9 ms·

Enbrel? They just received another patent extension, too. This is what government granted monopolies look like.

dv_dt 9y ago
This is what the breakdown of working competitive markets look like, and in this case it takes both government monopolies, as well as well as overwhelming short-term greed on the part of the private companies. Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort... or maybe they think they should extract profits now because of a chance of drug price regulation coming to the US in the future?
- Sangermaine 9y ago
  >Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort No, because it demonstrably won't. People say they're angry and then do nothing about it. The US has an entire political party angrily decrying any effort to regulate healthcare as socialist slavery. The drug companies know they'll be just fine. Maybe some token slaps on the wrist and public performance of cosmetic changes to appease people now and then, but nothing will happen to them.
  - dv_dt 9y ago
    Perhaps, though I think I'm more energized personally voting & with campaign involvement in the upcoming elections this year than ever before. And part of that is knowing that it might help Medicare for all or other universal healthcare options - maybe not this election or the even the next - but personally I feel it has to happen and is worth working towards.
  - alexanderstears 9y ago
    the US has an entire political party angrily decrying any effort to regulate healthcare as socialist slavery. Argubly regulation is the problem we're in this mess. Do you think an epipen would cost $600 if there weren't a Government granted monopoly? We have two parties who love the current amount of regulations on competition - you need to go to an AMA approved medical school to become a doctor, there aren't H1Bs for health care workers, and the government gets to pick and chose who's allowed to sell medication. They just disagree on the amount of subsidies for poor people. One party thinks prepaid consumption with cross subsidies is insurance and the other party thinks that insurance shouldn't be so binding if you get sick.
    - dv_dt 9y ago
      Regulations can put pressure on prices (and if you look at epipens in particular, part of the regulations allowing the increase of their price have nothing to do with monopoly and a lot to do with getting policy placed into areas where organizations are required to keep an epipen on hand by regulation...). But in terms of overall effect, one can't ignore other nations which pay much lower prices for healthcare with both regulation for drug patents, as well as regulation on drug prices. That combination manages to deliver better care at lower costs than the US (we pay on average double per capita). So I don't think one can generically fault "regulation" for a poorly performing health market in the US.
      - alexanderstears 9y ago
        So I don't think one can generically fault "regulation" for a poorly performing health market in the US. You're absolutely right, however, I do think the worst parts of our medical system exist as consequences of regulation. The mandate that emergency rooms treat anyone who enters is onerous and there's no free lunch, paying customers are stuck with the bill. The licencing system isn't optimal for cost effective care. There's a lot to be desired for people who favor supply side solutions to expensive problems.
        dv_dt 9y ago
        > The mandate that emergency rooms treat anyone who enters is onerous and there's no free lunch, paying customers are stuck with the bill. I don't think that's onerous, I think that is a minimal, and admittedly imperfect, expression of our societal intent that people shouldn't die unnecessarily in emergency rooms - either from lack of being able to pay; nor from a practical standpoint, lack or delay of on-hand proof of ability to pay. Removing those regulations would cause all sorts of other problems. Someone arrives in an ambulance near-death, if I lack morals then one level of maximized extraction price is to have those patients commit to pay a value that represents the earning potential for that person for the rest of their life. They have to agree before getting admitted. Even more profitable, if I judge that person as having a well connected social network, I can charge even more because I know their friends and colleagues would chip in to save them... I'm not sure how a competitive market with no regulation changes the worst case for this transaction - if someone is near death then moving on to another emergency room is out of the question. I see universal healthcare with a shared cost-pool as the lowest overhead way to provide for our social moral desires (but then I'm not in fear of the regulation with may be needed to implement that policy). Insurace with a shared risk pool is a technically workable, but adds even more overhead, and ends up a more expensive way to do the same thing... but again regulations are involved (and fixing very flawed ones at that).
  - trapperkeeper74 9y ago
    Don’t get lost barking up the partisan tree, most Americans aren’t the enemy. Both parties are different flavors of corrupt (Gore Vidal’s Property party): one ignores their base while taking corporate money and the other panders to extremists and also takes the same blood money.
    - leggomylibro 9y ago
      It's a sliding scale, but it's not close to balanced right now. Saying things along the line of 'different sides of the same coin' does not make sense.
  - jaggederest 9y ago
    I suspect that at some point there will be a backlash in the form of someone or some people with nothing to lose becoming violent in the face of an effective death sentence in the form of unaffordable healthcare. "Ultima ratio regum" is an appalling way to enforce fairness, but it doesn't seem to me that greed in general will stop short of a true class war or an external threat ala a World War. Also to be clear I am definitely not advocating this route, I'm trying to figure out what anyone can do to prevent it and thus far I am at a loss.
    - Mz 9y ago
