8 ms·

Indian drug company slashes crucial medicine prices by 76%

170 points by heroic 14y ago

melling 14y ago
I'm not really sure how I should feel about this. I'd like medicine to be affordable by everyone. However, what I mainly get out of the article is that a company with little or no R&D is simply reducing the price on drugs, which for them is mostly profit anyway. The drugs themselves are cheap to produce, right? Somehow, I think we'd all benefit if we could get these companies involved in developing better medicines. Maybe reduce the price by 50% then take that additional pool of money and invest it into research within India, for example. Another idea...We always hear how great the IIT's are, which I believe they are. Let's turn them into great research universities. [Update] It's interesting to see my post get upvoted and downvoted, which most won't see. My suggestions don't really seem that divisive. I simply think getting more people working on the problem with funding from existing sales seems like a better idea than just reducing drug costs. Additionally, I think involving other institutions rather than sending the money back to Big Pharma, might provide different insights into solving the problems.
- kiba 14y ago
  Throwing money at the problem may not necessarily speed up research or give us more results.
  - pyre 14y ago
    How else would you pay for top-calibur talent to sold the problem?
    - bilbo0s 14y ago
      I believe what kiba is intimating is that no matter how much you pay... some drugs and diseases are just hard to come up with solutions for. To give an example everyone is fairly familiar with... even if you paid USD100 Million per research position to get a cancer vaccine, I'm not certain you would get it any faster than if you paid USD200000 per position. Or USD100000. It's just REALLY hard to come up with.
      - melling 14y ago
        But what I was suggesting was putting more people on the problem, not offering more per position. In fact, the research done in India would cost less than in the US.
    - kiba 14y ago
      Figure out a way to speed up the research process itself. We can't afford to wait 10 to 20 years. Many lives will be lost during those time period. Yes, research take time. Yes, medical research is extraordinary hard. It still doesn't excuse our slowness. We need to look at fighting diseases as a war, not a scientific exploration project. Science is good, but solutions are better. We don't need to understand in extreme details how cancer work, we just need a way to defeat cancer.
      - melling 14y ago
        Add more cores or make the existing ones faster? I said add more cores. If you can think of a way to make each core faster, that's great. In the meantime, getting more people on the problem should help. [Update] Please include include links that discuss the "better" method that you are describing. It sounds like you just want to "reinvent/disrupt" the process without actually having a plan.
        kiba 14y ago
        You should instead dedicate newer core into process optimization. We want to find a cure in 9 years, then 8 years, 7 years, 6 years, and so on. With each passing year, medical research should be progressing even faster. We don't want to wait ten years for a slightly higher chance of a cure appearing. We want a higher chance of a cure in a much shorter time period. Please include include links that discuss the "better" method that you are describing. It sounds like you just want to "reinvent/disrupt" the process without actually having a plan. It's not a "plan", or a "method". It's a goal. You could start with a small. Figure out what people are doing that should be done by robots or computers. What mistakes people are making that delay the whole research process? Are the bureaucrats holding up the approval for no good reason? How much time you spent fighting politics versus getting things done? The key insight is this: Speeds absolutely matter in medicine. One more day you wait for a cure, somebody die. If speed is not one of your nation's research goal, it should be.
        SoftwareMaven 14y ago
        This sounds like a very naive view of biological systems. The complexity of the most complex thing computer science has created (I would argue that is the Internet) is still trivially simple compared to the brain. What that means is the search space is huge, much larger than any space I've dealt with in computer science. However, there may be something to what you are saying (I don't know enough about medical research to know whether they are already doing this or not). In public key cryptography, you have a huge key space to try if you want to brute force a key (2^64 for a 64 bit key, unsurprisingly). However, you can break a 64 bit key in about 2^40 operations if you use the right technique [1]. Are we spending enough time looking for those techniques? I certainly hope so. There are a lot of smart people in medicine. 1. http://en.wikipedia.org/wiki/Meet-in-the-middle_attack http://en.wikipedia.org/wiki/Meet-in-the-middle_attack
    - pradocchia 14y ago
      That's a fashionable yet very narrow framing of the matter. If you insist on this formulation, then indeed many many problems are insoluble.
- mnazim 14y ago
