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New cancer immunotherapies such as checkpoint inhibitors are showing success in treating cancer, but can cost well over $100,000 a year:
Newer cancer drugs that enlist the body's immune system are improving the odds of survival, but competition between them is not reining in prices that can now top $250,000 a year.
The drugs' success for patients is the result of big bets in cancer therapy made by Bristol-Myers Squibb Co, Merck & Co Inc and Roche Holding AG, among others in big pharma. The industry's pipeline of cancer drugs expanded by 63 percent between 2005 and 2015, according to the QuintilesIMS Institute, and a good number are reaching the market.
The global market for cancer immunotherapies alone is expected to grow more than fourfold globally to $75.8 billion by 2022 from $16.9 billion in 2015, according to research firm GlobalData.
[...] "Competition is key to lowering drug prices," Trump told pharmaceutical executives at an Oval Office meeting in January.
But that is not happening with new drugs called checkpoint inhibitors that work by releasing a molecular brake, allowing the immune system to recognize and attack cancer cells the same way it fights infections caused by bacteria or viruses.
For cancers like melanoma, the treatments can mean long-term survival for around 20 percent of patients.
Bristol's Yervoy, first approved in 2011, targets a protein known as CTLA-4. Other immunotherapies, including Bristol's Opdivo, Keytruda from Merck, Roche's Tecentriq, and Pfizer Inc's Bavencio, involve a different protein called PD-1.
Other targets are being explored. Some new data will be presented this week in Washington at the American Association for Cancer Research's annual meeting.
Current checkpoint inhibitors each have a list price near $150,000 a year. A combination of Yervoy and Opdivo, approved by the Food and Drug Administration for advanced or inoperable melanoma, has a cost of $256,000 a year for patients who respond to the treatment.
Similar immunotherapies are in development at companies like AstraZeneca Plc (AZN.L). Merck, which declined to comment on pricing plans, expects an FDA decision by May 10 on its combination of Keytruda and chemotherapy as an initial treatment for the most common form of lung cancer - by far the biggest market for cancer drugs.
Pfizer said Bavencio, cleared by the FDA earlier this month to treat Merkel cell carcinoma, a rare type of skin cancer, has a price "comparable to other checkpoint inhibitors approved for different indications."
(Score: 2, Insightful) by Anonymous Coward on Tuesday April 04 2017, @12:03PM (51 children)
I'm glad companies have incentives to make progress and beat these horrible diseases. You probably agree if you've personally been affected by an incurable disease.
(Score: 2) by martyb on Tuesday April 04 2017, @12:38PM (11 children)
Agreed. And, I can't help but think to the progress we've seen in computers which went from $multi-million refrigerator-sized behemoths to cell phones at a $few-hundred. Who knows if this is laying the groundwork for what will later become much more affordable medicines. Possibly naive, but one can hope.
Wit is intellect, dancing.
(Score: 2) by Rivenaleem on Tuesday April 04 2017, @01:23PM
(Score: 4, Insightful) by Anonymous Coward on Tuesday April 04 2017, @01:58PM (4 children)
It has little to do with R&D costs and everything to do with the nature of the disease. Your life is priceless, and you have no bargaining power. Therefore, the price point will stay at "what you are worth plus whatever we can shake from whoever can't bare the guilt" median. Consequently, price will be lower in poorer countries, and in countries which are predominantly well-prepared, philosophically or religiously, for death (and quite unsurprisingly, the two sets are usually very much overlapping).
(Score: 5, Insightful) by bzipitidoo on Tuesday April 04 2017, @02:47PM (3 children)
This. It's "your money or your life" highway robbery, with your ultimately fatal disease as the weapon.
How many people choose to die rather than pay, I wonder? I suspect more than a few choose death, and we don't hear about it because of our squeamishness about death. Many older people who know they are terminal, and whose quality of life is terrible, as in they need help just to relieve themselves, and can't walk, can't use their hands, can't even shift around in their beds, can barely talk, would rather die sooner so their remaining savings go to their children instead of doctors. But at nearly every turn, people are encouraged and even pushed to fight on, browbeaten with religious dogma that suicide is a sin, period, and lead on by doctors partly stuck in and partly complicit with a "fee for service" system that puts profit first, and counts profit by the braindead measure of quantity of care given. From what I hear, the US is one of the nations least accepting of death.
(Score: 1, Insightful) by Anonymous Coward on Tuesday April 04 2017, @03:44PM
I guess less than those who don't have the decision to pay simply because they don't have the necessary money.
(Score: 2, Informative) by Anonymous Coward on Tuesday April 04 2017, @07:55PM
A good friend was diagnosed with non-Hodgkins Lymphoma (a blood cancer that is non-operable). He looked briefly at chemo that was recommended strongly by an oncologist but once he saw the chemo infusion room full of people grimacing in agony he lost interest. Then when he did some research and found that the average time it bought was about 6 months, he refused that treatment all together.
Instead he doubled down on medical marijuana and was pain free for more than a year, he did have some pain the last couple of weeks of his life. He was in very good shape when diagnosed (age about 70) and lived for about 18 months...after the initial diagnosis of 6 months to live without the chemo.
His comment after leaving the oncology office was that he could see the cash register numbers flipping by in the doctor's eyes. (old cash registers had a mechanical digital readout...)
(Score: 0) by Anonymous Coward on Wednesday April 05 2017, @12:33AM
The cognitive dissonance in you is amazing, maybe it is stockholm syndrome. Assuming the executioner who is torturing you is going to let you go for telling the truth is no different than expecting these treatments are actually going to help you when it is people like that pushing them...
