[HN Gopher] Cost of developing new drugs may be lower than indus...
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Cost of developing new drugs may be lower than industry claims:
trial
Author : swores
Score : 196 points
Date : 2024-04-25 12:25 UTC (1 days ago)
(HTM) web link (www.theguardian.com)
(TXT) w3m dump (www.theguardian.com)
| faeriechangling wrote:
| >The extortionate cost of trials is used to justify high prices
| of new medicines
|
| Ridiculous! Totally wrongheaded. The extortionate cost of trials
| is used to show that the pharmaceutical company lost money that
| year to cheat on taxes.
|
| It's additionally used to justify long and lengthening patent
| terms for medicines, to save lives, by allowing companies to pay
| for their research. Imagine if we instead had the public save
| their money and instead used that money to say, fund research for
| new medicines. People would DIE from a lack of progress!
| czl wrote:
| Say I run 10 trials that cost 10m each but only one of these
| finds a drug that works. How much did the trial cost to discover
| that drug? How much did it cost to discover that drug? 10m?
| 10*10m?
| valiant55 wrote:
| 10M. Failure is still useful information so the other 9 trials
| cost 10M each but didn't produce a viable product, but that
| doesn't mean nothing of value was gained.
| oneshtein wrote:
| With just 10M in bank, you will fail and learn a lot.
| okasaki wrote:
| So like any business. Just because 90% of restaurants fail
| doesn't mean the cost of running a restaurant is 10x of
| what it actually takes to run a successful one.
| FredPret wrote:
| Of course it is. Investors have to pony up for 100% of
| the restaurants, so society as a whole has to pay one way
| or another for each economic experiment
|
| EDIT
|
| I should clarify - since investors know they have to pay
| for 100% of restaurants, of which 90% will fail, they
| price this in when they decide to invest in a restaurant.
|
| Drug companies have to pay for all ten trials, not just
| the one that works out.
|
| Restaurants are a bad example because people invest in it
| on an emotional basis. Drug trials are probably decided
| on more the same basis as bond issues or insurance.
|
| If the risk of failure is high, investors have to demand
| a high premium or go broke.
| spywaregorilla wrote:
| Restaurants also price their food considering the risk
| taken by the entrepreneur launching the restaurant; which
| is substantially lower as its a high cash flow business
| with immediate feedback for a low capital investment
| tmnvdb wrote:
| Restaurants fail very differently from drug trials.
|
| They run at some % loss for a while until money or
| investor patience runs out.
|
| A drug trial that fails can be a 10 year process of
| shoveling money in a pit, none of it to be ever seen
| again.
|
| It's a businesses famous for its low succes rates, which
| can be from start to end less than 1 in 100.
|
| Drug companies need to offer those who provide the
| capital to run these experimental projects at huge losses
| for years a way to recoup their losses - otherwise nobody
| would be willing to fund the effort.
|
| The way to do that is patent and charge absurdly high
| prices for those few succesfull drugs that are developed
| for as long as you can.
| ipaddr wrote:
| Sounds like a losing strategy for most customers and
| businesses
|
| Why not pool costs and split profits. Everyone gets
| less.. less risk, less losses, less profits.
| loeg wrote:
| Fewer drugs developed.
| lazide wrote:
| Why have only a single winner get the proceeds of getting
| a winning lottery ticket, when everyone could band
| together, buy all the tickets, and split the proceeds?
| heavyset_go wrote:
| You're describing mining pools and they're incredibly
| popular for their profitability compared to trying to
| find a winning lottery ticket on your own.
| lazide wrote:
| Crypto != the lottery or drug development.
| tmnvdb wrote:
| That's already the case. This is why most drug companies
| are quite large. And investors spread their investments.
| Competing as a small startup is extremely hard compared
| in this field compared to for example software.
|
| Unless you're asking why there is not a single state-run
| drug company doing everything, in which the case the
| answer is scale has disadvantages, having some diverse
| set of companies in a space like this has advantages, and
| state run centralism has been debunked so many times I
| can't be arsed.
| pfdietz wrote:
| It's worse than that. Say 100 companies run trials on their
| drugs, and only one succeeds, and you buy that company. You
| have to look not just at the company that ends up with the drug
| that works, but the whole ecosystem of small companies that are
| doing the exploration, hoping to hit it big and cash in by
| being bought.
| hi-v-rocknroll wrote:
| Semaglutide retails for $17k USD/year in the US but costs only
| $60 to make. Perhaps it could be argued that the autoinjectors
| are "expensive", but not $17k/year and oral forms are coming
| online to make this item moot. In limited circumstances,
| excessive profits cross into the realm of price gouging and
| shouldn't be allowed by regulatory enforcement.
| pfdietz wrote:
| The cost of manufacturing the drug is only relevant if the drug
| can be discovered and proved effective by the Magic Drug Fairy.
|
| Here in the real world, that manufacturing cost is largely
| irrelevant.
| narrator wrote:
| This reminds me of P=NP. It's hard to find a sha256 with a
| given number of leading zeros, but it's super easy to verify.
| It's hard to make Microsoft Office, or a Pharmaceutical Drug,
| but easy to see that they work. The confusion is at the root
| of most economic fallacies.
| willcipriano wrote:
| > the Magic Drug Fairy.
|
| Thats the government funded universities.
| pfdietz wrote:
| They do not, in fact, do the hard work of drug development.
| philipkglass wrote:
| The universities find compounds that work in cell cultures
| or mice. They don't currently optimize candidate compounds
| for use in humans or perform actual human clinical trials.
| In theory, there's no reason that a government couldn't
| fund all phases of drug development through final approval
| and then manufacture new drugs without seeking a profit.
| But most compounds that work in mice fail in clinical
| trials, and human testing is a lot more expensive than
| mouse testing.
|
| There would need to be consistent support for such a drug
| development program even though most attempts will fail and
| "breakthrough" drugs will arrive irregularly, separated by
| many years. It is politically difficult to maintain that
| sort of long term support in a system where voters and
| representatives are swayed by short-term arguments to cut
| programs that don't show results.
| vineyardmike wrote:
| You say all this, while the literal title of the article
| you're commenting on is _" The cost of developing new drugs
| may be far lower than industry claims"_.
|
| I think this comment perfectly proves that this is relevant.
|
| Manufacturing is quite relevant. If the actual cost of
| "discovered and proved effective" is far lower than claimed,
| then manufacturability becomes a concern. If the cost of
| discovery and proven effectiveness is borne by governments
| and universities, then the manufacturing is the only cost
| borne by the pharmaceutical companies.
| pfdietz wrote:
| The article appears to imply that the direct cost of
| developing a successful drug is the relevant metric. It
| isn't; the cost must include the indirect costs of
| development on drugs that didn't pan out. And the vast
| majority of drug candidates don't pan out, often in Phase 3
| trials where much of the cost has already been sunk.
|
| Put it another way: if making new drugs was so cheap and
| easy, drug companies would be doing that in competition
| with each other, and prices would be low as a result of
| that competition.
| renewiltord wrote:
| Yeah, I was discussing this with my wife the other day. She
| spent about 10 minutes looking for a doodad and when she
| eventually found it, I was quite surprised. It took mere
| seconds to open that last drawer where she found it. She
| could have just opened it first and saved herself almost
| all of the 10 minutes.
