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View Full Version : A case study in why we need single payer?


Kimon
09-22-2015, 05:05 PM
http://www.bbc.com/news/world-us-canada-34320413

The head of a US pharmaceutical company has defended his company's decision to raise the price of a 62-year-old medication used by Aids patients by over 5,000%.
Turing Pharmaceuticals acquired the rights to Daraprim in August.
CEO Martin Shkreli has said that the company will use the money it makes from sales to research new treatments.
The drug treats toxoplasmosis, a parasitic affliction that affects people with compromised immune systems.
After Turing's acquisition, a dose of Daraprim in the US increased from $13.50 (8.70) to $750.
The pill costs about $1 to produce, but Mr Shkreli, a former hedge fund manager, said that does not include other costs like marketing and distribution, which have increased dramatically in recent years.

This drug is 62 years old, meaning it was developed long before the AIDS outbreak, and any research expenditures have long since been recovered. And marketing costs? This is about as niche a drug as one could find. That hardly seems something that needs a huge marketing budget. This is just greed, and maybe some lingering bias against homosexuality, but mostly greed.

If we had a sane system, like's England's, we'd have this...

In the UK, the National Health Service is the main buyer and prices are set through a voluntary scheme between manufacturers and the government, trying to strike the right balance of serving patients and generating money to keep the drug pipeline going. Profits are capped to stop prices creeping too high.

Meanwhile in our system...

"We needed to turn a profit on this drug," Mr Shkreli told Bloomberg TV. "The companies before us were actually giving it away almost."
He says the practice is not out of line with the rest of the industry.
"These days, modern pharmaceuticals, cancer drugs can cost $100,000 or more, whereas these drugs can cost half a million dollars. Daraprim is still underpriced relative to its peers," he told Bloomberg TV.
On Twitter, Mr Shkreli mocked several users who questioned the company's decision, calling one reporter "a moron".

Or, in other words, the same drug costs 43 pence in England per pill, and $750 per pill here. That is insane.

tworiverswoman
09-22-2015, 05:28 PM
I am stunned by this guy's smug self-righteousness. "We need to make a profit..." Well, ok - I'm not anti-profit. But the original $12.00 per pill profit ($1.00 to produce - add a bit to cover packaging and shipping) is a MORE than handsome a turn-around for a 62-year-old drug.

SEVEN HUNDRED FIFTY DOLLARS PER DOSE? WTF? It's obscene.

This article (http://www.fiercebiotech.com/story/shkrelis-turing-pharma-banks-90m-murky-funding-round/2015-08-10) gives a bit more information on this guy Shkreli. He's as close to an evil human being as I'm prepared to believe in in a secular world. Retrophin's [Shkreli's previous company - which kicked him out last year] stated goal was ferreting out value in biopharma by acquiring assets with potential in rare and neglected diseases, a process that can mean acquiring an underused drug and jacking up its cost to take advantage of rare disease pricing. He's using that identical "goal" in his new company, Turing Pharmaceutical. The article adds that CDC lists Toxoplasmosis (the disease now requiring $750 per dose to combat) as the "second leading cause of death by foodborne illness."

Nazbaque
09-22-2015, 06:15 PM
The other day I paid 3 euros for 200*1 g worth of diabetes medication. Would have been 17,61 euros for the 200 pills but I've got medical coverage. Just to give you a comparison.

Davian93
09-22-2015, 07:38 PM
He should be put up against a wall and shot.

What an ass.

Davian93
09-22-2015, 08:00 PM
Minor upside: the outrageous action actually backfired a bit in that they are now lowering the price a bit (but not back to the initial price because FU, that's why)

The chickenshit also took his Twitter account private so he won't be getting into any public pissing battles with the peasant class anymore.

Shkreli said Tuesday the price would be lowered to allow the company to break even or make a smaller profit.

Oh, okay then...I'm sure it won't still be utterly ridiculous.

Oh, and there's this little tidbit too:

Also Tuesday, it was reported that the company that bought the rights to produce a tuberculosis drug, and then increased the price from $500 for 30 capsules to $10,800, was returning rights to its previous owner.

The Wall Street Journal and the New York Times reported that the price for cycloserine will now be $1,050. The nonprofit Chao Center, associated with Purdue University, said the increase was necessary to reduce the amount of money it loses in making the medicine.



So, in the end, the drug companies still win, we still pay the highest price in the world for prescriptions and he'll get another yacht.

GonzoTheGreat
09-23-2015, 03:49 AM
I like the fact that the company seems to be named after Alan Turing. I suspect that is not intentional, but it is a nice detail nonetheless.

