone. Also: melatonin. Your doctor CAN NOT PRESCRIBE MELATONIN. https://slatestarcodex.com/2013/09/28/sleep-now-by-prescription/ https://slatestarcodex.com/2013/09/28/sleep-now-by-prescript... And you can't prescribe fish oil, but at least there's LOVAZA™®©.
- auganov 10y ago
  Many niche drugs have no protection, yet because of the FDA approval process, it doesn't make sense for anyone to try to compete.
  - HarryHirsch 10y ago
    Compounding drugs is a non-trivial problem, public safety demands compliance and testing. Not too long ago, there was a rash of deaths (!) from a homoeopathic (!!) belladonna preparation. Turns out, the manufacturer was honest and did use belladonna but had a problem with their dilutions, the distribution was uneven and some of their globuli actually had sufficient atropine to kill an infant. The things were sold as a teething aid. For some hair-raisers, try Chemjobber's "Warning Letter of the Week" category: http://chemjobber.blogspot.com/search/label/warning%20letter%20of%20the%20week http://chemjobber.blogspot.com/search/label/warning%20letter... I don't want to find out what things would look like without adult supervision. You also need to prove equivalence for your preparation, bioavailability depends on the filler composition in your pill.

mtgx 10y ago

The U.S. pharmaceuticals market is far from a free market. And it's actually the main cause of the high drug prices in the U.S.: http://abcnews.go.com/Health/us-drug-prices-remain-high-generic-competitors-study/story?id=41589653 http://abcnews.go.com/Health/us-drug-prices-remain-high-gene... Companies wouldn't be able to "charge a billion dollars" or even increase the existing prices by 5,000% overnight, as it happened for several different drugs last year, if the generics and drug importation markets were much more "free".

kolinko 10y ago
But then they wouldn't be able to do research either.

HarryHirsch 10y ago

How does FDA testing even affect drug prices? They demand proof of safety and efficacy. As far as safety goes, the interests of pharma and the FDA coincide. You really don't want to find out that your compounds causes adverse effects once it has hit the market, it's a guaranteed win for the lawyers. People in the field will remember the Vioxx lawsuits. They were expensive to defend and a PR disaster as well, because it became known that Merck had a list of people it wanted silenced. And if the FDA won't confirm efficacy for you you can be sure that your health insurance will be asking for proof before they pay. The only reason that Gilead can charge as much for their Hep C drug is that it is still cheaper than a liver transplant, and it is proven to work!

Anderkent 10y ago
There's lots of drugs that everyone knows are safe and effective, but no one wants to shell out the money to get them approved. Just because the FDA says it provides proof of safety and efficacy doesn't mean that's what actually happens. But, even more, your argument as presented is self defeating. If the companies already have to do enough research into the drug to make it safe (because 'You really don't want to find out that your compounds causes adverse effects once it has hit the market, it's a guaranteed win for the lawyers'), and that it works ('your health insurance will be asking for proof before they pay'), then why do we need another organisation that requires a different set of tests?
- rincebrain 10y ago
  I'd be curious to see even a partial list of those "safe and effective" meds that nobody wants to pay to run through the approval process. From my perspective, it seems like a substance that's already through the R&D pipeline would be relatively cheap to turn into something for sale, compared to developing new drugs "from scratch".
  - Anderkent 10y ago
    Ok, simplest example - antixilotics (https://en.wikipedia.org/wiki/Anxiolytic https://en.wikipedia.org/wiki/Anxiolytic): Selank https://en.wikipedia.org/wiki/Selank https://en.wikipedia.org/wiki/Selank Afobazole https://en.wikipedia.org/wiki/Fabomotizole https://en.wikipedia.org/wiki/Fabomotizole Emoxypine https://en.wikipedia.org/wiki/Emoxypine https://en.wikipedia.org/wiki/Emoxypine Picamilon https://en.wikipedia.org/wiki/Picamilon https://en.wikipedia.org/wiki/Picamilon There's an entire category of anti-anxiety drugs developed in Russia that are not licensed in the US, because it's not worth the price for anyone. Also: melatonin. Your doctor CAN NOT PRESCRIBE MELATONIN. https://slatestarcodex.com/2013/09/28/sleep-now-by-prescription/ https://slatestarcodex.com/2013/09/28/sleep-now-by-prescript... And you can't prescribe fish oil, but at least there's LOVAZA™®©.
auganov 10y ago
Many niche drugs have no protection, yet because of the FDA approval process, it doesn't make sense for anyone to try to compete.
- HarryHirsch 10y ago
  Compounding drugs is a non-trivial problem, public safety demands compliance and testing. Not too long ago, there was a rash of deaths (!) from a homoeopathic (!!) belladonna preparation. Turns out, the manufacturer was honest and did use belladonna but had a problem with their dilutions, the distribution was uneven and some of their globuli actually had sufficient atropine to kill an infant. The things were sold as a teething aid. For some hair-raisers, try Chemjobber's "Warning Letter of the Week" category: http://chemjobber.blogspot.com/search/label/warning%20letter%20of%20the%20week http://chemjobber.blogspot.com/search/label/warning%20letter... I don't want to find out what things would look like without adult supervision. You also need to prove equivalence for your preparation, bioavailability depends on the filler composition in your pill.