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> A study by researchers at Yale estimated that drugs like Wegovy can be profitably manufactured for less than $5 per month. Serious question: Why not just bo
by A_D_E_P_T 2y ago
> A study by researchers at Yale estimated that drugs like Wegovy can be profitably manufactured for less than $5 per month.
Serious question: Why not just bootleg the stuff?
It's a very small protein, easy to make, and "research chemical" companies that sell structurally similar bodybuilding drugs and nootropics are a dime a dozen. Search online for "BPC-157" (a protein drug of only slightly inferior complexity) and you'll find a million places that sell it at $25 for a month's supply. Those vendors are legitimate far more often than not.
If Novo Nordisk won't sell to humans at a humane price -- instead preferring to gouge insurance companies and the gatekeeping medical bureaucracy -- I'd argue that there's a moral imperative to bootleg the drug and distribute it to those who would benefit from it at a fair price.
And, unlike many of the bodybuilding drugs (which are a big business,) these new weight-loss drugs aren't scheduled, so you won't get in much trouble even in the unlikely event you are caught.
- loloquwowndueo 2y agoPatents?
- ggm 2y agoI believe the most likely outcome is a price curve downwards as Novo nordisk is quietly forced info JV with US manufacturers under implicit threat of some one-off ruling akin to an IPR eminent domain action. Nobody in government wants to accept IPR is broken but they'll find a way to bend it's ruling into a hoop, for the specific needs of the moment.
- redwoolf 2y agoWhen it comes to pharmaceuticals, the patents are ridiculous. Take for example Contrave[0]. It is a combination of Naltrexone and Bupropion, both of which are no longer under a patent. Put them both in the same pill and it's under a new patent. [0] https://en.wikipedia.org/wiki/Naltrexone/bupropion https://en.wikipedia.org/wiki/Naltrexone/bupropion
- 3abiton 2y agoSo buying them separately and mixing them in your mouth is legal? It's like combining 2 pieces of open-source software and selling them under one product.
- clipsy 2y ago> It's like combining 2 pieces of open-source software and selling them under one product. That describes a decent chunk of the tech industry!
- redwoolf 2y agoTotally legal. You can have your doctor prescribe 50mg Naltrexone and 300mg Bupropion and you can take them at the same time every day. It's the same drugs in the same ratios. Contrave is not novel in any way. There's substantial prior art. And yet a patent was granted to cover this combination and prevent anyone else from taking two generic drugs and combining them into one pill.
- shawn_w 2y agoInteresting. I'm pretty familiar with both drugs in the context of addiction treatment and mental health (and seen plenty of people taking both as separate pills), but I've never heard of them indicated for weight loss.
- adbge 2y agoThese same companies that manufacture and distribute BPC-157 and bodybuilding drugs already also offer various GLP1 drugs, semaglutide, tirzepatide, retatrutide. Google around and you can find them available for much cheaper via grey market vendors.
- A_D_E_P_T 2y agoWell, there you go, I guess. So high semaglutide pricing won't end up "bankrupting" the US medical system. It'll push an ever larger number of patients -- and more than a few well-meaning doctors, who already recommend things like BPC-157 -- into the gray market. That this would further delegitimize the medical establishment and FDA would be a well-deserved outcome.
- namlem 2y agoWhere does one go to find these vendors? Are they the sorts of places that other sites prohibit links to?
- mise_en_place 2y agoThey already are. Weight loss clinics will send the Rx to a compounding pharmacy.
- hollerith 2y ago>clinics will send the Rx to a compounding pharmacy. I think you are confused about what a compounding pharmacy is -- at least if you refer to how it works in the US.
- adam_arthur 2y agoNot sure what you mean. You can sign up for compounded semaglutide from many online services (e.g. Ro https://ro.co/weight-loss/compounded-semaglutide/ https://ro.co/weight-loss/compounded-semaglutide/) It's still expensive, but far cheaper than brand name with similar efficacy. Competition from these programs will likely drive costs much lower over the next few years.
