Musing thoughts on perscription drugs.

[TotalFusionOne]

I listen to the BBC a lot while I'm driving. Tonight's program (I think it was "The world today") was talking about the issues hospitals in India and the NHS is currently facing: Let up on drug rationing or make improvements to hospitals. I was trying to think of a way to make drugs cheaper for all (Since capitalism seems to be very anti current political climate), and I wanted to run something by the general public.

Currently in the US we have patent restrictions on FDA approved drugs. Once a drug is approved the formula is protected for a limited amount of time (I can't remember how long, but it's something along 7 or 17 years) before the formula is opened up and many drug companies can carbon copy. Now people always find a way around this by changing a thing here or there... But I have an odd solution to keep the cost of drugs low:

If a company agrees to cap the profit margin of a drug on the market at 10% - 15% above cost, the patent is extended an additional 10 years.

Now I'm opening this up for debate because I can't really see the downside, and I know there must be one. But what we'd have would be lower cost drugs with the drug companies seeing a reasonable, maybe better in some cases, return on their investment over time. Driving down the cost of medication would open it up for more people to be able to afford, improving the quality of life and still allowing profit margins for drug companies to keep researching new drugs. Everyone wins, except the competitors who have to try even harder to research the next big thing. Which ends up helping people more.

Thoughts?

 

[strawman]

Current profit margins are in the thousands of percent of the "cost to produce the pill" not including R&D, testing, etc.

Doubling the length of patent time while dropping the profit margin to 10-20% will reduce the profit over the life of the drug significantly.

If you include the cost to develop just that one drug (and not account for the other failures) then you still reduce the overall cost of the drug, which reduces profit, which means they cannot afford any failures.

Yes, drugs are overpriced, but it costs 1-50 million dollars to bring a given drug to market, and a failed drug (failed as in doesn't work, or the side effects are too adverse) costs nearly as much as a working drug. 90% of the drugs they take to animal trials fail, and a large percentage of drugs they decide to do human trials with also fail.

By the time any one drug has gone to market, hundreds of other drugs that cost nearly as much to try out have failed, so the cumulative effect is that one drug that makes it needs to recoup hundreds of millions of dollars so the company may continue to survive.

It's already the case where they cannot pursue drugs that aren't guaranteed to be blockbuster drugs - drugs that will be purchased by the millions each month during the patent period. We don't see drug research for rare disorders because the cost is too high and the profit is too low.

If we restrict the profits companies can make, this will only widen the gulf between the drugs they try to develop and the drugs that people actually need.

More gov't regulation isn't going to produce cheaper drugs.

I agree with you that the system doesn't work well, and patents are really borked, but they aren't the source of the problem. The nature of the research, the riskiness of health care, is the real issue.

 

[AshburnerX]

The downside is that when your product only costs you cents to make, and you can sell it for $20+ a pill, your profits take a nosedive. Why would they want the formula for another 10 years, when you can make billions more in less time by selling it at whatever price you like?

And yes, they ARE a bunch of crooks.

 

[Shakey]

I doubt they would do it. They can make more by doing what they do now. Once they get their name out there people will ask for that specific drug, not the generic alternative.

I say get rid of drug specific commercials completely. This will stop companies from preying on the fears of consumers, and making drugs specifically made because they work for a condition that can be easily misdiagnosed. I'm talking about ads for stuff like restless leg syndrome. I'm not saying it doesn't exist, but very few people actually have it.

 

[TotalFusionOne]

More gov't regulation isn't going to produce cheaper drugs.

I agree with you that the system doesn't work well, and patents are really borked, but they aren't the source of the problem. The nature of the research, the riskiness of health care, is the real issue.

I agree with every single point you made. The only way this would work would be a forced payscale that goes along with patent lengths.

And yes, the "System" doesn't work well. And I think it's time to start asking the question no one wants to think about because it makes them seem heartless:

When did health care become a "right?"

 

[Sparhawk]

More gov't regulation isn't going to produce cheaper drugs.

I agree with you that the system doesn't work well, and patents are really borked, but they aren't the source of the problem. The nature of the research, the riskiness of health care, is the real issue.

I agree with every single point you made. The only way this would work would be a forced payscale that goes along with patent lengths.

