|
Leon Trotsky 2012 posted:The other side of this is that a 100% public pharmaceutical industry would just not ever pursue the development of that medicine. Developing a cure that the free market decides nobody can have seems crueler to me than just not finding the cure to begin with.
|
#
?
Nov 20, 2018 00:50
|
|
|
|
| # ? May 29, 2024 18:21 |
|
|
Leon Trotsky 2012 posted:Google what country "British Columbia" is in. You said "no government would research a drug like this" about a drug that the Canadian government researched, when are you getting banned for trolling
|
|
#
?
Nov 20, 2018 00:50
|
|
|
Leon Trotsky 2012 posted:Can you name 5 prescriptions released in 2018 that were developed and released by the NHS? Look at those goalposts move from "no country would spend hundreds of millions on medical research"
|
|
#
?
Nov 20, 2018 01:03
|
|
|
VitalSigns posted:You said "no government would research a drug like this" about a drug that the Canadian government researched, when are you getting banned for trolling Not only is British Columbia not part of the NHS, but the very next paragraph you left out says: quote:But it's the only way scientific discoveries ever get to patients, because universities don't make drugs. The BBC and NHS even explicitly say: quote:Imagine an industry that generates higher profit margins than any other and is no stranger to multi-billion dollar fines for malpractice. You may think of banking. quote:Richard Sullivan of Kings College, London, said some drug companies price their drugs correctly but others "vastly overprice" their drugs. The pharmaceutical industry is the one sector of health research where the NHS has relatively little involvement and is often subject to the whims of American pharmaceutical companies.There are calls for government action to discourage overpricing. Here is a list of the 25 biggest pharmaceutical R&D spenders in the U.K. The NHS is not on the list. quote:1 GlaxoSmithKline There were 1,579 new pharmaceuticals developed and approved for distribution in the U.K. in 2018. List 5 that were researched and developed exclusively by the NHS.
|
|
#
?
Nov 20, 2018 01:04
|
|
|
Leon Trotsky 2012 posted:Not only is British Columbia not part of the NHS, but the very next paragraph you left out says: You didn't say strictly NHS, you said "no government" And I didn't leave out the sentence that universities don't manufacture drugs I quoted that too, but you didn't say manufacture or perform clinical trials, you said "research" which the Canadian government did do. Why even bother lying about posts I can scroll up and read, what's in it for you and why are you still here
|
|
#
?
Nov 20, 2018 01:06
|
|
|
I mean just take a gander at this quote again:quote:Because Glybera is a one-time treatment that can last at least 10 years (according to patient data collected so far), the $1-million price seemed reasonable, van Deventer said. Asking one million dollars for a single dose of a lifesaving medicine is a ransom demand, not a sane or reasonable market-driven decision.
|
|
#
?
Nov 20, 2018 01:07
|
|
|
Leon Trotsky 2012 posted:The other side of this is that a 100% public pharmaceutical industry would just not ever pursue the development of that medicine. Two things here. 1) It didn't cost hundreds of millions to produce; this is simply a lie 2) taxpayers already fully funded the research from idea to full-blown medicine; it was capitalist interests that killed it entirely because they decided they needed $1 million/dose. They paid $31 million for the rights to produce it. #2 is especially important because that is true for a lot of drugs these days. It's probably important to note that most pharmaceutical companies spend more on advertising than R&D too. But even more important to note is that taxpayers fund a huge portion of the R&D that goes into new medicines; and we still get reamed when it comes to bringing those medicines to market.
|
|
#
?
Nov 20, 2018 01:09
|
|
|
Rhesus Pieces posted:Developing a cure that the free market decides nobody can have seems crueler to me than just not finding the cure to begin with. But at least the cure is out there. The company that was charging $1 million for the dose let its European market license for the drug expire.
|
|
#
?