|
| It was a learning experience: always look in the place
| where the thing is. It saves a lot of time. Her problem was
| that she first checked all the places it wasn't.
| aspenmayer wrote:
| It's always the last place you look, because you'd need
| to have lost your mind to keep looking after you'd found
| it.
|
| This is true even if you find it the first place you
| look.
|
| A big part of the issue is too readily discounting or
| assuming where it isn't too early. It's often better to
| methodically search sections and areas at a time in a
| thorough process of elimination even of places you know
| it isn't, just as a matter of practicality, and so the
| process of elimination is actually fully eliminating
| possibilities, and not just confirming biases.
| maxerickson wrote:
| I bet the manufacturing cost is the largely relevant factor
| once the patents expire.
|
| Which from the perspective of generic manufacturers, the
| drugs are discovered and proved effective by the Magic Drug
| Fairy.
| eitally wrote:
| Not particularly, but there really isn't much difference
| between a generic drug plant and a branded factory. Same
| machines, same kinds of people, basically all the same.
| maxerickson wrote:
| Yes, that is why once regulatory exclusivity is removed,
| the market price tends to be based more or less on the
| manufacturing cost.
| ProjectArcturis wrote:
| Microsoft Office retails for $250 but costs $0 to make. Perhaps
| it could be argued that installation CDs are "expensive", but
| not $250, and online downloads make this item moot.
| aaomidi wrote:
| Is there a difference between Microsoft Office and medication
| that can help solve an endemic/pandemic of Obesity I wonder?
|
| There are times where the government, can, and should drop in
| and buy the entire IP associated with a medication. This
| price should be set with a council of various
| representatives, and it should not be something that the drug
| manufacturing company can reject.
|
| Most of the research here is already partially funded by the
| tax payer through Government funds of colleges, etc etc
| anyway.
|
| This isn't even something unheard of. The US has the power to
| unilaterally cancel patents.
| spywaregorilla wrote:
| > There are times where the government, can, and should
| drop in and buy the entire IP associated with a medication.
|
| For what price?
| aaomidi wrote:
| > This price should be set with a council of various
| representatives, and it should not be something that the
| drug manufacturing company can reject.
|
| This is part of the cost of doing business. If a drug
| company is going to close shop and want to go operate in
| Europe or China, that's a risk we should be fine taking.
| yorwba wrote:
| Semaglutide was developed in Europe...
| spywaregorilla wrote:
| Ok great. So what's the price?
|
| Drug X was funded for development for $XXX million
| because it was perceived to have a strong positive
| expected ROI dependent on selling the drug for $Y leading
| to an expected value of $ZZZ million.
|
| If you're offering $ZZZ million for it then the drug
| companies won't complain but you're just having the
| public pay the total cost up front. If you're offering
| substantially less than $ZZZ million, then the drug
| company will not invest $XXX million because you've just
| slashed he potential ROI.
| zaroth wrote:
| The answer is to publicly fund the R&D and claim only
| those drugs to be royalty-free.
|
| Private R&D can still fund development and set prices how
| they want. But they'll have to compete with publicly
| funded alternatives.
|
| The shame is that NIH already provides an incredible
| quantity of funding, but it certainly doesn't result in
| the US getting any better drug prices...
| spywaregorilla wrote:
| So, hypothetically, if the government is funding a
| research team to cure X; and a private research team
| discovers it first with no government funding, the US
| should just accept that and pay full price
| richwater wrote:
| > help solve an endemic/pandemic of Obesity I wonder?
|
| Solving obesity is free. For the vast majority of people,
| Ozempic or Wigovy is solving a motivation/discipline
| problem, not an obesity problem.
|
| > This price should be set with a council of various
| representatives, and it should not be something that the
| drug manufacturing company can reject.
|
| Any other authoritarian ideas? What a great way to destroy
| innovation.
| karaterobot wrote:
| > For the vast majority of people, Ozempic or Wigovy is
| solving a motivation/discipline problem, not an obesity
| problem.
|
| I'd invert that: on the scale of a population, motivation
| and discipline are empirically not the cure for obesity.
| The statistics and the studies are on my side here. I
| agree that it would be convenient if that strategy, which
| we've been trying for about 80 years now, suddenly turned
| out to work. But my guess is doubling down on it wouldn't
| be any more effective than it has been, so let's take
| this new approach, which appears to work much better,
| seriously.
| squigz wrote:
| > Is there a difference between Microsoft Office and
| medication
|
| Obviously not, silly. A product is a product. It doesn't
| matter if it saves millions of lives, ends them, or nothing
| in between - companies should be free to charge whatever
| they want, and if you judge them negatively for that,
| you're clearly in the wrong.
|
| I can't believe I have to explain this!
| renewiltord wrote:
| The smartest thing we should do is make it profitable to
| build software and make it not at all profitable to save
| millions of lives. If we do it that way, people will work
| on the latter to the exclusion of the former. In fact,
| the more unprofitable we make the latter, the more of it
| we'll get.
| pkaye wrote:
| Semaglutide is made by Novo Nordisk in Denmark. Maybe
| Denmark could buy the IP and give it free to everyone?
| pkaye wrote:
| Semaglutide is made by Novo Nordisk in Denmark. Maybe
| Denmark could buy the IP or cancel the patent?
| RetroTechie wrote:
| > Most of the research here is already partially funded by
| the tax payer through Government funds of colleges, etc etc
| anyway.
|
| Why not take the extra step then? Government funds the
| research, result is free-to-use for all.
|
| Or: drug developed through research _mostly_ at public
| institutions like universities etc? - > sorry, no patent
| 'protection' then.
|
| Pharmaceutical companies could then produce whatever they
| consider worthwhile. But... squeezing buyers too hard?
| Competitor will step in with a cheaper offer.
| ProjectArcturis wrote:
| Is your reasoning that people who create the most valuable,
| life-saving products should be rewarded by having the
| government break their parents?
|
| And the research is not paid for by the taxpayer. The NIH
| budget is $20B per year. Pharma R&D is $200B per year.
| larkost wrote:
| Actually, last year the NIH budget was $48B, 4/5ths of
| that went straight out as grants for research, and
| another 11% went to internal labs:
| https://www.nih.gov/about-nih/what-we-do/budget
|
| And you have to be very careful about what counts as R&D,
| for example Merck reported $30B in R&D, but one half of
| that was actual for mergers and acquisitions (of research
| related companies). I have yet to find anyone who has
| good numbers on this, which is why the study in this
| article is interesting: it sounds like the article is
| going to be very transparent about what it means.
|
| And for absolute candor here, you have to remember that
| once the NIH grants arrive at a university somewhere
| between 15% and 60% (really, it varies wildly) is taken
| off the top for University expenses, some of which are
| related to the research (e.g.: building costs), and some
| of which are not (arguably: university administration).
| DaveExeter wrote:
| If you only had to pay 20% of the retail price of Microsoft
| Office, it would retail for $1250 and you would pay a $250
| co-pay.
