4 ms·

Without the U.S. subsidizing the drug research R&D, who pays for it? You could fill notebooks with worthy, approachable hypotheses for any number of diseases t

by aantix 8y ago

Without the U.S. subsidizing the drug research R&D, who pays for it? You could fill notebooks with worthy, approachable hypotheses for any number of diseases that could show promise if given the funding. But if everyone makes it law to cap prices - fewer scientists, labs, studies are performed. The money has to come from somewhere. I think countries take for granted the progress we've made. No progress is made without incredible intellectual efforts and monetary backings.

8note 8y ago
Isn't the R&D money for scientists and labs coming from the US government? business drug R&D follows the "which drug patents can we buy and Jack the prices up for extra profit?"
antisthenes 8y ago
> Without the U.S. subsidizing the drug research R&D, who pays for it? I wish we could stop using this tired trope once and for all in debates about medical care. Most medical care is routine and does not require cutting edge drugs. Things like insulin, epinephrine, anesthetics, antibiotics, antihistamines, vaccines, most of those things have been developed in the 1st half of the 20th century. How much do the cutting age drugs account for in the scope of the total health care costs in the US? Even if it was higher than 1% (I'm willing to bet money that it isn't), the marketing budgets for drug companies far exceed their R&D spending.
dv_dt 8y ago
This paper gives pretty interesting breakdown of how private companies are increasingly bad at paying for it. https://www.ucl.ac.uk/bartlett/public-purpose/sites/public-purpose/files/peoples_prescription_report_final_online.pdf https://www.ucl.ac.uk/bartlett/public-purpose/sites/public-p... One quote from the paper: In the last ten years, Pizer has spent US$139 billion on share buybacks and dividends compared to US$82 billion on R&D. Edit: It shouldn't require massive profit margins to make the drug industry work for a basic human need like healthcare. Other sectors for human basics like the grocery industry, run on margins of 1-5%.
- aantix 8y ago
  Food production is predictable. Finding a safe, effective treatment for Alzheimer’s is not. If you want thin margins, maybe government research wing can take its findings from idea to market (imagine waiting on a cure and that’s your only hope?) But you can’t force a private company to operate on low margins by way of capping prices, you’ll kill them. You can’t taje away their ability to control their risks (cash flow). Drug R&D already has a huge failure rate and now the company can only take a 5% profit on the slight chance they’ve found something effective?
  - dv_dt 8y ago
    If you look at the paper, private drug discovery is creating drugs at a declining rate. I would suggest this is because those private efforts are much less research than development, and it's actually the public system that drives much fundamental research. And the drugs to market rate is in serious decline because of a the widespread application of increasingly austure public funding budgets for medical research causing an early pipeline bottleneck.
    - aantix 8y ago
      When you dump a link to a 60 page pdf and you’re going to reference it, please list the page number and/graph you’re referring to. I don’t want to guess.
      - dv_dt 8y ago
        Sorry, Fig 1, page 15 is the data on drugs discovered per billion. Table 1, pg 18 shows some sample breakdowns of drug investments broken down between basic research and commercial development. I don't necessarily subscribe to everything in that report, but I do think that modeling drug development in terms of a simple risk-reward model for the private drug industry needs further thought.
- tomp 8y ago
  Does the "huge margins of the healthcare industry" include all the money spent on failed pharma startups? If you spend $1bn on a drug then make $1bn profit but the other 9 drugs failed (after someone having spent $1bn for each) the margin isn't 100%, it's 10%.
munk-a 8y ago
Ha! This is a silly talking point that lots of companies bounce around - you know how insulin costs money because it was so expensive to develop... Except no, it was invented in Canada and the researchers released the formula for free[1] as a "benefit to humanity" thing... then a few US companies acquired rights to produce it and proceeded to establish market control in the US - the fact that insulin isn't being sold at cost is just pure greed. And this happens a lot, very often drugs are innovated using public funds and then sold to private companies to produce which milk the consumers for profit - this whole "it pays for R&D" is a pharmaceutical PR line, just like when McDonalds buried their hot coffee lawsuit under "well, if people weren't such klutzes". The US isn't the great innovator here to save us all and a huge proportion of your drug prices cycles back into marketing to sell more of the drug. [1] Technically, they sold it for a dollar to the University of Toronto
- aantix 8y ago
  Of course it does. Because people don’t buy and use the drug if they don’t know about it..? Money matters. Marketing to recoup costs matters. Piles of cash to get every dollar of return on an investment matters. That allows the company to turn around and invest in future promising drugs, trials, other companies, marketing to bring awareness to the solution and hopefully get people to buy and use it.
  - munk-a 8y ago
    Making sure doctors are well informed about treatment options are one thing... egging patients on to request a possibly mismatched medication and taking doctors out to lunch to encourage the prescription of a possibly mismatched medication is entirely different. The ideal case for drugs is that no one actually needs them so no one takes them - this is a large contributor as to why this market should be heavily nationalized.
    - aantix 8y ago
      The patient can egg on all they want - it’s still the doctor’s (expert) decision whether to prescribe. And as an informed patient, I want to know my options. My doctor and I will discuss trade offs, he’ll sign off if he thinks it’s appropriate.