And yes, the "System" doesn't work well. And I think it's time to start asking the question no one wants to think about because it makes them seem heartless:

When did health care become a "right?"[/QUOTE]

Wouldn't work at all. How many companies would continue to do the research and lay out the money for that if the government came along and said, "You can only make this much on this pill."? My bet, none. Or, how many companies would start using "Hollywood" math to make it look like they never made any money at all?

No, the system isn't perfect, but people are willing to spend the money for research in the hopes of making money in profit from it. You take away the "reward" and everyone stops playing the game.

 

[strawman]

The only way this would work would be a forced payscale that goes along with patent lengths.

The equipment, research, processes cost far more than the salaries. You could reduce the pay rate to 0 and the researchers would still need the spend millions of dollars a year maintaining, nevermind testing, a small room full of lab animals.

This, of course, doesn't count the reaction chambers, organic chemistry labs, supplies and raw materials, plating cells, etc. I've toured a local pharmaceutical research center (Pfizer) and the equipment was just amazing, and must cost a small fortune.

And they have to upgrade and replace much of it yearly just to keep up with the latest advancements in the field.

When did health care become a \"right?\"

Late 5th century BC.

 

[TotalFusionOne]

The only way this would work would be a forced payscale that goes along with patent lengths.

The equipment, research, processes cost far more than the salaries. You could reduce the pay rate to 0 and the researchers would still need the spend millions of dollars a year maintaining, nevermind testing, a small room full of lab animals.

And they have to upgrade and replace much of it yearly just to keep up with the latest advancements in the field. [/quote]

Sorry, sorry. I used the wrong word. I meant payscale as related to the earlier idea. Let me rephrase: A forced profit margin that goes along with patent lengths. I'm tired :\

As for the Oath, that relates in the way that doctors treat their patients. Not how the world funds healthcare. If a doctor wants to treat you for free, I think that's amazing. But when did it suddenly become a "Right" to have access to medicine on the cheap?

 

[Bowielee]

Denying critical treatment is illegal in the USA. Preventative and non emergent care is a different story, though. So, yes, to an extent, healthcare is a right. The question is the quantity and quality of that health care that is a right.

That's all I'm going to say on that seeing as there is a HUMUNGOUS thread titled "Is healthcare a right" already in progress and I'm not rehashing it.

 

[TotalFusionOne]

Yeah, I read through that thread and was trying to go a different way. Stienman was following along with the cost of research educational lecture (Which I really love, and will be copying).

It just seems to me that drugs HAVE to be expensive at the moment. Our options are severely limited. Until we invent working nanobots.

 

[Shakey]

Yeah, I read through that thread and was trying to go a different way. Stienman was following along with the cost of research educational lecture (Which I really love, and will be copying).

It just seems to me that drugs HAVE to be expensive at the moment. Our options are severely limited. Until we invent working nanobots.

I don't buy that. To me it seems like bull shit the companies come up with to justify the costs.

Why are prescription drugs cheaper in Canada and Mexico?

After seeing all the shit my sister came home with after going to a drug convention as a pharmacy student it made me sick. I've been to tech conventions and this put them to shame. She came home with at least a $100 in USB drives, a shit ton of drug samples, and an insane amount of stuffed animals and novelty items. This was all as a student.

Too much of the drug industry money is spent on advertising. Whether it is to the general public, or if it is to the doctors and pharmacists.

 

[TotalFusionOne]

So what is your answer to the situation? Government restrictions on advertisement?

 

[Shakey]

Too much of the drug industry money is spent on advertising. Whether it is to the general public, or if it is to the doctors and pharmacists.

So what is your answer to the situation? Government restrictions on advertisement?[/quote]

Yes. They already put some restrictions on what kinds of favors can be given to doctors for prescribing their product, but they haven't done enough.

Get all the ads off the TV. Anyone who buys in to the idea that they are there to help people and to inform people that there is a cure to their problem is naive.

Also figure out why the exact same drugs sold by the exact same companies are cheaper in different countries. I'm sorry, but this just blows my mind. I can buy my drugs through mail order from Canada for cheaper than I can get them by walking down the street to the local pharmacy.

 

[AshburnerX]

Why are prescription drugs cheaper in Canada and Mexico?

Canada: Government subsidies and the fact that the government gets to dictate the prices they will pay.

Mexico: It's all illegal knock-off medication or stolen. However, don't confuse knock-off with lack of quality.

 

[@Li3n]

Why are prescription drugs cheaper in Canada and Mexico?

Canada: Government subsidies and the fact that the government gets to dictate the prices they will pay.