| ipaddr wrote:
| But it costs 0 to download from thepiratebay. Until a
| piratesickbay exists a monopoly exists and prices need to
| drop.
| silverquiet wrote:
| Interestingly, there are also places to get generic
| semaglutide. I'll admit to some interest in the idea
| myself, but so far I've not been willing to roll the dice
| on that process.
| hi-v-rocknroll wrote:
| Most people don't need Microsoft Office to survive. And, the
| price of Ozempic is $83 in France. American patients are
| being outright ripped off, and this is not an isolated
| incident.
| adammarples wrote:
| Exactly why "developing" drugs is mentioned
| bhk wrote:
| But they need these huge margins to pay for the politicians and
| media coverage (or absence thereof) that allow them to do what
| they do.
| hi-v-rocknroll wrote:
| Martin Shkreli approves because some medications just don't
| cost enough for the benefits they provide. When we
| reductively reduce the value of human life to QALY and
| profits, part of our humanity slips away.
|
| PS: I can't currently afford semaglutide but require it to
| offset the side-effects of mirtazapine. Resting HR: 110(!),
| BP: 175/95, BMI: 32.0. Perhaps I should find a cheap way to
| visit France or maybe someone in France would send me a
| year's worth if I paid them.
| heavyset_go wrote:
| > _PS: I can 't currently afford semaglutide but require it
| to offset the side-effects of mirtazapine_
|
| What side-effects? I take the same medication.
| 0cf8612b2e1e wrote:
| The first pill of a drug costs $1 billion to make. The
| remainder are all $0.01 a piece.
| willcipriano wrote:
| 900 million or so of the total is used in the most important
| part of drug safety, share buybacks.
| ProjectArcturis wrote:
| Wait, these companies are making PROFITS that they're
| returning to INVESTORS??? I don't know whether to call 60
| Minutes, the FBI, or The Daily Worker.
| geysersam wrote:
| In that sense it's not so different from digital content.
| Another arena where IP concept from the last century are a
| bad fit
| itopaloglu83 wrote:
| Sure. The drug companies should be able to recoup their
| initial investment and also make a healthy profit as well.
| Nobody expects them to develop and manufacture something for
| free.
|
| However, this must be based on their actual cost and not an
| arbitrary figure, which in the article was revealed to be
| roughly $34M real cost compared to $3B as it was advertised
| for lobbying purposes.
|
| What is the best way to protect private ventures but also
| prevent them from sucking the public funds and the entire
| population dry? Transparency. Let's see where the money is
| being spent and compare it with other companies to see what's
| really happening here. The society doesn't allow vital
| resources like water, and recently internet be priced at
| extraordinary numbers, and control how much profit you can
| make. Maybe there should be even a cap at 100% profit, or
| 300%, or let's say 500%. But once a company starts selling a
| life saving drug at 17 thousand times the cost of developing
| AND manufacturing it, then there's something definitely wrong
| in that industry and the market must be investigated.
| s1artibartfast wrote:
| This trial used drugs that were first developed 90 years
| ago, and the people running the trial didnt do any
| development work, just bought them off the shelf. Check in
| on the cost of Semaglutide in 80 years.
| SkyPuncher wrote:
| "But it only costs X" is not a great argument. Most of tech
| jobs would be gone if things had to be within a fraction of
| what they cost to deliver.
|
| The world runs on value. Coat is simply a limiting factor in
| the floor that something can be made for.
| aantix wrote:
| That's like saying "It took them five minutes to enter these
| lines of code. Why are we paying them so much!?!?!?"
| jfoutz wrote:
| We really did this wrong. We should get paid for every time
| the lines are run.
| tompccs wrote:
| That's SaaS
| abecedarius wrote:
| More directly, like "it costs, like, a penny to download the
| software to the client, why do we pay so much?" Marginal cost
| vs. amortized development.
|
| (Making a limited point separate from my general opinions of
| Big Drug, etc.)
| heavyset_go wrote:
| We can look at what those drugs retail in other countries to
| see how much price gouging is going on. Turns out it's a lot.
| davisr wrote:
| In your example, if it did take a programmer 5 minutes, and
| they don't have any real accountability anyway (not like a
| real engineer), then why _are_ we paying them so much?
| Der_Einzige wrote:
| SWEs are massively overpaid. News at 11...
| heavyset_go wrote:
| I've seen on-patent medications sell for $500 to over $4000 a
| month for a 30-day supply. Those same medications cost between
| $20 and $40 in sane countries, and none of them included
| autoinjectors, they were just simple pills for simple
| conditions.
|
| It was also NIH research and money that lead to discovery of
| the drugs in the first place.
| ceejayoz wrote:
| My most recent Skyrizi shot (one mililiter, once every 12
| weeks) cost $23,685.03. https://imgur.com/s5q4ZEt (That three
| cents at the end kinda made me laugh.)
|
| It's about 1/10th that in the UK (not even counting the NHS's
| "confidential discount");
| https://www.spglobal.com/marketintelligence/en/news-
| insights....
| holoduke wrote:
| Sometimes I think that this attitude will cause the western world
| to become a second tier world. How can you build a sustainable
| world where this level of greed is accepted and even lobbied into
| political levels.
| MostlyStable wrote:
| "It is not from the benevolence of the butcher, the brewer, or
| the baker, that we expect our dinner, but from their regard to
| their own interest. "
| Aerbil313 wrote:
| The dead sibling comment really exposes how a good fraction of
| people in the western world think.
|
| But truly greed was the real primary motivator of technological
| progress for the past centuries. Not the desire to benefit
| humanity.
|
| They say greed kills the greedy person.
| aantix wrote:
| A pharmaceutical company can capitalize on current successes
| and have enough to hire 1,000 research scientists for future
| developments.
|
| Or they could take "just enough", hire 10 research scientists,
| and potentially not make the next breakthrough. Or the company
| just dies.
| FredPret wrote:
| Drugs may be overpriced.
|
| There is probably some bloat in drug development. But then again,
| maybe not. I'm not an expert.
|
| What I do know is that drugs have gotten dramatically better in
| the short amount of time I've been alive.
|
| The other thing we all know is that the source of this article,
| The Guardian and their friends, have a shitlist of industries and
| institutions it loves to hate.
|
| Ask yourself: will they ever write a positive article about a
| defense contractor, a bank, big pharma, a US billionaire, or a
| landlord, even if said entity walks on water and then saves a
| million babies and the penguins and the world?
| pfdietz wrote:
| People who don't like prices of new drugs are free to not use
| those drugs.
|
| They want to have the benefits of the existence of drugs
| without paying the cost of discovering the drugs and bringing
| them to market. It's pernicious entitlement, made more
| outrageous by complaining about the greed of those actually
| providing the new drugs.
| AlexandrB wrote:
| Ah yes exciting new drugs like insulin[1] and epinephrine[2].
| I'm also certain that someone going into anaphylactic shock
| is extremely well positioned to make a considered decision on
| whether they like the prices of new drugs like epinephrine or
| not.
|
| [1] https://www.rand.org/pubs/articles/2021/the-astronomical-
| pri...
|
| [2] https://www.vox.com/policy/23658275/epipen-cost-price-
| how-mu...
