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Read the rules in the OP before posting, please.

In order to ensure that this thread continues to meet TL standards and follows the proper guidelines, we will be enforcing the rules in the OP more strictly. Be sure to give them a re-read to refresh your memory! The vast majority of you are contributing in a healthy way, keep it up!

NOTE: When providing a source, explain why you feel it is relevant and what purpose it adds to the discussion if it's not obvious.
Also take note that unsubstantiated tweets/posts meant only to rekindle old arguments can result in a mod action.
Nyxisto
Profile Joined August 2010
Germany6287 Posts
December 30 2013 17:54 GMT
#15061
Does he think the problem with Obamacare is that people who don't need it have to sign up for it? Because that's just how insurances work. The people who don't need it pay for the people who do. If only sick people sign up for insurances it's not an insurance, it's just treatment.
JonnyBNoHo
Profile Joined July 2011
United States6277 Posts
December 30 2013 18:07 GMT
#15062
On December 31 2013 02:54 Nyxisto wrote:
Does he think the problem with Obamacare is that people who don't need it have to sign up for it? Because that's just how insurances work. The people who don't need it pay for the people who do. If only sick people sign up for insurances it's not an insurance, it's just treatment.

Dean? He seems to think people who don't need it will largely sign up even without the mandate.
JonnyBNoHo
Profile Joined July 2011
United States6277 Posts
December 30 2013 19:33 GMT
#15063
$1,000 Pill For Hepatitis C Spurs Debate Over Drug Prices

Federal regulators this month opened a new era in the treatment of a deadly liver virus that infects three to five times more people than HIV. Now the question is: Who will get access to the new drug for hepatitis C, and when?

The drug sofosbuvir (brand name Sovaldi) will cost $1,000 per pill. A typical course of treatment will last 12 weeks and run $84,000, plus the cost of necessary companion drugs. Some patients may need treatment for twice as long.

Hepatitis researchers call the drug a landmark in the treatment of this deadly infection. More than 90 percent of patients who get the new drug can expect to be cured of their hepatitis C infection, with few side effects.

Curing hepatitis C has been difficult, involving regimens that don't work as well as the new option and bring harsh side effects.

More than 3 million Americans are infected with hepatitis C, and perhaps 170 million people have the disease worldwide. By comparison, about 1.1 million Americans have HIV, which has infected about 34 million people globally. ...

Gregg Alton, a vice president at Gilead, says the high price is fully justified. "We didn't really say, 'We want to charge $1,000 a pill,' " Alton says. "We're just looking at what we think was a fair price for the value that we're bringing into the health care system and to the patients."

But Andrew Hill, a researcher in the Department of Pharmacology and Therapeutics at the University of Liverpool, says $84,000 per cure is too much, based on his estimate of Gilead's cost to produce the drug.

"Even when we were very conservative [with our estimate], the cost of a course of these treatments would be on the order of $150 to $250 per person," Hill says. He questions whether the $84,000 price tag represents "a fair profit." ...

Dr. Camilla Graham of Beth Israel Deaconess Medical Center in Boston thinks that the high cost of the new hepatitis C treatments might be justified.

"Maybe we decide that $100,000 is a worthwhile investment to cure someone of an otherwise devastating chronic infection," Graham says. After all, it can now cost up to $300,000 to treat patients with advanced hepatitis C, using less effective and more harrowing regimens. ...
Link

Cheaper, more effective and yet still controversial. Can't say we lack for high standards
Nyxisto
Profile Joined August 2010
Germany6287 Posts
December 30 2013 19:47 GMT
#15064
Saw this on reddit a few days ago: http://imgur.com/a/WIfeN

I think by now the medical industry is just making up numbers. Obamacare or not, what would actually help a ton is if the government would regulate the crap out of the prices. They can't be serious and charge 1000$ for drugs or 60k for an appendectomy.
JonnyBNoHo
Profile Joined July 2011
United States6277 Posts
Last Edited: 2013-12-30 20:01:32
December 30 2013 19:58 GMT
#15065
On December 31 2013 04:47 Nyxisto wrote:
Saw this on reddit a few days ago: http://imgur.com/a/WIfeN

I think by now the medical industry is just making up numbers. Obamacare or not, what would actually help a ton is if the government would regulate the crap out of the prices. They can't be serious and charge 1000$ for drugs or 60k for an appendectomy.

Hospitals make up numbers, not sure about drug co's. Regulation is part of the reason why the prices are the way they are, so what we want is better regs, not just more regs.