  IITs have failed to deliver in research and development. In my very humble opinion, they have transformed in glorified employment exchanges main emphasis being on fetching a 7 figure paycheck after 4 years.
  - melling 14y ago
    I still think the opportunity is there. I've seen several specials on the IITs, and they are a very well respected institution both in and out India. In addition, I think people generally realize that the educational system should offer more. I'll offer up Aamir Khan and friends as anecdotal evidence. :-) Great movie. http://en.wikipedia.org/wiki/3_Idiots http://en.wikipedia.org/wiki/3_Idiots
    - mayanksinghal 14y ago
      I actually hated that movie. While the message that 'One should pursue his/her own dream' was neat, the portrayal was bad. It showed that Engineering education in India sucks largely because of orthodox bad teachers who lack vision. It portrayed it is alright to play bad hurtful pranks (though a joke, but unfortunately immaturity is still prevails in college students). The professors were shown in such bad light and without any emotions that even suicides don't make them change their facial expressions. They really took it to the extreme, it was sad because it might have demotivated some people.
      - denzil_correa 14y ago
        > It showed that Engineering education in India sucks largely because of orthodox bad teachers who lack vision. And pray, you being from IIT what makes you qualified enough to show this statement is wrong? I'm not saying the portrayal of the movie was correct but to make a sweeping generalizable statement above ; one needs to be part of a setup other than IITs.
        mayanksinghal 14y ago
        I didn't make that generalization - I was commenting on the sweeping generalization that was made in the movie. I know some very great teachers who do not teach at IITs. My parents are college professors and at least 4 aunts/uncles of mine are also in teaching profession. While I agree that a lot of educational institutes in India suffer from under-qualified or uninspired teaching - I do not believe that it is the core reason of all that is wrong with the education system. My being an IITian actually contributes less to this belief of mine than my school teachers in a small town. It did get reinforced here but I have always had some great teachers.
- spiffworks 14y ago
  As someone who once worked at an IIT, money is not lacking, imagination is.
  - mayanksinghal 14y ago
    Teaching, I suppose. Which IIT?
iamgopal 14y ago
A nice idea to get something back from such companies is to have them collect data of the patients and gave back to the original company/copyright owner etc.
- carbocation 14y ago
  What you are describing is postmarketing surveillance ('phase IV clinical trial'). In the US, this is overseen by the FDA.
  - iamgopal 14y ago
    India's huge market could give lots of data point for analysis. My opinion was to look for other opportunities to take advantage of such situation.
option_greek 14y ago
The pharma and media industries are so similar. Both lobby governments for passing bills to support their business models. Both rely on questionable extensions to IP rights and make loud noises about how much money they lose on piracy and generics. There has to be something fundamentally screwed up to have this much conflict of interest between public good and IP rights.
- gaius 14y ago
  Where's the public good if these drugs are never developed in the first place?
  - option_greek 14y ago
    Whether they would be developed if industry margins go down is a contentious issue. They seem to do just fine despite the competition from generics. In general everything related to biology seem to suffer from the problem of high cost . There got to be a lot of inefficiency some where to sustain such high cost. It need not necessarily be human inefficiency. Just like computers moved from being as big and costly as big buildings to being very affordable (raspberry pi) - thanks to the invention of transistor, there must be some kind of bottle neck that can be targeted first to advance the whole field. You can't do that by simply throwing more money at it. You have to create incentives to attack the inefficiencies.
    - gaius 14y ago
      Generics are not directly competing with newly-discovered drugs, but they do reduce the funding available for that discovery.
DanI-S 14y ago
For me, issues like this raise the question: Does capitalism still make moral sense in a world where a large proportion of the population is so poor as to be unlikely to participate in the free market during their lifetime? Even at $150 per month, those drugs aren't in any way affordable for most without government funding.
- gaius 14y ago
  You don't have to ask us: you can ask the scientists (who should be working for subsistence wages, apparently). Of course manufacturing is cheap once the difficult, risky bit - discovery and clinical trials - has been done.
  - DanI-S 14y ago
    I'm not sure where you derived 'subsistence wages' from. If I were going to suggest a solution, it would be more centered around increased government funding of drug research, specifically with the aim reducing manufacturing costs. Funding cheap drugs for the developing world would probably reduce the need for other forms of economic aid in the long term, lessening the burden on all.
    - gaius 14y ago
