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Comment by dekhn | Hacker News Reader

I work in pharma. Pricing in pharma for drugs like that is complicated. Usually these drugs do actually require rather expensive manufacturing processes, that have to run in extremely large facilities with extensive QA, but in fairly small batches.

More importantly, every major pharma has a compassionate use program that helps people who can't afford the drugs get them, through offsets and credits. I understand the desire to make pharma look like pure-evil profit mongers, but the reality is that this is not an easy business to be in.

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Many drugs invented by US companies are available cheaper in countries that don't respect US IP law (with no differences in quality/QA process/etc). The reason for this is obvious: in the US the government gives the inventor a temporary monopoly.

It's pretty widely accepted the presence of this government-enforced monopoly significantly increases the price of many drugs.

The standard argument in favor of this is that it incentivizes R&D and we wouldn't have these drugs otherwise. I think it's debatable either way, but claiming these companies don't take advantage of this arrangement to increase prices is not true.

The price of drugs in US also reflects expensive R&D and sometimes even more expensive approval process. Plus the companies has to account for the possibility of third parties manufacturing without the license which in turn requires higher unit price.

This is nonsense. Most Western nations fully respect IPR and patents.

There is nothing wrong with patents "promoting the Arts and Sciences".

The problem in the US is that your largest buyers (Medicare, Medicaid, VA, Tricare) aren't allowed to properly use their buying power to push pharma companies on prices.

At the same time, there's very little restriction on pharma companies advertising directly to patients (banned in most nations) which puts pressure on GPs and specialists to over/off-label prescribe unnecessary pharma.

Prices in most countries are cheaper than the US because of that buying power that the government has, along with independent assessment of the value of new drugs and treatments in terms of QALY and cost/benefit to the people.

I am not aware of any large-scale alternative manufacturing facilities that explicitly avoid IP laws and market their product legally. Can you give an example?

I work for a US biotech that is wholly owned by a EU pharma, not the US.

It's the scandals on stuff like Albendazole that make y'all evil, not the cancer drugs. I mean the FDA forces us to live like we are in some Soviet style dystopia. Some ancient commodity antiparasite drugs that are cheap as salt -- so abundant that people literally use them as a drench on livestock -- can only be bought from one or two approved marketers (manufacturers), through only approved distribution channels, only at approved retailers, after unnecessary high-skilled laborers press some buttons, and only after you have the right script from the right gatekeepers.

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