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


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I guess if I'm a CEO of a drug company, I stop developing life saving drugs. I focus on boner pills and weight loss medicine. Because I need to grow profits or I am fired. Who needs the hassle of a congressional investigation every time I need to raise a price?

One problem with your analysis is Turing the company run by Shkreli didn't develop anything.. They purchased the exclusive rights to produce Daraprim one month, and raised prices 5555% the next month. The costs of the ingredients didn't go up. As Pete pointed out a compounding pharma organization could produce pills using the same ingredient for each named patient and still make a profit charging only 1$ a pill.. or 7% of the original $13.50 price. A company like Turing which could mass produce Daraprim probable could knock an order of magnitude or two off of the production costs of a compounding pharmacist.

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Peter, 

 

Let me be very clear Pete..  Because I know you like forfeit wars,  and concentrate on winning battles nobody cares about but you..

 

First the Battle.... 

-----------------------

(1)   Turing did and still does have a monopoly on Daraprim.  that's what Shkreli paid 55 million dollars for.

Daraprim is only a name. That's like saying that Kellogs has a monopoly on Frosted Flakes even if I can go to the grocery store and buy things that are essentially the equivalent because I can't go to the grocery store and buy a box from another company that says Frosted Flakes on it.

 

(3)   Imprimis initiative provides an alternative that doesn’t encroach on Turing’s product

How can they produce an alternative that doesn't encroach on Turing's product? How does that make sense?

 

If I have Toxoplasma, I can order a drug from them to treat it, and I can do it today (you were wrong).

 

(7)   Imprimis cannot and does not compete with Turing,  Imprimis with their custom made for each patient at four small labs alternative doesn't have the volume to compete with Turing which runs a mass produced drug manufacturing line.

Sure they are. If I have Toxoplasma, I can buy it from Turing or I can get a product from Imprimis. How is that not competition?

In addition, I think you are over doing it with the "custom made". They do need a specific person with a specific prescription to generate the drug for that person, but they are making only a couple of different types of pills (see their order form). It isn't like they are making a new recipe for each person (though, they will do that if that's what you want, but I suspect that would cost you more).

How do you know if they are competing with Turing on volume? How many orders is Imprimis getting and how far behind how they are? How much of Imprimis' alternative would be needed to treat everybody in the US, and how much can they produce?

I don't know, but I strongly suspect that you don't know either. You were wrong when you said that what they were doing was only going to happen in the future. They are doing it NOW, and now I suspect you are making up something that you don't know, and I can't easily disprove.

Rather than admit you are wrong, you have now moved the argument to a set of things that aren't really right or that I don't think you really know.

 

Please cite something the quantity that Imprimis can generate and the quantity needed to actually fill the US demand.

Out of the whole post, the only thing that is actually really accurate is the hospital stock, and I'm not sure how relevant that is in the context how many people are walking off the street into a hospital where they need treatment for Toxoplasma faster than Imprimis can make it and get it shipped.

I don't believe that Toxoplasma is normally what originally causes somebody to be diagnosed with HIV/AIDS today, and I don't think it is generally quickly/extremely life threatening.

 

Turing/Shkreli which owns the rights to Daraprim  also hiked the price of another important  drug, Thiola(2) for kidney stones, to $30 a pill from $1.50.   or a hike of 2000%.    There are no generic or compounded alternatives to that drug.. and That Price remains unchanged today even as Shkreli has left the Turing Company.

There is ALWAYS a compounding alternative for non-patent protected drugs (which all of these are). You can call them and ask them what they'll charge. That's what compounding companies do. You tell them what they want, they look at it, and quote you a price.

They just aren't publicly pushing an alternative, and I'm not sure it would be cheaper to go the compounding route.

 

But if the price gets to the point that they think the can compete (and the FDA lets them), I'm sure they will jump in.

 

it's a systemic problem across the entire pharma industry.   What allowed these half a dozen companies to raise prices by hundreds or thousands of percents to increase their bottom line isn't even all that rare.

What are you talking about? It is 3 companies! Not 6! And even it if was 6, it wouldn't be "systemic" for an industry as large as the Pharma industry.

(I'll note that, your link actually only talks about 2 COMPANIES. I've added a 3rd because the last company Shkreli was associated with was doing something similar so we got 3 companies, two of which were headed by the same guy.)

 

The war Pete is Americans pay more money for name brand drugs than any country on earth..   We pay 200-600% more than other countries for our drugs.

And we also pay less for generics in general, we also use more drugs, and we tend to use more newer drugs.

 

Again the central premise is our pharma regulations and laws are designed to convey profits to the corporations and not services and efficiency for the consumer; and that needs to change.