Nov 20, 2018 01:11
|
|
|
Rhesus Pieces posted:Developing a cure that the free market decides nobody can have seems crueler to me than just not finding the cure to begin with. You're accepting a false premise because the government did develop the cure and private industry killed it because it wasn't profitable enough to cure people with it
|
|
#
?
Nov 20, 2018 01:13
|
|
|
Rhesus Pieces posted:I mean just take a gander at this quote again: It's crazy, but he is actually right in terms of the cost vs. other treatments. This treatment was a replacement for a process that cost $300,000 per year for life. That's the fundamental problem with pharmaceutical research into what they call "orphan diseases." It can cost tremendous amounts of money to research (with no guarantee of eventual success) and if you are able to develop something, then the benefiting population is limited. It's why almost all public money put into healthcare research is in delivery, holistic treatment, and broad foundational research for ways to improve "common" conditions like high blood pressure or diabetes and almost none of it goes into direct pharmaceutical development.
|
|
#
?
Nov 20, 2018 01:19
|
|
|
Cool this cure doesn't actually exist because governments don't research the kind of cures that the government researched.
|
|
#
?
Nov 20, 2018 01:30
|
|
|
WampaLord posted:Why do we let this liar continue to post here? VitalSigns posted:Seriously, he was banned from USPol for trolling why is he allowed in other US politics threads where he does the same thing. Leon is a complete loving imbecile; he ruined the Retail Collapse thread as well. The only way he's ever going to go away is if everyone ignores him, but it's a "tragedy of the commons" situation because, like all trolls, he feeds off of annoyance and it only takes one reply to give him reinforcement.
|
|
#
?
Nov 20, 2018 02:22
|
|
|
JustJeff88 posted:Leon is a complete loving imbecile; he ruined the Retail Collapse thread as well. The only way he's ever going to go away is if everyone ignores him, but it's a "tragedy of the commons" situation because, like all trolls, he feeds off of annoyance and it only takes one reply to give him reinforcement. Have you looked into the exchanges in your area? I'm for real actually worried that you are hurting yourself out of tens of thousands of dollars a year. If you need any actual help, you can PM me. I've copied the relevant part from the original post below: quote:At the income level you cited, you would be eligible for a plan with a monthly premium of between $17.45 and $26.21 per month depending on what plan you got. The deductible is $100 per year for that plan as well.
|
|
#
?
Nov 20, 2018 02:32
|
|
|
Leon Trotsky 2012 posted:The other side of this is that a 100% public pharmaceutical industry would just not ever pursue the development of that medicine. Meanwhile Cuba has developed vaccines to treat cancer so shut the gently caress up
|
|
#
?
Nov 20, 2018 03:31
|
|
|
Pablo Nergigante posted:Meanwhile Cuba has developed vaccines to treat cancer so shut the gently caress up Actually that would never happen, so it didn't qed
|
|
#
?
Nov 20, 2018 03:33
|
|
|
Pablo Nergigante posted:Meanwhile Cuba has developed vaccines to treat cancer so shut the gently caress up You know this came up awhile ago and we determined that "vaccine" really isn't even the proper term for it. It doesn't prevent cancer. Which is not to say that Cuban healthcare isn't better than American healthcare, because every account I've read indicates that it is. But framing it as "Cuban cancer vaccine" is really not true and the science surrounding what they do have is in dispute in the medical community.
|
|
#
?
Nov 20, 2018 04:46
|
|
|
Lightning Knight posted:You know this came up awhile ago and we determined that "vaccine" really isn't even the proper term for it. It doesn't prevent cancer. It’s a therapeutic vaccine, the mechanism of action is similar to preventative vaccines. It’s a legit use of the term
|
|
#
?
Nov 20, 2018 04:52
|
|
|
Pablo Nergigante posted:It’s a therapeutic vaccine, the mechanism of action is similar to preventative vaccines. It’s a legit use of the term Oh I see. Interesting! I retract my point then.
|
|
#
?