      What pays for government funding? Taxes on profits. Besides manufacturing is already cheap. That's the whole reason generic drugs exist. It's easy to copy something someone else has invested 10s of billions in creating in the first place.
      - EvilTerran 14y ago
        "What pays for government funding? Taxes on profits." ...those profits don't have to be drug company profits, so that's irrelevant. Not to mention, focusing on the status quo source of government spending power somewhat begs the question in the context of "does capitalism still make moral sense?"
    - 14y ago
pmr_ 14y ago
I think one of the failings of the pharma industry is to incorporate both, production and R&D. If R&D would be done in the public sector and its results freely available industrial pharma could compete on an even level concentrating on churning out medication in huge numbers at the lowest price possible and piggy-backing on companies that actively do R&D based on national laws that allow you do produce generica wouldn't be possible. Of course, this is no silver bullet. There is no guarantee that research in the public sector is going to be as effective as in the private sector. Which makes me wonder why medical research is so unevenly distributed between the academic world and the industry in the first place.
- aggronn 14y ago
  pharmaceutical research is an extremely expensive, long term process. it could never get the same kind of funding in a public 'open source'-like setting that it could get in a setting where its treated as IP and is given the opportunity to create economic profits. society is notoriously bad as innovating when there is no profit motive. the pace of the 'march of science' due to curiosity and dedication to the betterment of mankind is, unfortunately, glacial. thats not to say there isn't somewhere in between, but when we have this discussion, we have to appreciate the role that money plays in innovation--something people at HN might be able to appreciate.
  - orbitingpluto 14y ago
    Yeah, I know. Thankfully computing and the Internet was developed with private funds... no... wait, it wasn't. I don't disagree with you that a profit motive is a powerful force, but there reaches a point where greed causes more damage than good. Pharma is the prime example.
    - spullara 14y ago
      The infrastructure was done with public funds. People making something useful out of it was done in the private sector almost exclusively. In fact, the government is now one of the biggest threats to the internet.
nhebb 14y ago
From Times of India [1]: "Cipla, which has 23 oncology drugs in its portfolio, has been able to offer the price advantage because of backward integration and reverse engineering, its chairman Y K Hamied told TOI" I'm not sure what backward integration means, but the part about reverse engineering implies these are not drugs that they spent a large sum on R&D. It makes the moral hazard of capitalism vs compassion less hazardous when you copy someone else's product. [1] http://timesofindia.indiatimes.com/business/india-business/Cipla-may-cut-prices-of-other-cancer-drugs-too/articleshow/13004180.cms http://timesofindia.indiatimes.com/business/india-business/C...
- jandrewrogers 14y ago
  Reverse engineering drugs is straightforward and relatively trivial. There is no correlation between ease of reverse engineering and R&D cost. The very high cost comes from development of a drug candidate, not the initial discovery of a candidate. If you skip the part where they demonstrate that the chemical is effective, efficient, and safe for its intended purpose in large human populations then you are correct. At that point it is just a moderately low-cost chemical manufacturing problem. However, I only see them copying drugs where someone else spent billions of dollars demonstrating safety and effectiveness. There are myriad drug candidates that no one has proven safe and effective that they are not copying because that would require real investment on their part.
  - medstudent 14y ago
    Uhm, "Reverse engineering drugs is straightforward and relatively trivial". Any proof to backup your claim? "spent billions of dollars demonstrating safety and effectiveness". Really? How much of the corporate koolaid have you drunk? Have you heard of Vioxx? Numerous other drugs being recalled. http://en.wikipedia.org/wiki/Rofecoxib http://en.wikipedia.org/wiki/Rofecoxib Have you heard of how intertwined the FDA and lobbyists are? Sheesh.
    - jandrewrogers 14y ago
      Reverse engineering a drug is simple for a couple reasons. First, the compound is clearly described in the patent. Second, chemical analysis of so-called "small molecule" compounds is a basic skill every chemistry undergrad learns. The most difficult part is probably designing the production synthesis process but even that is routine for people who do that kind of thing (chemical engineers).
exim 14y ago
I don't think that this will affect original (western) company. Most people who will choose Indian drug over original, simply can't afford it, even in their dreams. On the other hand, those who can easily afford it, will go for it over "fake" Indian one.
Freestyler_3 14y ago