Figbiscuit
09-24-2015, 04:41 AM
The NHS is a brilliant, world class, amazing service which we are incredibly lucky to have.

But I'm not sure it could be considered sane.

It's abused like everything else. The media reports that it's in serious trouble because the Tory government want us to believe that privatising it is necessary.

Generally I have no idea what to think about it. I do know we should fight to keep it but also that it should be better regulated and not quite as free for all as it currently is. I personally pay 12% of my gross salary to fund it, and my employer pays a further 13% on top, so that's 25% per salary of everyone who pays income tax in the UK. And yet they tell us it's struggling.

There are people who claim benefits who go to the doctors to get a prescription for ibuprofen or paracetamol, because they're 'entitled' to it. Bearing in mind you can buy either of those drugs over the counter for 30p. Yet they claim a free prescription (prescriptions for your normal working soul like me are around 8 per item), probably because a lot of people don't have a clue how much medicine costs to produce and buy. There have been calls for the cost of medicine to be printed on the packaging so people can see how much it would have cost them either with or without the NHS. I support that.

I also believe that if you aren't a UK citizen then you should have to pay for your medical treatment, (not necessarily before treatment I'm not a total monster), or carry insurance to cover it, in the same way that when I go on holiday I have travel insurance.

yks 6nnetu hing
09-24-2015, 05:15 AM
so... devil's advocate here...

I've some friends in the farmaceutical research, and I used to work at a company that sold test tubes. It takes a lot of time, effort and money to research a drug; and more often than not, the experimental drug either doesn't work or has too many side effects and thus has to be abandoned before the medical company can ever claim any profit on it. The funding of research thus needs to come from the already working patents and/or the government. Knowing what most people think about spending government money on things that have a success rate of 30% if you're lucky, well... This, btw, not even getting into the difficulties of testing new drugs. Did you know, for example, that due to the fact that women have wildly different hormonal indicators not only from individual to individual, but also across the month, and therefore testing new drugs on females is really difficult, almost all medical testing is done on men? Resulting in rather a lot of mis-dosage, unexpected side-effects and other issues for women once the drug is released for use. If you're lucky, your doctor is aware of these risks, and tries to modulate the risks. Or keeps track of what that particular drug does to other female patients. You know, as there are no databases for reference or comparison. If you're unlucky, your doctor is used to women complaining of more side-effects than the package says the medicine should give; and concludes that women in general just complain more.

so, yes, perhaps it's a pill with an own cost of just a few cents; but in order to keep your research into possible replacements or even completely new medicines running, medical companies need to sell it at a huge markup. Now, this particular example is clearly an example of corporate greed rather than an attempt to re-funnel money into creating new meds. Still, this outrage on med-ripoff is a little ridiculous.

GonzoTheGreat
09-24-2015, 05:19 AM
I do think it would make more sense if governments financed drug research, or if they set up some international organisation to do this. But you're right that I seem to be in a minority on this. Most people think that letting companies extort money from sick people (or to let them die if they can't pay) is more reasonable.

You're quite right about the problems involved in being a woman. Then again, you still have a higher life expectancy than men, so there's that. Which, when you think on it, puts into perspective how much (or little) good the medical profession does on average.

yks 6nnetu hing
09-24-2015, 05:48 AM
You're quite right about the problems involved in being a woman. Then again, you still have a higher life expectancy than men, so there's that. Which, when you think on it, puts into perspective how much (or little) good the medical profession does on average.

this is a fairly new development though - the tide started turning when contraceptions became commonly available and used. Historically, due to the many, many, many pregnancy and childbirth related dangers, women would live significantly shorter than men.

ETA: actually, I got interested and did some digging. I was wrong; it's not contraceptions, it's nutrition. Proper nutrition seems to have had a much greater effect on the life expectancy of women than it does on men, though of course both are affected. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625386/table/tbl2/ - this table shows the development of life expectancy for women, and you can see it steadily increasing, with significant jumps in the Modern Ages. More efficiency in most aspects of life, including farming and ways to procure food.

GonzoTheGreat
09-24-2015, 06:06 AM
That's what war was invented to rectify, wasn't it?
Sure, there turned out to be some side effects, especially bothersome for women, but that's the case with most medicines.

But yes, historically speaking, "not having babies" does increase your life expectancy.

yks 6nnetu hing
09-24-2015, 06:29 AM
To an extent governments do support medical developments in that governments support universities. it's not enough though; and even in Universities, which are supposed to focus on interesting academical challenges rather than make a profit, the fact is, grants are available in... er... well, let's just say that if you're studying old people, you're in luck. that's where the money is.