Nov 20, 2018 04:53
|
|
|
The most effective treatment for malaria was a chinese invention and secret PLA project. Western doctors scoffed at the idea that Chinese people could've created something so effective until they started using it themselves and quickly adopted it. I'm not sure why it takes a profit motive to discover lifesaving cures, that's like claiming that people go into the movie business to make money. Obviously there's an intrinsic motivation involved outside of just profit.
|
|
#
?
Nov 20, 2018 05:08
|
|
|
Lightning Knight posted:Oh I see. Interesting! I retract my point then. No worries, it’s pretty cool and fascinating stuff honestly
|
|
#
?
Nov 20, 2018 05:10
|
|
|
Even ignoring the dumb "moving goalposts from government funding stuff to the NHS directly developing it" stuff, Leon's point is stupid because it assumes that there would be nothing filling the hole left by private industry. In reality, you could just expand grant funding or something, and I'd trust that more than private industry to allocate money effectively (with regards to helping people, rather than making money, anyways).SousaphoneColossus posted:I pretty much agree with you on that, but I'm more interested in the question of how people who are sincerely pro-single payer would, once the system was passed/in place/etc., view a multi-payer system with a much more robust public insurance setup like Germany or Australia -- i.e. one that maintains a sizable private health insurance market. The issue is that even if a multi-payer option could possible be made to work, we have a guaranteed effective solution in the form of a single-payer system like that proposed by Medicare for All, and I don't trust the sort of person opposing the latter to ever implement the former in a way that would actually be good. Basically, in the context of our current political situation/discourse, it only serves to pointlessly muddy the waters, and no politicians (or think tanks or whatever) who make this point are doing so in good faith. Ytlaya fucked around with this message at 05:36 on Nov 20, 2018 |
|
#
?
Nov 20, 2018 05:27
|
|
|
Ytlaya posted:Even ignoring the dumb "moving goalposts from government funding stuff to the NHS directly developing it" stuff, Leon's point is stupid because it assumes that there would be nothing filling the hole left by private industry. In reality, you could just expand grant funding or something, and I'd trust that more than private industry to allocate money effectively (with regards to helping people, rather than making money, anyways). Yeah that's another good point that was overlooked as LT2012 furiously backpedaled away with the goalposts when he realized he hadn't read the article to see who was responsible for the research. Even if clinical trials cost $100 million there's no practical reason the US can't spend 0.001% of the military budget on a lifesaving medicine, except that then the government would own the license and drug lobbyists won't allow that. But the research is already done you don't need a capitalist to run a trial, he will just hire scientists to do all the work for a salary anyways And there's no reason the government couldn't contract with a manufacturer to produce the drug, production costs are insignificant after the initial research and trials are done. The argument against boils down to "the government is currently doing this, therefore it must be incapable of doing it" which could have been made against anything the government is currently doing before it started doing it: Medicare, Medicaid, the Air Force, Social Security, etc etc VitalSigns fucked around with this message at 07:02 on Nov 20, 2018 |
|
#
?
Nov 20, 2018 06:42
|
|
|
$1million/dose actually seems less insane after poking numbers at it some. Someone on another site talking about the same story who works in similarish gene therapy resarch (but in academia instead of industry) ballparked direct manufacturing cost at scale at a few hundred thousand per dose, which seems reasonable to me for what it is. Call it $700,000 of revenue per patient. Also the viruses fall apart even at -80C in about a month, so you can't hold inventory [the companies entire stock when they gave up was 3 doses]. Prevalence of the pancreas thing it treats is about 1/1000000. So across the entire EU where it was approved, there's about 400 people/year who it could potentially treat. The entire EU market is at most about $250 million/year. I can believe that at a point where they'd only going to be treating ~10 people per year (~$7 million revenue), fixed costs on the factory and spoilage could eat all that money.
|
|
#
?
