[HN Gopher] Big Pharma claims lower prices means giving up mirac...
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       Big Pharma claims lower prices means giving up miracle medications.
       Ignore them
        
       Author : rntn
       Score  : 64 points
       Date   : 2024-08-25 20:14 UTC (2 hours ago)
        
 (HTM) web link (www.vox.com)
 (TXT) w3m dump (www.vox.com)
        
       | AlbertCory wrote:
       | Drug for discussion:
       | 
       | Bimzelx (for psoriasis). This costs six figures or more per year,
       | from what I can glean. Watching baseball a lot, I see this
       | advertised multiple times per game, and God only knows what else
       | they spend on marketing.                 (I don't have psoriasis
       | or know anyone with it, if that matters)
       | 
       | Looking at UCB's financials (helpfully broken out by drug), they
       | took in $242 million on that drug alone in fiscal 2024. So that's
       | how they can afford all those ads. It's also probably something
       | patients would demand, and maybe even be happy to pay for out of
       | pocket.
       | 
       | > they will help the Medicare program cap what individual
       | patients spend out of pocket on their prescriptions in a year at
       | $2,000.
       | 
       | So if you want clear skin, you probably have to pay big bucks.
       | But maybe these immensely profitable drugs subsidize the life-
       | saving ones.
        
         | bryanlarsen wrote:
         | > (I don't have psoriasis or know anyone with it, if that
         | matters)
         | 
         | Psoriasis is very common, especially the mild forms. You
         | probably know people who have it.
        
         | __MatrixMan__ wrote:
         | C6552 H10132 N1750 O2029 S42, 147229.87 g*mol, what a monster.
         | Probably not making that one in your garage.
        
           | exyi wrote:
           | It's apparently a monoclonal antibody
           | (https://en.wikipedia.org/wiki/Bimekizumab). That's just a
           | protein, so it might actually be easier to make in your
           | garage than your average small molecule ;) ... not that
           | either would be practically possible, but it might be
           | available in countries where they don't care too much about
           | patents and such
        
             | twic wrote:
             | And if you're really willing to DIY, easier to make in your
             | body than in your garage.
        
         | zdragnar wrote:
         | Clear skin is the least of the problems with psoriasis. From
         | their website:                   Bimzelx, alone or in
         | combination with methotrexate, is indicated for the treatment
         | of active psoriatic arthritis in adults who have had an
         | inadequate response or who have been intolerant to one or more
         | disease-modifying antirheumatic drugs (DMARDs).
         | 
         | In other words, it's for people with bad cases who don't
         | respond well to other drugs. Keep in mind, other drugs often
         | come with serious complications- constant use of topical
         | steroids will thin your skin, and give you glaucoma if you
         | develop it and use them near your eyes. Many biologics have
         | even worse potential side effects.
         | 
         | On top of that, psoriatic arthritis is degenerative, if you're
         | unlucky enough to get that too, so not treating it means not
         | only constant pain, constant threat of skin infections from
         | scabbing, but permanent joint damage.
         | 
         | I ended up on Taltz, another very expensive biologic, but the
         | eli lily foundation covered almost all of the cost since my
         | insurance wouldn't. Before then, I looked like an alcoholic,
         | because my nose was constantly red and inflamed, and I didn't
         | have anything safe to put on it- glaucoma runs in my family,
         | and I wasn't brave enough to risk anything strong enough.
         | 
         | If that was the only problem, I might not have even gone the
         | route of Taltz, but I was also developing it all over my body,
         | and there wasn't much that was helping.
        
           | AlbertCory wrote:
           | Thanks.
           | 
           | I finally realized I was seeing this ad _constantly_ and
           | decided to look into it.
        
           | vostok wrote:
           | Assuming this is post-Obamacare, do you know why your
           | insurance didn't cover it? I had this simplified model that
           | insurance covers everything once you hit maximum out of
           | pocket and I'd love to learn how that model breaks down in
           | practice.
        
