4 ms·

Comparison with Japan: 1. The price of drugs are regulated. There is no chance such a bullshit drug just combining OTC ingredients are allowed to be sold with

by ezoe 4y ago

Comparison with Japan: 1. The price of drugs are regulated. There is no chance such a bullshit drug just combining OTC ingredients are allowed to be sold with such a high price. 2. Since there is no bullshit expensive drugs, doctors don't need to worry about it. Rebate is prohibited, but even if it exists, you can't prescribe the drugs you can't use. 3. I'm not sure about the quality of pharmacy in Japan but they regularly call doctor when they have concerns about the prescription and they switch to generic drugs on default unless patient strongly object not to. 4. Universal Health Care. The govt regulate the insurance so it's either all covered by insurance or nothing.

tomcam 4y ago
How many new drugs is Japan developing? From what I can tell, a fraction of what we do. The free market is pretty damn good at that.
- toomuchtodo 4y ago
  The US pays the most for healthcare for worse outcomes. Free market not doing so great. An expensive new drug is not necessarily an effective drug, nor is a free market required to innovate. The US imports a very effective lung cancer immunotherapy vaccine from Cuba, for example (CIMAvax EGF). https://khn.org/news/article/medicare-ruling-aduhelm-controversial-alzheimer-drug-critics/ https://khn.org/news/article/medicare-ruling-aduhelm-controv... https://hbr.org/2021/10/the-u-s-can-lower-drug-prices-without-sacrificing-innovation https://hbr.org/2021/10/the-u-s-can-lower-drug-prices-withou... https://en.wikipedia.org/wiki/CimaVax-EGF https://en.wikipedia.org/wiki/CimaVax-EGF
- rentfree-media 4y ago
  If it's so good at it, why does it always need government funding? (As testified before a congressional committee by an FDA official, his response to the question of "how many drugs receive government research funding?" was "all of them.")
  - ekianjo 4y ago
    > why does it always need government funding? Where is the "always" coming from? Check actual clinical trials registries and you will see that most clinical trials are not funded by the government.
    - salawat 4y ago
      Not all clinical trials are done just to get approval to sell. Some are exploratory, or to create datasets for meta-analysis/other research.
      - ekianjo 4y ago
        Previous post mentioned "always" and your answer is "some", so I guess my point was right?
        rentfree-media 4y ago
        > so I guess my point was right? No, it was not. US Tax Dollars Funded Every New Pharmaceutical in the Last Decade: https://www.ineteconomics.org/perspectives/blog/us-tax-dollars-funded-every-new-pharmaceutical-in-the-last-decade https://www.ineteconomics.org/perspectives/blog/us-tax-dolla... How many new drugs rely on government-funded science? All of them: https://www.cbc.ca/news/health/drugs-government-funded-science-1.4547640 https://www.cbc.ca/news/health/drugs-government-funded-scien...
        ekianjo 4y ago
        That's a very biased way of looking at things, because you don't seem to understand how the research is organized in the first place. The industry works all the time with academics. Academics do the fundamental science labor, which means identifying new targets, new pathways, new proteins and so on. This kind of research is indeed usually funded by a combination of public and private grants. Most of that research leads to nothing in the end, by the way - not everything they produce is picked up by the pharma industry, because most of what they produce fails to give results - that's the inherent property of doing fundamental research. Then the industry purchases/licenses (and patents) what is considered to have the largest commercial potential - then pre-clinical, phase 1 up to phase 3 are mostly funded by the pharma industry. This is also where the bulk of the cost is. A clinical trial in phase 3 can costs in the dozens of millions of dollars, and there's always a solid chance that it fails to meet its endpoints so the risk is far from nil. Based on the NIH numbers, the funding for research (i.e. grants) is about 45 billions annually. At the same time, the pharma industry spends 87 billions per year on R&D, which is about twice more.
