3 ms·

It would be pretty bad if the only phone options were iPhones or Pixels. For broad society we need cheap phones. Same for drugs or other medical treatments. Fir

It would be pretty bad if the only phone options were iPhones or Pixels. For broad society we need cheap phones. Same for drugs or other medical treatments. First we need cheap options for all before we should worry about luxury treatments.

AnthonyMouse 8y ago
> First we need cheap options for all before we should worry about luxury treatments. In this context the "luxury treatments" are drugs under patent and the "cheap options for all" are generics. And then we can identify a specific problem -- we don't have enough generics because unless a drug is under patent, nobody has the incentive to pay to put it through FDA trials. But you can't solve that by removing the profit from the "luxury drugs" -- that only makes it worse. Then nobody has the incentive to pay for FDA trials for anything. The actual problem is that FDA trials are an unfunded mandate. Either they need to be made significantly less expensive somehow or the government needs to fund them itself so that more unpatented generics can actually get approved.
- PretzelFisch 8y ago
  My understanding is that the FDA trial is a trivial expense[1][2] in the whole drug development cycle. What I usually hear is that R&D that spans years to decades is what the pharma company wants to recoup during the patent phase. https://www.jhsph.edu/news/news-releases/2018/cost-of-clinical-trials-for-new-drug-FDA-approval-are-fraction-of-total-tab.html https://www.jhsph.edu/news/news-releases/2018/cost-of-clinic... https://www.outsourcing-pharma.com/Article/2018/09/26/Clinical-trial-cost-is-a-fraction-of-the-drug-development-bill https://www.outsourcing-pharma.com/Article/2018/09/26/Clinic...
  - AnthonyMouse 8y ago
    You're comparing the wrong numbers. The trial costs are small compared to R&D costs, but that's only because R&D costs are very large. So it's millions of dollars compared to billions of dollars. But generics don't have R&D costs, they already exist and are out of patent. Which correspondingly makes them much less profitable -- that's the whole point -- and then "millions of dollars" becomes a significant cost. Moreover, it's a free rider problem, because once you pay for it for a generic drug, anyone can make it, but they didn't have to pay the millions of dollars for the trials so now they can undercut your price. As a result everybody sits around waiting for somebody else to spend several million dollars for a trial instead of doing it themselves, which means that nobody does it.

AnthonyMouse 8y ago

> First we need cheap options for all before we should worry about luxury treatments. In this context the "luxury treatments" are drugs under patent and the "cheap options for all" are generics. And then we can identify a specific problem -- we don't have enough generics because unless a drug is under patent, nobody has the incentive to pay to put it through FDA trials. But you can't solve that by removing the profit from the "luxury drugs" -- that only makes it worse. Then nobody has the incentive to pay for FDA trials for anything. The actual problem is that FDA trials are an unfunded mandate. Either they need to be made significantly less expensive somehow or the government needs to fund them itself so that more unpatented generics can actually get approved.

PretzelFisch 8y ago
My understanding is that the FDA trial is a trivial expense[1][2] in the whole drug development cycle. What I usually hear is that R&D that spans years to decades is what the pharma company wants to recoup during the patent phase. https://www.jhsph.edu/news/news-releases/2018/cost-of-clinical-trials-for-new-drug-FDA-approval-are-fraction-of-total-tab.html https://www.jhsph.edu/news/news-releases/2018/cost-of-clinic... https://www.outsourcing-pharma.com/Article/2018/09/26/Clinical-trial-cost-is-a-fraction-of-the-drug-development-bill https://www.outsourcing-pharma.com/Article/2018/09/26/Clinic...
- AnthonyMouse 8y ago
  You're comparing the wrong numbers. The trial costs are small compared to R&D costs, but that's only because R&D costs are very large. So it's millions of dollars compared to billions of dollars. But generics don't have R&D costs, they already exist and are out of patent. Which correspondingly makes them much less profitable -- that's the whole point -- and then "millions of dollars" becomes a significant cost. Moreover, it's a free rider problem, because once you pay for it for a generic drug, anyone can make it, but they didn't have to pay the millions of dollars for the trials so now they can undercut your price. As a result everybody sits around waiting for somebody else to spend several million dollars for a trial instead of doing it themselves, which means that nobody does it.