Given what Shkreli and Valeant (the other company in your link) have done, we need to look at the FDA regulations needed to enter into the generic market.

How can we lower the barriers and make them cheaper and faster?

I don't think anybody disagrees with that. People have been complaining about the length of time the FDA takes to approve generics for years. Maybe this sort of thing will actually make Congress/FDA to do something about it.

 

I'll point out going to a single payer system doesn't really eliminate this issue.  There are drugs that do not get carried in single payer systems because they cannot come to an agreement with the manufacture of the drug.  If one of these companies decided to hike their prices in Canada, the Canadians would have choice, pay the price or not have the drug be available.

 

For example:

 

http://www.theglobeandmail.com/life/health-and-fitness/health/arthritis-drug-stops-selling-in-canada-leaves-young-patients-desperate/article18067474/

 

"About 24,000 Canadians under 18 live with some form of arthritis, a disease that can cause severe pain, permanent joint damage and serious growth problems. For many, a simple injection of an inexpensive drug called Aristospan can eliminate symptoms and put their arthritis in remission for months at a time. But the company that markets the drug in Canada has decided to stop selling it, leaving patients, doctors and their families scrambling for a solution. Instead of going to their local pharmacy, families now must wait weeks or months for access to the drug – an unnecessary delay that is causing children and teens to suffer irreversible joint damage, according to arthritis specialists and families of those affected.  

 

Although they’ve been unable to find out why Aristospan is no longer available on the Canadian market, some experts are concerned that this lack of access is part of a wider trend: the growing disappearance of inexpensive, older drugs that have small profit margins."

 

We do have a problem, but you aren't really proposing a solution to his particular problem.

 

I think there are some other things we could do beyond just the speed at which the FDA approves generics and the regulations requires to get a generic on the market):

 

http://es.redskins.com/topic/393333-nyt-drug-goes-from-1350-a-tablet-to-750-overnight/?p=10352120

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I'll take that as a victory and move on.

From page 2 of this thread:

 

I was thinking about a fix for this problem.

 

:lol:

 

You did a lot of writing to declare a victory that you could have declared if you'd bothered to read the thread before you start spouting out garbage.

 

I think it is Jumbo that says read more write less.

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You did a lot of writing to declare a victory that you could have declared if you'd bothered to read the thread before you start spouting out garbage.

 

I always say the more personal you make the post,  the weaker your case.   In this thread you never engaged in the overall point that the pharma industry which you are part of is immoral and uses corruption and price fixing as a central business case.    Monopolies are rampant in this industry.  Profiteering are rampant.    

 

I'm glad we can both agree on all these facts.   Hopefully we get for our next President someone who hasn't accepted tens of millions of dollars from this industry to safeguard a system which no longer works to the advantage of the US Consumer but rather serves the narrow self interests of criminals.

Criminals not by our laws of coarse.. but criminals none the less.

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I always say the more personal you make the post,  the weaker your case.

This sentence is ironic in the context of the rest of this post where you try to throw me in with an industry that you then call criminal (essentially calling me criminal).

 

In this thread you never engaged in the overall int that the pharma industry

I engaged your over all point before you entered this thread back on page 2.

 

which you are part of

Why do you say that I am part of the Pharma industry?

JMS just be factually correct, and if you don't know something than don't write in a post, and if I tell you something, and you think I'm wrong, then ask instead of incorrectly insisting I'm wrong.

I get tired of writing posts to correct your factually incorrect statements. It's annoying.

You have some big point you think you can and want to make. Great! Do it!

But do it in a manner where you don't make factually incorrect statements.

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This sentence is ironic in the context of the rest of this post where you try to throw me in with an industry that you then call criminal (essentially calling me criminal).

 

I didn't mean to imply that you were criminal or immoral,  just the pharma industry which you have identified yourself as part of in previous threads.   Does pharma research I think you said at one time.

 

When the pharma industry spends $240 million a year on lobbying for a decade they must think it's pretty beneficial to their business to make that kind of commitment...   And I believe what they get back is the lax regulatory oversight which allows them to profiteer on the backs of the American consumer.. systemically..  hence the systemic overcharging... .Americans pay 200-600% more for our named brand drugs than any other country on earth.    I think that is immoral and criminal.

 

And before you bring up again Generic Drug prices.. I will again say the Net effect is Americans pay more for Drugs than any country on earth by a significant margin.

 

That's one reason why I'm a liberal right now..   Because I think we need change.   We need to renew regulations and renew our commitment to consumer driven markets and not markets which only serve corporate greed..   We need a renewed commitment to oversight and prosecution for malfeasance.    Corruption like this comes in cycles and we are overdue for someone to address these issues.     Corruption busting is not a traditional conservative strength.    Conservatives have other strength's.