Nov 20, 2018 06:47
|
|
|
Charging $1 million per dose for any drug is completely insane and morally disgusting. I really don’t give a gently caress how it shakes out in excel, under no circumstances should any single dose of a drug cost that much. It might as well cost $500 billion for the amount of good it will do. When you crunch the numbers and come to over six figures per dose you acknowledge that you hosed something up and try again until it’s reasonably affordable.
|
|
#
?
Nov 20, 2018 07:01
|
|
|
Foxfire_ posted:$1million/dose actually seems less insane after poking numbers at it some. Excellent analysis, oh wait except for one small thing: they interviewed an executive of the drug company as to why the price tag was $1 million and he didn't say anything about fixed production costs being so high on such low volume that they can't break even below $1 million price point, he said: quote:The decision to price Glybera at $1 million was based on a business calculation, according to van Deventer. They determined the seven-figure price tag based on the cost of 10 years of the currently existing treatment, in other words "because we can". Nothing to do with production cost. Honestly would it kill people to read the article before making GBS threads out some Ayn Rand free market fanfic fairytale to justify corporate greed.
|
|
#
?
Nov 20, 2018 07:07
|
|
|
Oh yeah and lowering it wasn't even considered, not because of per-unit production costs but because:quote:Van Deventer says the company never considered lowering the price. They just didn't want to make less money
|
|
#
?
Nov 20, 2018 07:10
|
|
|
Rhesus Pieces posted:Charging $1 million per dose for any drug is completely insane and morally disgusting. It costs more than six figures to: - Make a shitton of DNA with exactly the sequence you want and nothing else, then test and document it (or you gave the patient cancer) - Culture a couple hundred liters of bacteria in suspension, infect them with exactly the virus you want and nothing else, then test and document it (or you give the patient a massive viral infection) - Extract all the virus out of your cells and purify it (horribly expensive/labor intensive, and if you screw up you either don't deliver enough virus [treatment doesn't work] or deliver too many live bacteria [now your patient has sepsis]) - Do animal studies on your end product for every batch to make sure it still works. You can do it cheaper but it's a tradeoff between treatment works/does nothing/kills the patient. We don't know how to mass-produce gene therapy treatments cheaply. They were in the EU selling to mostly single-payer national health systems, so they weren't trying to stick individual people with enormous drug costs, they were trying to get NHS-type organizations to pay it. Trying to gouge the national health system is immoral, but the pricing isn't implausibly out of line with what gene therapy costs to produce. edit: They have public financial stuff. They're losing about $70million/year. Foxfire_ fucked around with this message at 07:42 on Nov 20, 2018 |
|
#
?
Nov 20, 2018 07:36
|
|
|
Foxfire_ posted:It costs more than six figures to: I mean they asked the company exec "hey why does it cost this much" and he didn't say "it costs us six figures to produce one dose", he said "we based it on the cost of 10 years of the current therapy" in other words "because we can"
|
|
#
?
Nov 20, 2018 07:44
|
|
|
VitalSigns posted:Oh yeah and lowering it wasn't even considered, not because of per-unit production costs but because: We need to replace these assholes with state and federal labs or something. Accretionist fucked around with this message at 08:05 on Nov 20, 2018 |
|
#
?
Nov 20, 2018 07:46
|
|
|
Ytlaya posted:Even ignoring the dumb "moving goalposts from government funding stuff to the NHS directly developing it" stuff, Leon's point is stupid because it assumes that there would be nothing filling the hole left by private industry. In reality, you could just expand grant funding or something, and I'd trust that more than private industry to allocate money effectively (with regards to helping people, rather than making money, anyways). I don't have an intimate knowledge of the pharmaceutical industry, but I do know something about other industries. In those other industries, foundational research, which is often, but not always, done at universities & government labs, and industrial product research/development are not as alike as people in this thread seem to think they are. They are kind of two totally different things and are solving very different problems. I think the posters in this thread are also under-rating the difficulty & investment involved for product development. We don't usually get the product the next day once some researcher has shown that maybe, in principle, some technology might be able to be achieved. I'm a little skeptical of people in this thread who claim that government researchers would be able to easily take on the function of product-izing technologies and that they'd be so good at it, they'd do it at lower cost. I suspect that in a world where we banned private development of pharmaceuticals, we would just have fewer new drugs (maybe this is okay!). Especially with what I've heard about pharmaceuticals & drug development--which is that the scientific theory on this subject is not as great as we'd like it to be, so it is hard to be very smart about the development process, and as a result, the way drugs get developed is by doing like a million trial and error experiments and spending many dollars in order to find the drug that works.