      I'm trying to figure out what anyone can do to prevent it and thus far I am at a loss. You quietly find another path and make these insanely expensive drugs vastly less relevant. The real challenge is effectively spreading the word. Something truly disruptive in this area seems to be about the most offensive thing a human being can do.
      - jaggederest 9y ago
        The funny thing is that pharmaceuticals are simply one of a number of unconscionable negative-sum-games that are being played these days. I just don't understand how people can make such a blatantly destructive set of choices when it's really clear that it will come back and bite them in a way even the most psychopathically mercenary people should understand, let alone anyone with a more advanced morality than "I got mine".
        Mz 9y ago
        Currently, the world actively makes it hard to make any other choice. I have made other choices. Part of the result: I spent ~5.7 years homeless while classist assholes (online and off) shit all over me. I believe part of this is happenstance. Humans are little monkeys with brains designed to parse a social order for a tribe of 150 members. With 7 billion people on the planet and a global economy by necessity, the paradigms developed to parse our tribe break in the face of a sudden new world order. It is actively dangerous to give a damn about the welfare of other people. Some of that is also happenstance. Strangers from extremely different backgrounds face substantial obstacles to good communication. But, we really need to solve this, even if we are all cold hearted sociopaths who don't give a damn about anyone but ourselves. Like you said: If we don't, this will eventually go very bad places. Given the recent mass shooting in Las Vegas, the record destruction of hurricanes in Texas and Florida, and the ongoing fires in California, I think it is reasonable to assert that our choices are already coming back to bite us. We can do something more sensible or continue to suffer the consequences.
- rubyn00bie 9y ago
  No. :( Businesses have no concern over their long term viability. Executives are not incentivized in anyway to care about long term interests. In fact all their bonuses and compensation explicitly reward the short term. Compounding the problem is a simple cost benefit analysis means they've already costed out the future "backlash," and still find themselves to be more profitable. The "long term" is nothing but a mental exercise with no real world manifestation for businesses. The closest you can probably get to it having meaning is for business school grad students doing case studies.
- freethinker777 9y ago
  You don't need price regulation if you reduce the length of the patents or get rid of the patents completely. Keep in mind patents are a government granted monopoly, the problem is the patents not the prices. If someone else can make the drug for 800 and is happy to sell it for 1000 then it won't be sold for 84,000 anymore because no one will buy it for that price.
- PeterStuer 9y ago
  No, this is exactly what a 'working competitive market' looks like. If you somehow still believe the simplistic fantasies of economics 101 with a clean partition between 'the market' and the meta-market game, then you urgently need to wake-up.
rightos 9y ago
It's a difficult balance to strike - you want the companies to keep developing drugs, you want onerous regulation on those drugs to make sure they're produced and tested for safety and efficacy. But then you want them to be cheap for patients and insurance companies. The best solution is probably to simply drop patent extensions for these things and allow generic drug manufacturers to do what they do best, but if you do that too early you risk damaging funding for new drug development. Too late and you wind up with companies just building up piles of cash like we have today. You need to hit that point of "we need to develop new drugs to make a profit" - what that is, I'm not sure.
- knieveltech 9y ago
  You want pharma companies to keep doing drug discovery why not ban outright any kind of marketing or advertising for their products? R&D spend across the industry is a fraction of the marketing spend. Think of all the good research that money would fund once pharma companies were freed from spending it on advertising.
  - rightos 9y ago
    Seems like a reasonable idea to me, has anyone attempted to apply some of the less controversial possible solutions here in the US? Like shorter patent lifetimes or a ban or reduction on drug advertising?
    - ajmurmann 9y ago
      Things definitely have been tried. However, companies find loop holes and frequently things get worse after. Check out this amazing episode of econtalk: http://www.econtalk.org/archives/2017/06/robin_feldman_o.html http://www.econtalk.org/archives/2017/06/robin_feldman_o.htm...
  - djhworld 9y ago
    Whenever I visit the US I find it insane how much advertising for drugs is shown on TV, with the usual "ask your doctor about..." disclaimer at the end. Why aren't more American's up in arms about this?
rayiner 9y ago
Enbrel didn't receive a patent extension.[1] In 2011, a patent was issued that covered certain aspects of Enbrel that had originally been applied for in 1990. Under the rules applicable to pre-1995 patents, the life of that patent runs 17 years from the date of issuance (or 2028). That could not happen under the current law. Patents issued after 1995 are only valid for 20 years from the date of filing, with current limited adjustments due to delays at the USPTO. [1] There isn't really any such thing, at least as a way to resurrect patents that would otherwise expire.
johnny99 9y ago
And this is what populists should be irate about. Not... other things.
WalterSear 9y ago
EMSAM Unfortunately, no other class of drug class has worked, and the traditional delivery methods (ie - pill form) caused measurable hearing damage, just from the trial periods.
- deftnerd 9y ago
  If you take the oral version (as opposed to the patch version) you can get it from India (where the patents have expired). A site I've used in the past that's reliable is AllDayChemist. Search for Selegiline and you can get it for as cheap as 18 cents per 5mg tablet. Good luck! Edit: Sorry, read below that you need the trans-dermal version.