(Score: 4, Insightful) by LoRdTAW on Tuesday April 04 2017, @02:24PM (3 children)
An estimated 14 million have cancer in the USA alone. An estimated 12.7 million people across the globe are diagnosed with cancer per year. Thats's instant market demand and plenty of profit opportunity. There weren't 14 million people in dire need of a computer.
Even if it cost them 10 billion to develop they could sell it at $714 to recoup just the research costs from 14 million people. Hell, they could sell it at $5k per year and make a killing in no time.
Either they are price gouging to recoup the costs up front, or perhaps they know the drug wont be as effective in the long run and are trying to milk it before the market declares it a dud and abandons it.
(Score: 3, Informative) by Joe on Tuesday April 04 2017, @03:02PM (2 children)
recoup the costs up front
They are recouping the costs of these drugs, their failed drug candidates, providing funding for current and future drug development, and (obviously) extra so they turn a profit.
Typical pharmaceutical economies of scale don't quite work out since these are biological drugs (complicates generic production) that also require medical facilities and personal.
they know the drug wont be as effective in the long run and are trying to milk it before the market declares it a dud and abandons it.
The clinical trial data on immune checkpoint inhibitors disagree. The main problem with their effectiveness is the variability in patient responses (some are cured of late stage, no therapies left cancer while others do not respond at all). The effectiveness of these drugs will improve as we are better able to understand the correlates of a positive response.
- Joe
(Score: 0) by Anonymous Coward on Tuesday April 04 2017, @07:11PM (1 child)
They are recouping the costs of these drugs, their failed drug candidates, providing funding for current and future drug development
I have drugs A, B, C, D, and E.
Drugs A and B are complete failures. Drug C is a success, so I build in to the cost of C the cost of A and B. I haven't started work on D and E yet, so I'll build in the cost of those to C as well.
Drug D is a complete failure and drug E is a success, so I build in to the cost of E the cost of A, B, and D. I haven't started work on F and G yet, so I'll build in the cost of those to E as well.
That's a neat trick.
(Score: 2) by Joe on Tuesday April 04 2017, @08:10PM
That's a neat trick.
No, it's part of the reality of modern pharmaceutical development in a for-profit system.
9/10 drugs that start human clinical trials fail and, out of the drugs that make it, 4/10 drugs fail at Phase III (approximate cost to take a drug this far, which takes about ten years, is 1 billion dollars).
http://blogs.sciencemag.org/pipeline/archives/2017/01/23/i-do-hate-to-tell-you-this-but [sciencemag.org]
- Joe
(Score: 0) by Anonymous Coward on Tuesday April 04 2017, @03:40PM
I think you must have a very large refrigerator. [wikimedia.org] :-)
(Score: -1, Troll) by Anonymous Coward on Tuesday April 04 2017, @12:40PM (31 children)
Rather incurable disease than incurable poverty
(Score: 2) by Geezer on Tuesday April 04 2017, @12:55PM (30 children)
Fuck you. I have stage 4 cancer. In case you missed it the first time, fuck you.
(Score: 0, Troll) by Anonymous Coward on Tuesday April 04 2017, @01:22PM (1 child)
"You owe God a death" -- William Shakespeare
(Score: 0) by Anonymous Coward on Tuesday April 04 2017, @03:46PM
But I'd like to delay the payment for as long as possible.
(Score: 0) by Anonymous Coward on Tuesday April 04 2017, @02:18PM
I'm sorry to hear that, I wouldn't wish it on anyone and my uncle is in the same boat. But don't be mad at OP over the comment, they are just trying to think of the greater good. It doesn't matter anyway, their comment won't change medical progress. Besides, can you afford 100k+ / year?
(Score: 2) by bzipitidoo on Tuesday April 04 2017, @03:04PM (25 children)
But poverty is not incurable, far from it. Must be one of the easiest things to cure, if only there is the will to do so. I take the OPs post as commentary on our harsh capitalist version of medicine. Sky high medical bills cause over half of personal bankruptcies, and the rationales for inflicting such financial stress and pain on someone who is already battling for their life has always seemed stupid, mean, and opportunistic.
Good luck to you. I understand stage 4 cancer is dire, but not hopeless. It can be cured.
(Score: 1, Insightful) by Anonymous Coward on Tuesday April 04 2017, @03:09PM
I understand stage 4 cancer is dire, but not hopeless. It can be cured.
Depends on the type of cancer. But life is hopeless.
(Score: 4, Informative) by Thexalon on Tuesday April 04 2017, @03:37PM (22 children)
And for some actual number crunching: To write every man, woman, and child in America a monthly check that would put them above the federal poverty line would cost approximately $1.8 trillion. The US GDP is currently $19 trillion, or approximately 10 times that amount. Ergo, poverty is completely 100% unnecessary, and has been for some time.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 0, Flamebait) by jmorris on Tuesday April 04 2017, @04:28PM (21 children)
So show me the stone tablets where God wrote that anyone born in His promised land (and you guys also think anyone who sneaks in gets the government teat too so what about the rest of the billions out there? Do the math.) deserves not only to not starve, not just live a First World lifestyle but to have the full American lifestyle?
Just to push you to reveal how little you have actually thought this through.... So why can't we promise everyone a Second World lifestyle? Nobody is starving there and it is a Hell of a lot cheaper. The implied premise of your proposal is we have a huge surplus of utterly useless people who we are simply maintaining in a breathing state because of feelings, right? Can't we do compassion on a budget? Or since you folks splooge over it so often, why can't we give welfare clients the lifestyle of an average Cuban? (oppression part not required, they could have Internet, but reducing their franchise to Cuban levels makes some sense: No Representation without Taxation!)
