The Glade 4.0

wiki probably explains better.
http://en.wikipedia.org/wiki/Pharmaceut ... its_Scheme

it's not that brands are not subsidized but that they incur a premium.

After a little bit of research, canada actually varies by city/province and not all prescriptions are subsidized.

Uk however does subsidize and no mention of distinguishing between brand and generic.

If you have certain types of cancer or AIDS, it's pretty likely you'll get into a situation where there's literally only one drug that will save you from death. (with AIDS it's virtually guaranteed, eventually it develops a resistance to everything) Then you get to take a drug that costs $20 a pill which you have to take six of a day.

I can think of no condition for which there is only a single drug.

And developing drugs is pretty much my area of work, so I'm up on it.

Most of the time, the big three companies come out with similar drugs at about the same time, it's how they stay competitive.

And I'm not sure where you're getting your profit margin figures... The industry periodicals I subscribe to show an 8% max profit for the most successful companies, with some even working with negative profit margins.

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Darksiege: You are not a god damned vulcan homie.

So.. within the very narrow sectors of certain types of cancer and AIDS your statement that you applied to drug production in general is pretty likely to be true? Can we say Hasty Generalization?

I should also point out that AIDS is inevitably fatal anyhow, and cancer is pretty damn fatal too; some types such as pancreatic cancer are a virtual death sentence. You're complaining that they can "kill you" by overcharging for a drug to treat a disease which is extremely likely, possibly certain to kill you anyhow?

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

I have come to believe that the best policy a government could enact, assuming that some degree of health is a public good, would be to allow a patent that extended only exactly long enough to completely recoup the costs of R&D, and all other overhead surrounding the costs of producing a new drug. After that, the market can take over.

My belief is that this would lead to a much greater percentage of drugs and procedures developed being cures rather than treatments, as there would no longer be more money in the treatment than the cure for the developing companies.

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Ezekiel 23:19-20 

We're not really talking about the OP anymore here, that was about Pfizer comitting fraud and getting away with it because the government couldn't afford to strip them of the privilege of billing Medicare.

At this point we're talking about patenting drugs, I've never come out against patenting drugs, I'm not sure why everyone decided to fixate on me calling it a monopoly.



I realize this is your area of expertise, but everything I look at claims higher numbers:

http://www.nybooks.com/articles/17244



http://www.cmaj.ca/cgi/content/full/171/12/1451



http://www.healingdaily.com/conditions/ ... panies.htm



http://www.citizen.org/congress/reform/ ... cfm?ID=935



http://www.usnews.com/money/blogs/flowc ... lains.html

I'd just like to point out that there is a higher margin on generics than other types. Also not all generics are marketed as such (especially complementary and OTC). Big companies like pfizer also has generics bumping up their margin.

margin could be anything from aspirin (2% margin) to cold and flu (150%) from a manufacturing in Australia point of view.

Those were some interesting reads, I'll have to look back over them when I have more time.

It may just be a difference in how profit margins are being defined, or it may be a time-line difference- most of the figures I'm looking at are 2008/2009 figures, which were pretty significant drops from previous years.

And as Lydiaa mentioned, it may also be that the figures I saw were only concerning non-generic drugs, since the periodical is biased towards research funding.

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Darksiege: You are not a god damned vulcan homie.

Since pricing drugs out of people's reach is about the only way a drug company could remotely be said to be "killing people", the linkage to the OP was obvious. Fraud =/= killing people.



Because that is absurd.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

A drug company can kill you by lying about the side effects of the drug and what the drug is indicated for, causing people to take it who otherwise wouldn't have, which is what they did with Bextra.



It's not absurd. I don't know how you're trying to extend what I said to a whole class of drugs. For example, GlaxoSmithKline currently has a monopoly on the molecule "4-amino-1-[(2R,5S)-2-(hydroxymethyl)-1,3-oxathiolan-5-yl]-1,2-dihydropyrimidin-2-one" (Lamivudine) Nobody else is allow to sell this compound to the public besides their company. How do they not have a monopoly on it?

