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Drug Cost A Likely Death Sentence - Page 10

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MasterOfChaos
Profile Blog Joined April 2007
Germany2896 Posts
Last Edited: 2011-06-22 21:44:01
June 22 2011 21:43 GMT
#181
I'm a bit surprised with the price. If they priced it at 50k a year they'd need to sell about 10 times as much of it(assuming R&D dominates production cost). And that doesn't sound unlikely to me. More insurances will cover it for that cost, and more people will be able to pay it themselves.
LiquipediaOne eye to kill. Two eyes to live.
SOB_Maj_Brian
Profile Blog Joined September 2008
United States522 Posts
June 22 2011 21:46 GMT
#182
On June 23 2011 06:00 Lunchador wrote:
Show nested quote +
On June 23 2011 04:42 Frequencyy wrote:
That money to spend on living ridiculous this is yet another example of companies that just care about the money, not considering the LIFE of a human being. I really hope your friend can pull through, make sure he stays positive, and if he is that's half the battle won.


Why don't you go kick your friends studying chemistry/biology/pharm in the balls repeatedly then? You should also laugh and ridicule them for pursuing a profession that would barely pay more than a McDonald's job if the world worked the way you're stating.

Now time for a reality check on companies doing it "for the money (oooooh so scarrry)":

New drugs can take anywhere from two to a dozen years to get on the market. Also, people saying it costs roughly $800 million are being generous. Try $1.8 billion for a more realistic estimate. That's money spent to make sure the proposed drug actually does something about a disease and to make sure it doesn't flat out kill you 3 years later. Think about that next time you're getting your prescription drug. Also consider that for every 1 drug that has made it to market, 10000 additional ones have failed. And for every 3 drugs that make it to market, 1 actually sells well enough to make a profitable return. What do companies do with their profits? Invest in future R&D projects to create better drugs.

Okay, damn. That's sooooooooo much money and time that has to go nowhere before those companies start seeing any of it back.

You're saying they should stop caring about the money and on prioritizing people's lives. Well, sorry. It can't happen. If things work out the way you want it to, you're robbing from the people who spent endless years in med school hell and read more textbooks than you will read novels your entire life. Sure, they're working for private firms, but they are still doing the world a public service by discovering these miracle drugs. But if the companies don't get the money, guess what? They go bankrupt. The hard workers go unemployed and live miserably. And ultimately, R&D halts and down the years, 200,000 more people are condemned to die terribly because the proper drug couldn't cure them in time.

Look, I feel for the guy just as much as everyone else (I hope) does. Be supportive for him, but don't be ignorant and start blindly bashing pharmaceutical corporations because of his plight.


This is 100% correct. Having done research on the topic and having parents who work in the Orphan Drug industry, there are essentially 2 options: (1) charge a ton of money for these drugs or (2) don't have these drugs at all. You can alleviate the price by government intervention, but basically no one will do pharmaceutical research if they cannot recoup the cost. Also consider that the patent side of the equation 2; the drug will only be that expensive for the next 20 years or so (if no patent protection then under ODA then market exclusivity is 10 years), after which generics can come in and severely undercut the price.
lixlix
Profile Blog Joined December 2009
United States482 Posts
Last Edited: 2011-06-22 21:47:42
June 22 2011 21:47 GMT
#183
On June 23 2011 06:25 domovoi wrote:
Show nested quote +
On June 23 2011 05:25 VIB wrote:
On June 23 2011 04:52 sunprince wrote:
On June 23 2011 04:45 Baarn wrote:
It's too bad drug companies don't have to conform to Duty to Rescue.


If they did then they would simply stop doing research on all rare conditions and only develop drugs likely to turn a huge profit, and that's if they don't simply go out of business. Your bleeding-heart view doesn't look very far.
Prove it.

http://en.wikipedia.org/wiki/History_of_penicillin

This Mr. History dude disagrees with you.

What exactly does your link prove? That it's cheap to discover any medical treatment because somehow we'll always get lucky that some randomly growing fungus will have medical treatment properties?

I think the fact that pharma companies spend billions in R&D is enough proof that developing drugs costs a lot of money.