Good news, but over here it wont help. Third parties will turn 76% of the price drop into extra profit for themselves. The downside of a closed market where everyone is obligated to have health insurance and the health insurance companies have all the power they need.
checoivan 14y ago
Even when some of these drugs are very expensive to produce and R&D is expensive, some retail prices are in one word greedy. Looking up a chemotherapy compound priced bulk online will show you how big of a markup these drugs are being sold at. For example: a quick search shows Everolimus costing USD1341.27 per gram to the public bulk, and one retail box of 30 - 0.010 gram tablets costing around 5,000 usd. And I honestly doubt the bulk chemical is being sold at a loss. Now mind these aren't aspirins, but the only option to a slim chance of living for many people. Ideal for drugs companies since whoever can afford it will pay any outrageous price. The problem has gotten big enough that now there are counterfeit chemo drugs being sold, and given this chemo compounds may or may not work for everybody it's hard to track them. That is another problem which may be solved by these companies by selling affordable drugs.
- anusinha 14y ago
  This is not _entirely_ relevant, but I would like to illustrate the complexity and cost of the problem. Many large pharmaceutical companies have completely pulled out of the market for developing drugs in one of the three main classes of diseases that affect most Americans: Neurodegenerative diseases (the other two classes being cancer and cardiovascular disease). This is because the cost of drug development is incredibly expensive. First, suppose we have a drug candidate. Great. This would take many, many years of study of neurons/brain tissue cultures using in vitro techniques (petri dish, etc. out of the native environment). These are great and relatively cheap, but it's difficult to isolate good drug candidates. Eventually, after high throughput screening or whatever other research method is used, a candidate is found. This would (realistically) take many years and require many millions in funding. Then, once you have this in vitro drug candidate, you have to start testing it in animal systems, starting with simple mice. Animal studies are expensive, because the organisms are essentially disposable. These sorts of studies for neural problems are even more expensive because the animals need to be observed carefully using various research techniques for very extended periods of time, on the order of months to years (since this is the timescale on which most neural disease work). This is obviously both expensive timewise and monetarily. So our theoretical candidate works in simple animal and in vitro systems. Great! There a lot of drugs that get this far and then utterly fail on human subjects. Assuming that it passes FDA standards for human testing (which, at this point, seems fairly reasonable), human testing will start. The main purpose of Phase I trials is to determine toxicity of the drug in human systems, and to see if it has any significant effect. Let's say ~40 patients are being tested. These 40 (lucky? unlucky?) patients will take the drug, and then be investigated using a variety of techniques to judge the efficiency. One of the standard techniques in neural imaging is the MRI scan. The typical cost to the company carrying out the test is around $3000+ USD per scan carried out. Each patient will need to be scanned many times (let's say 10) over a period of time to determine whether or not the drug had any affect. Compared to other techniques where simpler blood tests or post-mortem tissue analyses can tell the story, this is very expensive. And this is just phase I. Phases II and III expand the number of patients into the several thousands. The cost of drug development for one potential compound for so long (the timeframe can be order of 15+ years) for a very, very small chance (due to the complexity of the field and the few successes so far) of a huge earning is simply unjustified for many companies. Earning back hundreds of millions of dollars of losses back must be done by passing the cost along to the customer. Note that the patent lifetime on drugs is very short. Nominally, the compound is protected for 20 years. But this is applied for before any clinical trials start, so the effective lifetime is significantly shorter. For a neurodegenerative disease, the effective lifetime of the patent could very well be much sorter than the more "usual" effective lifetime of 7-12 years [1]. Also, as an extra. Organic synthesis is hard. I mean, really, really hard. You have to design a good synthetic pathway, then make sure it works, then scale it up from working in a fume hood, to working in large chemical reactors that can produce it on an industrial scale. I'd like to point people at the synthesis of Tamiflu, the antiviral used against various influenza strains [2]. These are long pathways and accordingly tend to have lower total yields. Drug synthesis is really hard, regardless of the cost of R&D of the drug. TL;DR: Finding drug candidates is really difficult. FDA clinical trials is really difficult. Making the drugs themselves is really difficult. [1]: http://en.wikipedia.org/wiki/Generic_drug http://en.wikipedia.org/wiki/Generic_drug [2]: http://en.wikipedia.org/wiki/Oseltamivir_total_synthesis http://en.wikipedia.org/wiki/Oseltamivir_total_synthesis