On the other side, since once we go Basic Income almost everybody will get pushed onto it since all of the arguments about globalization eliminating 1st world employment will be muted, why do you guys get wood about pushing most of the country down to the poverty line? Is it because even you idiots realize that if you promise to give everyone the "median" too many people will laugh at your innumeracy?
Now to today's actual topic. Said something similar in recent threads but from the comments it clearly bears repeating. Medical science is offering more and more treatment options like this that are far too expensive to promise to every welfare client. Many, like the one under discussion are probably too expensive for typical private insurance too. At some point we have to simply say no. To all the idiots who say we have to value all life, we can't put a price on life, etc. look them firmly in the eye and say "Shut up moron, serious people are talking." Because there isn't enough wealth on the planet to extend every possible treatment that is coming just to every American, assuming we raped of the whole Planet of resources in a final death throe of Empire trying. Math trumps feelings.
Let small numbers of desperate rich people buy these products and services and pay the early adopter prices, suffer the early adopter risks and failures and sooner or later the really effective ones will survive the process to get better and cheaper.
(Score: 3, Insightful) by Immerman on Tuesday April 04 2017, @04:48PM (6 children)
Where has God written that it is the right of those men who have wealth and power to abusively exploit the less fortunate by claiming the lion's share of the wealth they generate through their labor? Because that's the current situation. In nature there is no extreme wealth inequality, because you can only keep as much as you can personally defend.
Capitalism is a human construct designed to transfer wealth from the poor to the rich, and it's fulfilling it's designed purpose wonderfully, but without some other form of wealth transfer in the other direction it inevitably starves itself out as the lower classes become too impoverished to purchase the goods and services they produce.
(Score: 0, Troll) by Anonymous Coward on Tuesday April 04 2017, @05:09PM (1 child)
You're speaking to someone who fundamentally disagrees with that viewpoint of capitalism. Many have pointed it out, I'm sure it is a viewpoint he has heard plenty of, but he just can't wrap his brain around the problem.
For you Jmo: the solution isn't about eliminating the idea of capitalism but to limit the wealth that any one person can acquire. Ridiculously high tax rates for incomes over a certain point do a great job and they worked fine some 50+ years ago. No need to go full communist. This fear of "marxist socialism" is pretty hilarious since we already have so many social programs. Stop ignoring the facts: socialized healthcare results in statistically better health while also being more efficient. If you are fiscally conservative then this should really be important to you, otherwise you're A FUCKING HYPOCRITE!
(Score: 2) by jmorris on Tuesday April 04 2017, @10:13PM
limit the wealth that any one person can acquire
So what, tell people they have earned too much and to cease and desist from being productive? Any limit you set that would be meaningful would have put Steve Jobs on his ass after the Apple II. So that means no Mac, no Next, no Pixar, no iMac, no iPod, no iPhone and no iPad. The world is better off in that alternate reality? Multiply that loss of GDP by a million and you start to see the beginnings of the impact telling the fraction of a percent of people who can create to stop would have. Seems somebody wrote a book about that, can't for the life of me think who that could have been though.....
(Score: 2, Insightful) by jmorris on Tuesday April 04 2017, @05:36PM (3 children)
Spoken like someone college educated. Now actually go read Marx's Capital, which is where the ideas you are assuming come from and see if you can spot the fallacy behind his Labor Theory of Value. A hundred million souls scream from the grave for the idea which killed them to finally die itself but it lives on in you. If you spot it, congratulations, you are smarter (or more honest) than your prof, if not then well you at least have lots of company in being WRONG. Go back and reread it until you do see the problem.
because you can only keep as much as you can personally defend.
No, that is how much wealth a bear can have. Men form tribes, communities and nation states to mutually defend their wealth. Civilization, you should look into it sometime.
Capitalism is a human construct designed to transfer wealth from the poor to the rich..
So explain to us how much wealth Steve Jobs transferred from the poor. How much wealth did Tiger Woods transfer from the poor? For that matter, how much does Exxon transfer from the poor? From where I sit people quite willingly lined up around the block to tell the clerk at the Apple Store to "Shut up and take my money!" Televised golf was transformed into a gusher of money while Tiger Woods was playing at the top of his game and he got his share of the loot. Exxon sells me the ability to fill up a tank and visit a faraway place for a pittance and I'm happy to make the exchange with them, their employees seem happy to accept employment with them and the shareholders haven't found a better place to park their investment.
(Score: 5, Informative) by Thexalon on Tuesday April 04 2017, @07:11PM
I have read Marx's Capital, cover to cover. I am pretty sure you, jmorris, have not. Because if you had, you'd know that:
1. The Labor Theory of Value predates Karl Marx. It's biggest advocate was David Ricardo.
2. Marx specifically points out some of the flaws of the Labor Theory of Value.
3. Most of Marx's arguments do not in fact rest on the Labor Theory of Value, since Marx considered it suspect, most notably in failing to take into account the social conditions in which the labor was carried out.
4. The contradiction you are probably thinking of, that labor-intensive industries do not tend to be the most profitable, is still up for debate. Indeed, volumes 2 and 3 go into great detail about the effects of increasing investment in automation versus increasing investment in labor, and provides explanations for the problem. Marx didn't have much by way of empirical evidence of how heavily automated industries behave: He did the best he could manage with the reports on the textile industry, which was the most automated industry in his day, but even so by modern standards almost everything in the 19th century would be considered labor-intensive today.
