3 ms·

I broadly agree, with two caveats: 1) some of the extra cost is used to buy state of the art treatments and systems, that help drive down their cost in other co

I broadly agree, with two caveats: 1) some of the extra cost is used to buy state of the art treatments and systems, that help drive down their cost in other countries, and 2) it's been just as captured by legislative tug of war over the decades, that cause strange loopholes and constraints.

scarface_74 2y ago
https://marylandmatters.org/2024/01/19/report-finds-some-drug-manufacturers-spend-more-on-advertising-executives-salaries-than-new-research/ https://marylandmatters.org/2024/01/19/report-finds-some-dru...
- robertlagrant 2y ago
  Not everything is drug discovery. Even stuff like "this digital system would save you going into a hospital in person" is done very well in the US, as it can afford it. Kaiser Permanente IT is particularly amazing, from what I hear.
  - scarface_74 2y ago
    It really doesn’t take billions of dollars for that type of system - coming from someone who worked at healthcare SaaS companies between 2014-2020. That’s not where the money is going
    - robertlagrant 2y ago
      My question would be - which countries did your companies target if not the US for their SaaS solutions? What was the place that made you the money if not the US?
      - scarface_74 2y ago
        For the most part, because of laws, regulations and certifications, all healthcare IT systems are localized to the country. Investments in software in the US, only helps the US.
        robertlagrant 2y ago
        That's definitely not the case. I've worked in the UK on two health platform things, and the US market was by far the only one that could sustain normal prices. And the UK buys US software (EPIC/Cerner, for example) from the US. It's not localised at all. There aren't that many systems. Plenty of countries use the FDA's rules, and many standards are relatively global.
- AnthonyMouse 2y ago
  That one's kind of a math problem. Suppose you're selling your new drug for a net margin of $100/unit and then you put all of that back into R&D. If you don't buy advertising, you sell 10,000 units and put $1M back into R&D. If you buy $7M in advertising, you sell 100,000 units, get $10M, $7M goes to pay for the advertising and you put $3M back into R&D. Then you're spending more on advertising than R&D. But then you're spending three times as much on R&D. So which one of these is better?
  - scarface_74 2y ago
    There are only two countries where you are allowed to advertise prescription drugs. https://www.health.harvard.edu/medications/do-not-get-sold-on-drug-advertising https://www.health.harvard.edu/medications/do-not-get-sold-o... You can’t buy them anyway without talking to your doctor who should be better informed than a consumer would be based on a 30 second commercial. One thing that RFK is pushing for that I agree with is getting rid of commercials for prescription drugs. I doubt he can.
    - AnthonyMouse 2y ago
      The purpose of the commercial is to make the patient aware of the drug so they ask a doctor about it, instead of e.g. having given up on finding any treatment for the condition because there hadn't been one when they asked a doctor about it five years ago. This can result in people getting treatment for something they wouldn't otherwise have been aware was available. It could also result in people buying stuff they don't need, but then their doctor should be advising them that they don't need it, right?
      - scarface_74 2y ago
        I have mixed feelings about it. I would hope that the doctors keep up with the latest developments and would know the options available. But I also like the idea of patients having agency to advocate for themselves to do their research and talk to doctors and they can’t do that without knowing what they don’t know. On the other hand, if it weren’t for marketing, could costs come down? As you can tell, these are weak opinions weakly held instead of strong opinions weakly held

scarface_74 2y ago

https://marylandmatters.org/2024/01/19/report-finds-some-drug-manufacturers-spend-more-on-advertising-executives-salaries-than-new-research/ https://marylandmatters.org/2024/01/19/report-finds-some-dru...

robertlagrant 2y ago
Not everything is drug discovery. Even stuff like "this digital system would save you going into a hospital in person" is done very well in the US, as it can afford it. Kaiser Permanente IT is particularly amazing, from what I hear.
- scarface_74 2y ago
  It really doesn’t take billions of dollars for that type of system - coming from someone who worked at healthcare SaaS companies between 2014-2020. That’s not where the money is going
  - robertlagrant 2y ago
    My question would be - which countries did your companies target if not the US for their SaaS solutions? What was the place that made you the money if not the US?
    - scarface_74 2y ago
      For the most part, because of laws, regulations and certifications, all healthcare IT systems are localized to the country. Investments in software in the US, only helps the US.
      - robertlagrant 2y ago
        That's definitely not the case. I've worked in the UK on two health platform things, and the US market was by far the only one that could sustain normal prices. And the UK buys US software (EPIC/Cerner, for example) from the US. It's not localised at all. There aren't that many systems. Plenty of countries use the FDA's rules, and many standards are relatively global.
AnthonyMouse 2y ago
That one's kind of a math problem. Suppose you're selling your new drug for a net margin of $100/unit and then you put all of that back into R&D. If you don't buy advertising, you sell 10,000 units and put $1M back into R&D. If you buy $7M in advertising, you sell 100,000 units, get $10M, $7M goes to pay for the advertising and you put $3M back into R&D. Then you're spending more on advertising than R&D. But then you're spending three times as much on R&D. So which one of these is better?
- scarface_74 2y ago
  There are only two countries where you are allowed to advertise prescription drugs. https://www.health.harvard.edu/medications/do-not-get-sold-on-drug-advertising https://www.health.harvard.edu/medications/do-not-get-sold-o... You can’t buy them anyway without talking to your doctor who should be better informed than a consumer would be based on a 30 second commercial. One thing that RFK is pushing for that I agree with is getting rid of commercials for prescription drugs. I doubt he can.
  - AnthonyMouse 2y ago
    The purpose of the commercial is to make the patient aware of the drug so they ask a doctor about it, instead of e.g. having given up on finding any treatment for the condition because there hadn't been one when they asked a doctor about it five years ago. This can result in people getting treatment for something they wouldn't otherwise have been aware was available. It could also result in people buying stuff they don't need, but then their doctor should be advising them that they don't need it, right?
    - scarface_74 2y ago
      I have mixed feelings about it. I would hope that the doctors keep up with the latest developments and would know the options available. But I also like the idea of patients having agency to advocate for themselves to do their research and talk to doctors and they can’t do that without knowing what they don’t know. On the other hand, if it weren’t for marketing, could costs come down? As you can tell, these are weak opinions weakly held instead of strong opinions weakly held