Edit: regs ARE getting better.
AUGcodon
Profile Blog Joined February 2011
Canada536 Posts
Last Edited: 2013-12-30 20:08:29
December 30 2013 20:06 GMT
#15066
Drug pricing is disconnected from the cost of manufacturing, and I would even argue pricing is disconnected from the R/D cost of the specific drug and the R/D history of the company for the past 15 years or so. The price of the drug is of course what the market is willing to bear. The reimbursement pathway in this case are the HMO in the U.S. They negotiate pricing with the pharma company on how much they are willing to pay for the treatments.

Since Gilead's new drug is going to be the new standard of treatment in the Hep-C indication, they essentially have a monopoly and have quite a bit of leverage.
2809-8732-2116/ Fighting/ Mienfoo, Tyrogue, Sawk
Nyxisto
Profile Joined August 2010
Germany6287 Posts
Last Edited: 2013-12-30 20:08:39
December 30 2013 20:07 GMT
#15067
On December 31 2013 04:58 JonnyBNoHo wrote:
Show nested quote +
On December 31 2013 04:47 Nyxisto wrote:
Saw this on reddit a few days ago: http://imgur.com/a/WIfeN

I think by now the medical industry is just making up numbers. Obamacare or not, what would actually help a ton is if the government would regulate the crap out of the prices. They can't be serious and charge 1000$ for drugs or 60k for an appendectomy.

Hospitals make up numbers, not sure about drug co's. Regulation is part of the reason why the prices are the way they are, so what we want is better regs, not just more regs.

Edit: regs ARE getting better.


But what is the regulation discussion about? Why not just put a commission in place that decides how much stuff is allowed to cost? It's not exactly rocket science
AUGcodon
Profile Blog Joined February 2011
Canada536 Posts
December 30 2013 20:12 GMT
#15068
There are certain extent of price control in medicaid and veteran's affairs where they state we will only reimbursement $600/1000 for that drug. To be blunt, the US has a laxer reimbursement landscape compared to the western world. Resulting in what I hesitatingly call inflated drug prices.
2809-8732-2116/ Fighting/ Mienfoo, Tyrogue, Sawk
JonnyBNoHo
Profile Joined July 2011
United States6277 Posts
December 30 2013 20:17 GMT
#15069
On December 31 2013 05:06 AUGcodon wrote:
Drug pricing is disconnected from the cost of manufacturing, and I would even argue pricing is disconnected from the R/D cost of the specific drug and the R/D history of the company for the past 15 years or so. The price of the drug is of course what the market is willing to bear. The reimbursement pathway in this case are the HMO in the U.S. They negotiate pricing with the pharma company on how much they are willing to pay for the treatments.

Since Gilead's new drug is going to be the new standard of treatment in the Hep-C indication, they essentially have a monopoly and have quite a bit of leverage.

Yeah, cost plus pricing isn't used much anymore.
On December 31 2013 05:07 Nyxisto wrote:
Show nested quote +
On December 31 2013 04:58 JonnyBNoHo wrote:
On December 31 2013 04:47 Nyxisto wrote:
Saw this on reddit a few days ago: http://imgur.com/a/WIfeN

I think by now the medical industry is just making up numbers. Obamacare or not, what would actually help a ton is if the government would regulate the crap out of the prices. They can't be serious and charge 1000$ for drugs or 60k for an appendectomy.

Hospitals make up numbers, not sure about drug co's. Regulation is part of the reason why the prices are the way they are, so what we want is better regs, not just more regs.

Edit: regs ARE getting better.


But what is the regulation discussion about? Why not just put a commission in place that decides how much stuff is allowed to cost? It's not exactly rocket science

Costs aren't universal, some hospitals are low volume, others operate where the rent is high, etc. You could do a bracket to account for that but then you still have the problem of figuring pricing for care that isn't standardized.

In other words, you can do that, but it wouldn't be easy or happen overnight. To an extent it already happens, Medicare has standards for what it pays for a procedure and so do insurance co's.
Mercy13
Profile Joined January 2011
United States718 Posts
December 30 2013 20:22 GMT
#15070
Here's a very good article on health care costs, and why they are so high: http://livingwithmcl.com/BitterPill.pdf

Stuff like this is why I think a single payer system is the way to go - healthcare consumers just don't have any bargaining power.
FabledIntegral
Profile Blog Joined November 2008
United States9232 Posts
December 30 2013 20:47 GMT
#15071
On December 31 2013 05:06 AUGcodon wrote:
Drug pricing is disconnected from the cost of manufacturing, and I would even argue pricing is disconnected from the R/D cost of the specific drug and the R/D history of the company for the past 15 years or so. The price of the drug is of course what the market is willing to bear. The reimbursement pathway in this case are the HMO in the U.S. They negotiate pricing with the pharma company on how much they are willing to pay for the treatments.

