4 ms·

It would be far easier to regulate our prices to be the same as the average of say - Canada, the UK, Germany and Japan. We’d pay less. They’d probably need to

It would be far easier to regulate our prices to be the same as the average of say - Canada, the UK, Germany and Japan. We’d pay less. They’d probably need to pay more. It’s utterly insane how we’re essentially subsidizing drug development for the entire world.

grecy 4y ago
> It’s utterly insane how we’re essentially subsidizing drug development for the entire world I think you'll find the only thing you're subsidizing is the profits of American pharmaceutical companies and health insurance providers. Just get rid of health insurance, and spend that money on actual health care instead. It works mighty well in other countries.
- refurb 4y ago
  20% of revenue is put back in R&D on average. Cut revenue, you cut R&D. And the US is about half of all global revenue, so half of all R&D expenses. The other 95% of the global population pays the other half.
  - SonicTheSith1 4y ago
    20% goes into R&D, 30% goes into Marketing, 25% goes operating costs, 25% is profit. Since a lot of Pharma research is done at universities and is funded by the public, this holds true especially for insulin, maybe by cutting the costs of meds the companies optimise their system more. Less marketing, no Pharma people bribing doctors to use their meds etc. I bet if you cut those unnecessary jobs and expenses before touching R&D or Profit a lot can be done.
    - refurb 4y ago
      30% doesn't go into marketing. And no, most pharma research is not funded by the public (the NIH budget is 1/4 what pharma spends).
  - oblio 4y ago
    Or you know, they could, gasp cut lobbying expenses. Cut back on marketing (bribing doctors), cut back on admin overhead, cut back on... There are a million things they could cut back on. But the poor shareholders, would someone thing of the millionaires?!?
  - dmitriid 4y ago
    > 20% of revenue is put back in R&D on average. Cut revenue, you cut R&D. 34% of money spent on healthcare is administrative overhead. Cut that, and you'll still have plenty of money for R&D https://pubmed.ncbi.nlm.nih.gov/31905376/ https://pubmed.ncbi.nlm.nih.gov/31905376/
- vinay427 4y ago
  > It works mighty well in other countries. Very few countries have a single-payer system without health insurance providers, in case you're unaware. It's far from the norm in Europe and the developed world, or anywhere else for that matter. This map seems like a relatively decent source based on my spot-checking: https://worldpopulationreview.com/country-rankings/countries-with-single-payer https://worldpopulationreview.com/country-rankings/countries... This isn't necessarily an argument against it, to be clear. I think single-payer systems have certain practical benefits compared to which I quite disliked the system in the last European country in which I lived.
  - grecy 4y ago
    > Very few countries have a single-payer system without health insurance providers, in case you're unaware I lived in Australia for 23 years, and Canada for 15. Australia has single payer and universal, Canada (apparently according to your map has single payer) To be honest you're splitting hairs, and in practice it doesn't make any difference. You live in the country, you get healthcare without paying a cent out of pocket. Both of those countries spend less on healthcare per capita than the US, and both have measurably better health outcomes. So it costs less, and it's better. Why would any person not want something that is measurably better and costs less?
    - vinay427 4y ago
      > To be honest you're splitting hairs, and in practice it doesn't make any difference. This seems like a (probably unintentional, and partly due to my lack of specificity) straw man. The spectrum doesn't range from Australia to Canada, considering both offer a single payer system that covers a good amount of care, but rather from something like Switzerland to the UK/Nordics. > You live in the country, you get healthcare without paying a cent out of pocket. This is far from true in several/many of these systems, which was the point I was trying to make, but again I do believe I could have been clearer about this. My point was just that plenty of countries have healthcare systems that work well while spending money on health insurers rather than just on healthcare.
      - 4y ago
m000 4y ago
> It’s utterly insane how we’re essentially subsidizing drug development for the entire world. I'd say US should get over their lurking savior syndrome.
- krageon 4y ago
  At first reading these sentiments felt like I had stepped into some sort of horrible satire, but now I'm starting to think that maybe this is just how it is. Does the average US citizen really think this way?
  - jpgvm 4y ago
    If by average you mean approximately 50% then yes.
  - hcta 4y ago
    I guess I'm outing myself as an American here, but what exactly are you referring to by "this way", and what part of the thinking in question is distorted/inaccurate?
- oneoff786 4y ago
  How could it possibly be otherwise. If you have a bunch of drugs that are made profitable, net of r&d costs, only because of the American market, then these would never get invested in without American spending in. And remember, you can’t go pointing to single examples because you also need to consider all the funds that go into funding drugs that don’t pass clinical trials.
deleted 4y ago
[deleted]
jyounker 4y ago
Drug companies wouldn't be selling to other countries unless they made profits there. They just make absurd profits in the USA.
- nybble41 4y ago
  That's a plausible story for drugs which already exist. The problem, though, is that they wouldn't bother researching new drugs in the first place if it weren't for the prospect of those "absurd profits" in the USA, because that research would never pay off. Once they have the drug developed it makes sense to sell it wherever they can, at whatever price they can get (above COGS and overhead, of course), as profit is profit—so long as it doesn't cannibalize their much more profitable sales in the USA. If the USA were to suddenly allow retailers to import drugs at scale from other countries to reduce costs then those countries would find their supply of cheaper drugs drying up. They could either accept prices on par with those in the USA, thus eliminating the arbitrage, or simply go without.

