Jacinda

[husaberg]

Gosh, do my eyes deceive me ?

So what's your view of charging for medicines, or precisely the pricing of medicines according to what the market will bear ?

Cheers, Viking

Like all torries he will be user-pays all the way unless it needs to be paid by themselves then, it will be all "greater good fair share" rah rah
much like how Aucklander complain the rest of the county should pay for their roads as well as subsidise their power. like because of "AUCKLAND"

[pritch]

It absolutely does.


Smoker A has a number of complications that if they operate, there's big increase in the chance of Death during or soon after the procedure.
Smoker B does not have the complications.

The Surgeon goes ahead with Smoker B, but not Smoker A.

The determining factor is based solely on Medical risk of doing additional harm or causing death.

What you are trying to suggest happen is that both Smokers get told:

Don't try and blame me for your disfunctional thinking. Things are obviously different on your planet.

[TheDemonLord]

Like all torries he will be user-pays all the way unless it needs to be paid by themselves then, it will be all "greater good fair share" rah rah
much like how Aucklander complain the rest of the county should pay for their roads as well as subsidise their power. like because of "AUCKLAND"

That's the great thing about when you ignore someone and post a reply as to what they might say without reading what they actually said - because when it's the complete opposite of what you think, it makes you come off like a tool.

[TheDemonLord]

Don't try and blame me for your disfunctional thinking. Things are obviously different on your planet.

This is not Dysfunctional thinking, you are trying to conflate two things that are very distinct.

Not only that, you are trying to equate a universal 'this always happens' with a qualified 'this happens when these criteria are met'.

A Doctor telling someone they won't treat them because they've made bad life choices, is not the same as a Doctor telling someone they won't treat them because the treatment might kill them.

[FJRider]

I've always been pro-socialized Health Care - I believe that the net-public good (which cannot be measured) outweighs the net cost. Or to put it a different way:

Having lots of healthy people able to work to the maximum of their ability creates enough surplus wealth that we can afford to keep them healthy.

Now, charging for Medicines - that's a different question.

In terms of the likes of Pharmac - it's certainly true that purchasing for an entire Country means that you are buying in Volumes that enable you to negotiate the best Price. It also means that for the Supplier - the Buyer is less likely to go bankrupt or 'go out of business', so it's a very secure revenue stream.

So, for the majority of situations, it works great. Where a Pharmac type system fails is every other year or so, we get a news story about someone who has a rare condition and needs some expensive drug that Pharmac doesn't fund or that Pharmac doesn't have the Budget for or Pharmac isn't convinced of the efficiency of the drug.

The question of Pricing Medicine, that's a different question (I'm sure someone is going to mention the guy that bought the company and then jacked the price up by like 1000%).

I'm going to split my answer into 2 parts - the R&D side and the per-unit cost to manufacture.

The per-unit cost is the simpler one to address - If we go with Paracetamol (as an example) and I setup a new company to make it (maybe with a new way manufacturing it), it's reasonable to say that the price should be something like cost+X% (so 50% markup for example is reasonable - always gotta double your money).

R&D however is a different beast - I believe that the cost of the Covid Vaccine was around $6 Billion. How do you price for that? And more importantly - how do you price for the next big research project?

Certainly I believe that those that are first to market deserve a Competitive Edge and I also believe that the Price should be such that for the estimated number of units sold, not only is the research cost accounted for, but there should be a percentage to fund future endeavors.

To use a crude example - Imagine a disease that only affects one person on the entire planet, but the cost to develop the cure is $1 Billion, it would be right that the cost for that single shot of medicine to be more than $1 Billion.

Now, let's assume that said disease is Fatal, you might say 'well, it's a single Dose, so just give it to them' - but that denies all the other research on other fatal diseases that could have been done for that $1 billion.

The flipside is that the government confiscates your research and forces you to manufacture the drug for free - we'd call that Slavery.
Or, they simple confiscate the research and let other people make it, thus disincentivizing anyone else from spending all the time and effort to innovate, leading to an inevitable decline - we'd call that the Soviet Union .

TL;DR - Life isn't fair. If coming up with life saving drugs was easy, everyone would be doing it - but the reality is, it's very hard to do and so we incentivize the people that do it to do so in the form of giving them resources.

The NZ public health system is mostly free. As are most prescription medicines. Although sometimes a surcharge is required that is less than most pay for car parking fees. Having lots of healthy people on a benefit ... refusing to work ... is something we can't afford either.

The drugs for those rare conditions are usually still being trialed (often with varying reported [not always good] results) ... and the high cost is usually due to low production quantity's. That and long ongoing research on the medical condition involved. Those with those rare conditions are willing to try anything and happy to pay ... if it means they might continue living a bit longer. Not a lot gets said (or heard) about what happens to those that can't afford those medicines.