Here's the thing that I don't like about our current system:

The doctors who prescribed the drug should be at fault as much as the drug company.

All of the literature is posted, you shouldn't prescribe something without researching it.

The doctors who prescribed Bextra would have been 'killing' people- not Pfizer.

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Darksiege: You are not a god damned vulcan homie.

Were the doctor's following the FDA guidelines for allowable use of the medicine, based upon the FDA's testing?

If so, I don't believe that the doctor's are at fault.

Technically no, that was the whole root of the fraud case. It was being used off-label by doctors because Pfizer was telling them it had been FDA approved for those uses when it really hadn't been.

Ladas:

No. The doctors were listening to bad pharmaceutical reps for their dosing guidelines instead of actually looking at a) the packaging, b) the PDR, or c) the FDA regs on the medicine.

Not that Pfizer shouldn't have had to pay (and it did), but it irks me how the doctors aren't being held responsible, at all. We have a flaw in the system when the doctors we are trusting for decisions are making them without looking up facts.

And as a point of clarification, Pfizer was not saying it was FDA approved for that (ie, in the drug information packets), some of their sales representatives were telling doctors it was OK.

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Darksiege: You are not a god damned vulcan homie.

Because a "monopoly" generally means a monopoly on a particular product or service. The product people are concerned with buying, however, isn't any particular chemical compound; it's the effect. Therefore, a patent on one particular method of creating that effect is not a monopoly. It really isn't a monopoloy even if that drug is the only one producing the effect. The effect didn't exist at all until that drug was invented and nothing is preventing another drug from appearing that does the same thing other than scientific feasibility.



Trying to figure out where this point is would be an exceedingly complex and costly process in and of itself that would change for each new drug.



There might be some truth to this, but it is not necessarily just as scientifically feasable to cure something as to treat the symptoms.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

In the transitional phase, possibly. Once past that point, I think it would be fairly easy to chart with standard accounting practices.



At this time, yes, I agree. However, that is because we look at medical science through the eyes of a society in which we've never developed that sort of technology because we live in the world that doesn't cure.

I also think that funding would not be an issue. My solution there is to make 100% of all investments, and investment income from the healthcare/pharma industries tax free.

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Ezekiel 23:19-20 

I doubt this very much. In any R&D process there is, for lack of a better term "cross-pollination" of knowledge between the projects themselves. Accounting practices may be perfectly fine for tracking the flow of money, but they don't necessarily do a good job at tracking what's actually going on in the research. What cost is attributable to what project may or may not be clearly identifiable.



I don't see what "how we look at medical science as a society" has to do with what can or cannot be avhieved by science. We also look at the universe as a society that has never developed faster-than-light travel. That does not mean that faster-than-light travel somehow becomes more feasible if we decide to change our outlook.

That isn't to say that there would necessarily be no positive effect from reducing patent length, but we cannot definitively say that there would be, or that it would be of any given magnitude either.

I'm also not in favor of making things tax free. That seems to be just tax exemption for the sake of tax exemption. Yes, I know that too much taxation can harm innovation, but in terms of cost-benefit analysis for society as a whole (medical issues do not exist in a vaccuum) the ideal tax rate is not 0%.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

This may be true. I'm not sure, but I think much of this would be eliminated through a process of making pharma research and technology "open-source" for lack of a better term.



Yes, there are scientific barriers, but I hold to the belief that if something is biological it can be destroyed. I also hold to the belief that as a near certainty individuals will do as they are incentivized to do.

As far as the taxation exemption part of the idea goes, it absolutely isn't simply for the sake of itself. Profit margins within these companies would nessecarily decline if you lessened the length of patents, and suspended government subsidization. You need something to counterbalance that loss of funding if the industry is to work as my model intends. Stimulating private investment by creating tax shelter incentives seems to me to be the best way to do that.

