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Thread: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

      
   
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    Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    So, the PBS Newshour program featured a story tonight on the new miracle cure for Hepatitis C, a drug developed by Gilead Sciences, Inc., a Californian company known for its HIV drugs.

    http://www.foxbusiness.com/industrie...e-reaches-23b/

    http://www.firstwordpharma.com/node/...#axzz2zmuelw00

    The drug has a stunning effectivity rate, curing over 90% of those given the drug. The regimen requires an 84 day course to work, costing each patient over $84k for the treatment.

    Sadly, the Newshour coverage did not even address the ethics or morality of the pricing of the product, nor even question the basis of such pricing, despite Congress already looking into the issue. There appears to be a clear pro-med bias on PBS, preserving them from the same harsh light that they shine on other sectors of industry and society.

    What about it? In my former home state, there are laws against price gouging during a natural disaster. If there is an ice storm, a hardware store may not double or triple the price of a gas-powered portable generator simply to cash in on desperate people. Why should medical business ethics on pricing be any different?

    No one believes the pricing is merely based upon development costs being recovered. It is obviously a case of profiteering. Is the new norm live-and-let-die, or is this just the most obvious and egregious example of the wider problem?

    Should a government and an insurance industry pay any price?

    There once were bread riots. Maybe we have reached a day in which corrupt officials once again need to be tarred and feathered literally. Maybe the pharmaceutical Bastille's need to be brought down. We have sadly unfunded drug development and allowed the private sector to run loose, and let the citizens and patients be damned.
    Last edited by Dejavudoo; April 24th, 2014 at 12:53 AM.
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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    Quote Originally Posted by Dejavudoo View Post
    ... It is obviously a case of profiteering...
    How can you estimate that?

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    In general it is not profiteering unfortunately. They get a profit of course but that's little compared to the money they spent to create the drug. Here in the UK our medicine is free but yesterday they have said they will not cover a new drug that will keep a terminally ill woman with breast cancer alive as it would cost 90,000 for six months $151,000.00. I guess what is sad is that the rich will not even blink an eye at the amount. It has been said that they would have found a cure for aids if more people had it as terrible as it sounds.

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    That is assumed, just as my positing profiteering is assumed.

    The profits this quarter alone total $2.3 billion. Exactly how much are you assuming the development costs to be?

    If only 1/3 of the 3 million patients in the US alone were to receive the treatment, sales would hit $84 billion dollars. Do the math. This is no cost recovery, regardless of what other product lines are losing or which have not yet made it to market.

    They are publicly traded. Get their quarterly statements and prove they are not profiteering.
    Last edited by Dejavudoo; April 24th, 2014 at 01:23 AM.
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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    That is why sometimes private company is not good and need government interference.


    NEVER LISTEN TO A ONE SIDED STORY AND JUDGE.

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    The primary route of transmission of Hep C in the developed world is intravenous drug use


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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    I think it's wrong but the company will justify it saying it's to recoup their investment costs from developing it. If the price never dropped or generic was never allowed, I'd call that illegal.

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    It's much the same as Americans crossing the border into Canada in order to buy prescription drugs at a much smaller cost, even with the cost of the trip factored in. Of course, American drug stores and drug companies worked hard to put a stop to that. If Canada could, for example, sell a pill for $10 each and still make a profit, imagine the profit for American stores which sell the same pill for $100.

    As for this $1000 pill, all medications have high development costs, so why don't their pills cost $1000 each as well? This is a cure, not a treatment. People need cures. That's why the company is charging $1000 each. They know the customers will pay rather than live with Hep C the rest of their lives..

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    To be clear, it practically cures Hepatitis C, but one can be reinfected and contract the disease again. The majority of patients contracted HIV through intravenous drug use, and are susceptible to it again if that practice did not end.

    It is a treatment, not an inoculation.

    The company's books must be a matter of public review to some degree, as they are publicly traded. Being large manufacturers of HIV drugs, it is difficult to imagine that they are not already profitable based on that alone, so carrying huge unrecovered costs is hard to imagine.
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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    A great influence in lowering the cost of drugs would be to allow Medicare to negotiate drug prices, as may the VA, Medicaid, and private insurers.

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    My understanding here is that neither insurance company nor individual is getting a price break. You want the drug, you pay $1,000 a pill, or you don't get the drug.
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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    My unit does drug discovery and development, so I'll chip in here if I may.

    Roughly, a new drug costs about $1 billion to get into sales. The patent lasts 20 years, at which point anyone can make the generic. From the time the patent is filed to the time the drug hits the shelves is 9-13 years, leaving on average less than half the patent life to recover the development costs.

