5 ms·

should we be happy about the invention or mad because of another example of corporation grief?

by tbarbugli 12y ago

kseistrup 12y ago
I'm sure people infected with Hepatitis C are happy about this.
- eximius 12y ago
  I'm sure people with poor health insurance with Hepatitis C are a little upset. I doubt they could get an insurance company to pay for the better drug.
  - maxerickson 12y ago
    The existing treatment is a $150,000 liver transplant. In addition to being more expensive than the new drug, it isn't as good a treatment (among other things, anti rejection medications for life). This drug really brings to focus the various issues and interests involved in developing new drugs. It's a better, cheaper treatment (that cures!) and still the price tag is easy to balk at.
    - masklinn 12y ago
      liver transplant is not a treatment of hep c, as far as I know, it's a treatment of liver failure as a consequence of chronic hep c (~30% of chronic hep c patients end up in with cirrhosis), the patient still has hep c.
  - kseistrup 12y ago
    Even in countries like Denmark, where we don't pay for medical treatment (instead we pay exorbitant taxes), I'm unsure how those in power will prioritize treatment of Hep C.
  - rdl 12y ago
    Generally the drug companies selling "important" but expensive drugs also run their own "access programs" to give the uninsured or other people access to the drug at a much more reasonable price. The whole pharma industry is about price discrimination. As long as they can keep the list price high, they are ok with selling some units at production cost -- this prevents a major backlash based on a media report of a pretty young white girl dying because her disabled war veteran parents missed a payment. True, it is harder to get into these programs the less "sympathetic" your case would be to the media, and a lot of Hep C patients won't be. From what I've read it is actually easier to get the really expensive high margin drugs for nearly free than the moderately expensive ones. Medicare/Medicaid would be the true payer for most poor people, though. (Meaning ultimately the taxpayer)
    - km3k 12y ago
      > Generally the drug companies selling "important" but expensive drugs also run their own "access programs" to give the uninsured or other people access to the drug at a much more reasonable price. The whole pharma industry is about price discrimination. Very true. I'm more familiar with the the costs of Cystic Fibrosis medications, but those are similar to this. Most people with Cystic Fibrosis take medications that would total over $10k/month at full price. This is something they do every month because the disease is not curable. However, with insurance, numerous manufacturer "access programs", and numerous private assistance programs targeted at Cystic Fibrosis, most patients pay much much less, often under $1k/year in total. Depending on the combination of medications and programs, these programs may cover all medication costs entirely. It's all based on how much you can pay. If you have a lot of money (you need to have well over $100k/year income to be disqualified from many of these access programs) and no insurance, you're going to pay a lot. Otherwise, not so much. I'm sure some people fall through the cracks, but there's a lot of options out there for paying for these types of expensive medications. The more expensive the medication, the more likely there are access programs or assistance programs and the more likely they will cover a larger portion of the cost.
- tbarbugli 12y ago
  You mean infected people with 80k dollars to pay for the treatment :)
  - kseistrup 12y ago
    Some countries have other models than the US one. E.g., in Scandinavia we don't pay [directly] for medical treatment.
    - twoodfin 12y ago
      I bet you could count on two hands the number of U.S. patients who will pay for this drug directly, and they could all afford it 10x over. Yet Gilead will still sell plenty of it here. So I'm not sure what you're saying about the U.S. "model".
      - kseistrup 12y ago
        I'm saying about the US model for medicare that you either have to pay for your treatment or you have to have a health insurance that will pay for you. This is in contrast to e.g. the Scandinavian countries where you get treated whether you have an insurance or not, no matter what your income level is. Those are two “models” of paying for your medicare, and I'm sure there are even other ways.
glenra 12y ago
> should we be happy about the invention or mad because of another example of corporation grief? Happy, no question. Medicine this effective doesn't come along often and bodes very well in two ways: (1) a treatment that works but is expensive today will continue to work but be vastly cheaper within a decade. (2) the fact that a real cure exists for this disease suggests we may knock out cures for other "incurable" diseases in the future.
ds9 12y ago
Reading 'corporation grief' as 'corporate greed' - To play devil's advocate here for a moment, the drug development and approval processes are crazy expensive, and the pharmacos basically charge what the market will bear for each product, and spread the revenue to all costs - not necessarily allocated by individual drugs. IOW, drug A costs a little and sells for a lot, drug B the reverse, but the total revenue covers the cost and some profit. At least that's the argument the pharmacos make in public. If this situation is not as it should be, someone should articulate what's wrong and how to fix it. E.g. patients can't afford something they're dying without, but if the vendors are forced to discount for some drugs or some buyers, how is the whole business to be financed? I can think of arguments for and against various possible reforms, but won't bore you here. We do need something more specific tho.