GonzoTheGreat
09-24-2015, 06:37 AM
Yeah, getting a grant for something that is known to make money is a lot easier than getting a grant for something that simply looks interesting. Which, in my view, is one of the big problems in academics.

yks 6nnetu hing
09-24-2015, 06:51 AM
Yeah, getting a grant for something that is known to make money is a lot easier than getting a grant for something that simply looks interesting. Which, in my view, is one of the big problems in academics.

That, and if you do get a grant, then your results MUST be positive. you can't produce a paper that basically says: "I tried this thing and it didn't work at all"

fdsaf3
09-24-2015, 07:58 AM
It's worth pointing out that at least in the U.S. there is plenty of federally funded medical research going on. I know because I used to do it; well, the statistical analysis portion of the research, anyway.

I'm not saying that the amount of federal dollars is anywhere near sufficient, or even that such a research framework is anywhere close to ideal (my opinion: it's not). I just wanted to point out to people who might be unfamiliar with the daily ins and outs of the process that yes, the federal government funds some pharmaceutical research.

Frenzy
09-24-2015, 09:34 PM
i have a friend who works for a company that solicits volunteers for medical trials. i've done it twice and got paid $120 for a half hour of my time to give my opinion on a drug delivery device, nothing about the drug itself. They had to have a minimum number of opinions for the study to be valid.

Not sure how that cost is necessary...

Nazbaque
09-24-2015, 10:41 PM
i have a friend who works for a company that solicits volunteers for medical trials. i've done it twice and got paid $120 for a half hour of my time to give my opinion on a drug delivery device, nothing about the drug itself. They had to have a minimum number of opinions for the study to be valid.

Not sure how that cost is necessary...

Bureaucracy expands to meet the needs of the expanding bureaucracy.

GonzoTheGreat
09-25-2015, 03:29 AM
i have a friend who works for a company that solicits volunteers for medical trials. i've done it twice and got paid $120 for a half hour of my time to give my opinion on a drug delivery device, nothing about the drug itself. They had to have a minimum number of opinions for the study to be valid.

Not sure how that cost is necessary...
A few possibilities:

-They were doing a double blind test.
So you wouldn't know whether you were merely going to comment on some gadget or have it used on you to inject Polonium until after the fact, and neither did the experimenters know. Whichever happened, you'd get paid the same.

-An opinion is worth what one pays for it.
So by paying you a lot, they got very valuable information. I have some doubts about the validity of this, but I'm not a medical researcher.

-Somebody would get 10 percent of whatever each of the volunteers was paid.
That somebody then ended up in charge of deciding volunteer payment.

Frankly, I think something like option 3 is probably the correct explanation, but I may be too cynical.

Ozymandias
09-28-2015, 11:55 AM
Obviously both the price increase and the attitude associated with it are unconscionable, but there is a bit of a point underneath the smug self-righteousness. Yes, its an old drug, but the fund manager made the point that while production costs are very low, the other associated costs of producing the drug are high because of how little is produced. I mean... I cannot imagine the price needed to go up that high, but I can certainly see why he thinks modest increases are necessary. Additionally, he does have a right to make a profit; its called Big Pharma for a reason, its a lucrative business.

Again, I agree, handled extremely poorly and tactlessly, but some underlying points worth discussing.

tworiverswoman
10-02-2015, 06:01 PM
If the drug costs less than $1 per dose to produce, and as little as FIVE YEARS AGO was sold for $1 per pill, then there's no justification in the world even for charging the $13.50 per pill price that existed before Shkrelli upped the price to $750 per pill.

Yes, I understand the costs of research, marketing and all that. I have no objection to a company pricing it's medicines at a level to support research and a decent profit on top of that. "Decent" being a bit of a slippery term, let's just assume a 100% net profit. That's quite a bit more than most companies manage but it will do for the sake of argument.

Other Big Pharm companies are well and truly pissed at this jackass, because he brought the pricing strategies out into the public view in such an explosive way that politicians are getting involved, talking about "capping prices" and "regulating the industry" and stuff - not a happy prospect for their bottom lines.

Oh, and I found a fun article (http://motherboard.vice.com/blog/toxo-terror-are-our-brains-controlled-by-cat-loving-parasites) about toxoplasmosis (the disease this pill is for) that suggests that the parasites that cause the disease might be ultimately responsible for "cat ladies.":eek: