6 ms·
I always assumed it would be CVS that got into the game. There are are probably a dozen or so drugs that account for the majority of consumption. Flu vaccines,
by indescions_2018 9y ago
I always assumed it would be CVS that got into the game. There are are probably a dozen or so drugs that account for the majority of consumption. Flu vaccines, blood pressure, cholesterol, thyroid, insulin, asthma, progesterone, beta-blockers, gerd, etc. Providing these at minimum cost, as well as community public health services. Could be enormously cost effective. And extend general wellness and productivity many times over.
>>> "the trick will be in selecting the right third-party manufacturer to ensure good quality"
Obvious subtext here is outsourcing mass market generics to be produced in India, China and other emerging markets. "Pharma-security" might be a popular way to phrase it today. Quality is undoubtedly reflected in price. And there is enormous opportunity in exponentially reducing R&D costs and finding efficiencies.
- Clubber 9y agoI they seem to be explicitly targeting generics, so R&D doesn't come into play. It's really just find someone who can build a known compound and press it into a pill. This has the potential to be massively disruptive.
- mirimir 9y agoEven generics need FDA approval. Manufacturers must demonstrate therapeutic equivalence.
- akozak 9y agoThat's interesting - even if they can prove chemically they're producing something that's already been approved?
- toomuchtodo 9y agoThat is part of the approval process. https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/GenericDrugs/ucm506040.htm https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUs...
- mirimir 9y agoYes. Bioavailability and absorption kinetics are major factors.
- usefulcat 9y agoAnd in order to get that approval, you will likely need a sample of the product that you intend to demonstrate equivalence to. Good luck getting that sample from the maker of the incumbent product who has nothing to gain and much to lose if your product were to get approved.
- refurb 9y agoNot being able to get a sample to prove bioequivalence is typically very easy. There are a handful of drugs that have a REMS program whereby the manufacturer is required to restrict access. We're talking maybe a few tens of drugs. And yes, drug companies playing the game of "I'm not allowed to give you a sample" is super shady and ridiculous. Wouldn't surprise me if this gets fixed super fast.
- AstralStorm 9y agoFDA could give overriding authority to oblige manufacturers to provide a sample to the generic manufacturers for drugs older than <x>. Of course this is bad for business. Alternatively the generic manufacturer would have to run a phase 1 and 2 trial. (Skip requirement for phase 3) Expensive, but much less than full R&D.
- refurb 9y agoMy understanding is that's the plan. Right now branded drug companies say "REMS regulations mean we can't provide a drug for anyone but a patient." All the gov't has to do is say "no, if a generic company requests a sample you can provide de it without violating REMS regulations".
- phillc73 9y agoThere is still a significant R&D element in that "press it into a pill" step. This is manufacturing and process R&D. For example, continuous (rather than batch) manufacturing is the big hotness at the moment. Also new techniques, such as 3D printed pharmaceuticals, involve plenty of R&D effort.
- Clubber 9y agoYes, but compared to R&D for creating a new drug, it's a fraction of the cost. Also, I would think to save costs, they would do it the cheapest way that is proven and reliable.
- mirimir 9y agoYeah, I wonder why not CVS and other chains.
- jrnichols 9y agoi was thinking the same thing, but i was thinking that it was going to be Walmart who got into the game first, especially since they were starting to get into the clinic gig already.
- CoolGuySteve 9y agoAside from generics, Boots in the UK used their patent on ibuprofen to dominate their market. I’m always surprised there isn’t more pharmacy-driven research or investment into exclusive over-the-counter medicines to mimic that strategy, or bidding wars to get exclusive pharmacy rights to new drug patents so that firms can get halo effect shopping. (Not that I endorse this sort of corporate lechery, I’m just surprised, is all)
- refurb 9y agoWhy would a pharmacy care? They typically make a margin on each drug they fill. The more expensive the drug, the more money they make.
- phaemon 9y agoI think you misread that comment. He wasn't talking about the pharmacy making anything cheaper. Quite the contrary.
- refurb 9y agoYou're right I misread it. As for the exclusive pharmacy arrangements, that already happens. Some drugs are only available at one pharmacy. That may mean more business for the pharmacy, but manufacturers also extract more concessions because of it.
- mannykannot 9y agoI would not think that CVS, as a retailer, has much incentive - it is not paying the cost of the branded drugs. It is the insurance companies that I half-expected to make this move, unless there are anti-trust issues, or specific legislation (bought by the drug companies) to prevent them from doing so.
- Kalium 9y agoYou're right! It's insurance companies and benefit managers that are heavily concerned with this. CVS is acquiring Aetna and is one of the largest pharmacy benefit managers around.