 

When you want industries fixed,  it's time to call in the angry left..   Our greatest trust busters,  our greatest industry overseers have been liberals both in the GOP ( Teddy )... and in the Democratic Party.

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I didn't mean to imply that you were criminal or immoral,  just the pharma industry which you have identified yourself as part of in previous threads.   Does pharma research I think you said at one time.

I've never said that I do Pharma research. I've never worked for Pharma, taken a dime from Pharma or even considered working for Pharma.

(More incorrect statements by you- not surprising)

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I've never said that I do Pharma research. I've never worked for Pharma, taken a dime from Pharma or even considered working for Pharma.

(More incorrect statements by you- not surprising)

 

As I remember you said you worked in the chemistry dept. of a University which did or was conducting research for pharma companies  maybe medical research..  If I'm misremembering any part of that,  I apologize.   As you well know we've had this same discussion probable 3 or 4 times in the last 10 years.

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As I remember you said you worked in the chemistry dept. of a University which did or was conducting research for pharma companies  maybe medical research..  If I'm misremembering any part of that,  I apologize.   As you well know we've had this same discussion probable 3 or 4 times in the last 10 years.

I work at an academic institution and realistically have since leaving undergrad in the 1990s. I've never worked for or been funded by the Pharma industry.

Through out my career (going back to a grad student), I've had funding from the NIH.

I'm a biochemist and generally have and done basic unapplied science even as an undergrad. The closest thing I've ever had to funding from industry was as a PhD student my advisor had a grant from the Petroleum Research Fund (PRF) even though we weren't doing anything connected to the petroleum or oil (we were doing work on biocatalysts and the PRF at least at the time was funding research on catalysis very very broadly).

Currently, I do research on the evolution of various infectious disease causing organisms, but nobody would consider my work anything more than basic science.

At a scientific meeting I once had an informal discussion about a job with the then VP of research of Pioneeer (I was a post-doc and he had worked for my post-doctoral advisor so we ended up talking over a dinner and he/they were interested in people with my combination of skills).

My wife is in a very similar situation (as a post-doc she was actually funded by the American Cancer Society).

As far as I know nobody in my Department has funding from the Pharma industry, and I don't know of anybody that has ever had funding from Pharma at any institution while I was there (though I suspect that there might be people in Engineering that have Pharma money where I work now, but I don't interact with Engineering much at all). Though one person in my Dept. did recently launch a start up, but I don't think he's making any money from it.

Pharma doesn't fund much in academic institutions, especially basic science departments.

I do know several people and have known several people that have worked in Pharma and industry in general. I also know people that have quit industry jobs because they had issues with the ethical nature of industry in general.

Nobody would seriously consider me part of the Pharma industry unless you are going to claim that every basic science person in biochemistry and biology in the country is part of the Pharma industry.

And this post is the issue with what you do. You post things as facts based on what you think you know and what you might remember, and (like most people), you are frequently wrong about what you think you know.

Rather than say, I think PeterMP is part of the Pharma industry let me do a little search and see if I can find a post where he's said that, you write it into a post as if it is a fact. When it isn't! Instead, you just go ahead an indirectly accuse me of being a criminal via an association with the Pharma industry based on your incorrect recollection.

You don't ask. You don't put any qualifiers in your statement, and you make no real effort to verify them. You go with what you think you know.

Not that whether I'm part of the industry or not is irrelevant. matters. Your post still on a regular basis have factually incorrect statements, which I can and do document with supporting links.

And even when I tell you they are wrong rather than admit they are wrong or ask me for evidence that you are wrong, you respond by posting more wrong, irrelevant, or things you can't actually support.

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Easily the most punchable face ever.

My face punch wish list in order:

This jackass

Hillary

Ted Cruz

Rubio

And I don't mean just one shot.. I mean repeated and vicious blows. I would kiss Hillary for the chance, even Caitlyn for that matter... for Just one chance at giving that douche the fist shampoo he deserves.

It likely would be the most fulfilling moment in life and I am a freaking Buddhist (jk).

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Easily the most punchable face ever.

My face punch wish list in order:

This jackass

Hillary

Ted Cruz

Rubio

And I don't mean just one shot.. I mean repeated and vicious blows. I would kiss Hillary for the chance, even Caitlyn for that matter... for Just one chance at giving that douche the fist shampoo he deserves.

It likely would be the most fulfilling moment in life and I am a freaking Buddhist (jk).

 

Perhaps you should seek counseling.

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Good strategy.   Because you were getting pwned otherwise, IMO.

