5 ms·

If your drug is so good, you should let the market decide what the fair price. The problem is that drug companies and wholesalers don't let that happen by lobb

If your drug is so good, you should let the market decide what the fair price. The problem is that drug companies and wholesalers don't let that happen by lobbying against open markets and government paid healthcare.

rayiner 10y ago
I'm in favor of government-paid healthcare, but you can't have a functioning free market when one buyer dominates. It's the mirror situation of a monopoly.
refurb 10y ago
If your drug is so good, you should let the market decide what the fair price. Contrary to what people think, drug companies can't just charge whatever they want. Take a look at the HCV drugs. They priced too high and their sales are eroding very quickly. If they had priced lower, they probably would have seen even greater profits.
- kgwgk 10y ago
  How so? There are only so many patients to treat. Sales are eroding mostly because competition has brought prices down and improved drugs allow for shorter treatments.
  - refurb 10y ago
    The price was too high. There are millions of untreated HCV patients out there that can't get treated because insurance companies won't pay for the drugs.
    - kgwgk 10y ago
      Now the prices are lower... and the profits as well.
      - refurb 10y ago
        Yes, but insurance companies haven't loosened the reins on these drugs. Even with the lower prices, patients are being denied.
        kgwgk 10y ago
        Not completely true (the restrictions have been eased a bit) but how does this fact support your claim? ("If they had priced lower, they probably would have seen even greater profits.") Profits were higher when prices were higher.
        refurb 10y ago
        Yes, access has gotten better, somewhat driven by discounts, but also driven by lawsuits against Medicaid. Where I'm coming from is that there are 3.5M people in the US with HCV. Let's say 10% are in California (350,000). Many of them are on Medicaid. Medicaid estimates it will be spend $1B on these drugs in 2017[1]. Based on that article, it comes out to 14,300 patients. A small fraction of those with HCV. I would imagine if Gilead had priced lower (maybe starting at $40K and discounting from there) they would have had much less payer pushback and likely a huge increase in numbers treated. Payers are still telling people "yes you have HCV, but no you're not sick enough". [1]http://californiahealthline.org/news/medi-cal-to-spend-nearly-1-billion-on-hepatitis-c-drugs-next-year/ http://californiahealthline.org/news/medi-cal-to-spend-nearl...
        kgwgk 10y ago
        I see is no reason to think the increase in numbers treated would have been so large that payers would have spent more dollars than they did, so its not clear that Gilead's revenue (let alone profit) would have been higher.
        refurb 10y ago
        We agree to disagree! I think Gilead's pricing scheme left a bad taste in the payer's mouths and probably caused them to be much more restrictive than they otherwise would have. Yes, payers still would have worried about total budget impact, but a lower price means more value. If a payer can spend another $1M and treat another 50 patients (at $20K) vs. 10 patients (at $100K) I get the sense they would have felt it more worthwhile.

rayiner 10y ago

I'm in favor of government-paid healthcare, but you can't have a functioning free market when one buyer dominates. It's the mirror situation of a monopoly.

refurb 10y ago

If your drug is so good, you should let the market decide what the fair price. Contrary to what people think, drug companies can't just charge whatever they want. Take a look at the HCV drugs. They priced too high and their sales are eroding very quickly. If they had priced lower, they probably would have seen even greater profits.

kgwgk 10y ago
How so? There are only so many patients to treat. Sales are eroding mostly because competition has brought prices down and improved drugs allow for shorter treatments.
- refurb 10y ago
  The price was too high. There are millions of untreated HCV patients out there that can't get treated because insurance companies won't pay for the drugs.
  - kgwgk 10y ago
    Now the prices are lower... and the profits as well.
    - refurb 10y ago
      Yes, but insurance companies haven't loosened the reins on these drugs. Even with the lower prices, patients are being denied.
      - kgwgk 10y ago
        Not completely true (the restrictions have been eased a bit) but how does this fact support your claim? ("If they had priced lower, they probably would have seen even greater profits.") Profits were higher when prices were higher.
        refurb 10y ago
        Yes, access has gotten better, somewhat driven by discounts, but also driven by lawsuits against Medicaid. Where I'm coming from is that there are 3.5M people in the US with HCV. Let's say 10% are in California (350,000). Many of them are on Medicaid. Medicaid estimates it will be spend $1B on these drugs in 2017[1]. Based on that article, it comes out to 14,300 patients. A small fraction of those with HCV. I would imagine if Gilead had priced lower (maybe starting at $40K and discounting from there) they would have had much less payer pushback and likely a huge increase in numbers treated. Payers are still telling people "yes you have HCV, but no you're not sick enough". [1]http://californiahealthline.org/news/medi-cal-to-spend-nearly-1-billion-on-hepatitis-c-drugs-next-year/ http://californiahealthline.org/news/medi-cal-to-spend-nearl...
        kgwgk 10y ago
        I see is no reason to think the increase in numbers treated would have been so large that payers would have spent more dollars than they did, so its not clear that Gilead's revenue (let alone profit) would have been higher.
        refurb 10y ago
        We agree to disagree! I think Gilead's pricing scheme left a bad taste in the payer's mouths and probably caused them to be much more restrictive than they otherwise would have. Yes, payers still would have worried about total budget impact, but a lower price means more value. If a payer can spend another $1M and treat another 50 patients (at $20K) vs. 10 patients (at $100K) I get the sense they would have felt it more worthwhile.