The answer is that our insurance and medical billing system is a complete tirefire and needs to be burned to the ground and replaced with something sane.
But again mostly you need to get your drugs in the day.
Similarly, if you really wanted to subsidize pharmaceuticals for the rest of the world (and I'm not convinced you actually do) then again, hiding the cost in the pills, is a silly way to do it.
If on the other hand, you wanted to charge as much as you could get away with, and could pay off politicians in order to be allowed to take advantage of sick customers to line your own pockets then putting that in the cost would make perfect sense.
oh, you can: https://www.youtube.com/watch?v=FoU_9G1Ae_I
I'm surprised you don't remember the reason because it was in the news 24/7. It's because insurance costs 10X for sick people (because they also draw 10X in insurance), those sick people could not afford their insurance, and the ACA gave those uninsured sick people deeply subsidized insurance, raising the average cost to insurance companies of each insured person
Is that before or after the sticker price that hospitals give insurance companies?
I'm not sure anyone can get accurate prices, so I'm immediately distrustful of your 10x number.
sol_remmy seems to be making the case that lots of sick people didn't have coverage before ACA (Which would be a massive plus point for it if true) and that the number of new sick people buying insurance outweighed the number of new young, healthy people entering the pool, driving costs up.
There seems to be a lot of conflicting info on this, but at least Brookings made the case that the expected effect of ACA did actually happen, lots more people started paying for insurance and the average cost paid by individuals therefore went down (even while the average coverage they could recieve went up).
So we seem to be talking about the same thing, just with radically different facts about the same situation.
There is a very real and obvious reason. Thanks to the ("Affordable" Care Act, aka Obamacare), insurance companies have a captive audience of citizens (but interestingly, not illegal aliens) who MUST purchase their insurance product under threat of fine/imprisonment. There is no incentive to lower prices in this arrangement, and the insurance companies are immune from the pressures of a true competitive marketplace. The insurance marketplace is the equivalent of a prison commissary.
Americans should feel good about high drug prices: that's your aid to the Third World right there. Not the most efficient technique but still better than not doing it at all.
It's unclear to me why another drug manufacturer doesn't come in and undercut the price. This is what happens in most other industries. My gut suspects the arduous FDA approval process, but I have no real evidence for this hypothesis.
From the sound of things these diseases were until very recently isolated to poorer countries. Even today, with the increased number of cases, there might not be enough money to be made based on a few sick North Americans to justify tooling up to make a new drug. (Some of that is about FDA regulatory approval, but not much since it's not a new drug. They'd be manufacturing something that has already been tested and approved.)
Ideally the drug company making this thing would just stop being boneheads about pricing. Having this in the news will probably help.
The article also says albendazole, the drug in question, can be purchased in the UK for $2. Why can I not start a pharma company that A) imports albendazole (and other rare disease drugs) from the UK and other 1st world country at a reasonable markup or B) orders albendazole, and other rare disease drugs, from the same manufacturer that makes it for the UK, and other 1st world countries, at a reasonable markup?
I'm genuinely curious about the regulatory landscape of that question.
If you add burdensome regulatory costs to some competitors (domestic pills) but not others (foreign pills), the others will win all business. That is an unfair playing field. So part of the deal with regulating drugs in America is that you can't import drugs from other countries.
I think I'd probably allow importation of the exact drug, by the exact manufacturer. Or just set a price control saying you cannot sell a drug for more than 120% of the average price in the EU + Japan + Canada + Australia + NZ etc.
Well, right. It's pretty impossible to justify not allowing importation of the drug for any safety-related reasons if it is literally the same product from the same manufacturer.
1. https://www.unitedpharmacies-uk.md/Zentel-Albendazole-400mg-...
I think this is silly. We don't expect that companies "stop being boneheads" (by which I assume you mean act more ethically) when it comes to the pricing of televisions, or food, or household goods, or practically anything else. Why should we expect it for these pills? That expectation will be doomed to failure in many instances.
A more ideal scenario would be to examine the underlying reasons that allow the company to charge so much for something that apparently costs so little to make. If we can understand that problem we should be able to implement fixes that lead to proper pricing without the expectation that profit seeking corporations will magically decide to forgo profit just to be nice.
Sure we do. Companies react to non-market concerns like ethics, civics, reputation, government and public pressure at the expense of short-term profit all the time, in addition to reacting to market competition.
Even if you accept the notion that the corporation (if it were a person) should be considered a sociopath, it is not at all obvious that market factors or regulation will be as effective in any given case at moving a company's leadership to behave ethically as, say, negative PR that will keep the CEO from getting laid. (not that you'd want to base an economic system on that...)
> A more ideal scenario would be to examine the underlying reasons that allow the company to charge so much for something that apparently costs so little to make.
That is not the important question at all. (do you really want to argue that charging a lot for something that "costs so little to make" is inherently a bad thing?) The important question in this case is why the same company can sell the same thing in two different markets with a 10,000x price difference.
And if the FDA recognized that Europeans aren't particularly dying off from poor quality medicine and maybe we should allow import of EMA accepted drugs then maybe economies of scale would be less of a problem.
Also, it's difficult to acquire approval needed from the FDA to demonstrate the new drug is safe and equivalent to the already approved because the original producer won't cooperate and provide relevant samples to their competition so they can demonstrate equivalence.
This is a commonly cited reason but I don't buy it. They're selling these things for 4 cents in tanzania so we're talking about something that is practically free to make. There are lots of things that cheap where we see competition in the US: paperclips, reams of paper, chewing gum, whatever.
Why is there competition for these things but not cheap drugs?
Situations like these should count as evidence that something isn't quite as it should be.
Is there a chemist in the house? :)
Look for the explanation by Derek Lowe in the linked article. Key points:
> The FDA grants market exclusivity to companies that are willing to take ‘grandfathered’ compounds into compliance with their current regulatory framework.” Once a company does that, it gains an effective monopoly through the "generic bioequivalence" rules.
Setting up the production line isn't the issue, because the pharmaceutical company will outsource the actual manufacturing of the drugs anyway.
He points out that a large % of this R&D cost is actually marketing.
A lot of R&D is also spent on taking existing drugs and subtly changing them so that a non-generic one can be launched.
So it's not as cut and dried as it seems.
The largest expenses are marketing and sales. Doctors won't prescribe drugs they don't know exist, so "educating" doctors about the benefits of a drug is a paramount. Contracts have to be negotiated with all insurance companies, and that's expensive too.
How profitable the business of generics actually is, we don't know for sure. The pharmaceutical industry is notoriously vague about how much profit they make, and the numbers they report are questionable. For instance they'll call market research into which drug to buy next "R&D".
The same tired old and wrong argument. The article clearly states that the patent expired decades ago. So why not read the article and see that this old excuse is WRONG ?
What do you stand to gain by putting out these lies? What will it take for idiots like you to stop doing so??
[Note to "dang" or any other mod: yes, I called this person an idiot. I was trying to be restrained. I am tired of people making excuses for the greed of pharma companies. They always use "recoup R&D costs" as an excuse for price gouging, and killing people.]
(most money is spent marketing the drug, not developing it)
(marketing includes bribing doctors and healthcare systems to prescribe it)