That link in fact proves the opposite. If he had looked at the timeline, he would realize that it took a collaborative effort between multiple companies and scientists 24 years to go from Fleming's discovery of the properties of penicillin to the development of a drug.

That link also says nothing about the costs of development nor how much penicillin sold for when it was first on the market.
Iodem
Profile Joined October 2010
United States1173 Posts
June 22 2011 21:57 GMT
#184
So you just need to get 50,000 people to donate him $10 a year. Perhaps not even that much. Would the Canadian healthcare at the very least partially subsidize the cost, or is it $500,000 after a subsidization?
If you don't like it, you can quit.
BlackJack
Profile Blog Joined June 2003
United States10574 Posts
June 22 2011 22:02 GMT
#185
On June 23 2011 06:43 MasterOfChaos wrote:
I'm a bit surprised with the price. If they priced it at 50k a year they'd need to sell about 10 times as much of it(assuming R&D dominates production cost). And that doesn't sound unlikely to me. More insurances will cover it for that cost, and more people will be able to pay it themselves.


Perhaps they will do both. Kind of like when they come out with the new technology and it costs $500 for a Wii or whatever. Then in a year or two you can get a nice bundle for a couple hundred. Many years down the line you can buy an N64 off ebay for a few bucks.

The new stuff always gets to the people that are willing to pay top dollar for it first. I'm sure one day this drug will be covered in Canada. It was only fairly recent that Ontario got PET scans iirc, so it's not the first time that they've waited to get potentially life saving technology.
Eldanesh
Profile Joined April 2010
United States6 Posts
Last Edited: 2011-06-22 22:03:45
June 22 2011 22:02 GMT
#186
I know it sounds grim and insensitive, but what happened to natural selection? Modern medicine and doctors are just trying to play "god". Are we supposed to give all sick people in this world free medical care?
o__o
Probe1
Profile Blog Joined August 2010
United States17920 Posts
June 22 2011 22:04 GMT
#187
I read the entire thread and I'm shocked that everyone so freely gives their sympathy while millions die each day. We're so callous of the plight of those that don't live within driving distance that even the words millions die each day are meaningless. I'm very sorry your friend will die. It is tragic.

So are the millions just like him who couldn't even dream of living the life he had lived before his death sentence. My sorrow you can have but my sympathy I will not give.

I'm no bitter cynic if labeling me so is your reaction. I've just had my eyes open to the horror that our world survives, or doesn't, every day. Next time you see your friend, look at him and ask yourself, will he be the last? Is it the companies fault?

We, as an entire civilization, need to stand up to the inhumanity of our current human nature. It isn't capitalism or corporate culture. It isn't monsters under the bed or in the capitols. It's every one of us, every time we turn blind to those who aren't in our culture. In our neighborhood, or country or community. We are monsters.

We need to stand for medicine no longer being a business. Human life is a fundamental right, not a price.
우정호 KT_VIOLET 1988 - 2012 While we are postponing, life speeds by
Lowkin
Profile Joined September 2010
Canada232 Posts
June 22 2011 22:05 GMT
#188
On June 23 2011 06:43 MasterOfChaos wrote:
I'm a bit surprised with the price. If they priced it at 50k a year they'd need to sell about 10 times as much of it(assuming R&D dominates production cost). And that doesn't sound unlikely to me. More insurances will cover it for that cost, and more people will be able to pay it themselves.


It costs that much because the target market is so small only like 0.001 percent of the population is affected by this disease, and I guess the company figured 500k a year was the most reasonable price for them to see a return on investment. I do believe 500k is the price for Canada to use the drug and they price it differently around the world. Also many first world countries with health-care will foot the bill, but apparently Canada doesn't want too.
BlackJack
Profile Blog Joined June 2003
United States10574 Posts
June 22 2011 22:06 GMT
#189
On June 23 2011 07:02 Eldanesh wrote:
I know it sounds grim and insensitive, but what happened to natural selection? Modern medicine and doctors are just trying to play "god". Are we supposed to give all sick people in this world free medical care?