| FredPret wrote:
| I am of course talking about new drugs. There are lots of
| really great new ones.
|
| That doesn't mean there aren't shitheads taking advantage
| of things like insulin etc.
|
| But just because they're also being assholes with regards
| to insulin et al, doesn't mean that developing new drugs
| isn't genuinely very expensive, and that those drugs aren't
| genuinely very good.
| rufus_foreman wrote:
| >> Ah yes exciting new drugs like insulin
|
| The older type of insulin is $35 a month. There are
| exciting newer types and delivery methods of insulin that
| are more expensive. The drug companies developed better
| versions because they expected it to be profitable to do
| so. They will develop even better versions in the future if
| they expect it to be profitable to do so.
| loeg wrote:
| Insulin is a bad example because the old formulation is
| very cheap. The expensive variant is a new, better drug
| that was recently developed.
|
| People going into anaphylaxis aren't buying epi pens. You
| buy them in advance.
| s_dev wrote:
| > People who don't like prices of new drugs are free to not
| use those drugs.
|
| I recall in economics class, life saving/altering medicine
| being one of the genuinely few products that had a perfectly
| inelastic demand. Not all drugs are life saving or essential
| but then you do have Martin Shkreli's in the world.
| bongodongobob wrote:
| No, we want people to have healthcare regardless of how much
| money they have. The research can be paid for by taxes as we
| all benefit from it as a society.
| dlisboa wrote:
| That's a rather reductionist view of it. Companies don't
| exist in a vacuum, they have a social contract. It seems in
| your view there's nothing we can complain about them as we
| can always just not buy the drugs, freeing them of any
| scrutiny.
|
| But society create rules for companies to exist within, many
| of which are broken, but without which the never ending
| search for profits would do more harm than good. Society even
| provides these companies with their intellectual labor,
| training them in high schools and universities, which is not
| paid back by them in full (maybe partly if that) either in
| grants or in compensation for these workers.
|
| Maybe this is an offshoot of the anarcho-capitalism mindset
| that is popular these days where companies can do absolutely
| no wrong and we should all be thankful they exist to judge
| whether we're worthy enough to not die of diabetes.
| ryandrake wrote:
| Not only do companies not exist in a vacuum, but they have
| no inherent right to exist in the first place. Companies
| are _graciously allowed_ to exist because the state (a
| proxy for the people) approves them, the state grants their
| charter, the state provides them the corporate veil and
| limited liability they often abuse... Companies only exist
| because we the people decided that the public good they are
| supposed to serve outweighs their downsides. And we the
| people _should also_ be able to decide that a particular
| company should not exist, if that company operates against
| the public good.
| emperorcezar wrote:
| People who don't like prices of food are free to starve.
|
| They want to eay without paying the cost of bringing food to
| market. It's pernicious entitlement, made more outrageous by
| complaining about the greed of those actually providing the
| food.
| notaustinpowers wrote:
| I hope you never become a diabetic when you get older!
|
| An old coworker of mine dropped dead on her lunch break
| because her insulin was unusable when it got too warm during
| shipment. Her insurance said they would not pay for another
| month's doses until the next month and she'd have to pay
| $2,000 out of pocket. Which isn't the kind of money a poor
| girl from the middle of nowhere South Carolina has.
|
| And now she's dead...because she was $800 short of raising
| that money from a GoFundMe...
|
| But I sure am happy that her insurance company beat their
| quarterly earnings estimates!
| FredPret wrote:
| That's fucked-up and I'm sorry that happened.
|
| Clearly things could be much better.
|
| But that doesn't mean the system as a whole isn't a huge
| net positive.
|
| The right approach is tweaking, not destroying.
| notaustinpowers wrote:
| IDK about your philosophy, but any death that is 100%
| unavoidable invalidates the entire system of business
| that has been built.
|
| Nothing in this world is above a life. Not money, not
| profit, not a quarterly bonus. _Zilch, nada, zero._
|
| I'm biased, obviously, but by principle, I refuse to
| accept a system that accepts avoidable deaths as a
| "necessary" consequence of their business model.
| FredPret wrote:
| Yes but when you talk about system-wide decisions, it's
| not really clear which one will save the most lives.
|
| If drug companies are made to sell drug x cheaper, maybe
| they end up charging more for drug y, or now they can no
| longer afford to invent drug z.
|
| So we can look at someone dying for lack of $800 and say
| that's clearly a big mistake, but it's not clear what
| trade-offs and adjustments would make the system solve
| this problem without also making even worse mistakes
| elsewhere.
|
| To measure our system, the best you can probably do is
| population-wide stats, like life expectancy, infant
| mortality, maybe average height (healthier populations
| being taller). On those metrics, we're making tremendous
| progress.
| thethirdone wrote:
| > IDK about your philosophy, but any death that is 100%
| unavoidable invalidates the entire system of business
| that has been built.
|
| Assuming you meant _avoidable_ , I don't think there is
| ANY system of business that avoids EVERY avoidable death.
| Often saving each life may be 100% possible, but it may
| not be possible to save every life. As a real example, I
| would guess most civilians in Gaza that will die in the
| next month could have their death avoided if their
| singular life were the #1 priority of every around them.
| However, I do not think the humanitarian crisis in Gaza
| can be entirely solved within the next month so that no
| civilian will die (even assuming cooperation from both
| sides and massive external aid).
|
| The absolutism in your comments is not conducive to
| productive conversation. I would guess there are many
| people on HN that are too pro capitalism and don't
| recognize how it fails many people, but being absolutist
| to the point of impossibilities does not make you
| convincing.
| notaustinpowers wrote:
| Sorry, yes I meant avoidable.
|
| I'm aiming this in terms of businesses and corporations,
| not international conflicts and wars.
|
| Ultimately, when it comes to businesses and corporations
| that are in direct connection with life and death (e.g.,
| drug companies, architecture firms, power companies,
| water companies, etc), then everything must be done
| within their power to ensure that the risk of death is
| minimized as much as humanly possible. Either by de-
| prioritizing profits, ensuring equitable access, or any
| other measures that are necessary.
|
| I understand that a company has to make a profit
| somewhere. But a drug company that manufactures a drug
| for $4/pill and then selling it for $10,000/month to
| treat a disease that will kill without it - all while
| using taxpayer funds/grants/federal money to fund the
| research is heinous, greedy, and antithetical to what it
| means to be a human in a society.
|
| Private power companies (like my local one, Georgia
| Power) making $2bn/year charging $180/month for a 1
| bedroom, 660sqft apartment is criminal. Especially as I
| understand and knew many families growing up that would
| spend half their month with no power until their next
| paycheck.
|
| It's on me that my original comment was absolutist, but
| it's my principles.
| CogitoCogito wrote:
| > What I do know is that drugs have gotten dramatically better
| in the short amount of time I've been alive.
|
| How do you know this? How do you measure "better"? Something
| like QOL improvement per dollar? Have you done (or read) some
| large study on this or something?
| zer00eyz wrote:
| Were curing forms of cancer that would have killed you
| decades ago.
|
| HIV, in my life time was a death sentence. Now people are
| living almost full lives.
|
| Less dead people is a pretty good metric for drug
| development.