How much wealth did Steve Jobs transfer from the poor? Millions of dollars. Most notably from the people that were forced (by a lack of other economic options) to spend 16 hours a day making iPhones in conditions that had the company installing nets so they wouldn't die if they jumped out of a tall building attempting to commit suicide. Also from the people whose land was poisoned by the mining operations to get the materials for said iPhones. And the miners who got occupational diseases and even died on the job. And that's just the systemic stuff: Jobs also screwed most of the early Apple employees out of a lot of money when they went public (basically, those guys would have gotten no payout at all for their effort had Woz not intervened). And of course he screwed Lisa's mother out of child support. I can keep going if you like: Just because you don't see the transfer happening does not mean it isn't happening.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 0) by Anonymous Coward on Tuesday April 04 2017, @07:15PM (1 child)
Oh I wish I could see the look on your face when you find out what's wrong with everything you wrote.
(Score: 2) by Azuma Hazuki on Tuesday April 04 2017, @07:45PM
By the time he realizes what's wrong with it, the look on his face will be screaming blistering and burning...
I am "that girl" your mother warned you about...
(Score: 2) by Azuma Hazuki on Tuesday April 04 2017, @05:22PM (3 children)
I thought you were an agnostic? Stop bringing God into this. Or if you want to, open your Bible to Mt. 25 and read up through verse 46. Paying special attention to verse 46.
I am "that girl" your mother warned you about...
(Score: 2, Insightful) by jmorris on Tuesday April 04 2017, @05:39PM (2 children)
I am. But a demand as irrational as demanding the productive remain productive while having the fruit of that effort redistributed to the useless (which IS the implied rationale behind the proposal) could only be sustained by some sort of equally irrational authority. So if God didn't command it, why shouldn't I simply tell the useless people making the demand to STFU?
(Score: 2) by bob_super on Tuesday April 04 2017, @06:13PM
It's not news that you're a selfish prick.
Why don't you go lobby congress for the right to hunt "the useless"?
(Score: 2) by Azuma Hazuki on Tuesday April 04 2017, @07:41PM
Define "useless." And tell me why whatever metric of "useful" you're using is the standard for something like this.
Your Moloch is the "false scarcity" paradigm. You've sold your soul to it, had it burned up in its red-hot hands, and now nothing remains but a shell animated by hate. You want to use this twisted conception you have of meritocracy as a screen to hide the reality: poor people and the weak disgust you viscerally and you want them dead.
You don't fool anyone but yourself with that bullshit, J-Mo. Quit the idol worship; all material things are for humankind, not the other way around.
I am "that girl" your mother warned you about...
(Score: 2) by DeathMonkey on Tuesday April 04 2017, @05:49PM (2 children)
So show me the stone tablets where God wrote that anyone born in His promised land (and you guys also think anyone who sneaks in gets the government teat too so what about the rest of the billions out there? Do the math.) deserves not only to not starve, not just live a First World lifestyle but to have the full American lifestyle?
1. Matthew 25:34-40 “Then the king will say to those on his right, ‘Come, my Father has blessed you! Inherit the kingdom prepared for you from the creation of the world. I was hungry, and you gave me something to eat. I was thirsty, and you gave me something to drink. I was a stranger, and you took me into your home. I needed clothes, and you gave me something to wear. I was sick, and you took care of me. I was in prison, and you visited me.’ “Then the people who have God’s approval will reply to him, ‘Lord, when did we see you hungry and feed you or see you thirsty and give you something to drink? When did we see you as a stranger and take you into our homes or see you in need of clothes and give you something to wear? When did we see you sick or in prison and visit you?’ “The king will answer them, ‘I can guarantee this truth: Whatever you did for one of my brothers or sisters, no matter how unimportant they seemed, you did for me.’
(Score: 2) by jmorris on Tuesday April 04 2017, @06:45PM (1 child)
Assuming Christianity to be True for the purposes of debate only. And noting that I'm only an observer and NOT a priest/pastor so no warranty for what follows, please see a (hopefully not Marxist) real one for actual theological assistance. Or read the danged book for yourself, it is harder than the Constitution or Federalist Papers but not rocket science.
Pretty sure Jesus is commanding the faithful in that passage to do works themselves. Person A voting to have the government seize resources from Person B and giving it to Person C because government idiot D decided C qualified for assistance isn't exactly what He had in mind. Especially if B isn't even a fellow Christian. So neither A, B, C or D gets into Heaven on that plan. If C is hungry and A or B feeds him and otherwise helps him get his life back then A or B has performed a worthy deed, and perhaps C will pass it on to E once he is able to support himself. Because that is the point, to actually HELP person C, not simply warehouse him in his squalor. And by the Witness of A it is hoped C comes to Jesus and then perhaps brings E along later. Remember, it is about saving souls when you are Christian.
And what we actually do in our current degraded Democracy, where A, C, D and E outvote B to help themselves to their stuff is simply coveting turning into outright stealing and I don't think Jesus overturned the nice compact listicle God handed carved for Moses that has something important to say about not doing that. But even that isn't the worst sin in Progressivism: God doesn't think anyone is useless, Progressives do. Left unchecked it spirals out of control until just about everybody gets deemed ovenworthy because it is at heart unholy and Moloch needs constant sacrifices of blood.
Remember that it is written that the Devil can quote Scripture when it serves His purposes... as you just did in a totally dishonest way. Think that listicle also has something important to say on that subject as well, you might want to reread the parts about bearing false witness and taking His name in vain because you are skirting really close, if not over the line, on those two. So by my count that makes four, wanna bet you can check off all ten for a perfect diabolic score?
Theology discussion ends here.
The problem is the government is barely competent to do those things we currently lack the social technology to do any other way. (Defense, Money, Law and Courts, perhaps Roads and some other infrastructure) It really sucks at most other things, charity being a very notable failure. It sucks huge amounts of resources out of the economy and makes the problem it claims to be solving worse while making the government stronger. So if you like more poor people, a bigger and more oppressive government and an overall darker, poorer world, then please continue because your plan is working. Otherwise the first step is admitting there is a problem.