This is what the breakdown of working competitive markets look like, and in this case it takes both government monopolies, as well as well as overwhelming short-term greed on the part of the private companies. Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort... or maybe they think they should extract profits now because of a chance of drug price regulation coming to the US in the future?

Sangermaine 9y ago
>Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort No, because it demonstrably won't. People say they're angry and then do nothing about it. The US has an entire political party angrily decrying any effort to regulate healthcare as socialist slavery. The drug companies know they'll be just fine. Maybe some token slaps on the wrist and public performance of cosmetic changes to appease people now and then, but nothing will happen to them.
- dv_dt 9y ago
  Perhaps, though I think I'm more energized personally voting & with campaign involvement in the upcoming elections this year than ever before. And part of that is knowing that it might help Medicare for all or other universal healthcare options - maybe not this election or the even the next - but personally I feel it has to happen and is worth working towards.
- alexanderstears 9y ago
  the US has an entire political party angrily decrying any effort to regulate healthcare as socialist slavery. Argubly regulation is the problem we're in this mess. Do you think an epipen would cost $600 if there weren't a Government granted monopoly? We have two parties who love the current amount of regulations on competition - you need to go to an AMA approved medical school to become a doctor, there aren't H1Bs for health care workers, and the government gets to pick and chose who's allowed to sell medication. They just disagree on the amount of subsidies for poor people. One party thinks prepaid consumption with cross subsidies is insurance and the other party thinks that insurance shouldn't be so binding if you get sick.
  - dv_dt 9y ago
    Regulations can put pressure on prices (and if you look at epipens in particular, part of the regulations allowing the increase of their price have nothing to do with monopoly and a lot to do with getting policy placed into areas where organizations are required to keep an epipen on hand by regulation...). But in terms of overall effect, one can't ignore other nations which pay much lower prices for healthcare with both regulation for drug patents, as well as regulation on drug prices. That combination manages to deliver better care at lower costs than the US (we pay on average double per capita). So I don't think one can generically fault "regulation" for a poorly performing health market in the US.
    - alexanderstears 9y ago
      So I don't think one can generically fault "regulation" for a poorly performing health market in the US. You're absolutely right, however, I do think the worst parts of our medical system exist as consequences of regulation. The mandate that emergency rooms treat anyone who enters is onerous and there's no free lunch, paying customers are stuck with the bill. The licencing system isn't optimal for cost effective care. There's a lot to be desired for people who favor supply side solutions to expensive problems.
      - dv_dt 9y ago
        > The mandate that emergency rooms treat anyone who enters is onerous and there's no free lunch, paying customers are stuck with the bill. I don't think that's onerous, I think that is a minimal, and admittedly imperfect, expression of our societal intent that people shouldn't die unnecessarily in emergency rooms - either from lack of being able to pay; nor from a practical standpoint, lack or delay of on-hand proof of ability to pay. Removing those regulations would cause all sorts of other problems. Someone arrives in an ambulance near-death, if I lack morals then one level of maximized extraction price is to have those patients commit to pay a value that represents the earning potential for that person for the rest of their life. They have to agree before getting admitted. Even more profitable, if I judge that person as having a well connected social network, I can charge even more because I know their friends and colleagues would chip in to save them... I'm not sure how a competitive market with no regulation changes the worst case for this transaction - if someone is near death then moving on to another emergency room is out of the question. I see universal healthcare with a shared cost-pool as the lowest overhead way to provide for our social moral desires (but then I'm not in fear of the regulation with may be needed to implement that policy). Insurace with a shared risk pool is a technically workable, but adds even more overhead, and ends up a more expensive way to do the same thing... but again regulations are involved (and fixing very flawed ones at that).