Funny. "What happened to natural selection?" is exactly what I thought when I read your post.
FabledIntegral
Profile Blog Joined November 2008
United States9232 Posts
June 22 2011 22:09 GMT
#190
On June 23 2011 07:04 Probe1 wrote:
We need to stand for medicine no longer being a business. Human life is a fundamental right, not a price.


Completely disagree. Private corporations having an interest in medicine is a good thing, government would just do it much more inefficiently, and instead of being funded by rich people, it would be funded by everyone, so we'd have significantly higher taxes to be pouring billions upon billions of dollars into research (and we already pour money into research). Just because government could be involved in research, do you want to bar others from researching as well? I hope not.

Human life is a fundamental right. It's a right in the sense other people cannot deny you from it. No one is denying him his right to live, to suggest so is completely ridiculous.
domovoi
Profile Joined August 2010
United States1478 Posts
June 22 2011 22:09 GMT
#191
We need to stand for medicine no longer being a business. Human life is a fundamental right, not a price.

I'm having trouble figuring who is going to do all the medical research if such work is no longer paid, because dammit, people working on saving lives should do it for free.
seiferoth10
Profile Joined May 2010
3362 Posts
June 22 2011 22:13 GMT
#192
Damn, I guess public healthcare in Canada isn't as great as I thought.
Probe1
Profile Blog Joined August 2010
United States17920 Posts
June 22 2011 23:26 GMT
#193
Sorry, my sentiments are strictly American. We spend more on bombs than anything else. There's something very wrong with that.
우정호 KT_VIOLET 1988 - 2012 While we are postponing, life speeds by
skindzer
Profile Blog Joined May 2005
Chile5114 Posts
June 22 2011 23:40 GMT
#194
Im most certain this has nothing to do with the healthcare system, this is about the so called "orphan diseases" (http://www.medterms.com/script/main/art.asp?articlekey=11418). The reason why the meicine is so expensive its because 10 years ago there was no treatment AT ALL so they had to give the monopoly to 1 company so that it was worth to invest in the development of a treatment.

Why is this needed? Because if not NO ONE would have invested in finding a cure because these diseases are extremely reare. In any case Im sorry for your friend.
Its not only the rain that brings the thunder
MERLIN.
Profile Blog Joined December 2010
Canada546 Posts
June 22 2011 23:45 GMT
#195
Canada health care is generally free, but you have to understand that even though we are known for are universal healthcare, a treatment of this magnitude is just... It's not simply 500k, its half a million annually.

Treatment is money, anywhere in the world, and if it were my choice it wouldnt be a question, but when you have money dictating politics and not humane reasoning, life doesnt matter and your friend isn't going to get the treatment, I'm sorry.

7 billion people, in the eyes of people looking at money, 1 doesn't matter.
"A bullet to the head will solve your problems."
IzieBoy
Profile Blog Joined November 2010
United States865 Posts
June 22 2011 23:48 GMT
#196
wow this is bad.... could he try being a lab guinea pig? sometimes they offer good treatment for free to further test it.

reason why the cost is high is because of batch process involved in making drugs

wow just give me the chemical name and you can probably get someone to make it for you for a much cheaper price. i might even do it for free.
Let's Do This! Leeeeeeeeeeeeeroy Jenkins!
IzieBoy
Profile Blog Joined November 2010
United States865 Posts
June 22 2011 23:52 GMT
#197
On June 22 2011 11:21 Lowkin wrote:
One of my best friends has a rare blood disease that is usually fatal withing 10 years of diagnoses(he is on year 11). However recently there has been found a possible cure or treatment to combat the disease. Although there is a new cure/treatment to obtain it requires and astronomical amount of money. Even in Canada where we are praised for our health-care system my friend has fallen through the cracks because of the price tag of the treatment.

He is currently on a treatment that is not very effective and has serious consequences after long term use (e.g. more than 1 year) and he needs this medicine to continue to live a full life.

The drug company charges this huge price for there cure because of the illnesses rarity and that there is not a huge target market and they say for them to make profit on their investment of finding a cure they need to charge this impossible amount to pay for a regular citizen.

He is currently trying to get the Provincial government to cover his drug costs but so far there has been little progress on that front.