Predicto.. You are a smart guy, A few Questions for you to ponder...

with regards to the Imprimis's alternative to Daraprim being competition which was the minor disagreement and only one example given.

You believe that Imprimis 1$ alternative to (Daraprim's $750 a pill) is indeed competition? In that every consumer of Daraprim today has the ability to purchase this alternative? Ok.. not every?, most? Ok not most.. some.. that some can purchase this alternative and that makes it competitive?

(1) because you believe that Imprimis with total revenue of $6 million dollars in the first 9 months of 2015, without using mass production or stock piling their drugs could supplant the need for Daraprim, given Daraprim was responsible for $98 million in revenue to Turing last year? (and given Turing only owned the rights to Daraprim for 4 months last year)?

Imprimis revenue ( see first blurb under Financial Highlights )

http://www.prnewswire.com/news-releases/imprimis-pharmaceuticals-announces-third-quarter-2015-financial-results-and-provides-business-update-300177932.html

 

Retzlaff, responding to a question from committee chair Jason Chaffetz, a Utah Republican, said that Daraprim....brought $98 million in revenue to Turing last year.

(2) Because you believe just in time, custom made drugs for named patients at four locations nation wide could be competitive with mass produced drugs which can be warehoused for years? You believe those two diverse production and distribution methods describe competitive methodologies?

(3) Feel free to make up your own reason taking into account the 2 above givens.

With regard to the larger and more important point which Petemp didn't wish to get into, in which Daraprim was only 1 example..

(1) You believe that the reason why Americans pay 200x600% more for named brand pharmaceuticals than anybody else in the world, is something other than graft, greed, and lax oversight? Do name it please.. 

But please don't tell me that Pharmaceuticals sell their drugs out of the goodness of their hearts abroad at a loss, and it's only overcharging American consumers which make their companies profitable. There is no force on earth that could make an industry sell their products at a loss globally and I'm sure you understand that. Drug companies sell their products abroad cheaper because it's profitable to do so. They sell their products here for 200-600% more because it's more profitable to do so. end of story.

(Americans also spend more in total on drugs than anybody else in the world).

(2) You believe that Turing pharmaceuticals abuses are unique?

(3) You believe that the laws which allow Turing to raise the consumer price 5555% without justification or recourse don't apply to every pharma company with a patent out there and are unrelated to our discussion about the pharma industry systemic overcharging the American Consumer?

 

(4) You believe that Americans paying 200-600% more for named brand drugs does not describe  systemic over charging?

(5) You believe the $180 million - $240 million the pharma industry spends on lobbying annually for the last decade has nothing to do with American consumers being so grossly overcharged? ( think they spend another 40 million on political contributions across the Us Gov ).

http://www.opensecrets.org/lobby/indusclient.php?id=h04

(6) You believe we have a free market with American pharmaceuticals complete with competition.. and that the rest of the worlds socialist single payer universal coverage healthcare systems are just out competing our free market?

Finally please tell me where you think Pete was pwning me?    Cause I don't see it.

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Predicto.. You are a smart guy, A few Questions for you to ponder...

with regards to the Imprimis's alternative to Daraprim being competition which was the minor disagreement and only one example given.

You believe that Imprimis 1$ alternative to (Daraprim's $750 a pill) is indeed competition? In that every consumer of Daraprim today has the ability to purchase this alternative? Ok.. not every?, most? Ok not most.. some.. that some can purchase this alternative and that makes it competitive?

(1) because you believe that Imprimis with total revenue of $6 million dollars in the first 9 months of 2015, without using mass production or stock piling their drugs could supplant the need for Daraprim, given Daraprim was responsible for $98 million in revenue to Turing last year? (and given Turing only owned the rights to Daraprim for 4 months last year)?

Compounding companies were previously limited to what they could ship across state lines. The law was changed last year in that if you would submit to a federal review then that increased the number of things that you could ship across state lines.

Imprimis actually had an excess of production capabilities in some areas of the country.

http://www.medscape.com/viewarticle/843991

"This is becoming an urgent problem for outsourcing facilities. "We have built a beautiful state-of-the-art facility in New Jersey," he said, "but we have no idea what we can make.""

Imprimis is/was looking for new markets to jump into, assuming they are getting cooperation from the FDA in terms of approvals.

The key part of this is now the deal with ExpressScripts. ExpressScripts had $581 million last quarter, which then helps Imprimis in the context of financial considerations (i.e. buying supplies). The fact that ExpressScripts is partnering with them I think is an indication of the extent that is going to work.

 

I still can't sit here and tell you that they are going to be able to fill demand and in a timely matter, partly because I don't know how "timely" things need to be (how many people walk off the street into a doctor or hospital and need treatment that day or the next.)