(Score: 2) by Thexalon on Tuesday April 04 2017, @07:35PM
The interesting thing about that, to me, is that none of those ideas come from Jesus directly. You won't find a lot of talk of saving souls in the gospels, but you will find a lot about helping people because they're people who need help. The whole "saving souls" concept comes from Paul.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 2) by Thexalon on Tuesday April 04 2017, @05:52PM (4 children)
The definition of the federal poverty guideline is enough money to not starve and keep a roof over your head. So that's all we're talking about ensuring here. And if you don't believe me, try to live on $12K a year. There are indeed biblical passages that command the Israelites to ensure their fellow citizens don't starve [biblegateway.com]. That's all I'm advocating for here.
Or not, because most people will still be pretty pissed off if their job that gave them, say, $30K a year disappeared and they now have to live on $12K a year.
There are 2 problems with your way of thinking about this, though:
1.In many cases, there's only a shortage of cash to pay for treatment if the treatment in question costs as much as its creator would like to be paid. Whereas if we used available mechanisms to reduce the cost of treatment to at or near the actual cost of creating said treatment, that cost could be much lower, meaning more people could be treated.
2. Even if after doing that, say, 15,000 people need the treatment to survive and we can only afford to give said treatment to 5,000 people, how does the system decide which of them gets the treatment and which ones die? What you're advocating is "The people with the most money survive." But that may not be the best approach: Drug kingpins, for example, have much more money available to spend on medical treatment than a middle-aged nurse, but I think we can agree that anyone being asked to make that moral choice would pick the nurse over the drug dealer.
In general, I get the distinct impression that you're treating a person's bank account as the objective measurement of their merit as a human being. Nothing in my life experience has suggested that that is remotely accurate, and I've known people who were both very rich and very poor.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 2) by jmorris on Tuesday April 04 2017, @07:26PM (3 children)
In many cases, there's only a shortage of cash to pay for treatment if the treatment in question costs as much as its creator would like to be paid. Whereas if we used available mechanisms to reduce the cost of treatment to at or near the actual cost of creating said treatment, that cost could be much lower, meaning more people could be treated.
You seem to have a poor grasp on what money actually is. Head over to mises.org and school up a bit. Hint: the TLDR; version is cash is a claim on resources so lack of cash is generally equal to a lack of resources.
Now as for the rest, the problem is that the creator is seeking not seeking to recover the cost of producing an incremental dose, they need to recover the initial investment and produce a return to the investors who loaned them the money to cover not only the successful drugs but even the failures. So yes you could vote to have the government seize the means of production for an already existing drug and make it essentially cost the price of producing it and then yes everybody who needs it could probably have it. But there would be no more new drugs. Ever. Maybe you think that exchange is worth it, I don't.
I see it as any other good offered in the marketplace. I have a problem, one or more people offer to solve it and I decide who, if any, gets the money. Everybody dies, so decide how much value you place on a few more years. Then we as a society have to decide how much WE will spend on a few extra years for someone who can't pay. The profit maximizing price will always prevail and the trend is usually to sell more product at a lower unit price over time.
(Score: 2) by Thexalon on Tuesday April 04 2017, @08:02PM (2 children)
I agree with the idea that money is a claim on somebody else's resources.
I'm with you so far.
Here's the question: How much of a return needs to be produced here? If they sold off bonds, then the answer is of course determined by the bond. If they borrowed from a bank of some kind, then their agreement with the bank determines that.
But that doesn't cover everything, because of stocks. And the company is legally obligated to make the return for stockholders as large as they possibly can. Which means that if they can charge customers more and get, say, a 25% ROI rather than not overcharge them and get a 7% ROI, they are required to charge more, never mind that increasing the price harms all their customers.
Normally, this gets solved by 3 forces: competition, substitute inferior goods, and doing without the product. The possibility of substitution and doing without create price elasticity, which determines the demand curve. And of course competition puts a check on the ability to overcharge because another company might offer the same product for less cost. But those don't work here because (a) patents mean there's no competition, (b) malpractice demands of best possible care means there's no substituting inferior goods, and (c) the fact that your life depends on it means there's no doing without the product.
In this case, the profit-maximizing price is: Every cent the patient has available now and can ever come up with for the rest of their life, because again none of the forces that would normally prevent this apply.
If I understand your argument, it basically boils down to this: If you're poor, and get sick or injured, your advice is for them to drop dead immediately. I'd much rather live in a society where pharmaceutical stockholders don't get as much of a return as they might like than a society where a broken leg is a death sentence for a poor person.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 2) by jmorris on Tuesday April 04 2017, @08:56PM (1 child)
You are saying some really nasty things about yourself and your world view. So you believe, and project upon everyone else, that they are so desperate to live another year they would spend the inheritance of their children, perhaps even sell their children themselves? in a pointless effort to buy a product that didn't even exist a year ago and might not even work. Humm. Ok. And I'm the selfish uncaring bastard here. All righty then!
If a product is going to be a success it has to eventually be affordable by enough people to maximize profit. Why is this a difficult concept?
And it is cheap virtue signaling to say you are for lower returns for pharma stocks but if you had a brain you would understand the problem with that is that if pharma stocks consistently have substandard returns investors will put their money elsewhere and there won't BE pharma stocks anymore. And if they return "too much" consistently it is called a "bubble" and self corrects after a crash. The market works. It works far better than your socialism in providing plenty for all. Capitalism and the market have worked every time they have been allowed to exist and socialism has failed every time it has been tried. Some people aren't swayed by evidence, it is a religious question for them and apparently you are one of those people.
