3 ms·

"Obviously." I like how this is the argument for drug patents, and if you don't just simply agree with this, the only real other option is to accuse the person

by yebyen 3y ago

"Obviously." I like how this is the argument for drug patents, and if you don't just simply agree with this, the only real other option is to accuse the person arguing that it "obviously" is the right decision of arguing in bad faith. ...because it's an argument in bad faith? I too don't see why drug patents are "obvious" or clear case that it is helpful enough to be in the public interest to maintain drug patents. Is there any evidence that drug patents can actually enter the public domain productively at their end of their expiration period? I mean, if James Collip and Charles Best sold the insulin patent to the University of Toronto for a mere $1 each, "so that everyone could have it" and we still don't have universal low-cost insulin over 100 years later, and prices continue to skyrocket, I'm more inclined to believe that for-profit medicine is just evil.

CodesInChaos 3y ago
I believe the original insulin is cheaply available. But newer, faster acting, variants which are easier to administer are still patented.
- yebyen 3y ago
  I don't know much about it honestly, but this article that talks about PBMs is very interesting: https://publichealth.jhu.edu/2023/eli-lilly-lowers-insulin-prices https://publichealth.jhu.edu/2023/eli-lilly-lowers-insulin-p... > “Even though they're dropping their list price by 70% and capping their cost to patients at $35, it’s important for us to make this very, very clear—the company is still making a profit,” ... > During a 2019 congressional hearing, insulin makers admitted that there’s pressure to keep list prices high so that PBMs can also profit. > PBMs favor the drugs that will yield them higher profits. By lowering prices, Lilly runs the risk of being excluded from formularies, meaning the insurance companies will no longer cover the product for their patients.
AlbertCory 3y ago
> Is there any evidence that drug patents can actually enter the public domain productively at their end of their expiration period? Practically all generic drugs are available because the original drug is off-patent. You picked one (insulin) and ignored all the others: https://www.healthgrades.com/right-care/patient-advocate/drugs-going-generic-in-2023 https://www.healthgrades.com/right-care/patient-advocate/dru...
- yebyen 3y ago
  I picked the one that was donated on purpose by its creators though, and it's still making profits for the drug companies 100 years later. So why do we need patents, then? From the page you linked: > While these drugs are nearing the end of their patent term, the release of generics may be delayed due to litigation, acquisitions, or other exclusivities. As a result, some expected generics from previous years may still be in progress. The point about the PBMs is that apparently, drugs have to be profitable or they are not made anymore. So even the generic companies need to position themselves in a way where their products are profitable, not only for them but for the insurance (or they will be dropped by formularies, and nobody's insurance will cover it.) If patents are the only way for firms to protect the profitability of their drugs then we are doomed. I picked one, sure, and you provided a list as counter-example. But the FDA also ships its own list... of off-patent approved drugs without an approved generic (and the current publication is a full 16 pages of drug names): https://www.fda.gov/drugs/abbreviated-new-drug-application-anda/list-patent-exclusivity-drugs-without-approved-generic https://www.fda.gov/drugs/abbreviated-new-drug-application-a... If the pharma companies can make a change to the formula so that the new formula of a drug is no longer covered by the original patent, they can get a new patent. I'm not an expert, but this is how I've understood the problem through reading about it. Yes, we have generics, but what doctor will prescribe "worse-pirin" when there's a better aspirin on the market now? What insurance company will cover it? So, with 20 years of head start and a deep war chest, the companies you mentioned can all iterate, stop research on the previous drug, put up legal roadblocks in the way of their competition, put out a new drug which cannot be copied, while it costs a lot of money (and time) for competition to get their generic form of the drug tested and approved. It's not as automatic as the term "patent cliff" might suggest. I'm just saying that the intent of patents in general is for innovations to enter the public domain after the period of exclusivity on the idea that enables their creators to enjoy profitability and a legally protected (temporary) monopoly on the idea. It seems like a fair question to ask, is that really what's happening? (What percent of time does it happen like that, what percent of time does it go down some other way?)
  - AlbertCory 3y ago
    First of all, you made a general statement and I demonstrated its falsity. Now you're changing the subject to, "Oh, but not all patented drugs become generics." I never said they did. However, there are giant companies that do almost nothing but generics, like Teva, so obviously lots of generics exist: https://www.tevapharm.com/our-company/teva-facts-figures/ https://www.tevapharm.com/our-company/teva-facts-figures/ As for "what doctor will prescribe "worse-pirin" when there's a better aspirin on the market now? What insurance company will cover it?" nearly all insurance companies require a generic to be used unless there's a very strong reason to use the branded product. In your example, if the new drug genuinely is better, then the patients deserve to have it. If it's a trivial improvement then it won't get approved.