| pfdietz wrote:
| The advances in oncology are startling.
| cal5k wrote:
| You forgot to mention that we can now effectively "cure"
| obesity with GLP-1 receptor agonists.
|
| Oh, and as a nice little bonus they also curb substance use
| disorder!
| heavyset_go wrote:
| In sane countries, HIV drugs cost dozens of dollars per
| month. In the US, those same HIV drugs retail for thousands
| of dollars for only a 30-day supply.
|
| Similarly, companies that patent HIV drugs purposely hold
| off on bringing new, better drugs to market until the
| patents for their old drugs expire. For example, Gilead
| held on to Descovy and timed its launch to conveniently
| match up with the patent expiration of their drug Truvada.
| It's planned obsolescence in drug form.
|
| Truvada had common complications like kidney damage and
| failure, and bone density loss, that Descovy mitigated. Had
| Gilead brought Descovy to market sooner, instead of holding
| on to it until Truvada's patent expiration, people could
| have had the option to choose between the two drugs, and
| those at risk of complications wouldn't have received
| needless kidney damage/failure and bone deterioration from
| their only option on the market.
|
| During Truvada's patent period, Gilead raised prices
| practically every year, and a drug that already cost $2k a
| month suddenly cost over $4,500 a month towards the end of
| its patent protection period. In other countries, it cost
| $40.
|
| Gilead is now doing the same thing with Descovy, charging
| $2,600 a month with rising prices for a drug that costs far
| less in sane countries.
|
| Just because things might be "better", doesn't mean they're
| perfect, and doesn't mean they don't need to improve.
|
| As an aside, these are drugs that prevent the acquisition
| of HIV in the first place. AIDS could virtually be
| eradicated in the US if HIV prophylaxis was widespread and
| affordable.
| krapht wrote:
| The measure in healthcare is QALY, or quality-adjusted life
| year.
| spiderxxxx wrote:
| They've been marketed better. I wouldn't say they are more
| effective. Still, if you have a problem and your doctor
| prescribes you a drug, you should ask if it's the most
| tested, reliable drug, or just the latest.
| notaustinpowers wrote:
| There is nothing positive about:
|
| - Companies that profit from murder.
|
| - Companies that profit billions by charging poor people more
| money.
|
| - Companies that profit by (essentially) extorted thousands of
| dollars from people with the only other option being death.
|
| - A person who profits by underpaying labor and creating false
| supply/demand.
|
| - A person who profits by extorting $1,000/month minimum from
| people with the only other option being homelessness (which is
| now a felony in many cities!)
|
| I don't care if Jesus came down from Heaven and told me to love
| these people. I do not care about companies or people who
| profit off of restricting the _basics of survival_ from your
| average, everyday person.
|
| And get this bud, they don't care about you either! If Northrop
| Grumann could make $10,000,000 by turning you into a fine red
| mist they'd push that button before the ink on the check was
| dry.
| FredPret wrote:
| > "- Companies that profit from murder."
|
| Holy conspiracy theory batman
|
| > "- Companies that profit billions by charging poor people
| more money."
|
| Would you prefer that companies that serve poor people stop
| doing so? Because that would only raise prices for products
| poor people use. Supply and demand - it's the only sure thing
| in economics.
|
| > "- Companies that profit by (essentially) extorted
| thousands of dollars from people with the only other option
| being death."
|
| The companies _created_ an alternative option to literally
| dying, and you call this extortion? Would you prefer they not
| offer this option at all?
|
| > "- A person who profits by underpaying labor and creating
| false supply/demand."
|
| Underpayment is only possible in some dreamworld. If workers
| are being underpaid, then by definition they can get better
| pay by switching jobs. Why aren't they? And if they can't get
| better pay, then they aren't being underpaid - they're being
| paid market rates.
|
| > "And get this bud, they don't care about you either! If
| Northrop Grumann could make $10,000,000 by turning you into a
| fine red mist they'd push that button before the ink on the
| check was dry."
|
| The basics of survival are provided by greedy, psychopathic,
| for-profit cybernetic organisms called corporations.
|
| And life has never been better, especially for the very
| poorest.
|
| I would suggest that you look at some hard data in this
| regard, rather than defining your own parallel economic
| reality in which you can be so very satisfied in your anger.
|
| If you want a hug, Northrop Grumman or your landlord or big
| pharma just don't do cuddly. Get a dog or a friend. If you
| want results that are measurable as housing provided, years
| of life added, or fighter jets built, or tons of wheat
| produced, then get a corporation.
| notaustinpowers wrote:
| Tell me, what do defense contractors produce? Because I'm
| telling you right now Lockheed Martin doesn't make $1.5
| billion this quarter by making friends.
|
| I'd prefer that banks stop making billions each year with
| junk overdraft fees. It's not like $35 is going to change
| their quarterly earnings but $35 can buy cheap groceries
| for a week until their next payday.
|
| If they use taxpayer grants and funds to research new drugs
| then I find that it's only fair to be treated like any
| other taxpayer-funded thing, make it free or cheap for the
| public like national parks, USPS, and the DMV. You don't
| get to socialize the funding and then privatize the
| profits.
|
| I'm sorry that I dream and hope to work towards of a better
| future for everyone! Enjoy the "greedy, psychopathic"
| corporations you seem to fight so hard for. Maybe they'll
| let you live in their new "utopia" city in California if
| you bark enough for them.
| FredPret wrote:
| In each case, you take the most negative aspect of the
| corporation and blow it out of proportion.
|
| Lockheed Martin makes weapons. Weapons seem like a great
| thing to have when it's the only thing preventing your
| country from being invaded. (and by the way, we've never
| lived in a time with fewer battle deaths per 100k
| people).
|
| Banks charge overdraft fees. But they also provide secure
| transactions, storage of value, and they pool capital.
| This is a critical service without which there'd be no
| economy at all.
|
| Drug companies are not little angels with perfect
| behaviour. But without them, a lot of us would currently
| be dead.
|
| And so on and so on.
|
| We live in a complex world. If you only look for the
| worst, that's exactly what you'll find. If you look for
| hard facts, you'll see that there's never been a better
| time. Perhaps you would then ask - who benefits from
| keeping you continually outraged? Only the media, and a
| certain type of politician, and late-night comedy hosts.
| Certainly not you, and definitely not the rest of the
| world.
| kwhitefoot wrote:
| The article is mostly not about drug development as a whole,
| merely the cost of trials. All that is being asked is that the
| cost of trials be public information.
| pfisherman wrote:
| Without comment on the broader subject of drug pricing -
| especially in the US - this article leaves out enough relevant
| information that I would consider it to be intellectually
| dishonest.
|
| Where did they run the trials? Across how many sites? Do they
| plan to apply for marketing approval in the US or EU? Are they
| the manufacturer? Did they beat the cost of setting up the supply
| chain and manufacturing facilities prior to the phase 2/3 trials?
|
| The answers to those first three questions will have a huge
| impact on the price tag.
| PinkSheep wrote:
| > US or EU?
|
| I'm a bystander, but the gist I got from the official lists and
| trials is that each EU country needs it's own approval with the
| gov agency. It may be that "being EU" has equalized
| requirements to an extent, but each wants their own.