Since Gilead's new drug is going to be the new standard of treatment in the Hep-C indication, they essentially have a monopoly and have quite a bit of leverage.


Eh, while by no means am I stating their current price is a fair price, the only relevant factor you posted would be the R/D costs for the company overall. Have to factor in all the other R/D that didn't yield any results and resulted in near a total loss.
AUGcodon
Profile Blog Joined February 2011
Canada536 Posts
December 30 2013 20:53 GMT
#15072
I think I wasn't clear. I was referring to the total R/D cost as you stated. But I would still argue that drug price is disconnected from the total R/D cost.
2809-8732-2116/ Fighting/ Mienfoo, Tyrogue, Sawk
KwarK
Profile Blog Joined July 2006
United States42831 Posts
Last Edited: 2013-12-30 21:08:18
December 30 2013 21:02 GMT
#15073
In terms of capitalism they're doing the correct thing here. They're saying "if it costs X to treat them without our drug then we'll charge X-1 dollars and you'll save a dollar and we'll make money and everyone wins freemarkethighfive". The issue is that you'll end up with people not being able to afford either and dying or having the cost subsidised by the healthcare system which just hurts other people elsewhere because it's a limited pot of money. So while there is a capitalist fair price where everyone involved in the transaction is better off there is also a just price wherein the maximum social benefit is obtained which is completely different. For that you'd need to look at how much profit pharma companies need to make to keep curing diseases and cap their pricing to reflect that.

I don't think it'd be especially unreasonable drug companies to be reminded that the only reason they're able to make any profit at all is that society collectively decided to honour their patents and allow them to maintain a monopoly on their brand of healthcare to the short term detriment of the people. Their monopoly exists only because we choose not to make generic versions of their patents so they ought to not to take the piss.
ModeratorThe angels have the phone box
Nyxisto
Profile Joined August 2010
Germany6287 Posts
Last Edited: 2013-12-30 21:10:59
December 30 2013 21:10 GMT
#15074
You're not doing anybody a favour if you're throwing capitalism into one pot with stupid laissez-faire politics. Just because private persons are allowed to own means of production doesn't mean everybody has to be dying in the streets. We have a lot of welfare and social market economies that function very well(and have a capitalist basis)
Crushinator
Profile Joined August 2011
Netherlands2138 Posts
December 30 2013 21:23 GMT
#15075
On December 31 2013 05:53 AUGcodon wrote:
I think I wasn't clear. I was referring to the total R/D cost as you stated. But I would still argue that drug price is disconnected from the total R/D cost.


Last year, the industry average return on assets was 11% for pharmaceutical companies. Top performer for big industry, but it isnt exactly spectacular. It really is very hard to say what a fair price would be. The winners sure are milking their finds for whatever they can, but if you take the winner's winnings, will they still be willing to play?
farvacola
Profile Blog Joined January 2011
United States18830 Posts
December 30 2013 21:26 GMT
#15076
If the rules of the game don't lend themselves to the continued playing of the game given reductions in winnings along a reasonable and unobscurant metric, then they need to change.
"when the Dead Kennedys found out they had skinhead fans, they literally wrote a song titled 'Nazi Punks Fuck Off'"
Nyxisto
Profile Joined August 2010
Germany6287 Posts
Last Edited: 2013-12-30 21:51:23
December 30 2013 21:50 GMT
#15077
On December 31 2013 06:23 Crushinator wrote:
The winners sure are milking their finds for whatever they can, but if you take the winner's winnings, will they still be willing to play?

Given the fact that there is still healthcare available in Europe and Canada i guess the answer is pretty much yes, they are still willing to play.

And I don't think it's hard to figure out reasonable prices. Make them so that the industry earns their fair share , but not so much that there are people who earn more money than god. For example here in Germany pharmacies are allowed to charge 15% more than they buy the drugs for. Sounds pretty reasonable to me.
Crushinator
Profile Joined August 2011
Netherlands2138 Posts
Last Edited: 2013-12-30 22:06:47
December 30 2013 22:04 GMT
#15078
On December 31 2013 06:50 Nyxisto wrote:
Show nested quote +
On December 31 2013 06:23 Crushinator wrote:
The winners sure are milking their finds for whatever they can, but if you take the winner's winnings, will they still be willing to play?