should we be happy about the invention or mad because of another example of corporation grief?

kseistrup 12y ago

I'm sure people infected with Hepatitis C are happy about this.

eximius 12y ago
I'm sure people with poor health insurance with Hepatitis C are a little upset. I doubt they could get an insurance company to pay for the better drug.
- maxerickson 12y ago
  The existing treatment is a $150,000 liver transplant. In addition to being more expensive than the new drug, it isn't as good a treatment (among other things, anti rejection medications for life). This drug really brings to focus the various issues and interests involved in developing new drugs. It's a better, cheaper treatment (that cures!) and still the price tag is easy to balk at.
  - masklinn 12y ago
    liver transplant is not a treatment of hep c, as far as I know, it's a treatment of liver failure as a consequence of chronic hep c (~30% of chronic hep c patients end up in with cirrhosis), the patient still has hep c.
- kseistrup 12y ago
  Even in countries like Denmark, where we don't pay for medical treatment (instead we pay exorbitant taxes), I'm unsure how those in power will prioritize treatment of Hep C.
- rdl 12y ago
  Generally the drug companies selling "important" but expensive drugs also run their own "access programs" to give the uninsured or other people access to the drug at a much more reasonable price. The whole pharma industry is about price discrimination. As long as they can keep the list price high, they are ok with selling some units at production cost -- this prevents a major backlash based on a media report of a pretty young white girl dying because her disabled war veteran parents missed a payment. True, it is harder to get into these programs the less "sympathetic" your case would be to the media, and a lot of Hep C patients won't be. From what I've read it is actually easier to get the really expensive high margin drugs for nearly free than the moderately expensive ones. Medicare/Medicaid would be the true payer for most poor people, though. (Meaning ultimately the taxpayer)
  - km3k 12y ago
    > Generally the drug companies selling "important" but expensive drugs also run their own "access programs" to give the uninsured or other people access to the drug at a much more reasonable price. The whole pharma industry is about price discrimination. Very true. I'm more familiar with the the costs of Cystic Fibrosis medications, but those are similar to this. Most people with Cystic Fibrosis take medications that would total over $10k/month at full price. This is something they do every month because the disease is not curable. However, with insurance, numerous manufacturer "access programs", and numerous private assistance programs targeted at Cystic Fibrosis, most patients pay much much less, often under $1k/year in total. Depending on the combination of medications and programs, these programs may cover all medication costs entirely. It's all based on how much you can pay. If you have a lot of money (you need to have well over $100k/year income to be disqualified from many of these access programs) and no insurance, you're going to pay a lot. Otherwise, not so much. I'm sure some people fall through the cracks, but there's a lot of options out there for paying for these types of expensive medications. The more expensive the medication, the more likely there are access programs or assistance programs and the more likely they will cover a larger portion of the cost.
tbarbugli 12y ago
You mean infected people with 80k dollars to pay for the treatment :)
- kseistrup 12y ago
  Some countries have other models than the US one. E.g., in Scandinavia we don't pay [directly] for medical treatment.
  - twoodfin 12y ago
    I bet you could count on two hands the number of U.S. patients who will pay for this drug directly, and they could all afford it 10x over. Yet Gilead will still sell plenty of it here. So I'm not sure what you're saying about the U.S. "model".
    - kseistrup 12y ago
      I'm saying about the US model for medicare that you either have to pay for your treatment or you have to have a health insurance that will pay for you. This is in contrast to e.g. the Scandinavian countries where you get treated whether you have an insurance or not, no matter what your income level is. Those are two “models” of paying for your medicare, and I'm sure there are even other ways.

glenra 12y ago

> should we be happy about the invention or mad because of another example of corporation grief? Happy, no question. Medicine this effective doesn't come along often and bodes very well in two ways: (1) a treatment that works but is expensive today will continue to work but be vastly cheaper within a decade. (2) the fact that a real cure exists for this disease suggests we may knock out cures for other "incurable" diseases in the future.

ds9 12y ago

Reading 'corporation grief' as 'corporate greed' - To play devil's advocate here for a moment, the drug development and approval processes are crazy expensive, and the pharmacos basically charge what the market will bear for each product, and spread the revenue to all costs - not necessarily allocated by individual drugs. IOW, drug A costs a little and sells for a lot, drug B the reverse, but the total revenue covers the cost and some profit. At least that's the argument the pharmacos make in public. If this situation is not as it should be, someone should articulate what's wrong and how to fix it. E.g. patients can't afford something they're dying without, but if the vendors are forced to discount for some drugs or some buyers, how is the whole business to be financed? I can think of arguments for and against various possible reforms, but won't bore you here. We do need something more specific tho.