Mexico: It's all illegal knock-off medication or stolen. However, don't confuse knock-off with lack of quality.

Alternative:
Because selling extra units at a lower profit margin in a market that would not buy them otherwise still goes towards paying for the development costs.
If they also lowered the prices in the primary market it is possible that they won't be making the R&D money back.

Of course without actual numbers to compare it's as likely that they're just greedy fucks.

 

[AshburnerX]

Actually, factories producing knock-off meds are incredibly common in places like India, where Big Pharma doesn't have the same stranglehold it has in the US. Those places manage to make a profit too, by providing a product that is just as good as the name brand (and many actually do use the same formulas as the name brand.) It's not illegal to do this in some countries ether.

 

[@Li3n]

I wasn't exactly saying that's not the case, bootlegs are aplenty here.

 

[Bowielee]

What you get with a free market medicine field? More research on curing erectile dysfunction and baldness than on diseases that kill people.

 

[TotalFusionOne]

Actually, factories producing knock-off meds are incredibly common in places like India, where Big Pharma doesn't have the same stranglehold it has in the US. Those places manage to make a profit too, by providing a product that is just as good as the name brand (and many actually do use the same formulas as the name brand.) It's not illegal to do this in some countries ether.

Good point but, not that I'm an expert on such things at ALL, from what the news story was talking about India happens to be the place where there is the worst problem financially. The entire episode was talking about how they're not quite sure what to do about the cost of drugs, and that they're having to decide between drugs and fascilities; prolonging life for the sick or providing for those just entering the world

 

[Armadillo]

What you get with a free market medicine field? More research on curing erectile dysfunction and baldness than on diseases that kill people.

...which is why certain cancer death rates have cratered in the last 30 years, why AIDS is increasingly becoming a manageable disease, and how we now have all kinds of imaging and surgical innovations we didn't have even ten years ago, right? :eyeroll:

EDIT: Gas put this link up in his thread, but it fits really well here:

Vaccines on horizon for HIV, Alzheimer's, herpes

 

[AshburnerX]

What you get with a free market medicine field? More research on curing erectile dysfunction and baldness than on diseases that kill people.

...which is why certain cancer death rates have cratered in the last 30 years, why AIDS is increasingly becoming a manageable disease, and how we now have all kinds of imaging and surgical innovations we didn't have even ten years ago, right? :eyeroll:

EDIT: Gas put this link up in his thread, but it fits really well here:

Vaccines on horizon for HIV, Alzheimer's, herpes[/QUOTE]

Too bad those drugs will never hit the market until the drug companies can turn them into watered down doses that patients will have to be on for the rest of their lives. There is no money in finding a cure; only in keeping the sick dependent.

 

[Armadillo]

What you get with a free market medicine field? More research on curing erectile dysfunction and baldness than on diseases that kill people.

...which is why certain cancer death rates have cratered in the last 30 years, why AIDS is increasingly becoming a manageable disease, and how we now have all kinds of imaging and surgical innovations we didn't have even ten years ago, right? :eyeroll:

EDIT: Gas put this link up in his thread, but it fits really well here:

Vaccines on horizon for HIV, Alzheimer's, herpes[/QUOTE]

Too bad those drugs will never hit the market until the drug companies can turn them into watered down doses that patients will have to be on for the rest of their lives. There is no money in finding a cure; only in keeping the sick dependent.[/QUOTE]

Yet, people will live full lives where before, they were sentenced to painful deaths. Such awful people, those medical companies. Just awful.

 

[AshburnerX]

What you get with a free market medicine field? More research on curing erectile dysfunction and baldness than on diseases that kill people.

...which is why certain cancer death rates have cratered in the last 30 years, why AIDS is increasingly becoming a manageable disease, and how we now have all kinds of imaging and surgical innovations we didn't have even ten years ago, right? :eyeroll:

EDIT: Gas put this link up in his thread, but it fits really well here:

Vaccines on horizon for HIV, Alzheimer's, herpes[/QUOTE]

Too bad those drugs will never hit the market until the drug companies can turn them into watered down doses that patients will have to be on for the rest of their lives. There is no money in finding a cure; only in keeping the sick dependent.[/QUOTE]

Yet, people will live full lives where before, they were sentenced to painful deaths. Such awful people, those medical companies. Just awful.[/QUOTE]

I'll believe it when I see a fucking drug for those problems. Until then, I'm just going to point out how "cures" are always 5-10 years away anytime it looks like Big Pharma might be in danger of losing it's sky-high profits.

