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monkburger

Big Pharma's profits are a result of taxpayer funded research via the NIH and others for drug discovery.

https://www.ineteconomics.org/perspectives/blog/us-tax-dolla...

Big Pharma has a very powerful lobbying arm that is against Medicare negotiating down prices.

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> Big Pharma has a very powerful lobbying arm that is against Medicare negotiating down prices.

I particularly liked how all the Congresspeople involved in writing that the government couldn't negotiate drug prices into Medicare Part D immediately retired and went to work for the drug industry.

When faced with a regulatory issue in the USA, I often look at EU regs for reference. Here is their inquiry on the "revolving door" issue:

https://www.ombudsman.europa.eu/en/decision/en/155953

Weird how it’s framed as an issue of reputational damage. Ctrl+f “corruption”, 0 results.

It’s much easier to tackle the “appearance” of corruption than actual corruption because it changes the burden of proof and doesn’t imply wrongdoing.

> I particularly liked how all the Congresspeople involved in writing that the government couldn't negotiate drug prices into Medicare Part D immediately retired and went to work for the drug industry.

Wow that is wild. Could you share a source for this? I would love to look further into this.

That's a pretty standard practice in tobacco, banks, drug companies... Search for revolving doors <industry name> and you will find books and documentaries and articles ...

And let's not forget communication companies and the FTC.

I’m sure you meant “FCC”.

Yes, thanks!

What’s even funnier is this apparently powerful lobbying arm didn’t stop Congress from passing a law..that allows Medicare to negotiate drug prices.

https://www.cms.gov/inflation-reduction-act-and-medicare/med...

If it took two decades from the creation of part D and a worldwide pandemic/financial disaster just to allow for price negotiation, I see that more as evidence of power rather than weakness. Good that it finally changed though. Democrats also put price caps on insulin which seems nice for diabetics.

Well the kicker is that Medicare never paid the list price anyways. There are a ton of mandatory discounts the government gets.

With Part B, Medicare pays average selling price, which is the average price private insurers pays. Then add on top 340B discounts which many hospitals get, which knocks another 23.1% off plus penalties for price increases above inflation (Google "340B penny pricing", many hospitals only pay $0.01 per unit of drug).

With Part D, the government doesn't pay for drug anyways. Private insurers do the negotiating on behalf of he government.

Then look can look up VA pricing (24% off at a minimum). Medicaid gets "best price" which is the lowest price the drug sells for anywhere.

So the government has "negotiated" (by fiat) plenty of discounts. But saying "Medicare doesn't negotiate drug prices" makes plenty of political hay, and while technically true, doesn't really explain the prices the government gets.

> Medicaid gets "best price" which is the lowest price the drug sells for anywhere.

I'm guessing you mean anywhere in the US. Apparently Florida is currently pushing to import drugs from Canada.

https://www.reuters.com/business/healthcare-pharmaceuticals/...

Yes anywhere in the US. Private insurers often get discounts of 50%+, which then Medicaid gets.

And sure Florida can try to import Canadian drugs. They tried that 20 years ago.

The companies capped sales to Canada at no more than 10% of last years sales. Canada then put export restrictions in place to put prevent shortages.

The US government has talked about price referencing Europe. Which would actually be great. Companies would be forced to increase European prices and lower US prices.

I often find myself saying the US should do things like they do in Europe, but I'm told it's impossible for one reason or another (American Exceptionalism in some form or other no doubt), so that does have an appeal to me at least. I wonder though, given that these companies are generally (all?) for-profit entities, what stops them from raising prices in Europe now? It's always seemed a bit grim mixing market economics with human morbidity and mortality, but I would think the upshot is that you can really squeeze people for lots of money when their life is on the line.

Most European countries impose some form of price fixing on pharmaceuticals. The details vary by country but this is often done based on an economic value calculation, such as the number of quality-adjusted life years (QALYs) that the drug would add for a typical patient. It's not impossible to do this in the USA, at least in the sense that it wouldn't violate the Constitution. But if would somewhat slow down the pace of new drugs. The US pharmaceutical industry launches far more new drugs every year than all of Europe, largely due to the outsize profit potential in the US domestic market. With price fixing we would lose out on some percentage of those new drugs.

I have approximately zero interest in new drugs, but better drugs would be great. Is that the case? My impression is that the latest two blockbuster drugs that I’m aware of - mRNA vaccines and GLP1 agonists, had substantial European development, such that Novo-Nordisk is substantially impacting the GDP of Norway today.

> Norway

Denmark, not Norway.

    Novo Nordisk's market capitalization exceeded the GDP of
    Denmark's domestic economy in 2023, and it is the highest
    valued pharmaceutical company in Europe.

https://en.wikipedia.org/wiki/Novo_Nordisk

This is a wildly uninformed view.

They do raise prices in Europe. And what happens? The government says “no” so patients don’t get access.

Or the companies just don’t launch the drug at all.

https://www.pmlive.com/pharma_news/bms_will_not_launch_cance...

