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Comment by Torai | Hacker News Reader

> I'm interested in what ideas others might have though.

I'm not from the US, but I think there is enough people already, all pointing out in the same direction:

http://www.motherjones.com/politics/2016/09/opioid-lobbying-...

Over the past decade, pharmaceutical companies have spent more than $880 million on lobbying and political contributions at the state and federal level. That’s more than eight times what the gun lobby and more than 200 times what those advocating for stricter prescribing rules spent over the same time period. The makers of prescription painkillers have adopted a 50-state strategy that includes hundreds of lobbyists and millions in campaign contributions to help kill or weaken measures aimed at stemming the tide of prescription opioids

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The United States alone holds over 45 percent of the global pharmaceutical market [1]. And less then 5 percent of earths population. Welcome to the society of pharmaceutical addiction.

[1] https://www.statista.com/topics/1719/pharmaceutical-industry...

You're comparing a measure in dollars with a measure in people. Yes, per capita expenditure on prescription medication is high in the US. Most other countries have a national health care system which negotiates the price for the whole country. The US market is where pharmaceutical companies expect to recoup their R&D costs, which makes drugs more expensive in the US than anywhere else. This effectively means that the US subsidizes drug prices for the rest of the world in exchange for determining which drugs are safe for humans (via the FDA) and getting slightly earlier access to newly developed drugs.

> You're comparing a measure in dollars with a measure in people.

I'm not parent, but I'm sure this is intentional as the consequences of such a scenario are easy to extrapolate...

> The US market is where pharmaceutical companies expect to recoup their R&D costs.

They could do this in two ways - having high margins on their drugs, and/or selling a lot of drugs. It is no surprise to see pharma lobbying against tight laws on prescriptions, or anything that gets in the way of the 'market' getting access to their products. Not coincidentally, the opioid crises means they get to sell more drugs.

I think that they have both high margins on drugs (my gut estimate would be ten times what the rest of the world pays, but it looks like it is ordinarily only 2-5 times [0]) and they're selling a lot of drugs. It is disingenuous to claim that the US consumes 9 times more prescription drugs than the world average. The reality is probably closer to 2-5 times more drugs and that these drugs are 2-5 times more expensive by virtue of being sold in the US.

[0] https://www.vox.com/a/health-prices

Price difference may be a valid argument.

On the other hand in my home country we had some big pharmaceutical companies (compared to the size of the country) exporting drugs world wide. I thought that for example the pain killers I knew as I child would be used everywhere on the world. When I moved to Germany I realized that I was wrong. There are tons of different drugs for the same purpose with the same ingredients sold by different producers. Therefore only becasue you in the US buy some expensive - and highly addictive - pain killers you are not automatically financing the R&D of pain killers sold in Europe by Europian companies to the Europian people.

Let me be a smart ass and improve your calculation:

45% of drug revenue is generated by 5% of earth's population:

45% / 5% = 9

but you do not compare this number to 1 but to

55% of drug revenue is generated by 95% of earth's population:

55% / 95% = 0.58

So a US citizen spends 9 / 0.58 = 15.54 more on drugs as a non US citizen. Even if price difference is a valid argument, this number is still too high.

I would restate that to the "US market is where pharmaceutical companies like recoup their executive officer costs, which makes drugs more expensive in the US than anywhere else. The US subsidizes executive salaries for the rest of the world..." http://www.ibtimes.com/healthcare-pharma-ceos-paid-more-top-...

That, and criminalizing drug use. When people can no longer get access to or afford pharma drugs, they shift to illegal drugs. Once they are hooked on that, they are criminals, and they hide their problem, out of shame and fear or prosecution.

This. Anecdotally I know a friend whose doctor offered a potentially addictive medication, when the doctor knew or at least was told the friend drank frequently. The friend did not fill prescription for fear it would become addictive.

Did the doctor just say "Here, have these drugs" or did he/she prescribe the "potentially addictive" medication for a medical issue that should have been treated with that medication? Just not taking medication that your doctor thinks is necessary is not a good choice; you rarely know more than your doctor about the risk/reward profile of the medication.

That's not true at all. Drug companies bribe prominent doctors with multi-million dollar payments to convince other doctors that drugs are safer and more widely applicable than they actually are. If you refuse to take an opioid painkiller for fear of developing addiction, you are empirically demonstrating that you know more care more than your doctor about the risk/reward profile of the medication.

http://www.nybooks.com/articles/2009/01/15/drug-companies-do...

Hydrocodone costs like $3. Drug lobbying is a problem, but not this one.

What if you are actually in pain? In that case, it might be fully rational to take the potentially addictive opioid painkiller, despite the possibility of developing an addiction.

I agree that the lobbying is a huge problem, but exposing/stopping that is a sociopolitical approach to the problem, not a scientific/technological approach. I am skeptical that the latter can do much for this problem, but I'm curious if others have ideas on that front.

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