- willcipriano 4y ago
  Those drugs still get sold in Japan. It's just the American patient/taxpayer who gets the honor of paying for it.
- _heimdall 4y ago
  The important metric here ahould be average health of the population, not total number of new drugs developed. I dont have those stats handy, but given how unhealtht the American population is as a whole I dont expect that we'd end up on the better end of that comparison.
- resoluteteeth 4y ago
  > How many new drugs is Japan developing? From what I can tell, a fraction of what we do. The free market is pretty damn good at that. Japan actually has a bunch of fairly major pharma companies that develop a lot of new drugs. You just don't hear their names in the US because the drugs get licensed to other companies when they're sold in the US and you only hear the name of the company that licensed them, but there are plenty of drugs that are commonly described in the US that were developed by Japanese pharma companies. Local drug price regulations actually don't necessarily affect drug companies in a given country that much for this reason (they don't just develop drugs for the domestic market, and licensing to other countries to sell internationally is pretty much the norm). However, in the case of the US it seems like the US pays a disproportionate amount of the total costs so it's possible that US drug price controls would affect pharma companies worldwide more than other countries' drug price controls. I'm not sure whether or not this can really be described as the free market doing a good job or not since the location where drugs are developed doesn't really affect their availability in other countries.
ekianjo 4y ago
> 1. The price of drugs are regulated. There is no chance such a bullshit drug just combining OTC ingredients are allowed to be sold with such a high price. Wrong, the drug pricing in Japan is not based on the ingredients itself, it's based on what you can prove as an indication for a specific disease. Does not matter if you can mix off the shelf drugs to get the same drug. For example there are painkillers with prescriptions that contain the same drug than the OTC versions but are sold at a more expensive price. > Since there is no bullshit expensive drugs, You seem to have no idea what you are talking about, sorry, There are drugs that cost more than 1000 dollars per injection in Japan as well, and that are reimbursed. Oncology is full of such drugs, look at the highest pharma revenues in Japan, they are all coming from companies focusing on oncology. > Rebate is prohibited Rebate is happening between wholesalers and hospitals, and it's not unusual, it's the de-facto mode of operation in Japan. > they switch to generic drugs on default unless patient strongly object not to. Depends, if the doctor has prescribe the drug with the commercial name the pharmacist can't switch you to a generic. And generics are not equivalent to the original drug - the formulation matters, not just the active ingredient. > The govt regulate the insurance so it's either all covered by insurance or nothing You still have to pay out of pocket in Japan, while it&'s a fraction of the total cost (30% for regular employees, 10% for elderly people). It can still get fairly expensive if you add hospital nights and all. That's why you also have additional private insurances in Japan to get higher levels of reimbursement.