Also, I want my flying car!

 

[TotalFusionOne]

What you get with a free market medicine field? More research on curing erectile dysfunction and baldness than on diseases that kill people.

...which is why certain cancer death rates have cratered in the last 30 years, why AIDS is increasingly becoming a manageable disease, and how we now have all kinds of imaging and surgical innovations we didn't have even ten years ago, right? :eyeroll:[/QUOTE]

I always love that argument. It seems like taking the step before saying "We need to have someone in control about what companies are allowed to research." You have the best defense for it, Armadillo, but another thing I've been thinking about is diseases that aren't prevalent that still require research.

For instance, it took years for people to start working on the AIDS epidemic. Why? Because not many people had it. Reading about the era in which the AIDS rallys were going on you see one theme running: "Why does no one care about them?" And the answer was simple: More people were dying from a ton of other diseases and the sheer amount of people took priority. Once AIDS moved up the list of the amount of people who died from a seriously easy disease to prevent, more funding was directed to it.

So what happens when you have a disease that ISN'T prevalent? As a male your chances of having breast cancer are 1 in 1,000. And yet there's almost no research done for male-specific breast cancer. A government-directed research group would pass over it in a heartbeat for more prevelent issues such as females with breast cancer, heart disease, diabetes etc etc. So 1 in 1,000 men lose out on hope because it's not an issue for the greater good.

How is this different than what's going on now? Drug companies make money and do research based off of profit margins. The bigger the disease the higher the margin. The same conclusion is reached either way.

Like I said, these are just musing thoughts. Also: Fuck the American Breast Cancer Society or whatever the pink lids group is.

 

[Krisken]

Here are some truths about drug companies and drugs that come out for diseases-

1. Cures for diseases are not in the pharmaceuticals financial interest. When a disease is cured, you don't have repeat customers. Cure the symptoms whenever possible. Symptoms always come back.

2. Research into lesser known diseases is encouraged through HIPAA legislation (oh, that evil thing), giving tax benefits and exclusivity rights to companies that develop drugs for them.

3. Pharmaceutical companies spend billions on advertising, not just on T.V. and magazines, but free samples to doctors offices. Shit like clocks, notepads, pens, etc, all get sent to doctors to encourage them prescribe their product.

 

[Bowielee]

What you get with a free market medicine field? More research on curing erectile dysfunction and baldness than on diseases that kill people.

...which is why certain cancer death rates have cratered in the last 30 years, why AIDS is increasingly becoming a manageable disease, and how we now have all kinds of imaging and surgical innovations we didn't have even ten years ago, right? :eyeroll:

EDIT: Gas put this link up in his thread, but it fits really well here:

Vaccines on horizon for HIV, Alzheimer's, herpes[/QUOTE]

You do know that imaging and surgical procedures have absolutely nothing to do with the pharmaceutical industry, right?

 

[Armadillo]

What you get with a free market medicine field? More research on curing erectile dysfunction and baldness than on diseases that kill people.

...which is why certain cancer death rates have cratered in the last 30 years, why AIDS is increasingly becoming a manageable disease, and how we now have all kinds of imaging and surgical innovations we didn't have even ten years ago, right? :eyeroll:

EDIT: Gas put this link up in his thread, but it fits really well here:

Vaccines on horizon for HIV, Alzheimer's, herpes[/QUOTE]

You do know that imaging and surgical procedures have absolutely nothing to do with the pharmaceutical industry, right?[/QUOTE]

Your words were "medical field," not "pharmaceutical industry." In any event, my point still stands. Our life expectancy and overall standard of living have gone way up in the last century due in no small part to those evil, evil shitheads in the pharmaceutical field.

 

[Bowielee]

What you get with a free market medicine field? More research on curing erectile dysfunction and baldness than on diseases that kill people.

...which is why certain cancer death rates have cratered in the last 30 years, why AIDS is increasingly becoming a manageable disease, and how we now have all kinds of imaging and surgical innovations we didn't have even ten years ago, right? :eyeroll:

EDIT: Gas put this link up in his thread, but it fits really well here:

Vaccines on horizon for HIV, Alzheimer's, herpes[/quote]

You do know that imaging and surgical procedures have absolutely nothing to do with the pharmaceutical industry, right?[/quote]

Your words were "medical field," not "pharmaceutical industry." In any event, my point still stands. Our life expectancy and overall standard of living have gone way up in the last century due in no small part to those evil, evil shitheads in the pharmaceutical field.[/QUOTE]

Too bad those vaccines will be so expensive that poor people won't be able to afford them, and seeing as, at least on the part of AIDS vaccine, it will be viewed as preventative and won't be covered by insurance companies.