|
|
#
?
Nov 20, 2018 11:39
|
|
|
The pharmaceutical capitalists are just waging a war of attrition against the insurance capitalists. The pharma execs want the insurance execs to pay them a million per dose. The insurance execs don't want to pay that much. By not lowering the price per dose the pharma execs have put this issue into the spotlight. The goal of pharma execs is to convince the public that greedy insurance execs don't want to pay a million per dose for lifesaving treatment. Will their gambit work? Even if there's just a 20% chance that governments pass legislation to force insurance companies to pay a million per dose, that's still a nearly $200,000 per dose expected profit for the pharmas, and all they had to do was simply be patient.
|
|
#
?
Nov 20, 2018 11:56
|
|
|
silence_kit posted:I suspect that in a world where we banned private development of pharmaceuticals, we would just have fewer new drugs (maybe this is okay!). Why would we need to bad private development? We could just fund more public research and start allowing the government to conduct trials for the drugs it discovers and contract with manufacturers to produce it. That would just lead to more drugs, like in this case where the government discovered a drug and private industry bought the license and then refused to produce it because it wasn't profitable enough! silence_kit posted:Especially with what I've heard about pharmaceuticals & drug development--which is that the scientific theory on this subject is not as great as we'd like it to be, so it is hard to be very smart about the development process, and as a result, the way drugs get developed is by doing like a million trial and error experiments and spending many dollars in order to find the drug that works. This feels like yet another person who didn't read the article before falling back on Ayn Rand government-bad fanfic. The government did find the drug that works in this case, private industry won't let anyone have it even though all the work is already done, because no one can afford the profit margins that industry wants to make on selling it.
|
|
#
?
Nov 20, 2018 12:09
|
|
|
VitalSigns posted:This feels like yet another person who didn't read the article before falling back on Ayn Rand government-bad fanfic. The government did find the drug that works in this case, private industry won't let anyone have it even though all the work is already done, because no one can afford the profit margins that industry wants to make on selling it. What I’m getting from the article is that the Canadian researchers did the foundational research, and multiple European companies, who went bankrupt (the article liked to blame this on the regulatory process for approving drugs), did the product development. Part of what I’m saying is that the product development is not a layup! While it isn’t as big a gamble as foundational research, you still don’t get it for free, and it’s success isn’t guaranteed. Of course the university researcher interviewed for the article is going to downplay the importance of the drug-creation process in which he didn’t directly participate in. Product development also is very different from foundational research. Being good at one doesn’t transfer to the other. I’m not really getting why it is believed in this thread that the government is going to be way better at it than private industry.
|
|
#
?
Nov 20, 2018 14:21
|
|
|
Whether you have the profit motive of private research, or the efficiency goals of public research, I think people with particularly rare diseases that are expensive to treat are always going to get the shaft. It's not wrong to say that spending public funds on a drug that can treat/cure 40 people is less desirable than spending it on something that can help many more people. In either case, there are motives that work against people with rare and expensive diseases, which is why I don't think this is a great example case to determine the relative efficacy of public vs. private research. What this does reveal, however, is a fundamental flaw in the way pharmaceutical patents are handled. Drug production should be nationalized, and any pharmaceutical patent which is not being actively used should be taken out of effect until such time as the rights-holder wishes to use it again, removing such a circumstance where a pharmaceutical is taken out of production because it's not generating enough profit.
|
|
#
?