             | maxerickson wrote:
             | Your insurance has a pharmacy benefit manager (PBM) that
             | has a formulary (the list of drugs they cover). Multiple
             | insurers might use the same PBM. New drugs aren't
             | automatically covered, as they haven't necessarily made the
             | calculation that the cost of it justifies using it versus
             | the alternatives.
             | 
             | It's intentionally complicated in order to fracture
             | responsibility, avoid paying out claims and extract payment
             | from publicly funded insurers.
        
             | howard941 wrote:
             | _If_ the medication is on the formulary the max out of
             | pocket is usually somewhere around $12K. It 's not capped
             | if it's not on the formulary. And fancy new drugs are often
             | off the list.
        
         | Neil44 wrote:
         | Obviously you need to subtract costs from that, not just
         | production costs for this year but development costs, and the
         | development costs of other drugs that didn't even make it to
         | production.
        
           | AlbertCory wrote:
           | > Obviously
           | 
           | Yes, it is. I didn't say it was all profit.
        
         | fgonzag wrote:
         | My feet have had open wounds for the past year due to psoriasis
         | (and I've gone to every dermatologist I can). It's not just
         | clear skin, it gets very bad with quite painful wounds from the
         | scratching. Especially in hot humid conditions, and I play
         | tennis a lot. 3 people I train with have bad cases, as in
         | having to stop playing for a while
        
         | BenFranklin100 wrote:
         | You seem to be implying the advertising costs are a significant
         | driver of the price for drugs. They are not. The significant
         | driver of the cost in drug is the development costs, including
         | the cost of the many failures along the way. Also, in general
         | and not specific to this case, the prices need to targeted high
         | enough to encourage investors to invest in the first place. If
         | prices are not set at a sufficient premium to offset the
         | volatility and risk, in the future investors will realize
         | biomedical research is a poor investment and put their money in
         | less socially beneficial investments like Facebook.
        
           | AlbertCory wrote:
           | > You seem to be implying the advertising costs are a
           | significant driver
           | 
           | No, I'm not. That's in your mind.
           | 
           | The advertising costs can be justified by their return.
           | Business 101.
        
             | BenFranklin100 wrote:
             | Ok good, thanks. I just wanted to clarify that point for
             | other readers.
             | 
             | As an aside, as someone who works in the life sciences
             | field, I'm a bit conflicted about advertising new
             | therapeutics. I see why it is an often necessary practice
             | in order to raise awareness among potential patients. On
             | the other hand, in an ideal world, primary care physicians
             | would be up on the latest therapies and recommend them to
             | their patients as appropriate. Sadly, that is not always
             | the case.
        
               | AlbertCory wrote:
               | Good, I thought we were about to have a flame war there.
               | People are so accustomed to everything having an
               | ideological point that they infer one if you don't say
               | it.
               | 
               | Putting myself in the place of the doctor: if I say "hey,
               | there's this new drug Bimzelx!" and then I have to tell
               | the patient what it costs, I can imagine being happy to
               | wait until THEY bring it up. Of course, if they just ask
               | "are there any drugs for this?" I'd be duty-bound to
               | answer.
        
         | istultus wrote:
         | Like many a disease with an old name, Psoriasis refers to a
         | localized cutaneous autoimmune disease usually treated by
         | dermatologists, and a severe family of Rheumatic (autoimmune)
         | diseases, part of the Spondyloarthropathy family, that happens
         | to have a cutaneous element which is the same (and often is the
         | first symptom). This treats the latter, debilitating and
         | possibly life-threatening variety.
        
       | nemo44x wrote:
       | What needs to happen is more and more money has to go to pharma
       | from tax payers for novel medicine research. Today there is some,
       | yes. But the vast majority of money comes from the markets. And
       | anyone that has invested across the bio sector knows it's capital
       | intensive and almost everything fails. Money is just burned
       | through so quickly.
       | 
       | So yes with lower returns investors will look elsewhere.
       | Especially since overall pharma doesn't really outperform.
       | There's no alpha across the sector.
       | 
       | So the money has to come from somewhere. If not then yes,
       | innovation will slow down.
        