 

At some level, you are right Imprimis is not really going to be able to economically compete with Turing. On a per a pill basis, they aren't going to to make as much as Turing.

But why does that matter? If the federal government stepped in an told Turing they had to charge a lot less, Turing would not make as much on a per a pill basis.

The consumer in real dollars is saving money. They are actually saving money as compared to what it was BEFORE the price hike.

I don't think anybody is arguing this is an ideal solution (which is why I pointed you to the post that I wrote back on page 2), but in this case, it does appear to be a solution that is going to work.

 

(1) You believe that the reason why Americans pay 200x600% more for named brand pharmaceuticals than anybody else in the world, is something other than graft, greed, and lax oversight? Do name it please..

We pay more because the US throughout its history has valued a free market approach IN THE CONTEXT OF A STRONG PATENT SYSTEM.

That applies to EVERY industry that sells things in the US.

 

But please don't tell me that Pharmaceuticals sell their drugs out of the goodness of their hearts abroad at a loss, and it's only overcharging American consumers which make their companies profitable. There is no force on earth that could make an industry sell their products at a loss globally and I'm sure you understand that. Drug companies sell their products abroad cheaper because it's profitable to do so. They sell their products here for 200-600% more because it's more profitable to do so. end of story.

It isn't at all clear if they are profitable over seas if you take into account long term R&D costs. Once I've put those costs in place, then yes they are profitable.

But I will point out that's NOT universal. To my knowledge there is not a single payer system where they don't have some issue getting some drug.

 

I gave you a link to a case in Canada earlier.

Which of course you ignored.

 

(To make this political, the idea that Sanders can cut costs (through something like a single payer system) and not have people be able to get medications they can currently is almost certainly wrong.  Putting those decisions into the hands of the government in every case I know of results in a government that has to say no sometimes.  Now, it might not affect a lot of people, and when you take into account costs, it might be worth it.  But Sanders telling people they are going to be able to get everything they have now without co-pays and insurance companies is almost certainly false.)

 

(Americans also spend more in total on drugs than anybody else in the world).

We also use more drugs than other countries.

We also use different drugs than other countries

And generics also cost us less.

And the R&D research of Pharma is also more responsive to US spending (because we spend more), which means end products are more geared to what is needed in the US market- that is our excess spending directly benefits us. Now it certainly possible that benefit does not off set the costs, and when I made this point before the person I quoted directly made this point. It is possible that we have more health care technology than we need.

(And I actually don't think that's an unreasonable position. I'd say we have to much technology at the cure/treatment level and not enough good/clear information at the prevention level (an ounce of prevention is worth a pound of cure).

 

There is reasonable evidence that if you cut Pharma profits you are going to change their business practices, and depending how much you cut their profits, you might significantly affect their business model.

 

All points, I've made to you before (mostly in the other thread), and you have ignored.

 

(3) You believe that the laws which allow Turing to raise the consumer price 5555% without justification or recourse don't apply to every pharma company with a patent out there and are unrelated to our discussion about the pharma industry systemic overcharging the American Consumer?

I want to make this point last because I think it needs to be made clearly. Turing does not have a patent. What Turing has done has nothing to do with the patent system.

This is related to FDA regulations, which are at least supposed to be about keeping Americans and our drug supply safe (and just so you know that's been an issue in Canada too:

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

http://news.nationalpost.com/news/canada/health-canada-halts-import-of-drugs-from-two-indian-factories-over-data-integrity-concerns

)

To bring a drug onto the generic market in a way that you can give it an FDA label (which is required to mass produce it), you must demonstrate through tests that your drug is the equivalent to the drug that is already on the market.

This takes time and money. Turing was betting that they could make a bunch of money before anybody else would go through that process. In addition, since they could drop their price whenever the wanted, there was a lack of incentive for companies to even start the process. If I'm going to sink money into making a generic equivalent of Daraprim, I'd be worried that I'd be a year into the process, but before I could actually bring product to the market they'd cut their price.

Now, it isn't clear to me how important that regulation is with respect to people's safety. Maybe that's something the FDA should revisit.

But I doubt that you have a good understanding of how important that is the people's safety either.

And that wouldn't require a change in the law even. That's an executive branch rule/regulation.

 

And lastly, I've said I'm not against going to a single payer system.  I pro-actively stated in the election thread, you will almost certainly cut our over head expenses by doing so.  I'm not sure how much money you will actually save on Pharma costs and real doctor costs so I wouldn't be surprised if you make the change and find that the savings isn't that large.

 

(especially depending on fraud scales with spending, which I don't know.)

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