14 Comments

So, maybe we should fund pharmaceutical research using a mechanism that doesn't consist of allowing pharmaceutical companies to collect monopoly rents from United States customers and only United States customers?

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Banger

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People love to throw around the word genocide these days.

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Practical calculations can’t just look at net increases but also distributions of increases. Feel like this misses that

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Ok — then make it fair, add in the global cost and multiply the benefits by 20? Access concerns in the US are *chickenshit*, they are utter chickenshit in comparison. And if you’re so concerned, subsidize, don’t put price caps.

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Not a great look to start conjecturing w/ random numbers. Tens of thousands have died just from a lack of access to chemo in this country over the past decade. Also, plenty of evidence suggests subsidies lead to imbalanced price setting, as is common in markets of limited competition like R&D. What’s to say a Bennett Hypothesis wouldn’t root in the sector? This is an essay that postulates wildly and weighs future lives over current lives (already a flawed philosophical grounding to start with).

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> And if you’re so concerned, subsidize, don’t put price caps.

Economics question. Given government funded subsidies, and no price caps, what do prices do?

Are you arguing that medical R&D is utterly wonderful and that, despite all the inefficiencies of our current system, medical company profit is good because some of it is spent on R&D? Because that raises the question, why not spend on R&D in some other way instead?

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They will publish the prices pretty soon. Then I'll decide if they are actually lower than rebates, gap discounts, etc.

The system of having list prices 2-3x (sometimes 10x) net prices couldn't continue.

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So the prices came out and they are higher than current prices. Does that make it a good thing?

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It's a tradeoff between not investing in new drugs and not being able to afford the drugs we do have.

Note that, if we could afford the manufacturing cost, then not being able to afford an existing drug is clearly suboptimal.

Current big pharma apparently spends almost twice as much on adverts as it does on R&D. So at the best paying for drugs and investors system is a highly inefficient way to buy R&D.

There is also an extent to which big pharma aren't doing all the work. They do the last bit of the work, sure. But often on foundations of publicly funded research like the human genome project. And if we really reach for foundations, people like Darwin doing research on personal funds.

There is some sense in which an ideal economic system should give some share of modern drug profits to investment instruments originally created to fund the foundations of science.

And failing such structure, "just give all the money to the company that put in the last piece of the jigsaw" isn't actually a great plan.

The system is already borked with mismatched incentives and tangled regulation. So any "market prices are correct" goes out the window.

Quite a bit of modern drug development is getting a new chemical that does the same thing an old chemical did, and then marketing it well, in an effort to skirt patent expiry. A fair bit of the effort is more about convincing the FDA.

Ripping this festering mess down and mostly doing directly government funded R&D instead sounds like a good idea.

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Crocodile tears for pharmaceutical leaches.

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Would have to be compared to how many people die from buying less drugs because of the higher prices.

Though considering this is just the effect from regulating prices in the US it'll be tiny compared to the gain from increased innovation I imagine.

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> the pharmaceutical industry is adding a minimum of 225 billion dollars a year in value

If you're going for a fair calculation, shouldn't we:

1. Look at QALYs saved vs. life-years saved. After all, saving an infant is vastly more valuable than adding a year for someone in a nursing home.

2. Calculate the _costs_ to society from extending someone's lifespan. Social Security and Medicare kick in at 65 in the US, so every year added past 65 is a net loss for the budget. For this very reason smokers are _net positive_ for society: they die shortly after retiring and thus consume less social services.

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You want to look at the DWL from the SS/medicare spending and from the taxes used to fund them. Not how much it saves the government budget.

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