170 points by heroic 14y ago

I'm not really sure how I should feel about this. I'd like medicine to be affordable by everyone. However, what I mainly get out of the article is that a company with little or no R&D is simply reducing the price on drugs, which for them is mostly profit anyway. The drugs themselves are cheap to produce, right? Somehow, I think we'd all benefit if we could get these companies involved in developing better medicines. Maybe reduce the price by 50% then take that additional pool of money and invest it into research within India, for example. Another idea...We always hear how great the IIT's are, which I believe they are. Let's turn them into great research universities. [Update] It's interesting to see my post get upvoted and downvoted, which most won't see. My suggestions don't really seem that divisive. I simply think getting more people working on the problem with funding from existing sales seems like a better idea than just reducing drug costs. Additionally, I think involving other institutions rather than sending the money back to Big Pharma, might provide different insights into solving the problems.

kiba 14y ago
Throwing money at the problem may not necessarily speed up research or give us more results.
- pyre 14y ago
  How else would you pay for top-calibur talent to sold the problem?
  - bilbo0s 14y ago
    I believe what kiba is intimating is that no matter how much you pay... some drugs and diseases are just hard to come up with solutions for. To give an example everyone is fairly familiar with... even if you paid USD100 Million per research position to get a cancer vaccine, I'm not certain you would get it any faster than if you paid USD200000 per position. Or USD100000. It's just REALLY hard to come up with.
    - melling 14y ago
      But what I was suggesting was putting more people on the problem, not offering more per position. In fact, the research done in India would cost less than in the US.
  - kiba 14y ago
    Figure out a way to speed up the research process itself. We can't afford to wait 10 to 20 years. Many lives will be lost during those time period. Yes, research take time. Yes, medical research is extraordinary hard. It still doesn't excuse our slowness. We need to look at fighting diseases as a war, not a scientific exploration project. Science is good, but solutions are better. We don't need to understand in extreme details how cancer work, we just need a way to defeat cancer.
    - melling 14y ago
      Add more cores or make the existing ones faster? I said add more cores. If you can think of a way to make each core faster, that's great. In the meantime, getting more people on the problem should help. [Update] Please include include links that discuss the "better" method that you are describing. It sounds like you just want to "reinvent/disrupt" the process without actually having a plan.
      - kiba 14y ago
        You should instead dedicate newer core into process optimization. We want to find a cure in 9 years, then 8 years, 7 years, 6 years, and so on. With each passing year, medical research should be progressing even faster. We don't want to wait ten years for a slightly higher chance of a cure appearing. We want a higher chance of a cure in a much shorter time period. Please include include links that discuss the "better" method that you are describing. It sounds like you just want to "reinvent/disrupt" the process without actually having a plan. It's not a "plan", or a "method". It's a goal. You could start with a small. Figure out what people are doing that should be done by robots or computers. What mistakes people are making that delay the whole research process? Are the bureaucrats holding up the approval for no good reason? How much time you spent fighting politics versus getting things done? The key insight is this: Speeds absolutely matter in medicine. One more day you wait for a cure, somebody die. If speed is not one of your nation's research goal, it should be.
        SoftwareMaven 14y ago
        This sounds like a very naive view of biological systems. The complexity of the most complex thing computer science has created (I would argue that is the Internet) is still trivially simple compared to the brain. What that means is the search space is huge, much larger than any space I've dealt with in computer science. However, there may be something to what you are saying (I don't know enough about medical research to know whether they are already doing this or not). In public key cryptography, you have a huge key space to try if you want to brute force a key (2^64 for a 64 bit key, unsurprisingly). However, you can break a 64 bit key in about 2^40 operations if you use the right technique [1]. Are we spending enough time looking for those techniques? I certainly hope so. There are a lot of smart people in medicine. 1. http://en.wikipedia.org/wiki/Meet-in-the-middle_attack http://en.wikipedia.org/wiki/Meet-in-the-middle_attack
  - pradocchia 14y ago
    That's a fashionable yet very narrow framing of the matter. If you insist on this formulation, then indeed many many problems are insoluble.
mnazim 14y ago
IITs have failed to deliver in research and development. In my very humble opinion, they have transformed in glorified employment exchanges main emphasis being on fetching a 7 figure paycheck after 4 years.
- melling 14y ago
  I still think the opportunity is there. I've seen several specials on the IITs, and they are a very well respected institution both in and out India. In addition, I think people generally realize that the educational system should offer more. I'll offer up Aamir Khan and friends as anecdotal evidence. :-) Great movie. http://en.wikipedia.org/wiki/3_Idiots http://en.wikipedia.org/wiki/3_Idiots
  - mayanksinghal 14y ago
    I actually hated that movie. While the message that 'One should pursue his/her own dream' was neat, the portrayal was bad. It showed that Engineering education in India sucks largely because of orthodox bad teachers who lack vision. It portrayed it is alright to play bad hurtful pranks (though a joke, but unfortunately immaturity is still prevails in college students). The professors were shown in such bad light and without any emotions that even suicides don't make them change their facial expressions. They really took it to the extreme, it was sad because it might have demotivated some people.
    - denzil_correa 14y ago
      > It showed that Engineering education in India sucks largely because of orthodox bad teachers who lack vision. And pray, you being from IIT what makes you qualified enough to show this statement is wrong? I'm not saying the portrayal of the movie was correct but to make a sweeping generalizable statement above ; one needs to be part of a setup other than IITs.
      - mayanksinghal 14y ago
        I didn't make that generalization - I was commenting on the sweeping generalization that was made in the movie. I know some very great teachers who do not teach at IITs. My parents are college professors and at least 4 aunts/uncles of mine are also in teaching profession. While I agree that a lot of educational institutes in India suffer from under-qualified or uninspired teaching - I do not believe that it is the core reason of all that is wrong with the education system. My being an IITian actually contributes less to this belief of mine than my school teachers in a small town. It did get reinforced here but I have always had some great teachers.
spiffworks 14y ago
As someone who once worked at an IIT, money is not lacking, imagination is.
- mayanksinghal 14y ago
  Teaching, I suppose. Which IIT?

