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Comment by munk-a | Hacker News Reader

I disagree strongly with that, raising the price of a drug beyond the point of being able to sustain production of it is an ethical minefield, you are disqualifying some patients access to the drug by doing so and you're increasing the burden on patients that can afford the increased price. In our modern world we're pretty happy to excuse moves like this as "market effects" and ignore the real cost of them but there absolutely is a real cost in terms of the quality of lives other human beings are able to lead.

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I'm sorry but you act like the insurance companies weren't the target of his scheme and not the patients. Why do you think he got hit so hard? It's because his scheme was effective. I wouldn't be surprised if the insurance companies helped bankroll the investigation and prosecution at the start. He would even give the drug away for free if they couldn't afford it. The same thing goes for other specialty HIV drugs like truvada.

It's like the old saying about Russian vs. American missiles, "The Americans build a bomb that can flatten a one mile radius and drop it on the target, the Russians build a bomb that can flatten a ten mile radius and drop it near the target" his offer to "give away the drug for free if they couldn't afford it" wasn't realized, he may have intended it but people off insurance that didn't qualify for medicaid price reductions got hit with the full price - additionally insured customers who were getting the low out of pocket price were still being penalized for requiring such an expensive drug. The system is broken, absolutely, but that doesn't give him a get-out-of-ethical-violations-free card.

There's a sibling post I wrote with my personal experience dealing with the ridiculousness of drug pricing, these tricks and games do hit people.

> I'm sorry but you act like the insurance companies weren't the target of his scheme

They weren't; insurance company profits are limited to a percentage of reimbursed costs, so the insurers were incedental beneficiaries of the scheme.

The targets were insurance premium payers.

What you said is not entirely true. Daraprim (the drug you are referring to) costs $10 out of pocket for insured patients. For uninsured low income patients it's free of charge.

My line of work makes me pretty familiar with the insurance market, there is no way a drug manufacturer can ensure $10 out of pocket, they can lobby for certain drug level coverage in formularies but where they land and what those levels translate to in terms of cost is up to the drug company, ways around this that have been tried (drug companies offering manufacturer rebate coupons to lower out-of-pocket costs) can be countered by insurance companies refusing to cover costs that a rebate would cover or refusing to cover any costs without the rebate being activated...

What you said is not an achievable statement.

From what I understand only the patients insurance would have to carry the extra costs, those who were unable to pay up were given it for free.

Insurance companies are not a charity. Of course you're paying the cost. You just pay it in higher premiums.

That's possibly true, I don't know much about the American health care system however I can't imagine they would significantly raise the cost of your insurance plan beyond what you're able to pay because you needed a 2 week supply of drugs to treat a one-off parasitic infection.

If the American health care system is so broken that insurance companies are making people destitute for receiving care then the USA has bigger problems than a single CEO.

That is unfortunately exactly what is happening, as an example here's an article from back in 2018 about the 650mil being independently raised on GoFundMe to address inflated costs.

https://www.forbes.com/sites/carolynmcclanahan/2018/08/13/us...

"If the American health care system is so broken" – yes. yes it is that broken.

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