- hollerith 2y agoSemaglutide is still under patent in the US till at least Dec 2031 (say Wpedia). Blockbuster drugs still under patent usually don't have alternative avenues of supply that are significantly cheaper than the main avenue. I wonder what law or regulation allows this alternative avenue to persist.
- pbj1968 2y agoAbsolutely nowhere on that page is mentioned what you’ll actually pay for the compounded drug. Spoiler - $300+/mo
- adam_arthur 2y agoYes, less than half the price of brand name, and competition hasn't even really started. These are first mover prices. What's the monthly health cost of being obese?
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- voisin 2y ago> I'd argue that there's a moral imperative to bootleg the drug and distribute it to those who would benefit from it at a fair price. Why not do away with patents and IP altogether if the standard is that as soon as someone makes something needed it can be stolen?
- JKCalhoun 2y agoWhy not make an exception for life-saving patents/inventions? The irony that, were it not priced outrageously, it could save the health care industry billions as these people with obesity will otherwise require epesneive treatments if the remain obese.
- A_D_E_P_T 2y agoThere are already exceptions for technical products that must be licensed on fair, reasonable, and non-discriminatory terms. (RAND or FRAND. See: https://en.wikipedia.org/wiki/Reasonable_and_non-discriminatory_licensing https://en.wikipedia.org/wiki/Reasonable_and_non-discriminat... ) Why not carve out a new exception for breakthrough drugs that have the potential to add X% to the GDP or save X lives/annum?
- andsoitis 2y ago> Why not make an exception for life-saving patents/inventions? This ain’t it though.
- BurningFrog 2y agoIf it can actually save the health care so many billions, you'd think it was worth paying high prices for it.
- swatcoder 2y ago> it could save the health care industry billions as these people with obesity will otherwise require epesneive treatments if the remain obese. "Could" is doing a lot of work there. We don't really know what to expect for these patients 20 or 40 years out. Long-term outcomes and population-scale polypharmacy risks are not really clear, and won't be for decades. These drugs enable a valuable intervention for individuals at high risk of health hazards and it's fantastic that they're available, but the perspective changes when you look at outcomes for tens (hundreds?) of millions of people over long spans of time -- there are a lot of inescapable unknowns. One can't actually be sure that the benefits of fast, widespread use will outpace the costs, or at what scale. Many genuinely effective drugs have gone through exactly this kind of hype cycle only to lead to regret, embarassment, and/or skepticism later on. Good science, and the good public policy that's informed by it, moves slowly.
- hi-v-rocknroll 2y agoI'm down for it or something similar. Not even joking. A. The issue becomes creating a manufacturing and cold chain distribution system involving the fewest people with compartmentalized knowledge. I'm not sure how you'd launder it or keep enough of it a secret to not get eventually busted because someone would open their mouth. It'd probably be busted with RICO if any sort of profits were involved. Must pay taxes, for sure. B. DIY chems home pharma kit is another approach. C. Traffic from other countries like France at near cost prices. D. Send patients to low-cost countries to buy up medications for their own personal use, and post or FedEx it back to themselves in bulk. E. Hold politicians accountable and make the FDA and FTC set hard limits on price gouging so that Medicare, health insurance co's, and American patients aren't overcharged. You'd think health insurance co's would be right out in front complaining about the high cost of medications and lobbying for change.
- ASalazarMX 2y ago> get eventually busted because someone would open their mouth Aren't this what "corporations are people" prevent? Plenty of people doing shady, or outright evil stuff, get their way because they're behind a corporation.
- hi-v-rocknroll 2y agoIt's more like conspiracies fall apart whenever there is more than 1 person. When there are 800, then it's over immediately. Evil or shady acts must first be illegal to be potentially prosecutable crimes or be injurious to have standing as tort claims. And limited liability isn't unbounded.
