NYT: Drug Goes From $13.50 a Tablet to $750, Overnight

[Redskins Diehard]

I never really understood this logic.

Some large blocks of text quoted in that post

[Larry]

I never really understood this logic.

Granted, I'm assuming that somebody, somewhere outside the US, is making this drug. I'm assuming that they're making it in a country where their barriers to entry are lower than the US, but that's still a country where I'd trust their manufacturing technique.

(Which might be an unreasonable assumption.)

 

But then, your assuming that Canada just buys it from the US is an assumption, too. 

[Barney B]

This forum used to be teeming with libertarians. 

 

Did they all finally realize that their beliefs were incredibly naive, or did they migrate to an echo chamber website?

 

 

Any who are left should be in here defending the free market.

[PokerPacker]

This forum used to be teeming with libertarians. 

 

Did they all finally realize that their beliefs were incredibly naive, or did they migrate to an echo chamber website?

 

 

Any who are left should be in here defending the free market.

Or perhaps the concept of the free market is more complex than you like to hamfist us into believing in. We are not laissez-faire capitalists.

[Barney B]

Editing out smartass retort -

 

I'll meet you halfway:

 

You're not all laissez-faire capitalists, evidently. That's a good thing, IMO, and I won't expect you to defend anyone else.

 

 

But laissez-faire capitalists tend to be over-represented among libertarians, don't you think?

[PokerPacker]

Guilty as charged. Glad you've made it as far as you have.

 

Is it hamfisted to presume to speak for other (or all?) libertarians?

Perhaps I should just go sit in a corner rather than make such presumptuous statements as "we are not Laissez-Faire Capitalists".

[Kosher Ham]

The more I think about this...the worst I think the situation could become.

 

Folks robbing pharm companies, deliveries, etc...

 

Selling on the street for $50-100 bucks. Sure more than 13...but way less than 700.

 

I am certainly not against capitalism...there comes a point though, that the public will spend the money elsewhere for the same product.

[balki1867]

Reading some of the follow-up articles, it appears he's buying up orphan drugs, which have their own special set of government protections. Based on my limited knowledge-- orphan drugs are drugs designed for rare diseases.  Because there isn't a huge demand for these drugs, the government gives the drug creator a monopoly on the drug much longer than a typical patent period.  This gives drugmakers incentives to find treatments for rare conditions that wouldn't otherwise be profitable to cure.  Beyond the reasons posted earlier I think this is why you can't have someone manufacture a generic version of this drug.

 

If someone with way more knowledge of FDA regulations would like to correct me, please feel free.

[PeterMP]

Granted, I'm assuming that somebody, somewhere outside the US, is making this drug. I'm assuming that they're making it in a country where their barriers to entry are lower than the US, but that's still a country where I'd trust their manufacturing technique.

(Which might be an unreasonable assumption.)

 

But then, your assuming that Canada just buys it from the US is an assumption, too. 

 

I'm sure somebody else somewhere out there is making this drug, but I doubt to sell it to Canada.  In India, sure.

 

While I've made an assumption, it is an assumption based on what is generally true, and that's why the idea is generally called REimporting drugs (e.g. http://economix.blogs.nytimes.com/2009/12/18/reimporting-american-drugs-from-canada/?_r=0).

 

The vast majority of companies that sell drugs in Canada are the same companies that sell them in the US, and in most cases, the same facilities are used.

 

There has actually been some stories about the US FDA cracking down on Canadian companies that are manufacturing drugs in a way they consider unsafe in India, while Canada allows the drugs to continue to come into the country from the same plants.

 

http://www.thestar.com/news/canada/2014/09/11/canadians_kept_in_dark_about_defective_drugs.html

So he's agreed to lower the price.

 

To what isn't clear yet.

 

http://www.nbcnews.com/news/us-news/drug-ceo-will-lower-price-daraprim-after-outrage-n431926

[Kosher Ham]

See these are the topics I wish McQueen and China would investigate for us.

 

Balki, from what I understand they are a typically used drug as part of the HIV c0cktail. Sure it doesn't get used like ibuprofen...but it is used and for more than just that.

 

My only problem is the increase. 50 bucks a pill sure...700+...that's unreasonable to me for any med that they got funded to create in most instances.

[PeterMP]

It don't think it is under any protection other than for a new company to sell the drug, they'd have to get their formulation, manufacturing process, etc. approved by the FDA, which is true for any drug.

 

In order to do that, they have to compare the efficacy of the new drug to the existing one, which means you have to get the existing one and test your formulation.  Then one way that competition can be prevented is by controlling the supply of my drug so that the competition can't get it to do the tests or reverse engineer my formulation (that's the easiest way to create something that is essentially equivalent).

 

The drug itself has no impact directly on HIV.  Toxoplasma is a parasite that largely affects cats.  Something like 35% of humans are actually infected.  It just doesn't seem to affect most healthy humans.

 

But if you have an HIV infection that has developed into AIDS (or a immune systemp suppressed for another reason), it is an issue.  This drug kills the Toxoplasma.

 

(Interestingly, Toxoplasma might have largely undetected affects in humans in some cases.  In mice the infection does not precede as it does in cats, and it goes to the mouse brain.  After being infected mice are no longer scared of cats.  So at some level it is an advantage for a cat to have it if then can infect mice with it (it is in the cats feces so if mice become exposed to cat feces they can have the infection.)

 

http://www.nature.com/news/parasite-makes-mice-lose-fear-of-cats-permanently-1.13777

 

In some cases, in humans, it is also known to enter the brain and is being found to affect human behavior.