iamgopal 14y ago

A nice idea to get something back from such companies is to have them collect data of the patients and gave back to the original company/copyright owner etc.

carbocation 14y ago
What you are describing is postmarketing surveillance ('phase IV clinical trial'). In the US, this is overseen by the FDA.
- iamgopal 14y ago
  India's huge market could give lots of data point for analysis. My opinion was to look for other opportunities to take advantage of such situation.

option_greek 14y ago

The pharma and media industries are so similar. Both lobby governments for passing bills to support their business models. Both rely on questionable extensions to IP rights and make loud noises about how much money they lose on piracy and generics. There has to be something fundamentally screwed up to have this much conflict of interest between public good and IP rights.

gaius 14y ago
Where's the public good if these drugs are never developed in the first place?
- option_greek 14y ago
  Whether they would be developed if industry margins go down is a contentious issue. They seem to do just fine despite the competition from generics. In general everything related to biology seem to suffer from the problem of high cost . There got to be a lot of inefficiency some where to sustain such high cost. It need not necessarily be human inefficiency. Just like computers moved from being as big and costly as big buildings to being very affordable (raspberry pi) - thanks to the invention of transistor, there must be some kind of bottle neck that can be targeted first to advance the whole field. You can't do that by simply throwing more money at it. You have to create incentives to attack the inefficiencies.
  - gaius 14y ago
    Generics are not directly competing with newly-discovered drugs, but they do reduce the funding available for that discovery.

DanI-S 14y ago

For me, issues like this raise the question: Does capitalism still make moral sense in a world where a large proportion of the population is so poor as to be unlikely to participate in the free market during their lifetime? Even at $150 per month, those drugs aren't in any way affordable for most without government funding.

