4 ms·

The only reason it costs millions to treat cancer patients is because of medical patents allowing companies to extract profit margins of several thousand percen

The only reason it costs millions to treat cancer patients is because of medical patents allowing companies to extract profit margins of several thousand percent (or more). In countries like Australia, where drug companies have to negotiate a fair price with a single government agency, the cost of treatment is an order of magnitude lower.

fastball 6y ago
This is not true. MRI machines are not expensive because of "patents". They are expensive because they are expensive devices that utilize superconducting magnets which need a constant supply of liquid helium. Various drugs are expensive because (regardless of patents) there aren't enough patients to justify mass-production, so the price stays high. Sometimes even with mass production drugs are hard enough to make that the price still stays high. Doctors are not cheap to train, so their services will always be expensive until we replace them with robots. There are a plethora of reasons why medicine and healthcare is expensive beyond "patents" – remove patents from the equation and you can still easily spend millions per patient for various diseases.
- jpetso 6y ago
  For diseases where there are just a handful of patients requiring sky-high treatment prices, it would be worth investigating whether society can spread their costs among enough people that the costs are bearable anyway. And 10 people yearly requiring a $10m (each) specialized treatment would cost a population of 100 million taxpayers a dollar each. Of course, if these treatments are more common at the same price, the social costs might be too high and we'd have to let people live or die depending on their financial situation or ability to fundraise.
- cpach 6y ago
  Good point. Not only are physicians needed, nurses are needed as well. They might be cheaper to train and hire compared to physicians – OTOH, there are more of the them and the numbers add up. Not all diseases can be cured by simply taking a pill.
  - michaelmrose 6y ago
    Doctors aren't paid as much outside of the US. It turns out skilled and intelligent people will do skilled labor for only 3 times what a grocery clerk makes instead of 30
    - fifteenforty 6y ago
      We also don’t have the stress of bankrupting our patients. For all the difficulties we face at work; in public practice we are more worried about the parking fee for our elderly patients than the cost of treatment.
- chadcmulligan 6y ago
  But millions per patient is the exception, most people don't have that spent on them, thats why it averages out, and why countries like Australia can afford public health care.
  - fastball 6y ago
    So Australia does not have any caps whatsoever on what they will spend for disease X?
    - angry_octet 6y ago
      We spend far more money on widely prescribed drugs like statins. The most expensive drugs are rarely needed by many people. The big one recently is a drug to treat Hep C, at about A$22000 a patient (but possibly saving years of dialysis) and a macular degeneration treatment (what price do you put in vision?). https://www.abc.net.au/news/health/2020-12-01/australias-most-commonly-prescribed-medicines-statins/12936626 https://www.abc.net.au/news/health/2020-12-01/australias-mos... From someone on the PBSAC: https://www.nps.org.au/australian-prescriber/articles/the-challenge-of-costly-drugs https://www.nps.org.au/australian-prescriber/articles/the-ch... It isn't so much the cost, but whether they actually work, or are any better than other treatments.
    - chadcmulligan 6y ago