- ajross 2y ago> Serious question: Why not just bootleg the stuff? Historically, the black market for medication has been vanishingly small. People don't as a rule trust drugs they get off of alibaba or wherever; even the viagra gray market is a small fraction of the prescription revenue. And this doesn't treat something critical, it's a weight loss drug. To be blunt most people would probably choose to remain fat vs. buying an illegal generic.
- operatingthetan 2y ago>To be blunt most people would probably choose to remain fat vs. buying an illegal generic. Wow, I think the exact opposite. Weight loss is a huge industry and people are desperate.
- paulryanrogers 2y agoFentanyl seems to be tainting a lot of black market drugs lately. I'd want to test anything if it came from unofficial sources.
- operatingthetan 2y agoTotally different markets. They are adding fentanyl to cut intoxicant drugs as a way to make more money. Nobody gets high on a GLP-1. Never heard of supplement/nootropic drugs being tainted and doesn't make sense that anyone would on purpose because they are sold by companies with web stores and credit card processors.
- ClassyJacket 2y agoI don't think this is true. Look at the number of people buying Modafinil off Indian websites.
- TheLoafOfBread 2y agoWell technically because India is not a black market, more like a grey market. They didn't pay for IP, Indians just copied the drugs, but they achieved their goal - selling affordable medicine with good enough quality to an average Indian.
- deleted 2y ago[deleted]
- ano-ther 2y agoThey have patent protection and the US government goes to great lengths to defend intellectual property rights. Technically, compulsory licensing is allowed under TRIPS (https://www.wto.org/english/tratop_e/trips_e/public_health_faq_e.htm https://www.wto.org/english/tratop_e/trips_e/public_health_f...). But the US and others opted out of this (https://www.wto.org/english/docs_e/legal_e/31bis_trips_annex_e.htm#fnt-3 https://www.wto.org/english/docs_e/legal_e/31bis_trips_annex...).
- tomohelix 2y agoMany reasons. One of them being doctors won't prescribe an off brand drug and insurance won't cover anything related to it. The other reasons are: 1/ Even the manufacturer doesn't know everything about how the drug was made. They characterize the final compound but the compound was made by some sort of living cells so each one has different properties. For the same molecule, one cell line may produce a drug with entirely different toxicology profile compared to another. You need a full manufacturing chain with different departments analyzing it at different stages to guarantee the desired effect. 2/ Patents make sure that the vanishingly few groups with the capability to do the above characterization would not want to risk their business doing it. 3/ For every one molecule that made it to market, dozens or hundreds of others were discarded. They all cost about the same amount to develop up to the point they were thrown away. Due to the amount of regulations in place, the cost to research is obscene and the final manufacturing cost is peanut compared to the price of the pipeline what the drug went through.
- mcphage 2y ago> insurance won't cover anything related to it If the grey market is cheaper than you would pay for the real drug after insurance’s contribution, who cares?
- A_D_E_P_T 2y agoUtter nonsense, especially point #1. Drugs absolutely are not random mixtures. Semaglutide's molecular structure is completely characterized -- on its wikipedia page, in its patent application, and elsewhere -- and it's very easy to make identical molecules in the lab. Novo Nordisk's patent -- US8129343B2 -- lays out the process, which is nothing more than Fmoc solid state synthesis. "The protected peptidyl resin was synthesized according to the Fmoc strategy on an Applied Biosystems 433 peptide synthesizer in 0.25 mmol or 1.0 mmol scale. . ." So they don't make it in cells, but by totally conventional peptide manufacturing techniques. As for #2, you must be unfamiliar with the existing gray market for pharmaceuticals. Among others, both the bodybuilding community and the nootropics community experiment extensively with pharmaceuticals -- and they do drug synthesis and distribution in a way that's actually extremely cost-effective! (Necessarily, because their customers are humans who pay out of pocket directly.) #3 is trite and overstated. It's a standard drug industry talking point, but it really has no bearing on this discussion.
- bananapub 2y ago> Why not just bootleg the stuff? because the US is largely responsible for the rich world's tyrannical patent and copyright laws?