(Score: 3, Informative) by Thexalon on Tuesday April 04 2017, @10:40PM
You mean evidence like this [who.int], showing that many countries with socialist government-run health care systems get substantially better patient outcomes at about half the cost? Or for that matter, the evidence from numerous sources that those socialists in Cuba get approximately the same patient outcomes as the US for 1/20th of the cost that the US pays?
I don't think it's me who is ignoring evidence here.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 2) by maxwell demon on Tuesday April 04 2017, @06:33PM (1 child)
Nobody was talking about Israel.
The Tao of math: The numbers you can count are not the real numbers.
(Score: 2) by jmorris on Tuesday April 04 2017, @07:34PM
Don't you watch South Park? If you did you would know that Mormon is the correct answer and thus America is the Promised Land.
(Score: 2) by jmorris on Tuesday April 04 2017, @08:46PM
But poverty is not incurable, far from it. Must be one of the easiest things to cure, if only there is the will to do so.
Citation needed. Once you correct the arrow of causality you realize the truth. Lack of money doesn't cause poverty, poverty results in a lack of money. Therefore throwing money at poor people won't work. If it did there would be a few lottery winners who didn't end up right back where they started a few years after winning.
There ARE examples of poverty being eased but it never happens with simply redistributing wealth to them. You have to identify and correct the pathological behaviors that caused them to be in poverty. Whether it is a substance abuse problem, short time preference, lack of motivation, lack of a salable skill, defective government, defective cultural practices, whatever, unless you are expending resources with an aim to correct the underlying issue any efforts are simply wasted.
(Score: 1, Insightful) by Anonymous Coward on Tuesday April 04 2017, @08:39PM
Good luck on your journey my friend, wherever it leads you.
(Score: 2) by hemocyanin on Tuesday April 04 2017, @02:46PM (3 children)
Yeah, without an obscene profit motive, science would never advance. Take for example, the moon shot or the
mars rovers.
(Score: 3, Insightful) by Dunbal on Tuesday April 04 2017, @03:12PM (1 child)
Rubbish. Science is advanced by EDUCATION. Profit gets you the $600 epi pen. That doesn't work [usatoday.com].
(Score: 4, Insightful) by Thexalon on Tuesday April 04 2017, @03:30PM
I think you missed the joke, since both of the things the GP mentioned were government efforts.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 0) by Anonymous Coward on Tuesday April 04 2017, @04:02PM
Part of the reason medical costs continue to raise faster than inflation is that such new inventions do happen, and it's hard to say "no" and let people die. It's a tricky situation for policy makers and insurance co's. We can perhaps tweak the incentives a bit, but I don't see an easy way out of the general conundrum.
(Score: 2) by JoeMerchant on Tuesday April 04 2017, @02:52PM (2 children)
$250,000 for a 20% chance of long term (5 year) survival seems like a waste of resources to me...
First: what are the chances of long term survival with $250,000 worth of lifestyle improvements like stress reduction, cleaner climate, healthy food?
🌻🌻 [google.com]
(Score: 1, Insightful) by Anonymous Coward on Tuesday April 04 2017, @03:48PM (1 child)
If you have cancer? Approximately zero.
(Score: 2) by bob_super on Tuesday April 04 2017, @06:17PM
But 125k buys a lot of hookers and blow, even on a tropical island.
I'll negotiate with my insurance company: you save 50%, I go away with a smile. Deal?
(Score: 5, Informative) by Joe on Tuesday April 04 2017, @12:53PM
The drugs mentioned in TFA are all antibodies that neutralize parts of the immune checkpoint pathways. Immune checkpoint proteins are normally involved in down-regulating the immune response in order to prevent excessive damage to healthy tissue ("friendly fire") as an infection is being cleared or to prevent unwarranted attack of healthy tissue by the immune system (e.g. autoimmunity). Because the antibodies target the proteins on healthy T cells instead of the cancer cells, classical drug resistance (mutation that prevents binding of a drug) is not possible.
Since the immune system will normally kill any cell that is becoming cancerous, there is strong selective pressure for cancer to hide (immunoediting) from or to suppress the immune system. The selective pressure of the immune system is something all cancer has to deal with and many different types of cancer take advantage of the PD-1, CTLA-4, and other immune checkpoint pathways by either producing immunosuppressive proteins themselves or by inducing their production by non-cancer cells (in the tumor microenvironment).
https://en.wikipedia.org/wiki/Immunoediting [wikipedia.org]
https://en.wikipedia.org/wiki/Tumor_microenvironment [wikipedia.org]
Previous Discussions:
https://soylentnews.org/article.pl?sid=16/10/11/0336255 [soylentnews.org]
https://soylentnews.org/article.pl?sid=15/04/17/2157254 [soylentnews.org]
https://soylentnews.org/article.pl?sid=15/06/04/1340257 [soylentnews.org]
(Score: 0) by Anonymous Coward on Tuesday April 04 2017, @01:00PM (1 child)
These ridiculous costs are US pricing. It is common knowledge that US pharmaceutical companies charge much more in the US than they do in other countries because the US government allows it (some would say encourages it) and it is against US law for the US government to negotiate lower drug prices for people receiving Medicare (and I believe Medicaid).
I wonder what these drugs cost in countries that protect consumers from US pharmaceutical gauging?
(Score: 1, Insightful) by Anonymous Coward on Tuesday April 04 2017, @02:04PM
Americans should consider emigrating to other countries for retirement, or even before retirement. In Soviet Land of Opportunity, the opportunity is you!
(Score: 1, Insightful) by Anonymous Coward on Tuesday April 04 2017, @01:32PM (10 children)
ADA is just pouring more money into the system.