      Not that I know of, medications make their way onto the Pharmaceutical Benefits schedule (PBS) schedule, so some new drugs aren't available for a short time - as someone else mentioned the government negotiates a fixed price for the drugs. You have to pay for drugs but there's a yearly cap of a few hundred dollars last time I was involved in it and you can claim that back, pensioners have a special low price per drug. There are some drugs that require the doctor to make a case for it - but thats a fairy routine matter. You do hear of people flying overseas for a special treatment (mainly experimental) thats not yet here, that isn't covered. Edit: an example - I had a checkup last year, got a bunch of tests done - total out of pocket for me was $30 or so, all the blood tests are free. The $30 was for the doctor, if I wanted to shop around there are free doctors that just charge the schedule price. I had to get an MRI about 7 years ago, now I could have waited, or got it in the hospital, but I chose to get it at a clinic, cause I wanted to get out of the hospital (which was free) - out of pocket was $800 for that.
- oneplane 6y ago
  How is it not true? Prices being high or things being expensive (both subjective terms that are hardly useful in this context) aren't a universal truth. Generally, a nation-organised and at least partially managed medial healthcare system costs less and delivers better results than a free-for-all corporations-decide system.
  - fastball 6y ago
    It's not true because it's not true. "Cheaper" =/= "cheap".
- AussieWog93 6y ago
  The comment about drug prices isn't some theoretical supply-and-demand problem. Go to chemistwarehouse.com.au (popular Australian chemist) and just type in the name of your favourite prescription drug. The "private prescription price" is the un-subsidised cost that people not covered by Medicare (e.g. foreign residents) pay. The discounted PBS price is what regular residents pay, the concession price is for people on low incomes or pensions. Even un-subsidised, you're typically looking at a price 80% lower than what people in the US pay. With subsidies, it's closer to 90-95% less. This has nothing to do with manufacturing costs - manufacturing in Australia is more expensive. It's entirely because our government doesn't allow pharmaceutical companies to profiteer from their IP to the obscene extent that the US government does, and we've had a right-leaning government for 19 out of the last 25 years.
- fifteenforty 6y ago
  In Australia, we treat this very differently. My training as an anaesthesiologist has cost the taxpayer roughly 2 million AUD from medical school to specialist qualification. The direct cost to me? About $75,000 AUD. Some treatments are expensive and futile. We aren’t compelled to offer them. We do have to prioritise treatments and triage patients, resources are not unlimited. By the same token, no-one is denied care on the basis of age or ability. Many patients suffer from too much medical intervention, and I am extremely grateful that I almost never feel compelled to perform treatments that don’t benefit patients.
hansvm 6y ago
Ha, immediately on reading the parent comment I was pretty sure somebody would have exactly this response. So yes you have a point in that especially in the US the dollar amounts attached to treatments aren't necessarily indicative of the effort involved. Treating their argument charitably though, as a species we have finite capacity, and "spend millions per patient" is a linguistic shorthand for "we don't have enough resources to evenly distribute this level of care to everyone." That argument isn't infallible (e.g., it's pretty easy to get a majority to agree on upper and lower bounds for such an idea, so picking a number in between might still be reasonable), but it's much more interesting to pick apart the thing they're trying to say rather than the exact words they used.