         | riffraff wrote:
         | There's a problem with this line of thinking: the rest of the
         | world already pays the same medicines less.
        
           | nemo44x wrote:
           | You're not serious, are you? The USA consumer subsidizes
           | everyone else in many cases. Similarly to how the USA
           | taxpayer subsidizes the protection of trade, supply lines,
           | and logistics through her mighty military.
           | 
           | Just compare the small and mid cap bio market of the USA to
           | the rest of the world. These are the companies that get
           | acquired by the large caps once they've gone through a P1 or
           | P2 successfully. But most die before acquisition. This is
           | where the real work happens in most cases.
        
           | istultus wrote:
           | The rest of the world has governments that negotiate directly
           | the Pharma companies and strike up deals that subsidize the
           | first X doses per year per Y number of people. Once the limit
           | is passed it's the same for everyone - pay the price or find
           | an alternative. NB that this doesn't happen only with US
           | companies, e.g. Roche is very profitable selling Million-
           | dollar-per-course cancer treatments. But in general, the fact
           | that Pharma companies can sell at "full price" in the US
           | subsidizes the drugs for the rest of the world.
        
         | BenFranklin100 wrote:
         | To add to your point about expensive failures, this weekend it
         | was announced that Tome Biosciences is going belly up. This is
         | only a few years after being founded on some very promising
         | research out of MIT. That's $213M in investor money gone.
         | 
         | https://www.statnews.com/2024/08/22/tome-biosciences-gene-ed...
        
       | lvl155 wrote:
       | US pharma already benefits from academic research which is paid
       | for by tax money. This is a classic example of socializing the
       | costs and privatizing the profits. Often times, you're looking at
       | 10-100x the cost for "statistically significant" uplift in
       | efficacy. What happened to value-based medicine?
        
         | gruez wrote:
         | Nobody is forcing you to buy the more expensive drug. You can
         | always use the older generic version.
        
           | mesk wrote:
           | Well, 'somebody' might be forcing you, the illness itself,
           | because the generic drug might not be good enough in your
           | case.
        
         | varispeed wrote:
         | "privatising profits" is a bit vague term. May suggest that
         | simply everyone but government benefits.
         | 
         | I think it's better to say that it is socialising losses and
         | making the rich richer.
        
       | jimmar wrote:
       | Why not make these same arguments for cars, food, or anything
       | else that we buy? Just have the government negotiate maximum
       | prices that manufacturers can charge. Maybe AI will help make
       | cars cheaper in the future.
        
         | cerved wrote:
         | Is the US government not already negotiating the prices for
         | cars and food it buys?
        
         | mesk wrote:
         | Car, food manufacturers etc... operate in mostly free market -
         | pharma, insurance, hospitals operate in highly regulated markes
         | and 'somehow' for all of them is better if the price goes up,
         | because 1% of 10mio is more than 1% of 1mio. And what is maybe
         | also important, when buying car you pay for it directly, and
         | know the price in advance and there is no urge to buy it just
         | to stay alive...
        
       | saulrh wrote:
       | If funding pharmaceutical research is a common public interest,
       | then it should be funded the way all common public interests
       | should be: taxes. Taxes pay for the weather predictions that make
       | modern agriculture possible. Taxes pay for the basic physics
       | research that keeps Moore's Law on track. Taxes pay for the
       | transportation and logistics infrastructure that make the modern
       | economy possible. Taxes pay for the fire engines that might keep
       | your house from burning down some day. Taxes can and should pay
       | for the pharmaceutical research that makes modern medicine
       | effective. This kind of generalized "everybody needs it but no
       | single person can pay for it and trying to do it through
       | capitalism distorts everything" benefit is precisely what taxes
       | are designed for.
        