grecy 4y ago

> It’s utterly insane how we’re essentially subsidizing drug development for the entire world I think you'll find the only thing you're subsidizing is the profits of American pharmaceutical companies and health insurance providers. Just get rid of health insurance, and spend that money on actual health care instead. It works mighty well in other countries.

refurb 4y ago
20% of revenue is put back in R&D on average. Cut revenue, you cut R&D. And the US is about half of all global revenue, so half of all R&D expenses. The other 95% of the global population pays the other half.
- SonicTheSith1 4y ago
  20% goes into R&D, 30% goes into Marketing, 25% goes operating costs, 25% is profit. Since a lot of Pharma research is done at universities and is funded by the public, this holds true especially for insulin, maybe by cutting the costs of meds the companies optimise their system more. Less marketing, no Pharma people bribing doctors to use their meds etc. I bet if you cut those unnecessary jobs and expenses before touching R&D or Profit a lot can be done.
  - refurb 4y ago
    30% doesn't go into marketing. And no, most pharma research is not funded by the public (the NIH budget is 1/4 what pharma spends).
- oblio 4y ago
  Or you know, they could, gasp cut lobbying expenses. Cut back on marketing (bribing doctors), cut back on admin overhead, cut back on... There are a million things they could cut back on. But the poor shareholders, would someone thing of the millionaires?!?
- dmitriid 4y ago
  > 20% of revenue is put back in R&D on average. Cut revenue, you cut R&D. 34% of money spent on healthcare is administrative overhead. Cut that, and you'll still have plenty of money for R&D https://pubmed.ncbi.nlm.nih.gov/31905376/ https://pubmed.ncbi.nlm.nih.gov/31905376/
vinay427 4y ago
> It works mighty well in other countries. Very few countries have a single-payer system without health insurance providers, in case you're unaware. It's far from the norm in Europe and the developed world, or anywhere else for that matter. This map seems like a relatively decent source based on my spot-checking: https://worldpopulationreview.com/country-rankings/countries-with-single-payer https://worldpopulationreview.com/country-rankings/countries... This isn't necessarily an argument against it, to be clear. I think single-payer systems have certain practical benefits compared to which I quite disliked the system in the last European country in which I lived.
- grecy 4y ago
  > Very few countries have a single-payer system without health insurance providers, in case you're unaware I lived in Australia for 23 years, and Canada for 15. Australia has single payer and universal, Canada (apparently according to your map has single payer) To be honest you're splitting hairs, and in practice it doesn't make any difference. You live in the country, you get healthcare without paying a cent out of pocket. Both of those countries spend less on healthcare per capita than the US, and both have measurably better health outcomes. So it costs less, and it's better. Why would any person not want something that is measurably better and costs less?
  - vinay427 4y ago
    > To be honest you're splitting hairs, and in practice it doesn't make any difference. This seems like a (probably unintentional, and partly due to my lack of specificity) straw man. The spectrum doesn't range from Australia to Canada, considering both offer a single payer system that covers a good amount of care, but rather from something like Switzerland to the UK/Nordics. > You live in the country, you get healthcare without paying a cent out of pocket. This is far from true in several/many of these systems, which was the point I was trying to make, but again I do believe I could have been clearer about this. My point was just that plenty of countries have healthcare systems that work well while spending money on health insurers rather than just on healthcare.
    - 4y ago

m000 4y ago

> It’s utterly insane how we’re essentially subsidizing drug development for the entire world. I'd say US should get over their lurking savior syndrome.

krageon 4y ago
At first reading these sentiments felt like I had stepped into some sort of horrible satire, but now I'm starting to think that maybe this is just how it is. Does the average US citizen really think this way?
- jpgvm 4y ago
  If by average you mean approximately 50% then yes.
- hcta 4y ago
  I guess I'm outing myself as an American here, but what exactly are you referring to by "this way", and what part of the thinking in question is distorted/inaccurate?
oneoff786 4y ago
How could it possibly be otherwise. If you have a bunch of drugs that are made profitable, net of r&d costs, only because of the American market, then these would never get invested in without American spending in. And remember, you can’t go pointing to single examples because you also need to consider all the funds that go into funding drugs that don’t pass clinical trials.

deleted 4y ago

[deleted]

jyounker 4y ago

Drug companies wouldn't be selling to other countries unless they made profits there. They just make absurd profits in the USA.

nybble41 4y ago
That's a plausible story for drugs which already exist. The problem, though, is that they wouldn't bother researching new drugs in the first place if it weren't for the prospect of those "absurd profits" in the USA, because that research would never pay off. Once they have the drug developed it makes sense to sell it wherever they can, at whatever price they can get (above COGS and overhead, of course), as profit is profit—so long as it doesn't cannibalize their much more profitable sales in the USA. If the USA were to suddenly allow retailers to import drugs at scale from other countries to reduce costs then those countries would find their supply of cheaper drugs drying up. They could either accept prices on par with those in the USA, thus eliminating the arbitrage, or simply go without.