by ezoe 4y ago

tomcam 4y ago

How many new drugs is Japan developing? From what I can tell, a fraction of what we do. The free market is pretty damn good at that.

toomuchtodo 4y ago
The US pays the most for healthcare for worse outcomes. Free market not doing so great. An expensive new drug is not necessarily an effective drug, nor is a free market required to innovate. The US imports a very effective lung cancer immunotherapy vaccine from Cuba, for example (CIMAvax EGF). https://khn.org/news/article/medicare-ruling-aduhelm-controversial-alzheimer-drug-critics/ https://khn.org/news/article/medicare-ruling-aduhelm-controv... https://hbr.org/2021/10/the-u-s-can-lower-drug-prices-without-sacrificing-innovation https://hbr.org/2021/10/the-u-s-can-lower-drug-prices-withou... https://en.wikipedia.org/wiki/CimaVax-EGF https://en.wikipedia.org/wiki/CimaVax-EGF
rentfree-media 4y ago
If it's so good at it, why does it always need government funding? (As testified before a congressional committee by an FDA official, his response to the question of "how many drugs receive government research funding?" was "all of them.")
- ekianjo 4y ago
  > why does it always need government funding? Where is the "always" coming from? Check actual clinical trials registries and you will see that most clinical trials are not funded by the government.
  - salawat 4y ago
    Not all clinical trials are done just to get approval to sell. Some are exploratory, or to create datasets for meta-analysis/other research.
    - ekianjo 4y ago
      Previous post mentioned "always" and your answer is "some", so I guess my point was right?
      - rentfree-media 4y ago
        > so I guess my point was right? No, it was not. US Tax Dollars Funded Every New Pharmaceutical in the Last Decade: https://www.ineteconomics.org/perspectives/blog/us-tax-dollars-funded-every-new-pharmaceutical-in-the-last-decade https://www.ineteconomics.org/perspectives/blog/us-tax-dolla... How many new drugs rely on government-funded science? All of them: https://www.cbc.ca/news/health/drugs-government-funded-science-1.4547640 https://www.cbc.ca/news/health/drugs-government-funded-scien...
        ekianjo 4y ago
        That's a very biased way of looking at things, because you don't seem to understand how the research is organized in the first place. The industry works all the time with academics. Academics do the fundamental science labor, which means identifying new targets, new pathways, new proteins and so on. This kind of research is indeed usually funded by a combination of public and private grants. Most of that research leads to nothing in the end, by the way - not everything they produce is picked up by the pharma industry, because most of what they produce fails to give results - that's the inherent property of doing fundamental research. Then the industry purchases/licenses (and patents) what is considered to have the largest commercial potential - then pre-clinical, phase 1 up to phase 3 are mostly funded by the pharma industry. This is also where the bulk of the cost is. A clinical trial in phase 3 can costs in the dozens of millions of dollars, and there's always a solid chance that it fails to meet its endpoints so the risk is far from nil. Based on the NIH numbers, the funding for research (i.e. grants) is about 45 billions annually. At the same time, the pharma industry spends 87 billions per year on R&D, which is about twice more.
willcipriano 4y ago
Those drugs still get sold in Japan. It's just the American patient/taxpayer who gets the honor of paying for it.
_heimdall 4y ago
The important metric here ahould be average health of the population, not total number of new drugs developed. I dont have those stats handy, but given how unhealtht the American population is as a whole I dont expect that we'd end up on the better end of that comparison.
resoluteteeth 4y ago
> How many new drugs is Japan developing? From what I can tell, a fraction of what we do. The free market is pretty damn good at that. Japan actually has a bunch of fairly major pharma companies that develop a lot of new drugs. You just don't hear their names in the US because the drugs get licensed to other companies when they're sold in the US and you only hear the name of the company that licensed them, but there are plenty of drugs that are commonly described in the US that were developed by Japanese pharma companies. Local drug price regulations actually don't necessarily affect drug companies in a given country that much for this reason (they don't just develop drugs for the domestic market, and licensing to other countries to sell internationally is pretty much the norm). However, in the case of the US it seems like the US pays a disproportionate amount of the total costs so it's possible that US drug price controls would affect pharma companies worldwide more than other countries' drug price controls. I'm not sure whether or not this can really be described as the free market doing a good job or not since the location where drugs are developed doesn't really affect their availability in other countries.

ekianjo 4y ago

> 1. The price of drugs are regulated. There is no chance such a bullshit drug just combining OTC ingredients are allowed to be sold with such a high price. Wrong, the drug pricing in Japan is not based on the ingredients itself, it's based on what you can prove as an indication for a specific disease. Does not matter if you can mix off the shelf drugs to get the same drug. For example there are painkillers with prescriptions that contain the same drug than the OTC versions but are sold at a more expensive price. > Since there is no bullshit expensive drugs, You seem to have no idea what you are talking about, sorry, There are drugs that cost more than 1000 dollars per injection in Japan as well, and that are reimbursed. Oncology is full of such drugs, look at the highest pharma revenues in Japan, they are all coming from companies focusing on oncology. > Rebate is prohibited Rebate is happening between wholesalers and hospitals, and it's not unusual, it's the de-facto mode of operation in Japan. > they switch to generic drugs on default unless patient strongly object not to. Depends, if the doctor has prescribe the drug with the commercial name the pharmacist can't switch you to a generic. And generics are not equivalent to the original drug - the formulation matters, not just the active ingredient. > The govt regulate the insurance so it's either all covered by insurance or nothing You still have to pay out of pocket in Japan, while it&'s a fraction of the total cost (30% for regular employees, 10% for elderly people). It can still get fairly expensive if you add hospital nights and all. That's why you also have additional private insurances in Japan to get higher levels of reimbursement.