         | gruez wrote:
         | Right, but what sort of taxes? If the answer is "just an
         | overall tax on everything", then that's basically the status
         | quo, with all the accompanying "socializing the costs and
         | privatizing the profits" (eg. [1]). If it's tax on the industry
         | in question specifically, then that's something that's not
         | usually done. For instance, you mention "Taxes pay for the
         | basic physics research that keeps Moore's Law on track", but to
         | my knowledge there's no semiconductor tax to attempt to recoup
         | the cost of that research. The same goes for agriculture. You
         | might have a point for roads since they're financed via a fuel
         | excise tax, but it doesn't generalize to ocean/air freight.
         | 
         | [1] https://news.ycombinator.com/item?id=41351872
        
           | spondylosaurus wrote:
           | Half-joking, half-serious counter: why not socialize the
           | costs and socialize the profits, too? Think big!
        
         | firesteelrain wrote:
         | Taxes do pay for pharmaceutical research though private funding
         | makes up the majority of the funding. For example, NIH, DoD and
         | CDC all provide funding.
         | 
         | NIH has an annual budget of $45 billion - all taxes.
         | 
         | [1] https://www.nih.gov/grants-funding [2]
         | https://jamanetwork.com/journals/jama/fullarticle/2775400
        
       | Noumenon72 wrote:
       | Am I summarizing this article right?
       | 
       | * The US premium paid is 150% of R&D costs, therefore cutting it
       | will only cut spending on the costs that aren't R&D
       | 
       | * M&A did not drop in the first year of the program, which
       | covered 10 drugs, therefore the program will have no effect once
       | phased in
       | 
       | * We think AI might develop new drugs for us someday, so it's
       | safe to throw away the existing system today
       | 
       | Not very solid reasons to go after the golden goose!
        
       | mschuster91 wrote:
       | First, one thing to keep in mind: "Big Pharma" is the medical
       | equivalent of "venture capital" in technology. They buy up _a
       | lot_ of patents and very early stage startups in the hope that 1
       | or 2 of 100 investments actually strike it big, and that explains
       | a part of why new medical innovations cost so much - all the loss
       | has to be distributed.
       | 
       | > It is a harrowing proposition: that in trying to control drug
       | prices for 67 million Medicare patients now, we might
       | inadvertently prevent the development of future drugs that could
       | save lives. Implied, if not stated outright, is that we're
       | putting a cure for cancer or Alzheimer's or some other
       | intractable disease in jeopardy.
       | 
       | Well... given that _a lot_ of the fundamental research in
       | pharmaceuticals happens at universities and /or on taxpayer
       | grants, what exactly is preventing the US government from taking
       | over the later stages of development _and the associated risk_
       | itself, and only use external providers for manufacturing at
       | scale?
       | 
       | Of course, it's a rhetorical question. The answer is two-fold
       | here - primarily the obvious: large parts of the US (and most
       | Western nations facing similar questions) prefer a "small state",
       | preferably as small as possible. But there's also a second
       | answer... the US' _very_ dark history in government-run medicine.
       | The Tuskeegee syphilis study, the consistent discrimination
       | against PoC and women in medical research, MKULTRA or the US just
       | about permanently burning all of its trust across the world by
       | using  "vaccination drives" as a pretext to verify Bin Laden's
       | presence in that compound in Pakistan [1] - antivaxxers, Covid
       | deniers and their ilk didn't sprout up from nothing, they have
       | very fertile soil.
       | 
       | [1] https://www.npr.org/2021/09/06/1034631928/the-cias-hunt-
       | for-...
        
       | Kye wrote:
       | What good is a miracle if the only people who can afford it don't
       | need it because they can afford to maintain their health?
        
         | pg_bot wrote:
         | Would you rather live in the world where we don't have a
         | solution or the world where the solution is expensive now but
         | will eventually become cheap?
        
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