    The clincher is this: Up to 100 000 compounds will have been tested to get to the 30 or so which are serious contenders to hit the market. That can take up to 4 years to complete. Now the patent is filed, and this is where it really starts getting expensive. Those will be whittled away to leave you with 4 or 5 really good ones, one of which is the Clinical Candidate. The rest are banked in case the candidate falls out. At this point, the process moves from Research to Development, and costs sky-rocket. Eventually, the candidate or one of the backups gets to human trials (Phase I is first in man - the small-scale safety study and dose-escalation studies done in healthy volunteers). Then Phase II, the proof of concept studies where it is tried for the first time on sick patients to see if it works properly. Then registration and the massive Phase III wider-use study, usually in diverse populations under diverse conditions (different goegraphies, diets etc) to see if it works in the real world. After this, you've spent the billion and 13 years have passed and you can start selling your drug.

    But... here's where the crazy money comes in. You have 9 other drugs reaching Phase I, II or III for different diseases to the one we're talking about. But they don't make it. Three drugs are too toxic, four of them don't work better than the existing drugs they are intended to replace, the other three don't work in the real world. So those drugs are pulled, close to $1 billion each later.

    So that one drug which makes it has to cover development cost of the other 9 which didn't, as well as itself.

    I'm not saying Big Pharma isn't evil (large chunks of their operations are), and they don't squander money on frivolous things like flying their marketing department round the world 1st Class and sponsoring all-expenses conferences at 5-star venues hoping to drum up future sales from doctors, but that is a fairly small amount in the grand scheme of things. But the huge money for the legitimate costs for everything has to come from somewhere...

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    Thanks, Dale. I was hoping you would post, although wasn't aware that you worked in drug research, only in science.

    And, most of us are aware that the winners for drug companies have to pay for their losers.

    But, it's still 84 billion in the US market alone, and that is a conservative estimate, assuming 2/3 of the currently infected never receive it.

    $84 billion.
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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    Intellectual property is difficult. How do you put a price on it? They ran with all the risks, and they alone run the risk of litigation should something go wrong. I'm sure there is an element of forward-cover in there as well, given how many of the big pharma subsidiaries are shutting up shop currently.

    As I said, I don't believe that they aren't all evil and they aren't in it for the money. But I'm not sure it's as bad as people make out. Of course I may be entirely wrong on that score. For safety's sake, though, people will have to go for the low-cost, low-risk alternative, which is taking care of their own health and not doing anything stupid enough to get them Hep C. Likewise with HIV, IMO - it is quite easy to not contract it for the most part, provided you are prepared to play safe.

    I'm heartless on that score, I'm afraid - I struggle to sympathise entirely with people who gamble, even though they know the risk, and lose.

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    My preferred model would be that development costs are funded as part of university budgets and then the health care system obtains the effective drugs at cost.

    Something that costs a billion and takes a decade to see any results is a poor candidate to be funded by private capital.
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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    Quote Originally Posted by Daximus View Post
    I think it's wrong but the company will justify it saying it's to recoup their investment costs from developing it. If the price never dropped or generic was never allowed, I'd call that illegal.
    I understand investment and research costs, however, many of these companies also receive huge government and private grants for research and development that do not have to be paid back.

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    It's a tough call. But personally, I think the pharma companies would have a big win if they'd voluntarily establish a fund of a small portion of their profits to pay for things like this for people who can't afford it. There are some Christian record companies who did that with music albums; people who couldn't afford the full price got to pay less, and the companies made up the difference -- and they ended up selling even more albums than they'd imagined, because people who paid full price understood that they were helping people who couldn't afford full price get the albums. I suspect the same thing would work with medications, though since there are physicians as middle men, in a fashion, perhaps not as effectively.

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    Oh -- as far as whether it should be allowed, from a government perspective a profit cap could be effective, say 15%, with anything extra going to fund government prescription coverage -- so the companies would know that the surtax would be coming back to buy more of their products, and people would be helped.

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

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    *the number is now forty

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    Re: Should unreasonably priced drugs be disallowed in the market? The case against Gilead's Sovaldi and the $1000 per pill costs.

    Quote Originally Posted by lambdaboy View Post
    In general it is not profiteering unfortunately. They get a profit of course but that's little compared to the money they spent to create the drug. Here in the UK our medicine is free but yesterday they have said they will not cover a new drug that will keep a terminally ill woman with breast cancer alive as it would cost 90,000 for six months $151,000.00. I guess what is sad is that the rich will not even blink an eye at the amount. It has been said that they would have found a cure for aids if more people had it as terrible as it sounds.
    Think of it as the rich volunteering to be guinea pigs for the rest of us.

    "Thirty-one* states allow all qualified citizens to carry concealed weapons. In those states, homosexuals should embark on organized efforts to become comfortable with guns, learn to use them safely and carry them. They should set up Pink Pistols task forces, sponsor shooting courses and help homosexuals get licensed to carry. And they should do it in a way that gets as much publicity as possible. "

    --Jonathan Rauch, Salon Magazine, March 13, 2000

    *the number is now forty

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