Nov 20, 2018 15:11
|
|
|
silence_kit posted:What I’m getting from the article is that the Canadian researchers did the foundational research, and multiple European companies, who went bankrupt (the article liked to blame this on the regulatory process for approving drugs), did the product development. Turning a drug that is already full-blown medicine into a product isn't like coming up with an iPhone after capacitive touchscreens and flash memory were invented. It's just a matter of doing the clinical trials to prove it's safe and effective, which follows well-established protocols, and then manufacturing it or contracting someone to manufacture it. It doesn't need a slick interface or a hip form-factor so I really don't think private industry is really essential to make sure the bottles the publicly imagined and researched medicine comes in are a fashionable color. All the creative stuff was already done. But hey if you think it's impossible for government to uh run a clinical trial and then manufacture something, you have no reason to oppose it they'll easily be outshone by the wonderful private pharma companies who are currently *checks notes* withholding critical treatments from patients out of greed.
|
|
#
?
Nov 20, 2018 15:17
|
|
|
VitalSigns posted:I mean they asked the company exec "hey why does it cost this much" and he didn't say "it costs us six figures to produce one dose", he said "we based it on the cost of 10 years of the current therapy" in other words "because we can" I mean, presumably the consumer isn't paying the price regardless of whether it's $1M or $300k. If they're talking to an insurance company (or national health system, like they were) saying 'right now, you pay $x per year to treat this person and will for the rest of their life. For $3x, you can cure them' doesn't really feel terrible. IIRC, he didn't say that they were basing it on the cost of 10 years, just that people hadn't needed re-treatment for 10 years and on-going, and that the average cost was $300k/yr. From the companies side, curing people is really a losing proposition which is a problem with profit motive in health. You're better off with people needing your drug indefinitely over curing them so they only need one dose. I was at one of the biotech conferences last year around the JPM Health conference, and a gene therapy company was talking about bringing their treatment to market, and they were also targeting around $1M per treatment, and that was exactly their logic -- it was essentially asking someone to pay 2 years of current treatment costs to cure them and 'never' have to pay for that disease again in that person. Their argument was that they couldn't price it to be competitive with other therapies because it was a one-and-done model rather than something that required constant maintenance and it was an orphan disease so they had to make their money on a low number of people - and it would be paid by the insurer, not the patient.
|
|
#
?
Nov 20, 2018 16:31
|
|
|
Zauper posted:From the companies side, curing people is really a losing proposition which is a problem with profit motive in health. This is why the profit motive belongs nowhere near health care
|
|
#
?
Nov 20, 2018 16:33
|
|
|
Pablo Nergigante posted:This is why the profit motive belongs nowhere near health care as Zauper can explain to us, it just wouldn't be cost-effective for insurers to cover these people how is he to keep these job, if he was expected to stop these people from dying. https://www.youtube.com/watch?v=QEJ9HrZq7Ro&t=16s
|
|
#
?
Nov 20, 2018 16:38
|
|
|
The more I learn about healthcare, the more I am convinced that maybe the command economy people were actually right all along.
|
|
#
?
Nov 20, 2018 16:38
|
|
|
|
| # ? May 29, 2024 18:21 |
|
|
Lightning Knight posted:The more I learn about healthcare, the more I am convinced that maybe the command economy people were actually right all along. Health care is an "impure" public good. https://en.wikipedia.org/wiki/Public_good Like the army, the interstate highway system, internet infrastructure, the postal service, etc., it's just better provided by the government. Back in the 1700's all the fire departments were funded by private fire insurance. Eventually we realized that, no, it was better to just have the government subsidize it, because private insurance meant fires got ignored if the wrong people's houses were on fire, and then the fires spread to everyone. Health care insurance now is where fire insurance was in 1750.
|
|
#
?
Nov 20, 2018 16:42
|
|