by aantix 8y ago

8note 8y ago

Isn't the R&D money for scientists and labs coming from the US government? business drug R&D follows the "which drug patents can we buy and Jack the prices up for extra profit?"

antisthenes 8y ago

> Without the U.S. subsidizing the drug research R&D, who pays for it? I wish we could stop using this tired trope once and for all in debates about medical care. Most medical care is routine and does not require cutting edge drugs. Things like insulin, epinephrine, anesthetics, antibiotics, antihistamines, vaccines, most of those things have been developed in the 1st half of the 20th century. How much do the cutting age drugs account for in the scope of the total health care costs in the US? Even if it was higher than 1% (I'm willing to bet money that it isn't), the marketing budgets for drug companies far exceed their R&D spending.

dv_dt 8y ago

This paper gives pretty interesting breakdown of how private companies are increasingly bad at paying for it. https://www.ucl.ac.uk/bartlett/public-purpose/sites/public-purpose/files/peoples_prescription_report_final_online.pdf https://www.ucl.ac.uk/bartlett/public-purpose/sites/public-p... One quote from the paper: In the last ten years, Pizer has spent US$139 billion on share buybacks and dividends compared to US$82 billion on R&D. Edit: It shouldn't require massive profit margins to make the drug industry work for a basic human need like healthcare. Other sectors for human basics like the grocery industry, run on margins of 1-5%.

aantix 8y ago
Food production is predictable. Finding a safe, effective treatment for Alzheimer’s is not. If you want thin margins, maybe government research wing can take its findings from idea to market (imagine waiting on a cure and that’s your only hope?) But you can’t force a private company to operate on low margins by way of capping prices, you’ll kill them. You can’t taje away their ability to control their risks (cash flow). Drug R&D already has a huge failure rate and now the company can only take a 5% profit on the slight chance they’ve found something effective?
- dv_dt 8y ago
  If you look at the paper, private drug discovery is creating drugs at a declining rate. I would suggest this is because those private efforts are much less research than development, and it's actually the public system that drives much fundamental research. And the drugs to market rate is in serious decline because of a the widespread application of increasingly austure public funding budgets for medical research causing an early pipeline bottleneck.
  - aantix 8y ago
    When you dump a link to a 60 page pdf and you’re going to reference it, please list the page number and/graph you’re referring to. I don’t want to guess.
    - dv_dt 8y ago
      Sorry, Fig 1, page 15 is the data on drugs discovered per billion. Table 1, pg 18 shows some sample breakdowns of drug investments broken down between basic research and commercial development. I don't necessarily subscribe to everything in that report, but I do think that modeling drug development in terms of a simple risk-reward model for the private drug industry needs further thought.
tomp 8y ago
Does the "huge margins of the healthcare industry" include all the money spent on failed pharma startups? If you spend $1bn on a drug then make $1bn profit but the other 9 drugs failed (after someone having spent $1bn for each) the margin isn't 100%, it's 10%.

munk-a 8y ago

Ha! This is a silly talking point that lots of companies bounce around - you know how insulin costs money because it was so expensive to develop... Except no, it was invented in Canada and the researchers released the formula for free[1] as a "benefit to humanity" thing... then a few US companies acquired rights to produce it and proceeded to establish market control in the US - the fact that insulin isn't being sold at cost is just pure greed. And this happens a lot, very often drugs are innovated using public funds and then sold to private companies to produce which milk the consumers for profit - this whole "it pays for R&D" is a pharmaceutical PR line, just like when McDonalds buried their hot coffee lawsuit under "well, if people weren't such klutzes". The US isn't the great innovator here to save us all and a huge proportion of your drug prices cycles back into marketing to sell more of the drug. [1] Technically, they sold it for a dollar to the University of Toronto

aantix 8y ago
Of course it does. Because people don’t buy and use the drug if they don’t know about it..? Money matters. Marketing to recoup costs matters. Piles of cash to get every dollar of return on an investment matters. That allows the company to turn around and invest in future promising drugs, trials, other companies, marketing to bring awareness to the solution and hopefully get people to buy and use it.
- munk-a 8y ago
  Making sure doctors are well informed about treatment options are one thing... egging patients on to request a possibly mismatched medication and taking doctors out to lunch to encourage the prescription of a possibly mismatched medication is entirely different. The ideal case for drugs is that no one actually needs them so no one takes them - this is a large contributor as to why this market should be heavily nationalized.
  - aantix 8y ago
    The patient can egg on all they want - it’s still the doctor’s (expert) decision whether to prescribe. And as an informed patient, I want to know my options. My doctor and I will discuss trade offs, he’ll sign off if he thinks it’s appropriate.