Kind of like giving a drunk more cash.
The first thing to fix is the multiple price thing.
It should be illegal to sell the drug or service at higher than the best price.
No more hospital bills for 3x to 5x the actual price to a connected insurance company.
No more cheap drug prices outside the US but not in the US.
The second thing to fix is the IP system.
No more ever greening and restraint of trade for generics.
Perhaps FDA licensing should include the responsibility to support generics.
Perhaps FDA licensing should consider cost.
A bit of morality wouldn't hurt.
Healthcare can not be a right that providers should be required to provide for free.
But it is something special and that should place a requirement on providers for sane pricing.
The system we have now is a schizophrenic mix of free and gouge.
It violates both of the above two morality constraints. That's just wrong.
(Score: 3, Informative) by curunir_wolf on Tuesday April 04 2017, @02:46PM (3 children)
No more cheap drug prices outside the US but not in the US.
Discriminatory pricing is one of the important ways that drug research gets funded AND allows people in poorer countries to have access to affordable medications. Drug prices are higher in the US because the US has traditionally been the wealthiest country in the world, better able to afford those drugs. Here is a primer for you on the issue [healthaffairs.org].
I am a crackpot
(Score: 1, Informative) by Anonymous Coward on Tuesday April 04 2017, @06:26PM (1 child)
Do not care.
I just don't. The fact that we alone are forced to subsidize the world is bull. There are other wealthy countries out there, but they all have price controls and socialized medicine so we get stuck with the entire cost, and everyone else leeches off of us.
(Score: 2) by curunir_wolf on Wednesday April 05 2017, @12:37AM
I actually agree with you. The principle behind those policies was a good one. But at this point, with the US in such great debt, and other wealthy countries using price controls to avoid paying their fair share, it's time to change the way pricing is done.
America first, and all that.
I am a crackpot
(Score: 0) by Anonymous Coward on Wednesday April 05 2017, @12:43PM
" Here is a primer for you on the issue."
That was an interesting read.
It says that the reasonable and customary way to do business is to charge what the market will bear.
Then it says that the fair way to price drugs is to charge poor countries the cost of production and charge rich countries this cost plus the cost of R&D.
Then it says that magically, both systems result in the same price so all is well.
I don't buy it. If this results in $100k/year/patient, then there are NO rich countries.
I'd have to see a full accounting to believe the price has anything to do with the cost.
What I suspect happened is ADA made unlimited cash available for cancer drugs and the market responded.
To imply that this is good way to pick which drug to make or a fair or sustainable funding model is nuts.
There has to be a better way.
(Score: 0) by Anonymous Coward on Tuesday April 04 2017, @02:53PM (1 child)
Prime example... A drug screen used to cost me $90 in California. The doctor switched labs to one in Texas that tried to charge me $3300 for the same piss test. After calling and complaining they gave me a $3000 discount. Nice guys!
(Score: 0) by Anonymous Coward on Tuesday April 04 2017, @05:50PM
When I lived in the US, every SINGLE encounter with a doctor spawned off multiple invoices sent to me that I had to track down and dispute. And I had insurance. It seems to me "they" (I don't know who ultimately benefits) habitually err in their own favor and make enough money from doing it to pay staff to handle all the disputes. Colossal waste of time for the end user.
(Score: 2) by JoeMerchant on Tuesday April 04 2017, @02:57PM (2 children)
3x to 5x is from 10 years ago, they're running 10x and up lately.
🌻🌻 [google.com]
(Score: 3, Insightful) by Thexalon on Tuesday April 04 2017, @03:13PM (1 child)
It's really simple to describe what's going on: The medical industries know that they are legally allowed to make you an offer you can't refuse.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 3, Interesting) by JoeMerchant on Tuesday April 04 2017, @05:32PM
What pisses me off is the cost of effective preventative care. Sure, the easy way to save money on medicine is to avoid the doctor and hospital unless you're about to die, but so many of these "oh, we could have caught that with additional screening" screening tests run $1000+ out of pocket, for something that's a $50 procedure in another country.
🌻🌻 [google.com]
(Score: 2) by kaszz on Tuesday April 04 2017, @04:58PM
Let the government fund way more research and prevent companies to cherry pick and steal both researchers and intellectual property.
(Score: 3, Insightful) by Thexalon on Tuesday April 04 2017, @03:11PM (11 children)
You can have market competition for a product. You can have patents that prevent others from producing what one company developed. But you cannot have both.
And while I agree that R&D is expensive, difficult and risky, it sure gets a lot easier when government agencies like NIH are funding the most expensive, difficult, and risky parts of the job, thus freeing the companies up to spend most of their money on marketing instead.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 0) by Anonymous Coward on Tuesday April 04 2017, @04:35PM (1 child)
Actually you can have both. By simply requiring that the patent owner licenses the patent to a certain minimum number of other pharmaceutical companies in order to get a drug approval. That way the original company can get compensation for the development cost (both by selling drugs and by licensing cost), while competition gives a control on the prices (they can't put the licensing cost arbitrary high, or else the companies will not license the product — it's, after all, just one of the possible products they can produce —, and they cannot put the selling price arbitrary high, as otherwise the competition will undercut them). Both licensing prices and market prices are then controlled by the market.
(Score: 2) by kaszz on Tuesday April 04 2017, @04:55PM
They will just collude instead.
(Score: 1) by khallow on Tuesday April 04 2017, @04:58PM (8 children)
You can have market competition for a product. You can have patents that prevent others from producing what one company developed. But you cannot have both.
The world is one giant counterexample to that. Patents have not meant the end of market competition. I do however agree that certain country's aggressive patent (and other IP) policies do impair market function with the US being a glaring example.