gaius 14y ago
You don't have to ask us: you can ask the scientists (who should be working for subsistence wages, apparently). Of course manufacturing is cheap once the difficult, risky bit - discovery and clinical trials - has been done.
- DanI-S 14y ago
  I'm not sure where you derived 'subsistence wages' from. If I were going to suggest a solution, it would be more centered around increased government funding of drug research, specifically with the aim reducing manufacturing costs. Funding cheap drugs for the developing world would probably reduce the need for other forms of economic aid in the long term, lessening the burden on all.
  - gaius 14y ago
    What pays for government funding? Taxes on profits. Besides manufacturing is already cheap. That's the whole reason generic drugs exist. It's easy to copy something someone else has invested 10s of billions in creating in the first place.
    - EvilTerran 14y ago
      "What pays for government funding? Taxes on profits." ...those profits don't have to be drug company profits, so that's irrelevant. Not to mention, focusing on the status quo source of government spending power somewhat begs the question in the context of "does capitalism still make moral sense?"
  - 14y ago

pmr_ 14y ago

I think one of the failings of the pharma industry is to incorporate both, production and R&D. If R&D would be done in the public sector and its results freely available industrial pharma could compete on an even level concentrating on churning out medication in huge numbers at the lowest price possible and piggy-backing on companies that actively do R&D based on national laws that allow you do produce generica wouldn't be possible. Of course, this is no silver bullet. There is no guarantee that research in the public sector is going to be as effective as in the private sector. Which makes me wonder why medical research is so unevenly distributed between the academic world and the industry in the first place.

aggronn 14y ago
pharmaceutical research is an extremely expensive, long term process. it could never get the same kind of funding in a public 'open source'-like setting that it could get in a setting where its treated as IP and is given the opportunity to create economic profits. society is notoriously bad as innovating when there is no profit motive. the pace of the 'march of science' due to curiosity and dedication to the betterment of mankind is, unfortunately, glacial. thats not to say there isn't somewhere in between, but when we have this discussion, we have to appreciate the role that money plays in innovation--something people at HN might be able to appreciate.
- orbitingpluto 14y ago
  Yeah, I know. Thankfully computing and the Internet was developed with private funds... no... wait, it wasn't. I don't disagree with you that a profit motive is a powerful force, but there reaches a point where greed causes more damage than good. Pharma is the prime example.
  - spullara 14y ago
    The infrastructure was done with public funds. People making something useful out of it was done in the private sector almost exclusively. In fact, the government is now one of the biggest threats to the internet.

nhebb 14y ago

From Times of India [1]: "Cipla, which has 23 oncology drugs in its portfolio, has been able to offer the price advantage because of backward integration and reverse engineering, its chairman Y K Hamied told TOI" I'm not sure what backward integration means, but the part about reverse engineering implies these are not drugs that they spent a large sum on R&D. It makes the moral hazard of capitalism vs compassion less hazardous when you copy someone else's product. [1] http://timesofindia.indiatimes.com/business/india-business/Cipla-may-cut-prices-of-other-cancer-drugs-too/articleshow/13004180.cms http://timesofindia.indiatimes.com/business/india-business/C...

jandrewrogers 14y ago
Reverse engineering drugs is straightforward and relatively trivial. There is no correlation between ease of reverse engineering and R&D cost. The very high cost comes from development of a drug candidate, not the initial discovery of a candidate. If you skip the part where they demonstrate that the chemical is effective, efficient, and safe for its intended purpose in large human populations then you are correct. At that point it is just a moderately low-cost chemical manufacturing problem. However, I only see them copying drugs where someone else spent billions of dollars demonstrating safety and effectiveness. There are myriad drug candidates that no one has proven safe and effective that they are not copying because that would require real investment on their part.
- medstudent 14y ago
  Uhm, "Reverse engineering drugs is straightforward and relatively trivial". Any proof to backup your claim? "spent billions of dollars demonstrating safety and effectiveness". Really? How much of the corporate koolaid have you drunk? Have you heard of Vioxx? Numerous other drugs being recalled. http://en.wikipedia.org/wiki/Rofecoxib http://en.wikipedia.org/wiki/Rofecoxib Have you heard of how intertwined the FDA and lobbyists are? Sheesh.
  - jandrewrogers 14y ago
    Reverse engineering a drug is simple for a couple reasons. First, the compound is clearly described in the patent. Second, chemical analysis of so-called "small molecule" compounds is a basic skill every chemistry undergrad learns. The most difficult part is probably designing the production synthesis process but even that is routine for people who do that kind of thing (chemical engineers).

exim 14y ago

I don't think that this will affect original (western) company. Most people who will choose Indian drug over original, simply can't afford it, even in their dreams. On the other hand, those who can easily afford it, will go for it over "fake" Indian one.