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Ezekiel 23:19-20 

I don't see how removing the lengthy patent period after the development is complete would make the research any more open source unless you're going to mandate that research be conducted with no industrial secrecy. I would find that demand unreasonable.



It's quite obvious that anything bilogical can be destroyed. I can very easily eliminate AIDS in a person by tossing them in a blast furnace. Unfortunately that's not acceptable because it eliminates the patient as well. Destroying only the disease without killing (and prefereably without severely or permenantly harming) the patient in the process is far more tricky. I don't see why it would be a near certainty that people will find a way to do it unless you're talking about over an unlimited timescale in which no other event happens that precludes such development.



I don't object to some tax incentives. I object to 100% tax immunity.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

DE:

I'm sure there are some flaws within the model, but I'm also convinced it is a far better model than the one we use now. How do you feel the model could be improved on?

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Ezekiel 23:19-20 

Depends what areas we want improved.

If we want improvements in ethics and safety, my solution would be to make people who commit fraud regarding the effects of drugs personally criminally liable, but shielding the company as an organization.

If we want improvements in terms of reducing costs.. costs to who? The overall cost of medicine to the economy? I would want to look at the entire process of drug approval and sales and trying to eliminate unnecessary regulation, red tape, and other "cost multipliers" - things that exist for no reason other than to give someone a job before changing the "model" itself

If we want improvements in innovation, I would need to know what practical barriers exist to new development - not just what regulatory or procedural barriers, but what physical problems are we currently unable to overcome?

Trying to alter a system that affects the availablitlity of a good without considering the phsyical realities of how that good works is a recipe for disaster.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

This I agree with.



Costs to individuals. Technological advances have led to price decline in every other industry, as competition works its magic on market share.



Regulation, and a business model built within the framework of that regulation in order to maximize profits.



I don't think that's what I'm doing here.

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Ezekiel 23:19-20 

Those are not practical barriers; they're artificial ones. I would need to know what the limitations of the science itself are at this point.



Maybe not completely, but I think you are too optomistic about the possibility for "cures", and are attributing too much of that lack to the state of the market as opposed to what can actually be done scientifically. Again, while almost anything may be possible on an ulimited timescale, what's possible on an unlimited (or even a limited but lengthy and undefined) timescale isn't necessarily a good guide to policy.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

Gotcha. I misunderstood you.



I hold that science is beholden to markets, just as everything else is. Not in the sense that things that are impossible would magically be possible if only unfettered capitalism took hold, but in the sense that we can't know what is possible because the framework of our current model doesn't incentivize us ever knowing.

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Ezekiel 23:19-20 

If we were under your model I could just as easily say that we couldn't know what is possible under the model we use now because we aren't incentivizing that. I don't see that our current model doesn't incentivize things; there's clearly a lot of incentive to create new drugs as evidenced by the sheer number of drugs available!

I agree that science is beholden to markets in the sense that there are limited resources for science and they must be allocated. Obviously medical research is not the only thing going on in the economy, and even if it were we do not have unlimited resources.

However, I don't know that "incentivizing" anything makes it possible. Once again, we could incentivize the hell out of FTL travel, but that would not necessarily make it possible or feasible.

I should also point out that while incentivizing companies certainly greatly helps medical advancement, its scientists who actually conduct the research, and for scientists the victory of new discovery (especially with their name attached to it) is a very serious incentive as well. Moreover, as cited elsewhere int his thread, there is no shortage of profit and incentive in drug development.

I do not agree that we have treatments as opposed to cures because of the market. I think it represents the limits of what current medical science can achieve. I would need to see actual evidence that cures are possible if only there were greater financial incentive - not proff in the sense of "this is what should be possible given the laws of ecnomics" but proof int he sense of "Here is principle X which points to cure Y being feasible but no one is pursuing it because treatment Z is profitable" along with some way to generalize that validly to the medical market.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."