It not the usual story of research/development costs being simply passed on to the consumer ... it depends who pays the bills to start with. And WHY. Some of those that can charge though ... often do. That it is fair, logical, or ethical ... is irrelevant. It happens.

The best part of your Flipside is ... the people that NEED the drugs ... get it (usually) for free. In that is the basis of all the Socialist systems ... anywhere in the world. Perhaps is is better to incentivize the ruling Government party to pay to keep all their citizens happy and healthy. Or be removed from power by those very people..

The cost of the Covid vaccine to develop and what it cost the Government to buy is irrelevant. The Public gets it for free. More people have died from taking Aspirins ... than those that have taken the Covid vaccines. But still many refuse to take it because they don't know whats in it. I bet all (ok most of) those that have had Chemotherapy treatment ... couldn't name any/all the chemicals it is made up of. But it means a possible way of living a little longer. Often ... little being the operative word.

Most of your above post is based on a bias of political ethics ... or lack of. Sometimes that bias has been to your advantage. Sometimes not.


Go figure.

[Viking01]

I've always been pro-socialized Health Care - I believe that the net-public good (which cannot be measured) outweighs the net cost. Or to put it a different way:

Having lots of healthy people able to work to the maximum of their ability creates enough surplus wealth that we can afford to keep them healthy.

Now, charging for Medicines - that's a different question.

....

TL;DR - Life isn't fair. If coming up with life saving drugs was easy, everyone would be doing it - but the reality is, it's very hard to do and so we incentivize the people that do it to do so in the form of giving them resources.

Afternoon,
Appears that the western Big Pharma companies producing Covid vaccines have been very well incentivised to date.

https://www.greanvillepost.com/2021/...l-vaccination/

Cheers,
Viking

[pritch]

Pharmacaeutical manufacturers in the US regularly claim R&D costs are expensive. Often though the price is jacked up massively by a new company having taken over the manufacturing rights and jacking up the price. No R&D there. The most egregious example was Martin Shkreli, a hedge fund manager, who bought the company that manufactured Daraprim an anti parasitic and jacked the price up 2000%. He had been involved in some fraudulent activity and needed lots of cash urgently. The law caught up with him on the securities fraud and he was sentenced to seven years.

Then there was the Epipen drama. Mylan bought the rights off Merck, famous as manufactureres of Ivermectin, and jacked the price from 98.38 for a pair (you can't buy just one) to US$608.61. IIRC the CEO received a bonus of 600 million. There was some blowback when it became public knowledge that said CEO was US Senator Joe Manchin's daughter. Yes, that Joe Manchin. No R&D there either.

Then there is insulin. The use of insulin for treatment of diabetes was introduced 100 years ago. The people who originated it gave it to the world no charge so that everyone who needed it could have it. R&D costs should be zero or close to it now, but the price went up massively. It seems that the price went up simply because the people who need it will die if they don't get it. Some pay, some can't afford it and die.

There was a recent example, I saw it just once but can't remember the detail. A company jacked up the price of a recent drug claiming R&D costs, but the R&D had been paid by the US taxpayer, not the company.

So pardon me but when i see R&D as the reasn for a price hike I'll need some convincing.

[Viking01]

Pharmacaeutical manufacturers in the US regularly claim R&D costs are expensive.

...

There was a recent example, I saw it just once but can't remember the detail. A company jacked up the price of a recent drug claiming R&D costs, but the R&D had been paid by the US taxpayer, not the company.

So pardon me but when i see R&D as the reason for a price hike I'll need some convincing.

Afternoon.
Yes, you mentioned three good recent examples. Thanks.

1. Political Parties
Drug pricing has been a well known issue, as far back as the Obama administration with its modest efforts - via Obamacare - to address increasing US drug and health costs (whilst not fundamentally addressing the mechanisms affecting drug pricing).

Not that the situation improved during Trump's turn in office:
https://www.counterpunch.org/2018/05...ump-delivered/

And the signs are currently not good for the US consumer, given recent internal Democrat divide:
Biden
https://www.commondreams.org/news/20...dying-medicare
Sanders
https://www.commondreams.org/news/20...eals-high-drug

2. State and Consumer Pushback
In the past few years, if it hasn't been US state efforts to address the (then) growing opioid epidemic in the US, it has been states filing lawsuits to try and rein in the costs of common prescription drugs (as well as address issues such as drug price fixing across Big Pharma companies)

https://www.bbc.com/news/world-us-canada-48241663

3. Congressional Oversight
A US Congress oversight committee this year sought to take US Big Pharma companies to task during two day hearings. Mind you, the CEO's of such organisations no doubt receive substantial bonuses for their actions, and their skins are bound to be sufficiently thick to handle the occasional senatorial inquisition. If that is what you can call it.

https://www.commondreams.org/news/20...rofits-expense

The above also contains a link to a report on various questionable Pharma industry practices, and makes interesting reading (if you have the time and inclination).