- trapperkeeper74 9y ago
  Don’t get lost barking up the partisan tree, most Americans aren’t the enemy. Both parties are different flavors of corrupt (Gore Vidal’s Property party): one ignores their base while taking corporate money and the other panders to extremists and also takes the same blood money.
  - leggomylibro 9y ago
    It's a sliding scale, but it's not close to balanced right now. Saying things along the line of 'different sides of the same coin' does not make sense.
- jaggederest 9y ago
  I suspect that at some point there will be a backlash in the form of someone or some people with nothing to lose becoming violent in the face of an effective death sentence in the form of unaffordable healthcare. "Ultima ratio regum" is an appalling way to enforce fairness, but it doesn't seem to me that greed in general will stop short of a true class war or an external threat ala a World War. Also to be clear I am definitely not advocating this route, I'm trying to figure out what anyone can do to prevent it and thus far I am at a loss.
  - Mz 9y ago
    I'm trying to figure out what anyone can do to prevent it and thus far I am at a loss. You quietly find another path and make these insanely expensive drugs vastly less relevant. The real challenge is effectively spreading the word. Something truly disruptive in this area seems to be about the most offensive thing a human being can do.
    - jaggederest 9y ago
      The funny thing is that pharmaceuticals are simply one of a number of unconscionable negative-sum-games that are being played these days. I just don't understand how people can make such a blatantly destructive set of choices when it's really clear that it will come back and bite them in a way even the most psychopathically mercenary people should understand, let alone anyone with a more advanced morality than "I got mine".
      - Mz 9y ago
        Currently, the world actively makes it hard to make any other choice. I have made other choices. Part of the result: I spent ~5.7 years homeless while classist assholes (online and off) shit all over me. I believe part of this is happenstance. Humans are little monkeys with brains designed to parse a social order for a tribe of 150 members. With 7 billion people on the planet and a global economy by necessity, the paradigms developed to parse our tribe break in the face of a sudden new world order. It is actively dangerous to give a damn about the welfare of other people. Some of that is also happenstance. Strangers from extremely different backgrounds face substantial obstacles to good communication. But, we really need to solve this, even if we are all cold hearted sociopaths who don't give a damn about anyone but ourselves. Like you said: If we don't, this will eventually go very bad places. Given the recent mass shooting in Las Vegas, the record destruction of hurricanes in Texas and Florida, and the ongoing fires in California, I think it is reasonable to assert that our choices are already coming back to bite us. We can do something more sensible or continue to suffer the consequences.
rubyn00bie 9y ago
No. :( Businesses have no concern over their long term viability. Executives are not incentivized in anyway to care about long term interests. In fact all their bonuses and compensation explicitly reward the short term. Compounding the problem is a simple cost benefit analysis means they've already costed out the future "backlash," and still find themselves to be more profitable. The "long term" is nothing but a mental exercise with no real world manifestation for businesses. The closest you can probably get to it having meaning is for business school grad students doing case studies.
freethinker777 9y ago
You don't need price regulation if you reduce the length of the patents or get rid of the patents completely. Keep in mind patents are a government granted monopoly, the problem is the patents not the prices. If someone else can make the drug for 800 and is happy to sell it for 1000 then it won't be sold for 84,000 anymore because no one will buy it for that price.
PeterStuer 9y ago
No, this is exactly what a 'working competitive market' looks like. If you somehow still believe the simplistic fantasies of economics 101 with a clean partition between 'the market' and the meta-market game, then you urgently need to wake-up.