Given the fact that there is still healthcare available in Europe and Canada i guess the answer is pretty much yes, they are still willing to play.

And I don't think it's hard to figure out reasonable prices. Make them so that the industry earns their fair share , but not so much that there are people who earn more money than god. For example here in Germany pharmacies are allowed to charge 15% more than they buy the drugs for. Sounds pretty reasonable to me.


I don't understand what healthcare being available in Europe and Canada has to do with anything. Pharmacies charging no more than 15% is indeed reasonable, but those pharmacies are just retailers, not the ones doing R&D.

The question is if pharmaceutical R&D would still happen to the same extent, if some sort of price ceiling is introduced? How much of a decrease are we willing to live with? I agree that some of these margins are utterly obscene, but maybe putting up with it is worth it, I don't know.
Adreme
Profile Joined June 2011
United States5574 Posts
December 30 2013 22:33 GMT
#15079
On December 31 2013 04:33 JonnyBNoHo wrote:
Show nested quote +
$1,000 Pill For Hepatitis C Spurs Debate Over Drug Prices

Federal regulators this month opened a new era in the treatment of a deadly liver virus that infects three to five times more people than HIV. Now the question is: Who will get access to the new drug for hepatitis C, and when?

The drug sofosbuvir (brand name Sovaldi) will cost $1,000 per pill. A typical course of treatment will last 12 weeks and run $84,000, plus the cost of necessary companion drugs. Some patients may need treatment for twice as long.

Hepatitis researchers call the drug a landmark in the treatment of this deadly infection. More than 90 percent of patients who get the new drug can expect to be cured of their hepatitis C infection, with few side effects.

Curing hepatitis C has been difficult, involving regimens that don't work as well as the new option and bring harsh side effects.

More than 3 million Americans are infected with hepatitis C, and perhaps 170 million people have the disease worldwide. By comparison, about 1.1 million Americans have HIV, which has infected about 34 million people globally. ...

Gregg Alton, a vice president at Gilead, says the high price is fully justified. "We didn't really say, 'We want to charge $1,000 a pill,' " Alton says. "We're just looking at what we think was a fair price for the value that we're bringing into the health care system and to the patients."

But Andrew Hill, a researcher in the Department of Pharmacology and Therapeutics at the University of Liverpool, says $84,000 per cure is too much, based on his estimate of Gilead's cost to produce the drug.

"Even when we were very conservative [with our estimate], the cost of a course of these treatments would be on the order of $150 to $250 per person," Hill says. He questions whether the $84,000 price tag represents "a fair profit." ...

Dr. Camilla Graham of Beth Israel Deaconess Medical Center in Boston thinks that the high cost of the new hepatitis C treatments might be justified.

"Maybe we decide that $100,000 is a worthwhile investment to cure someone of an otherwise devastating chronic infection," Graham says. After all, it can now cost up to $300,000 to treat patients with advanced hepatitis C, using less effective and more harrowing regimens. ...
Link

Cheaper, more effective and yet still controversial. Can't say we lack for high standards


If your store starts selling a normal toothbrush for 250$ and I offer you one for 150$ than that doesn't mean I am charging you a reasonable rate it just means I am gouging you slightly less then other guy.
{CC}StealthBlue
Profile Blog Joined January 2003
United States41117 Posts
December 30 2013 22:50 GMT
#15080
Belief in evolution among Republicans has dropped more than 10 percentage points since 2009, according to a new poll by the Pew Research Center.

Pew found that 43 percent of Republicans said they believed humans and other living beings had evolved over time, down from 54 percent in 2009. More (48 percent) said they believed all living things have existed in their present form since the beginning of time.

The percentages for Democrats and independents were considerably more stable: Democratic belief in evolution went from 64 percent in 2009 to 67 percent in 2013; independent belief dipped from 67 percent in 2009 to 65 percent in 2013.

Among all American adults, 60 percent said they believe in evolution, according to Pew, and 33 percent do not.

The poll surveyed 1,983 Americans ages 18 and older from March 21 to April 8.


Source
"Smokey, this is not 'Nam, this is bowling. There are rules."
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