Article

So any thoughts or ideas would be helpful and just wanted to create awareness of rare illnesses that fall through the cracks because of cost.


that is so wrong...if it's a drug, they can make it in a small quantity. they don't need to go into the kilos. are they just going to let your friend die just because he doesn't pay the astronomically high fee?
Let's Do This! Leeeeeeeeeeeeeroy Jenkins!
seiferoth10
Profile Joined May 2010
3362 Posts
June 23 2011 00:25 GMT
#198
On June 23 2011 08:52 IzieBoy wrote:
Show nested quote +
On June 22 2011 11:21 Lowkin wrote:
One of my best friends has a rare blood disease that is usually fatal withing 10 years of diagnoses(he is on year 11). However recently there has been found a possible cure or treatment to combat the disease. Although there is a new cure/treatment to obtain it requires and astronomical amount of money. Even in Canada where we are praised for our health-care system my friend has fallen through the cracks because of the price tag of the treatment.

He is currently on a treatment that is not very effective and has serious consequences after long term use (e.g. more than 1 year) and he needs this medicine to continue to live a full life.

The drug company charges this huge price for there cure because of the illnesses rarity and that there is not a huge target market and they say for them to make profit on their investment of finding a cure they need to charge this impossible amount to pay for a regular citizen.

He is currently trying to get the Provincial government to cover his drug costs but so far there has been little progress on that front.

Article

So any thoughts or ideas would be helpful and just wanted to create awareness of rare illnesses that fall through the cracks because of cost.


that is so wrong...if it's a drug, they can make it in a small quantity. they don't need to go into the kilos. are they just going to let your friend die just because he doesn't pay the astronomically high fee?


Just gonna point out that if they made it in smaller quantities it would surely cost more than what they're charging just for the company to stay afloat.

As for big pharm letting this guy die, I dunno, that one's hard to call. Obviously they have to charge this amount in order to recoup what they spent on R&D of this drug. They have to make some profit otherwise there would be no incentive to even develop this treatment. Then again, they could treat this guy for free and cause headlines all over the world about some humanistic company foregoing profits for the greater good of a disease only they can treat.

I think I read it somewhere earlier in this thread, but the days of medical miracles are gone. Every new advancement from here on will cost exorbitant amounts because of legislation, R&D, low target population, and other factors. The days of finding a miracle cure that everyone can use for a reasonable sum are over.
applejuice
Profile Joined October 2010
307 Posts
Last Edited: 2011-06-23 00:48:36
June 23 2011 00:47 GMT
#199
On June 22 2011 12:14 Arnstein wrote:
Move to Norway. You actually aren't allowed to pay more than 300 dollars each year for any kind of treatment, after the first 300 dollars it's free.


Cool story, but irrelevant.

If the government approved this drug for use, it would cost this guy next to nothing to obtain it. The same rules that apply to all drugs in Canada would apply to this one. Thing is, the government has not approved the drug.

The government denies the treatment because they deem it not to be cost effective. I would be very surprised if the Norwegian government does not deny treatment on the same grounds.

It's just not something you hear about.

Also, in BC, most people will not pay more than a few hundred dollars before the government pays for everything. Same thing.
Probulous
Profile Blog Joined March 2011
Australia3894 Posts
June 23 2011 01:00 GMT
#200
Calm down people, there is no need to get hysterical. You can't discuss with someone if they are shouting at you.

There seems to be a lot of meaningless platitudes in this thread, which is a disservice the OP. So here are some points to consider. If you don't like them or have a counter argument please use some facts and figures so the discussion moves on.

Is developing a drug expensive?
This is a complicated question because the price is determined by many factors. Mostly it is due to the following:
  • Research Costs including Clinical Testing
  • Regulation costs including compliance testing, application costs
  • Cost of drugs that don’t make it.
  • Production costs of the drug including shipping, storage and administration
  • Incidence of disease
  • Regularity of use

In 2006 the Clinical Trial Benchmarking put average per patient costs for clinical trials at $26,000.00 USD ( http://www.lifesciencesworld.com/news/view/11080 )

The number of patients required per trial depends on the expected benefit as well as expected toxicity profile, however most registration trials have a minimum of 500 patients.