rightos 9y ago

It's a difficult balance to strike - you want the companies to keep developing drugs, you want onerous regulation on those drugs to make sure they're produced and tested for safety and efficacy. But then you want them to be cheap for patients and insurance companies. The best solution is probably to simply drop patent extensions for these things and allow generic drug manufacturers to do what they do best, but if you do that too early you risk damaging funding for new drug development. Too late and you wind up with companies just building up piles of cash like we have today. You need to hit that point of "we need to develop new drugs to make a profit" - what that is, I'm not sure.

knieveltech 9y ago
You want pharma companies to keep doing drug discovery why not ban outright any kind of marketing or advertising for their products? R&D spend across the industry is a fraction of the marketing spend. Think of all the good research that money would fund once pharma companies were freed from spending it on advertising.
- rightos 9y ago
  Seems like a reasonable idea to me, has anyone attempted to apply some of the less controversial possible solutions here in the US? Like shorter patent lifetimes or a ban or reduction on drug advertising?
  - ajmurmann 9y ago
    Things definitely have been tried. However, companies find loop holes and frequently things get worse after. Check out this amazing episode of econtalk: http://www.econtalk.org/archives/2017/06/robin_feldman_o.html http://www.econtalk.org/archives/2017/06/robin_feldman_o.htm...
- djhworld 9y ago
  Whenever I visit the US I find it insane how much advertising for drugs is shown on TV, with the usual "ask your doctor about..." disclaimer at the end. Why aren't more American's up in arms about this?

rayiner 9y ago

Enbrel didn't receive a patent extension.[1] In 2011, a patent was issued that covered certain aspects of Enbrel that had originally been applied for in 1990. Under the rules applicable to pre-1995 patents, the life of that patent runs 17 years from the date of issuance (or 2028). That could not happen under the current law. Patents issued after 1995 are only valid for 20 years from the date of filing, with current limited adjustments due to delays at the USPTO. [1] There isn't really any such thing, at least as a way to resurrect patents that would otherwise expire.

johnny99 9y ago

And this is what populists should be irate about. Not... other things.

WalterSear 9y ago

EMSAM Unfortunately, no other class of drug class has worked, and the traditional delivery methods (ie - pill form) caused measurable hearing damage, just from the trial periods.

deftnerd 9y ago
If you take the oral version (as opposed to the patch version) you can get it from India (where the patents have expired). A site I've used in the past that's reliable is AllDayChemist. Search for Selegiline and you can get it for as cheap as 18 cents per 5mg tablet. Good luck! Edit: Sorry, read below that you need the trans-dermal version.