4 ms·

And a lot of pharma research is based on publicly-funded research in the first place.

by smt88 1y ago

deleted 1y ago
[deleted]
nradov 1y ago
Sure, but that's a bit of a red herring. The largest expense in bringing a new prescription drug to market is the phase 3 clinical trial, which now costs on the order of $1B each. Those often fail, so it's a huge gamble. There is very little public funding for type of research.
- throwanem 1y ago
  And a drug like Revlimid makes its manufacturer tens to hundreds of billions; the "legacy" portfolio in which BMS classes it pulled in a cool $5.6b just in Q1 '25, of which Revlimid itself was about a sixth, or just under a billion - down by almost half year on year. See https://www.bms.com/assets/bms/us/en-us/pdf/investor-info/doc_presentations/2025/BMY-2025-Q1-Results-Investor-Presentation.pdf https://www.bms.com/assets/bms/us/en-us/pdf/investor-info/do..., pp. 8-9. It is as if VCs in the tech industry demanded the taxpayer guarantee them a healthy rate of profit, to a standard of health the VCs themselves are privileged to define. Indeed, as with Allred and the regional airlines, perhaps now we see whence Altman has cribbed his "innovation."
  - nradov 1y ago
    I don't understand your point. Some drugs are enormously profitable. Others lose money. There are no taxpayer guarantees. Pharmaceutical companies on average don't generate higher shareholder returns than other industrial sectors. A few like K-V and Dendreon have even gone bankrupt. One could make an argument that taxpayer subsidized health plans which include prescription drug coverage such as Medicare Part D or Medicaid should limit the prices they are willing to reimburse on a QALY basis. And Medicare has started a limited drug price negotiation program. But generally, voters have been unwilling to accept the trade-offs inherent in drug price controls. https://www.cms.gov/newsroom/fact-sheets/medicare-drug-price-negotiation-program-negotiated-prices-initial-price-applicability-year-2026 https://www.cms.gov/newsroom/fact-sheets/medicare-drug-price...
    - throwanem 1y ago
      My point is that if you want to provide support for the advocacy argument, you've quite a long way yet to go. A good place to start would be to pick any one claim you have made and attempt to substantiate it. Until then, I've nothing with which to attempt further to argue. (If you want to do something else, I can't tell what it would be.)
      - nradov 1y ago
        What advocacy argument? You're not making any sense and are just posting lazy, low-effort criticism. None of my claims require further substantiation, you can easily look up for yourself if you want to understand how the system works and the incentives involved.
        deleted 1y ago
        [deleted]
        deleted 1y ago
        [deleted]
- mikeyouse 1y ago
  Phase 3 trials don’t cost $1B - they’re more on the order of $20M.
  - nradov 1y ago
    Sorry I should have been more specific. Average total cost to bring a new drug to market is on the order of $2B. https://www.fiercebiotech.com/biotech/drug-development-cost-pharma-22b-asset-2024-plus-how-glp-1s-impact-roi-deloitte https://www.fiercebiotech.com/biotech/drug-development-cost-...
    - throwawaymaths 1y ago
      yes, that includes failures, which includes shit that a beginning grad student could tell you wouldn't work.
- cogman10 1y ago
  The NIH already creates grants for Phase 1 and Phase 2 trials. It's a bit insane that we don't also do phase 3 trials. Heck, even drug manufacturing is already done both by the DoD and the VA. It's crazy that we have a vision that private investment will somehow make things either cheaper, more affordable, or more available. Big pharma is providing very little benefit and a lot of cost. We've seen their playbook with people like Martin Shkreli who'll buy up patents to existing drugs and jack up the price to make a quick buck. Do we really need that sort of "private investment"?
  - nradov 1y ago
    I don't think anyone is seriously making the argument that private investment in drug development is making things cheaper or more available. So that's a strawman argument. The primary claim in support of the current system is that it encourages greater levels of innovation than would happen under a socialized central planning system where government bureaucrats allocate funding for all trials. We don't have any solid evidence about that one way or the other. But year after year, US pharma companies do consistently release more new drugs than any other countries on a per-capita basis. We don't want to wreck that just because of high prices on a few patent protected drugs. Let's take a longer view and consider possible second-order effects before making any drastic changes.
    - throwanem 1y ago
      [flagged]
      - cogman10 1y ago
        Meh, I'm fine with it. The general argument for capitalism is usually one of cost and market efficiency which is why I argue that doesn't happen with medicine. But if you want to argue innovation instead, I see that as particularly worse in terms of medicine and science. Pure research is rarely profitable which is why you pretty rarely see it in an open marketplace. It's not that it never happens. Obviously some research specifically targeted at manufacturing efficiency does happen as that will increase profits. However, outside of maybe semiconductors you'll almost never see a purely private institution invest in something like material sciences. More often than not, that research actually comes from something like the DoD contacting out to a defense agency trying to do better tank armor. With medicine in the US, pretty much all innovation has come from public investment. The polio vaccine, for example, didn't come from a drug company, it came from a university researcher. That's the story of a large number of modern medicines. A private company doesn't need or in some cases even want new medicines. Why would they want to make something that benefits 1/100000 of the population when something like insulin has a huge market and few competitors. Manufacturing new medicines for rare diseases isn't profitable, so why would they ever research it in the first place?
- SAI_Peregrinus 1y ago
  "How can we lower the cost of phase 3 clinical trials without allowing non-functional medication (scams) to proliferate" is very important. The point of a phase 3 trial is to prove that a medication treats what it claims to treat.
- throwawaymaths 1y ago
  that number is not correct. you can get phase trials done in 100M ish. IIRC the 1B number is average cost, all three phases, including drug failures.