 

http://schizophreniabulletin.oxfordjournals.org/content/33/3/757.full

 

It is something people aren't generally treated for even if it is known they have an infection, but we might be changing our behavior unknowingly by exposure to cats.)

[Destino]

Could explain why the internet is filled with cat pictures.

[Rocky21]

http://www.bbc.com/news/business-28212223

Holy ****. We all know this is going on but this is really eye opening. And I always find it amusing that we have to go outside the U.S. to get truthful reporting on sacred cows in this country such as medicine.

[tshile]

This forum used to be teeming with libertarians. 

 

Did they all finally realize that their beliefs were incredibly naive, or did they migrate to an echo chamber website?

 

 

Any who are left should be in here defending the free market.

 

Speaking for myself, I realized how naive they were.

[PeterMP]

I was thinking about a fix for this problem.  I think making it illegal to change your drug prices by a certain amount of inflation (e.g. 1.5*inflation*current cost of durg) without approval where you can document a change in your costs (e.g. supply or labor costs went up in drastic manner) might work nicely.

 

And have a positive more general impact on the price of drugs.

 

This guy would have probably never acquired this drug because he wouldn't have been able to increase by more than a little bit.  There is no way he could document that the costs went up by that much.

 

But I think part of his plan was likely that he knew it was unlikely a competitor would jump in because of the hurdles involved into getting into the market and once they started getting close to entering the market, he could cut the price back and make it very difficult to get their investment back.

 

The FDA barriers do act to limit competition even in the generic market.

 

However, if he couldn't DECREASE his price more than 1.5*inflation*costs of the drug a year, then if you improperly price your drug, you can end up in a situation where somebody else can bring a new alternative to the market and under cut you, while your prices are left being high.

 

It might force companies to be more thoughtful on how they price their drugs.  Price it too high and then you invite competition that you can't respond to by simply cutting the price.

[DogofWar1]

This guy would have probably never acquired this drug because he wouldn't have been able to increase by more than a little bit.  There is no way he could document that the costs went up by that much.

 

The key for something like that would probably be to keep costs of purchasing the drug's rights out of the tabulation.  While I'm for more price controls generally (though I'd like to see how the market functioned if Medicare was allowed to negotiate first), I can understand the argument that research costs need to be recouped and then there needs to be a profit incentive.  I think that argument is overblown, but there's some truth there.  Once you've bought an approved drug though, you're not doing the research to make it, so the purchase price should be excluded.  Not sure how legislators, or big pharma, for that matter, would feel about that.  I can imagine that keeping purchase price of transferred drugs in the tabulation in a system like the one you suggest would be a high priority, as it would allow a sort of "pharma-swap" system where companies sell drugs amongst themselves to justify retaining high prices.

[PokerPacker]

The Taiwanese Animators are always so quick and topical.

[Predicto]

I still want to punch his smug face and then kick him right in the balls.

 

Does this make me a bad person?

[DogofWar1]

I still want to punch his smug face and then kick him right in the balls.

 

Does this make me a bad person?

 

Considering there's wide agreement that this guy is objectively evil, a kick to the balls is probably chaotic good.

[Zguy28]

I still want to punch his smug face and then kick him right in the balls.

 

Does this make me a bad person?

No, it doesn't. He will face justice, in this world or the next.

[mcsluggo]

They're fundamentally opposed.

 

Healthcare is not a choice, at least a portion of it is not a choice. Yet a group of people in this country want to run it like it is, making it adhere to a system that is based on competition and by extension choice.

 

yeah.. there are real huge market failures in medicine.  and obvious ones.  Anyone that doesn't see that either isn't being honest with themselves, or really doesn't understand economics at all.

[Lombardi's_kid_brother]

yeah.. there are real huge market failures in medicine.  and obvious ones.  Anyone that doesn't see that either isn't being honest with themselves, or really doesn't understand economics at all.

 

Maybe healthcare was more of a commodity when everyone died of TB at age 45 and every doctor just said, "I dunno. Move to Arizona" while smoking a cigarette. But it's clearly something different now.

[DogofWar1]

yeah.. there are real huge market failures in medicine.  and obvious ones.  Anyone that doesn't see that either isn't being honest with themselves, or really doesn't understand economics at all.

 

Yeah, in most places where you have a necessity, hard or soft, and especially where that necessity has a high barrier to market entry, there are strong incentives to warp the market for your firm's benefit.  The customer base for necessities is guaranteed, so if you can just clear the market of opposition, you've got a captive audience which cannot escape, without severe harm to themselves or their livelihoods.

[mcsluggo]

Maybe healthcare was more of a commodity when everyone died of TB at age 45 and every doctor just said, "I dunno. Move to Arizona" while smoking a cigarette. But it's clearly something different now.

 

if we just accept the basic fact that for 90% of the population 90% of healthcare costs pile up in the in their first and their last couple of years of life ... then markets will fail to reach economically efficient equilibriums <<<WITHOUT even looking at all the OTHER glaring peculiarities of the "market">>

 

 

 

** note.. i made up both 90% figures.  but I'll assert that neither is very far from the mark.   

[Lombardi's_kid_brother]

if we just accept the basic fact that for 90% of the population 90% of healthcare costs pile up in the in their first and their last couple of years of life ... then markets will fail to reach economically efficient equilibriums <<<WITHOUT even looking at all the OTHER glaring peculiarities of the "market">>

 

 

 

** note.. i made up both 90% figures.  but I'll assert that neither is very far from the mark.   

 

 

I think we do accept that to some degree, don't we? We have basically said, once you hit your 60s, your healthcare costs are paid for by the government.