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Comment by alexosh1 | Hacker News Reader

Ideally yeah, would be good if we didn't need to exist. There are a variety of policy initiatives the US could likely implement to bring costs down. My kind of mindset with the company though is I am a nobody from nowhere, and congress isn't going to listen to me. I can make cheap / sell medicine at an affordable price though. So I will do that.

I'm not sure drug importation will work though, not because it's a bad policy per se, but I'm not sure that other countries will let the US import their low-cost medicines if US law changes in order to protect their domestic supplies.

There's Canada as an example case. We have ~10x the population of Canada, and California alone could use up all of Canada's medicines. Not sure Canada would go for it.

Think it's worth a shot though. I know there are some trial programs going into place in Colorado and Florida around allowing drug importation. Will be cool to follow and see how they play out.

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Makes sense, I always appreciate healthcare companies that capitalize on bad laws saying that ideally they wouldn't exist and they're trying to work within the existing framework.

Cross-border drug buying works well in the EU, where any European country can buy drugs from any other European country, so whoever has the lowest price usually wins the market.

As a private company, your incentive is to maximize profit for shareholders. Since all you have to do is undercut high drug prices a little, what will stop you from the same price gouging that all other US drug companies perform?

Well, there's some technical measures we've taken and some practical ones to ensure we work to be profitable but remain focused primarily on improving public health and helping patients.

On the technical level, we incorporated as a public benefit corporation, so we are judged not only on how profitable we are for shareholders, but how well be maintain our social mission. That is actually in our charter documents and is a legal requirement.

On a practical level, Mark Cuban is our lead investor and his interest is very much focused on helping people and fixing system issues in healthcare. We also did some screening to ensure our other investors are socially minded and prioritize social benefit as well as profits.

My mindset is that we need to be profitable to be sustainable and grow enough to help the overall system, but we won't be extortionate.

> On a practical level, Mark Cuban is our lead investor and his interest is very much focused on helping people and fixing system issues in healthcare.

Also he got to write his name on it

I wonder how much credibility his name adds in the short term. People might take it more seriously if it's backed by someone with a reputation.

In the longer term, success in the health space could add prestige to his name, ala the Nobel prize.

Yes, I agree with both. Seems win/win, and a much better claim to fame than putting radio on the internet! ;-)

The only reason I clicked and am reading these threads right now is because I was curious why he put his name on a drug company.

Even more importantly, the company got to put his name on it.

Nice! We had Obamacare, now we get MCubanocare?

Obamacare actually increases the cost of drugs. Here is a study showing the comparison adjusted for inflation.

https://pubmed.ncbi.nlm.nih.gov/28224469/

For some single source drugs the suppliers absorbed some of the subsidies, while others and generics were cheaper for consumers. It is unfortunate that sometimes customer facing subsidies get abused by single source suppliers.

This study is not about drugs per se, but only some oncology drugs that were popular in 2006. It even states "however, generic oncology drug prices showed no significant changes" in the abstract.

That’s selective quoting. The study states in the abstract the top selling drugs saw price increases. Here is the full abstract.

> The results show that the average annual price of top-selling cancer drugs in 2006, adjusted for inflation and secular changes in drug prices, have increased by US$154 and US$235 for branded and competitive brand drugs, respectively, following the 2010 ACA; however, generic oncology drug prices showed no significant changes.

The top-selling branded drugs price increased. Generic drug prices (the relevant comparison to Cuban's Cost Plus) showed no significant changes.

Probably more "the company begged someone of high visibility to write their name on it".

Cost of advertising is a serious problem for generic drug makers. There are a lot of drugs where there exists an identical, cheaper, generic version, but the more expensive one gets sold because neither the doctors nor the patients have any idea that it exists. Hence all the "ask your doctor for x" ads, but the problem is that advertising on that scale, especially for low-incidence conditions, is very expensive compared to the amount of money you make, an so will result in just another expensive drug.

A celebrity putting their name on a drug company and then maybe mentioning it a few times publicly in places where normal people hear about it may make people who are facing very expensive drug bills look up the site and see if they make something useful for them.

If there’s an actual generic (e.g. Naproxen Sodium :: Alleve), then your doctor just has to ensure that the Rx isn’t “fill as written”. The pharmacist can then offer you options (Namebrand at X times 5 or generic at X)

If it’s the case where there’s an older generic and a newer product still under patent, that’s a discussion with your doctor: Is the newer product worth the money, or should I stick with the older thing?

Can you put your email in your profile please? Reaching out from working at a healthcare company now.

You can find it at the top of the thread: alex@costplusdrugs.com

In Italy our representatives negotiates the prices of the important drugs with the pharmaceutical industry, and they have little or no cost for the individual. There are always some very annoying exceptions, of course, but that's the general rule. We all take it for granted and demand it, doesn't matter the political orientation. I think your representatives are not doing a good job (not that ours are better, eh;), and makes me wonder what you vote for, if not for this basic things.

> There's Canada as an example case. We have ~10x the population of Canada, and California alone could use up all of Canada's medicines. Not sure Canada would go for it.

Depends on the country. For example India is the largest generic drug manufacturer and has a population of over 1 billion, and they already export their drugs to many countries.

Would it not be somewhere in the middle though? Instead of completely saying yes or no, maybe Canada would say "We'll allow you to purchase X% of all drugs produced in the country, as we need to hold onto some, but we'd love it if you'd buy the surplus."

Canada produces very little. They are importing it from the big manufacturers. Last time importation from Canada became an issue the companies just said to Canada “we’ll sell you what you bought last year plus 5%.”. Then Canada got to choose - give those drugs to Canadians or sell them to the US. But they can’t do both.

> We have ~10x the population of Canada, and California alone could use up all of Canada's medicines. Not sure Canada would go for it.

Couldn't Canadian drug companies increase supply if the demand was there? In the short term, sure, they would not be able to handle our level of demand, but unless there's some constraint I'm not aware of they could always just scale up and make more animal insulin or whatever.

They don’t make the drugs in Canada. They buy them in the open market, likely from us.

It's sort of the open market.

The history is that Canada used to have "compulsory licensing" for patented drugs. Anyone could manufacture a patented drug in Canada and pay a ?6?% or whatever royalty to the patent owner and they just had to deal with it.

Over the years, first 4, then 10 years of exclusivity were provided to the patent owner.

Then the WTO came along, and presently, everyone has agreed to ~20y exclusivity and charge/pay the median price of OECD countries before it's a royalty-free free-for-all.

http://publications.gc.ca/Collection-R/LoPBdP/BP/prb9946-e.h...

Canadian generic drugs today aren't usually cheaper than US generics, except where patent exclusivity mismatches.

India would go for it without even noticing I guess.

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