| (bureaucracy kills?)
|
| One example I read about was a yet experimental drug made by a
| Swiss company, but the trials only run in and for the US for
| financial and market reasons.
| pfisherman wrote:
| USD has the FDA and EU has the EMA. I am not sure how EMA
| interacts with each individual country.
|
| While regulatory agencies may consider data generated from
| trials in other jurisdictions, they may ask questions about
| whether those data and conclusions and relevant and
| generalizable to their patient populations and health care
| systems.
|
| There are also ethics to consider. Sure it may be cheaper to
| run trials in developing countries. But at what point does it
| become exploitative? Keep in mind that we are talking about
| human experiments, which is very serious business.
| frodo8sam wrote:
| No the EU has the EMA which approves drugs for all European
| countries in collaboration with national drug agencies. And
| the EMA FDA and japanese agency are pretty well aligned. So
| approval by one will typically mean you also meet the
| requirements for the others. Notable exceptions are the
| recent Alzheimer drugs.
| s1artibartfast wrote:
| The drugs are all previously developed and approved by other
| companies, some as early as the 1950s. They ran the trials in
| Kazakhstan, India, and similar developing countries.
|
| They have no manufacturing and supply chain, because they buy
| commercially available generics off the shelf for pennies.
|
| There is a lot to say about pricing, but the guardian is
| shamelessly spreading disinformation.
|
| https://endtb.org/sites/default/files/2023-11/Leaflet%20endT...
| TehCorwiz wrote:
| If the cost of developing the drug were relevant then every
| country would pay roughly the same for the same drug from the
| same company. They don't.
| foota wrote:
| This doesn't make sense. Pricing could very reasonably vary by
| country in order for a company to try to capture more revenue
| though price discrimination.
|
| This says nothing about whether this is done to cover the costs
| of development or not. Only an altruistic company wouldn't vary
| the prices.
| acover wrote:
| Why? A monopoly would want to charge more to richer customers.
| willcipriano wrote:
| The poorest customers would just resell what they buy to the
| richest ones in a functioning market.
| MisterDizzy wrote:
| Drug companies are unambiguously out of control. Some of these
| new molecules don't even need to be invented, they're just
| legally distinct repackaging of something they can't gouge on
| anymore. These companies could, if they had an incentive to do
| so, research effective off-label uses of existing drugs, say. But
| there's no money in that. There is a ton of money in making
| legally distinct "new" drugs that do the same thing as newly-
| generic drugs. It's unacceptable what they get away with.
|
| Covid ought to have been the final straw that brought all sides
| together to do something about drug companies.
| nimbius wrote:
| that we so rapidly transitioned to --and away from-- a rapid,
| effective and universal free COVID vaccine for the majority of
| americans in such a relatively short period of time without any
| sincere discussion or commentary from news media or public
| policy officials really spoke volumes to me about the kind of
| national policy the United States is either pursuing with
| conscientious determination, or blithe indifference.
|
| we could have done covid style vaccines for a litany of other
| incredibly dangerous yet common causes of death in the US like
| flu shots and HPV, but we dont. we charge real moneys for these
| things as though the cost of the development of the drug itself
| isnt borne almost exclusively by the taxpayer.
| ericmcer wrote:
| The government was paying just Pfizer like 50bn a year for
| Covid vaccines, I'm sure if you add up all the manufacturers
| they were easily paying 100bn a year from 2021-2023. I don't
| have all the math but I am guessing it ended up costing at
| least $500/yr to vaccinate a person.
|
| That is a long ways from free, there is just the bit of
| abstraction that allows corporations to rob us blind. If we
| had to go get $500 out of an ATM and hand it to the pharmacy
| everyone would have been throwing a fit. Bundle it in with
| the taxes that get silently pulled from your paycheck before
| you even get it though? No biggie.
| ceejayoz wrote:
| Any cite for this?
|
| https://www.kff.org/coronavirus-covid-19/issue-brief/how-
| muc... says as of a year ago the _total_ across _all_
| manufacturers for _multiple_ years was $30B, at a per-dose
| cost of $20.69. Given how dismal booster uptake has been
| and the cessation of free vaccination in the fall, I
| _severely_ doubt the last year has seen the extra $70B you
| assert.
| a_wild_dandan wrote:
| I have no idea why you're being downvoted. Is it because we
| do give out flu shots & such?
| serial_dev wrote:
| Rapid, effective, and free? I give you rapid, whatever the f
| that means for a vaccine.
|
| Effective? My whole family was vaxxed, yet everyone got
| COVID. We have friends who are on their 5+ jab, and they
| still get it. Of course, after this became painfully clear to
| everyone, big pharma quickly started to erase history and
| move the goalpost, and they still disappoint somehow.
|
| Free? Maybe free as in you don't need to take your cash and
| pay for it, but I can assure you, it cost a ton of tax payer
| money, benefits are unclear, it's based on government funded
| research, and somehow big pharma made enormous profits which
| will make sure they will never be held to account.
|
| I'm also surprised that we finally transitioned away from
| this farce, because for 2-3 years, it felt like they will do
| everything to force it onto you and vilify anyone who asks
| questions.
| acchow wrote:
| What's stopping people from using the old packaging when the
| patent expires?
| ceejayoz wrote:
| They stop making it, and pay generic manufacturers not to.
|
| https://www.nbcnews.com/business/business-news/drug-firms-
| st...
|
| > Known as "reverse settlement payments," or "pay-to-delay"
| deals, the financial arrangements are a unique but common
| practice in the pharmaceutical industry. Essentially, they
| allow drug manufacturers in some instances to pay competitors
| not to manufacture generic versions of their products,
| thereby ensuring that they maintain patent protection for as
| long as possible.
| RandomBK wrote:
| How is this not a blatent antitrust violation?
| ceejayoz wrote:
| The story of that particular legal saga is well laid out
| at https://www.theatlantic.com/ideas/archive/2023/06/phar
| maceut....
|
| FTC is trying, but it's one of many places in society
| where money speaks loudly. https://www.ftc.gov/news-
| events/topics/competition-enforceme...
| foota wrote:
| There's a convoluted process that they can game to extend
| their exclusivity with the FDA see e.g.,
| https://time.com/6336840/patent-manipulation-insulin-prices/
| sowbug wrote:
| "People" are the same drug companies that would rather use
| their manufacturing capabilities for high-margin on-patent
| drugs.
|
| For a particularly sad example, certain kinds of testicular
| cancer are considered curable with off-patent drugs like
| cisplatin and etoposide. But those drugs are often
| unavailable simply because nobody wants to manufacture such
| low-margin drugs. See, for
| example,https://www.fiercepharma.com/pharma/oncology-drug-
| shortage-c....
| kristopolous wrote:
| It wasn't because it has always and will always be about the
| leverage and execution of power asymmetries.
|
| There's no magic hand or market forces working in the public
| favor, it's competing factions exercising power.
|
| We will continue taking a bath on everything until we organize
| and exercise power. It's not about "voting" with your wallet
| because that doesn't set the rules. The terms of engagement
| need to change.
