3 ms·

The U.S. Health Care System Found a Way to Make Peanuts Cost $4,200

39 points by jawns 7y ago

refurb 7y ago
I know this company well and knew this was going to become a PR issue. Aimmune's product is just purified peanut flour. Convincing everyone it's worth thousands (to tens of thousands) of dollars is going to be tough. That said, you're not paying for the peanut flour, you're paying for the comprehensive set of data the company had to develop to prove the product actually works. Just rough numbers, a phase 3 clinical trials costs about $15K per patient per year. Aimmune ran a year long trial with 1000 patients (from clinicaltrials.gov), so the trial alone cost them almost $160M dollars. Add in manufacturing regulations, etc, you can understand why they raised $400M over the past 8 years since they were formed.[1] The other thing to keep in mind is the pharmacoeconomic arguments. If insurance companies are paying thousands of dollars each time a child goes to the ER for a allergic response, pay $10,000 for this drug to reduce those may make total sense. Also interesting that this article comes out the same day the stock is halted because the FDA review committee is meeting. You can peruse the briefing document to see what they'll be discussing.[2] [1]https://www.crunchbase.com/organization/allergen-research-corporation https://www.crunchbase.com/organization/allergen-research-co... [2]https://www.fda.gov/media/130654/download https://www.fda.gov/media/130654/download
jawns 7y ago
Obviously, the high cost of the therapy is news in and of itself, and it's very illustrative of the fact that high R&D costs need to be wrapped up in the cost of the drug, even if the drug itself costs peanuts to make. (LITERAL PEANUTS, get it?!?) But what's more worrisome is that although oral immunotherapy appears to desensitize patients to the allergen, real-world evidence shows that these people actually end up experiencing allergic reactions more frequently than those who practice strict avoidance, the article reports. Whether that's because the patients who've undergone therapy are letting their guard down, or because the drug is only semi-protective, is unknown. But the article argues that the therapy might lead to a net increase, rather than a decrease, in allergic episodes.
JohnClark1337 7y ago
"So, essentially, in order to make the therapy accessible, it has to become part of the system. The system is what allows pharmaceutical companies and doctors to charge insurers thousands of dollars for peanuts." *accessible to those who have insurance. Those who don't are SOL
junar 7y ago
One of the studies describes the exact doses: > AR101, a powder, was administered in graduated doses ... from capsules containing 0.5, 1, 10, 20, or 100 mg of peanut protein, formulated with bulking and flow agents ... Study product was consumed after opening the capsules and mixing its content into an age-appropriate, nonallergenic, vehicle food (eg, applesauce, pudding). https://www.jaci-inpractice.org/article/S2213-2198(17)30742-0/pdf https://www.jaci-inpractice.org/article/S2213-2198(17)30742-... Their website claims that 1 peanut is 250-300 mg peanut protein. https://www.aimmune.com/ar101-peanut-allergy/ https://www.aimmune.com/ar101-peanut-allergy/ So while $4,200 might be a bit high, there is probably still some value in isolating a 1/500 peanut dose.
m-p-3 7y ago
In case someone cannot get past the paywall https://ipfs.io/ipfs/QmVmaUKkcZwyWRZ5ZyK8MkxDzYPWL4dGdSLrfjNMWNWTt5/ https://ipfs.io/ipfs/QmVmaUKkcZwyWRZ5ZyK8MkxDzYPWL4dGdSLrfjN... https://cloudflare-ipfs.com/ipfs/QmVmaUKkcZwyWRZ5ZyK8MkxDzYPWL4dGdSLrfjNMWNWTt5/ https://cloudflare-ipfs.com/ipfs/QmVmaUKkcZwyWRZ5ZyK8MkxDzYP...

39 points by jawns 7y ago

I know this company well and knew this was going to become a PR issue. Aimmune's product is just purified peanut flour. Convincing everyone it's worth thousands (to tens of thousands) of dollars is going to be tough. That said, you're not paying for the peanut flour, you're paying for the comprehensive set of data the company had to develop to prove the product actually works. Just rough numbers, a phase 3 clinical trials costs about $15K per patient per year. Aimmune ran a year long trial with 1000 patients (from clinicaltrials.gov), so the trial alone cost them almost $160M dollars. Add in manufacturing regulations, etc, you can understand why they raised $400M over the past 8 years since they were formed.[1] The other thing to keep in mind is the pharmacoeconomic arguments. If insurance companies are paying thousands of dollars each time a child goes to the ER for a allergic response, pay $10,000 for this drug to reduce those may make total sense. Also interesting that this article comes out the same day the stock is halted because the FDA review committee is meeting. You can peruse the briefing document to see what they'll be discussing.[2] [1]https://www.crunchbase.com/organization/allergen-research-corporation https://www.crunchbase.com/organization/allergen-research-co... [2]https://www.fda.gov/media/130654/download https://www.fda.gov/media/130654/download

jawns 7y ago

Obviously, the high cost of the therapy is news in and of itself, and it's very illustrative of the fact that high R&D costs need to be wrapped up in the cost of the drug, even if the drug itself costs peanuts to make. (LITERAL PEANUTS, get it?!?) But what's more worrisome is that although oral immunotherapy appears to desensitize patients to the allergen, real-world evidence shows that these people actually end up experiencing allergic reactions more frequently than those who practice strict avoidance, the article reports. Whether that's because the patients who've undergone therapy are letting their guard down, or because the drug is only semi-protective, is unknown. But the article argues that the therapy might lead to a net increase, rather than a decrease, in allergic episodes.

JohnClark1337 7y ago

"So, essentially, in order to make the therapy accessible, it has to become part of the system. The system is what allows pharmaceutical companies and doctors to charge insurers thousands of dollars for peanuts." *accessible to those who have insurance. Those who don't are SOL

junar 7y ago

One of the studies describes the exact doses: > AR101, a powder, was administered in graduated doses ... from capsules containing 0.5, 1, 10, 20, or 100 mg of peanut protein, formulated with bulking and flow agents ... Study product was consumed after opening the capsules and mixing its content into an age-appropriate, nonallergenic, vehicle food (eg, applesauce, pudding). https://www.jaci-inpractice.org/article/S2213-2198(17)30742-0/pdf https://www.jaci-inpractice.org/article/S2213-2198(17)30742-... Their website claims that 1 peanut is 250-300 mg peanut protein. https://www.aimmune.com/ar101-peanut-allergy/ https://www.aimmune.com/ar101-peanut-allergy/ So while $4,200 might be a bit high, there is probably still some value in isolating a 1/500 peanut dose.

m-p-3 7y ago

In case someone cannot get past the paywall https://ipfs.io/ipfs/QmVmaUKkcZwyWRZ5ZyK8MkxDzYPWL4dGdSLrfjNMWNWTt5/ https://ipfs.io/ipfs/QmVmaUKkcZwyWRZ5ZyK8MkxDzYPWL4dGdSLrfjN... https://cloudflare-ipfs.com/ipfs/QmVmaUKkcZwyWRZ5ZyK8MkxDzYPWL4dGdSLrfjNMWNWTt5/ https://cloudflare-ipfs.com/ipfs/QmVmaUKkcZwyWRZ5ZyK8MkxDzYP...