And while I agree that R&D is expensive, difficult and risky, it sure gets a lot easier when government agencies like NIH are funding the most expensive, difficult, and risky parts of the job, thus freeing the companies up to spend most of their money on marketing instead.
I see two possible solutions here (though obviously there may be more): 1) defund the part of NIH's research that supports corporate profits, or 2) man up and accept the consequences of the choice to do that sort of research.
Finally, what does any of this have to so with the assertion of your title, "For-profit health care is nuts"? This is half a century of government policy slowly going nuts.
(Score: 3, Insightful) by Thexalon on Tuesday April 04 2017, @06:16PM (6 children)
First off, I was talking about the market for a specific product, not the markets in general. Patent protection is by definition a government-guaranteed monopoly on the product. Competition by definition involves more than 1 participant. Hence, a patented product is not subject to competition, which makes it not a free market at all. The world at large is not a counterexample: The patent on an iPhone of course has no effects on the price of a bushel of peaches, but definitely have an effect on the price of an iPhone.
As for your counterproposals:
1. In other words, eliminate the NIH, since all pure research on health and human biology is tapped by companies to develop treatments. Which, since that research is risky, is unlikely to be undertaken by any private company. Which means that the research won't happen at all, and instead of developing new treatments the companies will instead ruthlessly expand patent protection so they can continue to sell their older products forever. That doesn't seem smart.
2. I have no idea what "man up and accept the consequences" means, other than "don't change anything". But since the situation that currently exists is demonstrably not ideal, that doesn't seem smart either.
Competitive markets are efficient only when both buyers and sellers have the ability to refuse to engage in a specific transaction. What makes health care different is that the buyer has no ability to make that choice, because the alternative to buying the product in question is their own death.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 1) by khallow on Tuesday April 04 2017, @07:31PM (5 children)
First off, I was talking about the market for a specific product, not the markets in general.
Medicine is not about using a specific product. It's about trying to stay healthy. Just because someone has a temporary patent on a treatment doesn't mean that the treatment is the only approach or that the patent precludes anyone else from developing their own treatment.
(Score: 0) by Anonymous Coward on Wednesday April 05 2017, @04:11AM (4 children)
I take Xyrem for narcolepsy. The drug company has several patents and charges $12,000 per month. It is a Schedule 3 drug with a prescription and the diagnosis of narcolepsy, but any abuse, misuse, redistribution, etc. is subject to Schedule 1 penalties. The molecule is easy to synthesize, but there's no way in hell I would risk going to jail over it. The only other treatments are stimulants such as methylphenidate or amphetamine, to which one inevitably develops a tolerance. Xyrem is the only effective treatment, and our government gives Jazz Pharmaceuticals a limitless right to profit from it.
(Score: 1) by khallow on Wednesday April 05 2017, @04:35AM (3 children)
Finally, Jazz's patents will run out. Then generics can take over.
(Score: 0) by Anonymous Coward on Wednesday April 05 2017, @04:47PM (2 children)
You have not had the pleasure of replacing restorative sleep with stimulants on a long-term basis. It doesn't work. This is a far more significant reality than something that can be dismissed with "despite their drawbacks". Xyrem actually improves sleep quality, degradation of which is the primary symptom of narcolepsy.
The insurance company is paying for the medicine. It typically takes a month of appeals to get them to do so...
My doctor told me the FDA is not going to allow generic manufacturers to enter the market after Jazz's patents run out due to concerns about diversion of this regulated substance.
(Score: 1) by khallow on Wednesday April 05 2017, @09:45PM (1 child)
My doctor told me the FDA is not going to allow generic manufacturers to enter the market after Jazz's patents run out due to concerns about diversion of this regulated substance.
So what you're saying is that it's the War on Drugs rather than patents which make Jazz so unassailable. And the FDA is still concerned about near irrelevant matters while killing people with expensive drugs. Still not seeing it.
(Score: 0) by Anonymous Coward on Thursday April 06 2017, @04:22PM
The current government in the U.S. wants to both gut my access to healthcare (I get insurance through the affordable care act) and cut aspects of the social safety net. I suppose they want me to starve? I'm doing well with proper treatment and consider my current situation far preferable to going on disability. Single payer can't come soon enough. I would love to see the greedy pharmaceutical companies negotiating with an 800 lb gorilla of a national healthcare system.
(Score: 2) by JoeMerchant on Tuesday April 04 2017, @08:37PM
certain east Texas county's aggressive patent (and other IP) policies do impair market function
FTFY
🌻🌻 [google.com]
(Score: 3, Funny) by DannyB on Tuesday April 04 2017, @09:08PM (1 child)
Minor side effects may include:
* vomiting
* diarrhea
* convulsions
* seizures
* baldness
* color blindness
* loss of fingernails and toenails
* massive internal hemorrhage
* total hearing loss
* painful oozing boils and blisters on skin
* bleeding from the eyes
* shriveled up hands and feet
* extreme weight loss
* arms and legs eventually fall off
And worst of all:
* impotence
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.
(Score: 1) by khallow on Wednesday April 05 2017, @04:36AM
(Score: 0) by Anonymous Coward on Wednesday April 05 2017, @02:46AM
http://www.economist.com/blogs/babbage/2012/02/fasting-and-cancer [economist.com]
http://news.nationalpost.com/health/fasting-for-three-days-renews-entire-immune-system-protects-cancer-patients-remarkable-new-study-finds [nationalpost.com]
https://www.drfuhrman.com/learn/health-concerns/26/cancer [drfuhrman.com]
http://www.healingcancernaturally.com/sugar-and-cancer.html [healingcancernaturally.com]
etc.