And a lot of pharma research is based on publicly-funded research in the first place.

by smt88 1y ago

And a lot of pharma research is based on publicly-funded research in the first place.

deleted 1y ago

[deleted]

nradov 1y ago

Sure, but that's a bit of a red herring. The largest expense in bringing a new prescription drug to market is the phase 3 clinical trial, which now costs on the order of $1B each. Those often fail, so it's a huge gamble. There is very little public funding for type of research.

throwanem 1y ago
And a drug like Revlimid makes its manufacturer tens to hundreds of billions; the "legacy" portfolio in which BMS classes it pulled in a cool $5.6b just in Q1 '25, of which Revlimid itself was about a sixth, or just under a billion - down by almost half year on year. See https://www.bms.com/assets/bms/us/en-us/pdf/investor-info/doc_presentations/2025/BMY-2025-Q1-Results-Investor-Presentation.pdf https://www.bms.com/assets/bms/us/en-us/pdf/investor-info/do..., pp. 8-9. It is as if VCs in the tech industry demanded the taxpayer guarantee them a healthy rate of profit, to a standard of health the VCs themselves are privileged to define. Indeed, as with Allred and the regional airlines, perhaps now we see whence Altman has cribbed his "innovation."
- nradov 1y ago
  I don't understand your point. Some drugs are enormously profitable. Others lose money. There are no taxpayer guarantees. Pharmaceutical companies on average don't generate higher shareholder returns than other industrial sectors. A few like K-V and Dendreon have even gone bankrupt. One could make an argument that taxpayer subsidized health plans which include prescription drug coverage such as Medicare Part D or Medicaid should limit the prices they are willing to reimburse on a QALY basis. And Medicare has started a limited drug price negotiation program. But generally, voters have been unwilling to accept the trade-offs inherent in drug price controls. https://www.cms.gov/newsroom/fact-sheets/medicare-drug-price-negotiation-program-negotiated-prices-initial-price-applicability-year-2026 https://www.cms.gov/newsroom/fact-sheets/medicare-drug-price...
  - throwanem 1y ago
    My point is that if you want to provide support for the advocacy argument, you've quite a long way yet to go. A good place to start would be to pick any one claim you have made and attempt to substantiate it. Until then, I've nothing with which to attempt further to argue. (If you want to do something else, I can't tell what it would be.)
    - nradov 1y ago
      What advocacy argument? You're not making any sense and are just posting lazy, low-effort criticism. None of my claims require further substantiation, you can easily look up for yourself if you want to understand how the system works and the incentives involved.
      - deleted 1y ago
        [deleted]
      - deleted 1y ago
        [deleted]
mikeyouse 1y ago
Phase 3 trials don’t cost $1B - they’re more on the order of $20M.
- nradov 1y ago
  Sorry I should have been more specific. Average total cost to bring a new drug to market is on the order of $2B. https://www.fiercebiotech.com/biotech/drug-development-cost-pharma-22b-asset-2024-plus-how-glp-1s-impact-roi-deloitte https://www.fiercebiotech.com/biotech/drug-development-cost-...
  - throwawaymaths 1y ago
    yes, that includes failures, which includes shit that a beginning grad student could tell you wouldn't work.
cogman10 1y ago
The NIH already creates grants for Phase 1 and Phase 2 trials. It's a bit insane that we don't also do phase 3 trials. Heck, even drug manufacturing is already done both by the DoD and the VA. It's crazy that we have a vision that private investment will somehow make things either cheaper, more affordable, or more available. Big pharma is providing very little benefit and a lot of cost. We've seen their playbook with people like Martin Shkreli who'll buy up patents to existing drugs and jack up the price to make a quick buck. Do we really need that sort of "private investment"?
- nradov 1y ago
  I don't think anyone is seriously making the argument that private investment in drug development is making things cheaper or more available. So that's a strawman argument. The primary claim in support of the current system is that it encourages greater levels of innovation than would happen under a socialized central planning system where government bureaucrats allocate funding for all trials. We don't have any solid evidence about that one way or the other. But year after year, US pharma companies do consistently release more new drugs than any other countries on a per-capita basis. We don't want to wreck that just because of high prices on a few patent protected drugs. Let's take a longer view and consider possible second-order effects before making any drastic changes.
  - throwanem 1y ago
    [flagged]
    - cogman10 1y ago
      Meh, I'm fine with it. The general argument for capitalism is usually one of cost and market efficiency which is why I argue that doesn't happen with medicine. But if you want to argue innovation instead, I see that as particularly worse in terms of medicine and science. Pure research is rarely profitable which is why you pretty rarely see it in an open marketplace. It's not that it never happens. Obviously some research specifically targeted at manufacturing efficiency does happen as that will increase profits. However, outside of maybe semiconductors you'll almost never see a purely private institution invest in something like material sciences. More often than not, that research actually comes from something like the DoD contacting out to a defense agency trying to do better tank armor. With medicine in the US, pretty much all innovation has come from public investment. The polio vaccine, for example, didn't come from a drug company, it came from a university researcher. That's the story of a large number of modern medicines. A private company doesn't need or in some cases even want new medicines. Why would they want to make something that benefits 1/100000 of the population when something like insulin has a huge market and few competitors. Manufacturing new medicines for rare diseases isn't profitable, so why would they ever research it in the first place?
SAI_Peregrinus 1y ago
"How can we lower the cost of phase 3 clinical trials without allowing non-functional medication (scams) to proliferate" is very important. The point of a phase 3 trial is to prove that a medication treats what it claims to treat.
throwawaymaths 1y ago
that number is not correct. you can get phase trials done in 100M ish. IIRC the 1B number is average cost, all three phases, including drug failures.