|
| Things don't have to be this way, there is no "natural law" and
| things won't change due to prudence. That's all just classic
| hustling tactics - other countries don't operate this way.
| RcouF1uZ4gsC wrote:
| > Covid ought to have been the final straw that brought all
| sides together to do something about drug companies.
|
| If anything, Covid demonstrated the value of drug companies.
| What was the economic cost of Covid, just from the shutdowns,
| not including the deaths and disability? I am sure it ran into
| the trillions.
|
| So the drug companies made $100 billion dollars while producing
| an economic surplus of trillions? Sounds like a great deal to
| me.
|
| I want developing new drugs to be insanely profitable. I want
| the smartest people to go into finding new cures for diseases
| instead of into thinking about how to drive "engagement" to
| maximize ad revenue, or playing financial games on Wall Street.
|
| What were the revenues of Apple, Facebook, Google, Microsoft
| during Covid?
| streptomycin wrote:
| _Its own bill for landmark trials of a four-drug combination
| treatment for drug-resistant tuberculosis came to EUR34m
| (PS29m)._
|
| Okay, how does that compare to what pharma companies spend? The
| article cites some unrelated numbers, doesn't actually compare.
|
| A quick Google search says:
|
| _The average cost of phase 1, 2, and 3 clinical trials across
| therapeutic areas is around $4, 13, and 20 million respectively._
|
| So... not really that different? What's the big deal here?
| throwaway35777 wrote:
| Don't successful drugs also have to pay for the failed trials?
| kurthr wrote:
| And also for failed executive pay, and failed lobbying, which
| are much more expensive. In some cases (like Aduhelm) the
| marketing started before it was shown to have efficacy... so
| you have to pay for that very expensive failure too.
|
| https://www.washingtonpost.com/business/2024/03/08/eli-
| lilly...
| jrsdav wrote:
| This is essentially true. Pharma is incredibly expensive (for
| lots of different reasons), with R&D taking up a huge portion
| of those costs.
|
| So yes, it's safe to assume that part of the accounting
| around those published costs in the billions are all of the
| failed _candidates_ that never even made it to _trials_ (the
| failure rate varies depending on the area of biology and the
| type of drug, but it 's generally around 9 out of every 10
| candidates [1]. By the time you get to trials, that ratio
| gets even more abysmal).
|
| Disclaimer -- I work for Recursion, a company built around
| this very problem.
|
| - [1]: https://www.sciencedirect.com/science/article/pii/S221
| 138352...
|
| - [2]: https://www.recursion.com
| mc32 wrote:
| R&D takes lots, but so does compliance --for good reason.
| But compliance costs a lot of money, directly and
| indirectly. Lots of people, lots of inefficient processes,
| etc.
| tomrod wrote:
| Why do the phase testing not prevent overindexing failed
| projects?
| darth_avocado wrote:
| Yes. They also have to pay for the $4.2B the companies spend
| on lobbying efforts in 2023.
|
| https://www.nbcnews.com/investigations/lobbyists-spent-
| recor...
| ProjectArcturis wrote:
| Seems like a lot, but in the context of $200B spent on R&D,
| 2% spent on warding off confiscation is probably money well
| spent.
| Retric wrote:
| The S.
|
| "Its own bill for landmark trialS of a four-drug combination
| treatment for drug-resistant tuberculosis came to EUR34m
| (PS29m)"
|
| You're also looking at the cost from from 2015 to 2016 where a
| single phase 3 trial was already 20m and $41,117 per patient.
| https://www.linkedin.com/pulse/clinical-trial-budget-example...
| nickff wrote:
| I don't understand the difference you're trying to point out.
| You're both talking about the total cost for a testing a
| combination of drugs which required multiple phases, each of
| which is deemed a different trial. Am I wrong? What
| difference are you trying to highlight with the "s"?
| Retric wrote:
| Each of those different phases would have cost ~26 million
| (30% inflation on 2015 prices).
| cameldrv wrote:
| The super high clinical trial costs also mean problems for
| any drug that isn't expected to have a large effect size,
| because it's hard to get statistical significance.
|
| Some trials have been controversially going for a surrogate
| endpoint, which makes the stats easier since you can get a
| continuous variable instead of a binary one, but that's also
| how you get aducanumab, which reduces amyloid plaque, but
| it's unclear if it actually helps in alzheimers. Despite this
| they charge $56k a year.
| darth_avocado wrote:
| Cost of developing a new drug:
|
| - $10M research infra - $30M clinical trials - $200M executive
| pay - $200M lobbying - $600M sales and marketing
|
| Clearly clinical trials are too expensive and it takes too much
| to develop new drugs.
| ceejayoz wrote:
| See also: Hollywood accounting. It's fairly easy to make
| something look expensive if you put your mind to it.
| lotsofpulp wrote:
| Not applicable here because no one is discussing drug
| companies negotiating percentage commissions with their
| scientists.
|
| If Novartis was committing fraud by misstating expenses,
| they would be harming their own executives who get paid in
| equity. And if they were inflating expenses, they would,
| eventually, get beat by Merck/Pfizer/Lilly/myriad other
| competitors.
|
| Edit to respond to below comment:
|
| Hollywood accounting is not fraud because there are no laws
| requiring media makers to categorize and report expenses
| and income a certain way for the purposes of satisfying
| compensation agreements with their vendors
| (actors/producers/directors/etc). It all depends on each
| individual contract.
|
| A publicly listed business, however, has to comply with
| myriad rules regarding reporting of cash flow and assets,
| so it is always nonsensical to bring up Hollywood
| accounting when discussing official financial figures
| reported to the SEC.
| ceejayoz wrote:
| _Look_ expensive and _actually_ expensive aren 't the
| same, nor is creative accounting always _fraud_. That 's
| the entire point of Hollywood accounting (which, in the
| Hollywood example, helps equity like Disney
| shareholders).
| darby_eight wrote:
| It's almost like the market is extremely poorly suited for
| developing drugs
| nradov wrote:
| Do we have examples of non-market systems that have proven
| to be consistently more effective for developing drugs?
| sudosysgen wrote:
| Yes, universities and public research labs. What they
| aren't effective at, however, is financing trials, so
| unless we find a way to overhaul that issue we have to
| deal with pharma companies.
| downrightmike wrote:
| How much of that is Universities doing all the leg work?
| streptomycin wrote:
| Not much, universities basically never pay for clinical
| trials.
| larkost wrote:
| This is true, but it should also be pointed out here that
| Universities are where almost of all the initial research
| into finding and vetting candidate drugs happens, mostly on
| grants from the government. On the whole that is enormously
| costly, and the drug companies only step in to develop the
| drug once the lab tests are promising.
|
| It used to be that all of the profits went to the drug
| companies, but more recently Universities have started to
| claim a portion of the patent royalties, and thus the
| profits. I believe the first big example of this is the
| University of Wisconsin's royalties on Warfarin (blood
| thinner used as medicine in humans, and in large doses as a
| rat killer).
| squigz wrote:
| For those in favor of drug companies charging exorbitant amounts
| of money for life-saving medication in order to recoup their R&D
| costs (and we'll be generous and believe their reasoning and
| numbers)... it follows that, once they've recouped their costs,
| they should lower the price, right?