fastball 6y ago

This is not true. MRI machines are not expensive because of "patents". They are expensive because they are expensive devices that utilize superconducting magnets which need a constant supply of liquid helium. Various drugs are expensive because (regardless of patents) there aren't enough patients to justify mass-production, so the price stays high. Sometimes even with mass production drugs are hard enough to make that the price still stays high. Doctors are not cheap to train, so their services will always be expensive until we replace them with robots. There are a plethora of reasons why medicine and healthcare is expensive beyond "patents" – remove patents from the equation and you can still easily spend millions per patient for various diseases.

jpetso 6y ago
For diseases where there are just a handful of patients requiring sky-high treatment prices, it would be worth investigating whether society can spread their costs among enough people that the costs are bearable anyway. And 10 people yearly requiring a $10m (each) specialized treatment would cost a population of 100 million taxpayers a dollar each. Of course, if these treatments are more common at the same price, the social costs might be too high and we'd have to let people live or die depending on their financial situation or ability to fundraise.
cpach 6y ago
Good point. Not only are physicians needed, nurses are needed as well. They might be cheaper to train and hire compared to physicians – OTOH, there are more of the them and the numbers add up. Not all diseases can be cured by simply taking a pill.
- michaelmrose 6y ago
  Doctors aren't paid as much outside of the US. It turns out skilled and intelligent people will do skilled labor for only 3 times what a grocery clerk makes instead of 30
  - fifteenforty 6y ago
    We also don’t have the stress of bankrupting our patients. For all the difficulties we face at work; in public practice we are more worried about the parking fee for our elderly patients than the cost of treatment.
chadcmulligan 6y ago
But millions per patient is the exception, most people don't have that spent on them, thats why it averages out, and why countries like Australia can afford public health care.
- fastball 6y ago
  So Australia does not have any caps whatsoever on what they will spend for disease X?
  - angry_octet 6y ago
    We spend far more money on widely prescribed drugs like statins. The most expensive drugs are rarely needed by many people. The big one recently is a drug to treat Hep C, at about A$22000 a patient (but possibly saving years of dialysis) and a macular degeneration treatment (what price do you put in vision?). https://www.abc.net.au/news/health/2020-12-01/australias-most-commonly-prescribed-medicines-statins/12936626 https://www.abc.net.au/news/health/2020-12-01/australias-mos... From someone on the PBSAC: https://www.nps.org.au/australian-prescriber/articles/the-challenge-of-costly-drugs https://www.nps.org.au/australian-prescriber/articles/the-ch... It isn't so much the cost, but whether they actually work, or are any better than other treatments.
  - chadcmulligan 6y ago
    Not that I know of, medications make their way onto the Pharmaceutical Benefits schedule (PBS) schedule, so some new drugs aren't available for a short time - as someone else mentioned the government negotiates a fixed price for the drugs. You have to pay for drugs but there's a yearly cap of a few hundred dollars last time I was involved in it and you can claim that back, pensioners have a special low price per drug. There are some drugs that require the doctor to make a case for it - but thats a fairy routine matter. You do hear of people flying overseas for a special treatment (mainly experimental) thats not yet here, that isn't covered. Edit: an example - I had a checkup last year, got a bunch of tests done - total out of pocket for me was $30 or so, all the blood tests are free. The $30 was for the doctor, if I wanted to shop around there are free doctors that just charge the schedule price. I had to get an MRI about 7 years ago, now I could have waited, or got it in the hospital, but I chose to get it at a clinic, cause I wanted to get out of the hospital (which was free) - out of pocket was $800 for that.
oneplane 6y ago
How is it not true? Prices being high or things being expensive (both subjective terms that are hardly useful in this context) aren't a universal truth. Generally, a nation-organised and at least partially managed medial healthcare system costs less and delivers better results than a free-for-all corporations-decide system.
- fastball 6y ago
  It's not true because it's not true. "Cheaper" =/= "cheap".
AussieWog93 6y ago
The comment about drug prices isn't some theoretical supply-and-demand problem. Go to chemistwarehouse.com.au (popular Australian chemist) and just type in the name of your favourite prescription drug. The "private prescription price" is the un-subsidised cost that people not covered by Medicare (e.g. foreign residents) pay. The discounted PBS price is what regular residents pay, the concession price is for people on low incomes or pensions. Even un-subsidised, you're typically looking at a price 80% lower than what people in the US pay. With subsidies, it's closer to 90-95% less. This has nothing to do with manufacturing costs - manufacturing in Australia is more expensive. It's entirely because our government doesn't allow pharmaceutical companies to profiteer from their IP to the obscene extent that the US government does, and we've had a right-leaning government for 19 out of the last 25 years.
fifteenforty 6y ago
In Australia, we treat this very differently. My training as an anaesthesiologist has cost the taxpayer roughly 2 million AUD from medical school to specialist qualification. The direct cost to me? About $75,000 AUD. Some treatments are expensive and futile. We aren’t compelled to offer them. We do have to prioritise treatments and triage patients, resources are not unlimited. By the same token, no-one is denied care on the basis of age or ability. Many patients suffer from too much medical intervention, and I am extremely grateful that I almost never feel compelled to perform treatments that don’t benefit patients.

hansvm 6y ago

Ha, immediately on reading the parent comment I was pretty sure somebody would have exactly this response. So yes you have a point in that especially in the US the dollar amounts attached to treatments aren't necessarily indicative of the effort involved. Treating their argument charitably though, as a species we have finite capacity, and "spend millions per patient" is a linguistic shorthand for "we don't have enough resources to evenly distribute this level of care to everyone." That argument isn't infallible (e.g., it's pretty easy to get a majority to agree on upper and lower bounds for such an idea, so picking a number in between might still be reasonable), but it's much more interesting to pick apart the thing they're trying to say rather than the exact words they used.