Hacker News Reader

Comment by necessity | Hacker News Reader

The drug from the original company is expensive everywhere, what India has is generics, which in their turn might lower the price of the original drug because of the competition. It also lowers the incentive of selling the original drug there at all (and consequently allowing the government to press for agreements). I have some unpopular opinions regarding the subject...

View on HN

Actually, India basically refuses to recognise patents for a wide variety of pharmaceutical products. For a long time they refused to recognise patents for drugs that combat AIDS and a thriving market for generics sprung up.

There was a lot of posturing and complaining by pharmaceutical companies in the U.S. and the U.S. Government tried to heavy the Indian Government, but to no avail.

When it became apparent that the Indians weren't going to budge, and with a growing realisation that other nations would ether do the same thing or import their drugs from India, the companies agreed to drastically reduce their prices on "humanitarian" grounds. Now they still make massive profits, just they are less massive than they once were.

This is now happening with academic research.

Nobody will shed any tears because greedy multinationals make a lower profit to ensure less people die from disease. Nobody will weep over Elsevier's reduced earning if it frees up necessary information and research findings so science can progress for the benefit of all mankind.

The entrenched interests of rich, arrogant corporate executives and business owners in first world nations are finally being disrupted by poorer nations who don't care about this group of people. But that's what happens when you gain an attitude on I weaning entitlement - you eventually overreach so far you come undone, and nobody feels any sympathy when it happens.

While I tend to lean more to your side of the argument, the devil's advocate in me has to point out the fact that you leave out the massive costs of research, development, clinical trials / fda approval, etc. that go in to getting a drug to market.

This not to mention all the extra capital needed to fund research into all of the drugs that never make it to market before a company finds something that works.

This ignores the fact that the expensive, risky research is often funded by public money instead of by the pharmaceutical companies. So, the taxpayers pay for the research until it shows progress. Then it gets patented and sold to a large company which sells it back to the public for $1000/pill.

It's a pretty gross abuse of the original idea of patents.

The expensive, risky part of drug development is not the portion that is publically funded. Yay! You've found a compound that appears to shrink tumors when directly applied to them on glass slides.

Now, figure out what the correct dose is, how to get it into a mammal so that it's not metabolized into uselessness, how much you can safely give the mammal.

Now, start again with humans and hope you don't get to the final stage only to find out that it's not as effective as existing treatments or has side effects that will open you up to lawsuits.

Finally, once you've done all that, scale out the production of your compound such that you can prove that every dose meets FDA quality requirements.

To be fair the risky research side is relatively low cost. It's the development part - putting drugs through clinical trials that costs a hell of a lot. And its usually drug companies that pay for that.

Given that people would still die or become very sick from disease, I think that medicine would progress - whether at the same rate, I'm not sure but given Western nations other than the U.S. pretty much all don't have hangups about their government funded health systems, I suspect it wouldn't be all that bad.

I'm fairly sure most drug companies now spend more on marketing than on R&D/testing.

If you're going to parrot Marcia Angell, at least get the substance right: They spend more on marketing and administration than they do on R&D. Where "administration" is stuff like IT, HR, etc.

I've never read her work, so I'm hardly parroting her. IIRC I've read about this in a few news articles about pharma finances, and in Ben Goldacre's "Bad Pharma". I don't know whether the marketing/sales figures include administration, but it does appear to be true, and I'd be inclined to think it's bad...

Most drug companies sell generics because they don't want to enter costful R&D game.

Or they try to prolong their patents or very slightly change the formula of an existing drug so they can patent it again: https://en.wikipedia.org/wiki/Generic_drug#Prolongation

One of the problems with the patent system is that it pushes medical research in the direction of drugs because they are easier to market than alternatives such as knowledge of medical procedures.

There still needs to be incentive to lower the cost. For example, to lower costs of clinical trials, companies can invest more in computer simulations and find other ways to reduce those costs. Also this might also force big pharma companies to collaborate more with each other rather than re creating the wheel.

This is one of the "problems" the TTIP attempts to "fix", isn't it ? That Indians get access to cheap medication.

https://donttradeourlivesaway.wordpress.com/2015/10/20/how-t...

The future lies in "biologics", which unlike small-molecule compounds, cannot be (that) easily copied/manufactured. Initial and continuous capital costs prevent easy "piracy" and that is where the majority of large-pharam/biotech R&D is headed.

Reply on news.ycombinator.com