| ryandrake wrote:
| Yea, just like road and bridge tolls go away once the project
| that the toll was supposed to pay for completes... Fat chance!
| squigz wrote:
| This might be shocking to some, but yes, that should indeed
| be how it works.
| tmnvdb wrote:
| Unfortunately not, It follows that we set the length of drug
| patents at a high enough level that, on average, drug companies
| can continue their work of inventing drugs.
|
| In other words, they will sometimes make a unseemly profit on a
| monopoly position, but at least the existence of that
| possibility creates the incentive for development of drugs.
|
| The alternative is to kill the whole industry.
|
| Sorry - the world is not ideal.
| aantix wrote:
| No.
|
| Because there are infinite hypotheses for drug improvement,
| disease management, and cure.
|
| And for the company to pursue that research, they need to
| capitalize on current successes.
|
| The company needs to be able to survive in downturns.
|
| Just like any company.
| ano-ther wrote:
| I'd be eager to learn more, but it seems that they have only
| published the topline figures [1] and some of their methodology
| [2]. Details will follow in a journal.
|
| Perhaps worth noting that development cost account for more than
| the phase 2-3 studies and that cost are lower for combinations of
| known drugs. But yes, 34 million is a lot less than 3 billion.
|
| [1] https://msfaccess.org/precedent-setting-move-towards-drug-
| de...
|
| > *Total costs were EUR33.9 million. While the topline results
| were presented at the WHO PPRI conference, the full detailed
| costs of the clinical trial have been submitted for a peer-review
| publication to a journal. In the full publication, the costs are
| broken down into 27 cost categories, by year, and by trial site,
| in order to offer a high level of transparency.
|
| [2] https://msfaccess.org/transparency-core-clinical-trial-
| cost-...
| lotsofpulp wrote:
| If the authors were correct, they would have investors throwing
| money at them, and they would be competing with the existing
| drug companies, no? They are the second or third most
| profitable businesses in the world.
|
| Who would write a research paper instead of founding drug
| companies if they had the secret sauce to cutting expenses that
| drastically.
| javiramos wrote:
| I would love to know the shortcut to developing a commercially
| viable drug for $34M.
| s1artibartfast wrote:
| If I understand the trial[1] correctly, the "shortcut" is
| running a trial with small molecule drugs that were invented
| 90-20 years ago, commercially developed by someone else, and
| are now off or going off patent.
|
| Shameless propaganda from the guardian to put this in
| contrast with new biologic molecules.
|
| https://endtb.org/endtb-clinical-trial-results
|
| https://en.wikipedia.org/wiki/Bedaquiline
|
| https://en.wikipedia.org/wiki/Delamanid
|
| https://en.wikipedia.org/wiki/Clofazimine
|
| https://en.wikipedia.org/wiki/Linezolid
|
| https://en.wikipedia.org/wiki/Quinolone_antibiotic
|
| https://en.wikipedia.org/wiki/Pyrazinamide#History
| cde-v wrote:
| Corporations lying to inflate prices and profits? Impossible! Our
| perfect markets wouldn't allow for this.
| lr4444lr wrote:
| I'm not clear from the article whether this also accounts for
| recouping the cost of _failed_ drugs.
| Lendal wrote:
| Good point. Yep it sure would be nice if every drug worked out,
| every project was wildly successful, every new hire was a
| wonder-kid, every investment only went up and to the right.
| That would make all the math so much easier wouldn't it?
| darby_eight wrote:
| ...or the industry refusing to research a drug because of
| expense estimates!
| ProjectArcturis wrote:
| It's clear that it does NOT.
| fifteen1506 wrote:
| Maybe if pharmaceuticals were also insurance companies prices
| would drop to pay less income tax? Or a variant thereof.
| tompccs wrote:
| You can't compare running a clinical trial for a drug targeting a
| communicable disease in the developing world to trials for
| treatments of complex diseases in rich countries where you need
| serology, histopathology and radiological endpoints.
|
| Worth noting as well that J&J have shut down their entire
| division in communicable diseases because it was so unprofitable
| for them.
|
| (Source: I work in this industry)
| thomassmith65 wrote:
| Was it 'unprofitable' as in 'losing money', or 'unprofitable'
| as in 'not worth the time'? If it's the latter, I don't have
| enough information about the rest of J&J to draw any
| conclusions.
| s1artibartfast wrote:
| Financially, they are the same.
|
| If you can make more money by not doing X, than doing X, it
| doesnt matter.
| interstice wrote:
| That rules out just about any non regulated altruism. Eg
| open source
| s1artibartfast wrote:
| Charitable donations and altruism are outside the scope
| of financial analysis.
|
| You can donate time or money even if you are running a
| loss in real, nominal, or opportunity costs.
| s1artibartfast wrote:
| Just to build on this, many drug and device companies
| specifically run early trials in the developing world or
| eastern Europes specifically _because_ the costs are so much
| lower.
|
| Part of the costs are labor and materials, the majority is
| regulatory burden. It is a well established financial de-
| risking activity before spending the hundreds of millions more
| for a US/EU trial.
|
| Edit for visibility:
|
| The drugs in this trial are all previously developed and
| approved by other companies, some as early as the 1950s. They
| ran the trials in Kazakhstan, India, and similar developing
| countries. They have no manufacturing and supply chain, because
| they buy commercially available generics off the shelf for
| pennies.
|
| There is a lot to say about pricing, but the guardian is
| shamelessly engaging in disinformation.
| darby_eight wrote:
| Wow this is absolutely shocking
| aga98mtl wrote:
| If their claim is true, should they not do it themselves and make
| a lot of money? It would help their mission greatly to have a few
| extra billion dollars.
| RcouF1uZ4gsC wrote:
| From the page: >I hope you appreciated this article. Before you
| move on, I wanted to ask if you would consider supporting the
| Guardian's journalism as we enter one of the most consequential
| news cycles of our lifetimes in 2024.
|
| I have research that shows that the costs of journalism is a lot
| lower than the Guardian claims. I was able to type up a bunch of
| words (at my typing speed of 50 words per minute it took me
| around 1 hour to type 3000 words) into an article, and put them
| up on a website hosted on a $5/month VPS. Anyone can come read my
| article for free.
| kazinator wrote:
| The cost of developing drugs is high because of all the drugs
| that fail, after requiring lots of money to develop. You can't
| just look at the successful drug and say that's the cost. There
| are drugs that don't get to the trial stage, so also you can't
| just look at trials, even if you include failed ones.
|
| The researchers cited in this article seem to be promulgating the
| fallacy that we need only look at the cost of a successful drug
| trial, and that's the cost. The drugs magically appeared out of
| nowhere, for free, and equally magically, they are working drugs,
| so we already know our trial will succeed. It's just a charade we
| have to go pay for to get the government's rubber stamp, and then
| it's all good!
| redserk wrote:
| What about the public funding that led to research and
| presumably went towards some of the failed attempts?
|
| It sounds like there's simply not enough information to gauge
| if pharmaceutical companies are being honest about their claims
| of R&D costs.
| bloppe wrote:
| This does not even talk about pre-clinical research, which I
| thought was a pretty big component of "development".
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