 

[Armadillo]

Your words were "medical field," not "pharmaceutical industry." In any event, my point still stands. Our life expectancy and overall standard of living have gone way up in the last century due in no small part to those evil, evil shitheads in the pharmaceutical field.

Too bad those vaccines will be so expensive that poor people won't be able to afford them, and seeing as, at least on the part of AIDS vaccine, it will be viewed as preventative and won't be covered by insurance companies.[/QUOTE]

You realize that you're complaining about a problem that would never have existed in the first place if companies weren't free to innovate things like an AIDS vaccine, right?

I see a headline that says "AIDS and Alzheimer's vaccines in five years" and I go, "Holy hot shit! Amazing!" You choose to complain about a whole host of hypotheticals and unprovables.

 

[Bowielee]

How long have you been working for or with insurance companies?

I have been for 7 years. I've worked with them long enough to know what their policies are on things of this nature.

I do think it's amazing. I also know that the majority of funding for these vaccinations comes from government grants, not private investing.

 

[Covar]

How long have you been an astronaught?

I have been for 7 years. I've been in space long enough to know that water on the moon will never be used for anything.

I do think it's amazing. I also know that the majority of funding for space travel is going towards mars, not the moon.

 

[TotalFusionOne]

How long have you been an astronaught?

I have been for 7 years. I've been in space long enough to know that water on the moon will never be used for anything.

I do think it's amazing. I also know that the majority of funding for space travel is going towards mars, not the moon.

Fuck I've been spelling it wrong since I was seven.

 

[Covar]

 

[Bowielee]

Wow, you're so clever Covar.

• Self Pay A/R Analyst – St Mary’s Duluth Clinic (2007-2009)
• During my tenure as the analyst, I engaged in multiple projects to correct and improve internal systems processes. Worked on overall system improvements in both HBOC (acute billing) and Epic (ambulatory billing) systems.
• Focused particularly in the acute billing system (HBOC) where I made multiple system improvements to the collections process, and looked into the background processes involved in accounts qualifying for the collector’s workload and the ultimate referral process to bad debt.
• Worked with outside vendors to insure accuracy in the work done by our outsourced companies, such as Prosource and CCI, and our billing vendor to insure accuracy in the SMDC statements.
• Worked with the Epic billing system for the conversion from the Professional Billing to the Single Billing Office module for the Duluth Clinic.
• Processed bank notes via Western National Bank
• Supplied reports and analysis of account aging in both the Acute and Ambulatory systems to the Patient accounts director. Also responsible for insuring the accuracy of said reports.
• Audited employees for accuracy and phone manner. Suggesting improvement to internal processes, while assuring quality control and compliance to the Attorney General Agreement, the Fair Debt Collections Practices Act, and the Health Insurance Portability and Accountability Act.
• Worked with “High Profile” accounts. These accounts included employees of SMDC who were at a level of Manager or above and also special interest accounts.
• Worked on the conversion of reports from QMS (third party acute billing analysis software) to Clarity (our own in-house analysis software).
• Customer Service Representative – St Mary’s Duluth Clinic (2006 – 2007)
• Responsible for taking incoming calls, printing demand bills, and resolving insurance issues. This job built off the same knowledge used in collections.
• Collector – St Mary’s Duluth Clinic (2003 – 2006)
• Responsible for assisting patients with past due accounts. Offered financial assistance and set up payment plans for patients.
• Proficient with the office suite of products to compose workflows and spreadsheets.
• Organized many of the projects resulting from our deployment to the insurance billing side of the business due to an influx of new employees in that department.
• Assisted in organizing the training of my co-workers who were deployed to the project mentioned in the bullet point above.
• Thorough understanding of Epic resolute for medical billing, and am a quick study on new processes and procedures.

There's the pertinent info from my resume. I know insurance policies and I don't think that they're suddenly going to change their policies, especially for new and experimental procedures.

And much of the research done by these companies wouldn't even be able to go forward without grants and government financing.

 

[Shakey]

Tell me, was that billing system truly epic?