The following related link also makes mention of some other egregious drug pricing decisions (i.e. Teva’s multiple sclerosis drug Copaxone, and Celgene’s repeated price hikes for the cancer drug Revlimid):

https://www.nakedcapitalism.com/2020...ug-prices.html

One could also mention another recent cancer drug example:

https://www.greanvillepost.com/2019/...s-and-charity/

4. Initial Publicly Funded R&D Efforts
Considerable US taxpayer funding goes into original initial R&D efforts to identify candidate drugs, which many US Big Pharma companies are able to then develop further and take to market. The last section (6 paragraphs) of the following link probably capture the nub of drug pricing setting and regulation for the US consumer.

https://www.nakedcapitalism.com/2020...st-decade.html

---------------------------------------------------------------------------------------------------------------
[Edit]
Forgot to also add the following:

Twenty Top Selling Drugs - US Revenues Greater than ROW
https://www.citizen.org/news/report-...orld-combined/

Public Desire for Federal Government Drug Price Negotiation Powers
https://www.kff.org/health-costs/pre...ents-about-it/

Lobbying Industry
https://www.dailyposter.com/big-pharmas-reward/

[TheDemonLord]

Afternoon,
Appears that the western Big Pharma companies producing Covid vaccines have been very well incentivised to date.

https://www.greanvillepost.com/2021/...l-vaccination/

Cheers,
Viking

The private sector finding ways to profit from Public Policy?!?

Imagine my shock!

[TheDemonLord]

Pharmacaeutical manufacturers in the US regularly claim R&D costs are expensive. Often though the price is jacked up massively by a new company having taken over the manufacturing rights and jacking up the price. No R&D there. The most egregious example was Martin Shkreli, a hedge fund manager, who bought the company that manufactured Daraprim an anti parasitic and jacked the price up 2000%. He had been involved in some fraudulent activity and needed lots of cash urgently. The law caught up with him on the securities fraud and he was sentenced to seven years.

Then there was the Epipen drama. Mylan bought the rights off Merck, famous as manufactureres of Ivermectin, and jacked the price from 98.38 for a pair (you can't buy just one) to US$608.61. IIRC the CEO received a bonus of 600 million. There was some blowback when it became public knowledge that said CEO was US Senator Joe Manchin's daughter. Yes, that Joe Manchin. No R&D there either.

Then there is insulin. The use of insulin for treatment of diabetes was introduced 100 years ago. The people who originated it gave it to the world no charge so that everyone who needed it could have it. R&D costs should be zero or close to it now, but the price went up massively. It seems that the price went up simply because the people who need it will die if they don't get it. Some pay, some can't afford it and die.

There was a recent example, I saw it just once but can't remember the detail. A company jacked up the price of a recent drug claiming R&D costs, but the R&D had been paid by the US taxpayer, not the company.

So pardon me but when i see R&D as the reasn for a price hike I'll need some convincing.

(I'm sure someone is going to mention the guy that bought the company and then jacked the price up by like 1000%).

I'll grant you lots of scummy business practices - I never said that R&D was a reason for a price hike, only that it is reasonable to include it in the final price of a drug or vaccine.

[Viking01]

The private sector finding ways to profit from Public Policy?!?

Imagine my shock!

Think that there is a slight difference between profit and profiteer. If excess profit was not being earned, then there would be little benefit in share buyback.

Between lobby groups, "captured"politicians and weak legislation, seems that the US consumer will continue to pay excessive health costs for the foreseeable future.

[pritch]

The two recalcitrant Democrat US Senators, Manchin and Sinema are bought and paid for. The Manchin family owns a coal business but he has been receiving donations from fossil fuel interests. Sinema, currently 'fund raising' in Europe, has been receiving donations from big Pharma. The donations were relatively modest, Sinema is cheap.

[TheDemonLord]

Think that there is a slight difference between profit and profiteer. If excess profit was not being earned, then there would be little benefit in share buyback.

Between lobby groups, "captured"politicians and weak legislation, seems that the US consumer will continue to pay excessive health costs for the foreseeable future.

Sounds like the beginning of making the case for limiting Government intervention and powers on the idea that they invariably become Corrupt

[Viking01]

Sounds like the beginning of making the case for limiting Government intervention and powers on the idea that they invariably become Corrupt

Afternoon.

As opposed to placing restrictions on lobbying and enhancing legislation ? Chain duly pulled.

[TheDemonLord]

Afternoon.

As opposed to placing restrictions on lobbying and enhancing legislation ? Chain duly pulled.

'Legislation has created problems and Corruption!

How shall we fix it?

MORE LEGISLATION!'