Thus we can expect using rough estimates that each registration trial would cost approximately
$26,000 x 1000 = $26,000,000

That is a big number. Even if my number estimates are high (I can tell you they are an underestimate), you are still looking at millions of dollars per trial. Now this is only the successful final phase III trial. There are also the previous Phase I and Phase II trials, which have costs of $1.5 Million (100 pts at $15,700 per patient) and $400,000 (20 patients at $19,300 per patient).

This doesn’t include the other costs of development including side trials for clarifying indication scope, toxicity effects, additional indications, local populations, costing trials and the list goes on.
So for a drug that miraculously reached Phase I with no costs, had a perfect phase I,II and III trial, the total clinical costs would be approximately $28 Million

Now consider that most drugs have multiple clinical trials running. An example being one of our new compounds have 9 different registration trials running at the moment and you immediately up the costs to the almost $300 Million.

It is not hard to see how the $1 Billion price for reaching the market is easily achievable.
http://onlinelibrary.wiley.com/doi/10.1002/hec.1454/abstract

Less than 5% of cancer drugs that reach animal testing phase ever get to market. Whether the company makes a profit on those 5% is not certain. Most drugs don’t even get to animal testing phase. I work for a large pharmaceutical company, where we run over 1 million unique screenings a day looking for potential target matches.

This is pretty decent description of what happens during development.
[image loading]
Or alternatively
[image loading]

Now if you have a problem with accepting that bringing a drug to market is expensive please provide some counter argument as to why this is not the case.

Why is he being charged $500k for a life saving drug
As has been mentioned previously this is a rare disease with an incidence of “1-2 cases per million” ( http://en.wikipedia.org/wiki/Paroxysmal_nocturnal_hemoglobinuria#Epidemiology ). Thus the drug company can only expect to treat about 70 patients in Canada with which to recoup their costs. This assumes all patients would benefit and the company can get to them. Alexion is a small pharma company they have very little to diversify their costs and so have to charge the high price.

But life is sacred and pharma is making money from sick people!
Nobody is arguing that the sick should be taken advantage of. Quite the opposite, the Canadian system is celebrated as on of the best in the world because it provides the greatest benefit at the lowest cost.

It is built for this purpose. It was designed, legislated and constructed specifically to minimise costs whilst maximising benefit for the whole country. This is where ethics come in and to argue the ethics of a nationalised health service is really pointless now. Suffice it to say that the Canadian health system is constructed to treat as many people as possible at the lowest cost possible.

As for Pharma making money off of sick people, I counter with Pharma companies do not make people sick. In fact, often it is people who make people sick. I don’t see you guys up in arms about Intel, or Razor or Blizzard or any other company that vicariously supports a sedentary lifestyle. Lack of exercise and the increase in sedentary lifestyle is a known risk factor for diabetes and heart disease. So why should we support companies that support such a lifestyle?

But Probulous, Pharma companies need sick people so they can make money. I will concede that if there was no sickness there would be no need for pharma companies. There would also be no need for hospitals or doctors. Are they evil as well?

So what do we do?
This is the question that should be asked. I assume that this person has already approached the company directly for support. Most large companies have a compassionate use program but as mentioned Alexion is small. Moving countries isn’t going to help because, as mentioned, Canada has one of the best systems in the world. There may be countries where this is listed but good luck getting in with the condition. I guess you could try and look for a trial that is enrolling?

Probulous, you are a heartless bastard!
Maybe I am, I don’t believe this is the truth but it is not beyond the realm of possibility. I feel for this young man, no-one enjoys making these decisions. It is an ugly reality that rationing of medication is real and cannot be avoided. Unfortunately, this is reality.

Please if you disagree with what I have said, outline where and how you disagree. Otherwise this discussion just descends into rhetorical shouting matches.
"Dude has some really interesting midgame switches that I wouldn't have expected. "I violated your house" into "HIHO THE DAIRY OH!" really threw me. You don't usually expect children's poetry harass as a follow up " - AmericanUmlaut
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