Freestyler_3 14y ago

Good news, but over here it wont help. Third parties will turn 76% of the price drop into extra profit for themselves. The downside of a closed market where everyone is obligated to have health insurance and the health insurance companies have all the power they need.

checoivan 14y ago

Even when some of these drugs are very expensive to produce and R&D is expensive, some retail prices are in one word greedy. Looking up a chemotherapy compound priced bulk online will show you how big of a markup these drugs are being sold at. For example: a quick search shows Everolimus costing USD1341.27 per gram to the public bulk, and one retail box of 30 - 0.010 gram tablets costing around 5,000 usd. And I honestly doubt the bulk chemical is being sold at a loss. Now mind these aren't aspirins, but the only option to a slim chance of living for many people. Ideal for drugs companies since whoever can afford it will pay any outrageous price. The problem has gotten big enough that now there are counterfeit chemo drugs being sold, and given this chemo compounds may or may not work for everybody it's hard to track them. That is another problem which may be solved by these companies by selling affordable drugs.

anusinha 14y ago
This is not _entirely_ relevant, but I would like to illustrate the complexity and cost of the problem. Many large pharmaceutical companies have completely pulled out of the market for developing drugs in one of the three main classes of diseases that affect most Americans: Neurodegenerative diseases (the other two classes being cancer and cardiovascular disease). This is because the cost of drug development is incredibly expensive. First, suppose we have a drug candidate. Great. This would take many, many years of study of neurons/brain tissue cultures using in vitro techniques (petri dish, etc. out of the native environment). These are great and relatively cheap, but it's difficult to isolate good drug candidates. Eventually, after high throughput screening or whatever other research method is used, a candidate is found. This would (realistically) take many years and require many millions in funding. Then, once you have this in vitro drug candidate, you have to start testing it in animal systems, starting with simple mice. Animal studies are expensive, because the organisms are essentially disposable. These sorts of studies for neural problems are even more expensive because the animals need to be observed carefully using various research techniques for very extended periods of time, on the order of months to years (since this is the timescale on which most neural disease work). This is obviously both expensive timewise and monetarily. So our theoretical candidate works in simple animal and in vitro systems. Great! There a lot of drugs that get this far and then utterly fail on human subjects. Assuming that it passes FDA standards for human testing (which, at this point, seems fairly reasonable), human testing will start. The main purpose of Phase I trials is to determine toxicity of the drug in human systems, and to see if it has any significant effect. Let's say ~40 patients are being tested. These 40 (lucky? unlucky?) patients will take the drug, and then be investigated using a variety of techniques to judge the efficiency. One of the standard techniques in neural imaging is the MRI scan. The typical cost to the company carrying out the test is around $3000+ USD per scan carried out. Each patient will need to be scanned many times (let's say 10) over a period of time to determine whether or not the drug had any affect. Compared to other techniques where simpler blood tests or post-mortem tissue analyses can tell the story, this is very expensive. And this is just phase I. Phases II and III expand the number of patients into the several thousands. The cost of drug development for one potential compound for so long (the timeframe can be order of 15+ years) for a very, very small chance (due to the complexity of the field and the few successes so far) of a huge earning is simply unjustified for many companies. Earning back hundreds of millions of dollars of losses back must be done by passing the cost along to the customer. Note that the patent lifetime on drugs is very short. Nominally, the compound is protected for 20 years. But this is applied for before any clinical trials start, so the effective lifetime is significantly shorter. For a neurodegenerative disease, the effective lifetime of the patent could very well be much sorter than the more "usual" effective lifetime of 7-12 years [1]. Also, as an extra. Organic synthesis is hard. I mean, really, really hard. You have to design a good synthetic pathway, then make sure it works, then scale it up from working in a fume hood, to working in large chemical reactors that can produce it on an industrial scale. I'd like to point people at the synthesis of Tamiflu, the antiviral used against various influenza strains [2]. These are long pathways and accordingly tend to have lower total yields. Drug synthesis is really hard, regardless of the cost of R&D of the drug. TL;DR: Finding drug candidates is really difficult. FDA clinical trials is really difficult. Making the drugs themselves is really difficult. [1]: http://en.wikipedia.org/wiki/Generic_drug http://en.wikipedia.org/wiki/Generic_drug [2]: http://en.wikipedia.org/wiki/Oseltamivir_total_synthesis http://en.wikipedia.org/wiki/Oseltamivir_total_synthesis