by yebyen 3y ago

CodesInChaos 3y ago

I believe the original insulin is cheaply available. But newer, faster acting, variants which are easier to administer are still patented.

yebyen 3y ago
I don't know much about it honestly, but this article that talks about PBMs is very interesting: https://publichealth.jhu.edu/2023/eli-lilly-lowers-insulin-prices https://publichealth.jhu.edu/2023/eli-lilly-lowers-insulin-p... > “Even though they're dropping their list price by 70% and capping their cost to patients at $35, it’s important for us to make this very, very clear—the company is still making a profit,” ... > During a 2019 congressional hearing, insulin makers admitted that there’s pressure to keep list prices high so that PBMs can also profit. > PBMs favor the drugs that will yield them higher profits. By lowering prices, Lilly runs the risk of being excluded from formularies, meaning the insurance companies will no longer cover the product for their patients.

AlbertCory 3y ago

> Is there any evidence that drug patents can actually enter the public domain productively at their end of their expiration period? Practically all generic drugs are available because the original drug is off-patent. You picked one (insulin) and ignored all the others: https://www.healthgrades.com/right-care/patient-advocate/drugs-going-generic-in-2023 https://www.healthgrades.com/right-care/patient-advocate/dru...

yebyen 3y ago
I picked the one that was donated on purpose by its creators though, and it's still making profits for the drug companies 100 years later. So why do we need patents, then? From the page you linked: > While these drugs are nearing the end of their patent term, the release of generics may be delayed due to litigation, acquisitions, or other exclusivities. As a result, some expected generics from previous years may still be in progress. The point about the PBMs is that apparently, drugs have to be profitable or they are not made anymore. So even the generic companies need to position themselves in a way where their products are profitable, not only for them but for the insurance (or they will be dropped by formularies, and nobody's insurance will cover it.) If patents are the only way for firms to protect the profitability of their drugs then we are doomed. I picked one, sure, and you provided a list as counter-example. But the FDA also ships its own list... of off-patent approved drugs without an approved generic (and the current publication is a full 16 pages of drug names): https://www.fda.gov/drugs/abbreviated-new-drug-application-anda/list-patent-exclusivity-drugs-without-approved-generic https://www.fda.gov/drugs/abbreviated-new-drug-application-a... If the pharma companies can make a change to the formula so that the new formula of a drug is no longer covered by the original patent, they can get a new patent. I'm not an expert, but this is how I've understood the problem through reading about it. Yes, we have generics, but what doctor will prescribe "worse-pirin" when there's a better aspirin on the market now? What insurance company will cover it? So, with 20 years of head start and a deep war chest, the companies you mentioned can all iterate, stop research on the previous drug, put up legal roadblocks in the way of their competition, put out a new drug which cannot be copied, while it costs a lot of money (and time) for competition to get their generic form of the drug tested and approved. It's not as automatic as the term "patent cliff" might suggest. I'm just saying that the intent of patents in general is for innovations to enter the public domain after the period of exclusivity on the idea that enables their creators to enjoy profitability and a legally protected (temporary) monopoly on the idea. It seems like a fair question to ask, is that really what's happening? (What percent of time does it happen like that, what percent of time does it go down some other way?)
- AlbertCory 3y ago
  First of all, you made a general statement and I demonstrated its falsity. Now you're changing the subject to, "Oh, but not all patented drugs become generics." I never said they did. However, there are giant companies that do almost nothing but generics, like Teva, so obviously lots of generics exist: https://www.tevapharm.com/our-company/teva-facts-figures/ https://www.tevapharm.com/our-company/teva-facts-figures/ As for "what doctor will prescribe "worse-pirin" when there's a better aspirin on the market now? What insurance company will cover it?" nearly all insurance companies require a generic to be used unless there's a very strong reason to use the branded product. In your example, if the new drug genuinely is better, then the patients deserve to have it. If it's a trivial improvement then it won't get approved.