Bristol Myers Squibb (BMS) has decided against launching its cancer drug Opdualag (nivolumab and relatlimab) in Germany due to pricing pressures.

Oh I was just curious about the logistics of raising prices in Europe in order to lower them in the US; as you say, it doesn't seem so simple.

I wonder, how much does this Opdualag cost and how much benefit does it provide? My naive reading of your article seems that it adds an average of 3 months to the average patient's life? Here the math is quite simple but grim - how much would you pay for 3 more months of life?

It is true that pharma companies take advantage of publicly funded research, but from there to brining a new drug on the market it takes further 10/15 years and 100s million dollars of R&D. A large portion of the cost comes from the fact that most of these projects prove infeasible and are abandoned during development or later during trials.

The vast majority of this effort remains unpublished, so I am not sure that the article you cite supports your argument. Most of the research mentioned in that article talks about possible associations between target and disease, which is just the earliest step of drug development.

It's way more than hundreds of millions, it's now well over a billion and most of it by a large margin goes into failed programs. Though it does seem to be getting better (or getting worse more slowly?) recently.

https://media.nature.com/lw1024/magazine-assets/d41573-020-0...

https://en.m.wikipedia.org/wiki/Eroom%27s_law

There’s huge incentives to pad R&D spending numbers, so it’s important to consider the underlying reality here.

“In many cases, the estimated cost of capital can be substantial, representing almost half of total development costs in some recent estimates.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8855407/

Cost of capital makes sense in terms of ROI calculations, but it’s not going to show up as a line item on annual budgets. Similarly R&D at drug companies isn’t all drug development R&D.

I think the point of the article is that R&D is not the actual source of the cost for developing new products.

Forest for the trees. The main point of the main article still holds true:

Big Pharma (and Big Everything, really) consistently spends more on executive compensation and shareholders than R&D. And to the commenters' point, maybe if they put more of that in R&D, we'd have more promising and successful targets

Dividends are not spending. It’s just the shareholders taking money they own.

Money they own because the profits of the company far exceed the R&D costs.

There's a pretty nice article on this topic here. [1]

Shareholders do not own companies in any, way, shape or fashion, let alone owning the profits of a company. Shareholders own a right to vote on company matters and have certain privileges based around such, but increasingly often they don't even really own that in any meaningful way. Google, Facebook, and many other companies use tiered shares, where the executive owners of the company grant themselves shares with orders of magnitude greater voting power, generally enough for majority control. So the shares everybody else owns serve little purpose other than speculation.

In any case this is a [somewhat interesting] red herring. The issue is that big pharma profits are already very large (and in fact COVID sent a number of big pharma execs into the billionaires club) and so public funding serves little purpose other than to further increase their profit margins, which should not be the purpose of public funding - even though in practice it often is.

[1] - https://moneyweek.com/merryns-blog/shareholders-and-the-myth...

The thing is, pharma industry is clearly hugely profitable, so why doesn't the government invest in a wide shotgun approach to fund half (or more) of the entire industry and in return take half (or more) of the profits to either keep as revenue or reinvest in pharma or in other healthcare?

(Obviously theoretically ideal economically would be if the government could just have a socialised department discovering and developing all new drugs needed with no profit margins, but then you lose out on benefits of competition, profit motives etc. so a split model makes sense, where they're still private companies but the gov invests hugely in them - but in return for the fair share of profits, rather than so many current grants where the gov pays funding and it doesn't even get them a good discount on buying the overpriced final drug.

You could say that about any industry.

"The thing is, the S&P 500 is clearly hugely profitable, so why doesn't the government invest in a wide shotgun approach to fund half (or more) of the entire S&P 500 and in return take half (or more) of the profits to either keep as revenue or reinvest in the S&P 500 or in other stock indexes?"

Gov't investment in any industry just because it's profitable is a bad idea for obvious reasons.

Sure, except that investing in the S&P is just artificially inflating the economy as a whole, whereas my suggestion isn't intended to be "this is my advice for the most profitable use of a government $", it's a suggestion for boosting a small part of the economy to speed up the development / progress of new drugs as a societal benefit.

People who defend the huge profit amounts of pharma companies (which ultimately come from consumers needing healthcare, paying either directly or through insurance) say it's fair because of the huge amount they invest to create the drugs, if the government does most of the investing then they can take most of the profits to subsidise free pills for their population. Seems to me like a more direct benefit (in addition to potential economic benefits of boosting investment levels in a high-exporting industry too) than just the government buying S&P500 index funds.

Look what happens to University tuition when the government gets involved with funding. Not saying it would be the same model but I have doubts this could completely take over R&D funding.

define 'hugely profitable' - PFE is one of the biggest, their stock is at about the same price it was 25 years ago, so inflation already made you lose 50% of your money - with dividends maybe you broke even for a 25 year investment. I would not call that hugely profitable.

Why don't we go after the actual 'hugely profitable' companies if that is the goal.

Not ... sure that's the best reductio, since many governments do make broad-based equity investments, via Sovereign Wealth Funds, and it does bolster their long-term financial outlook.

To bring it back to the specifics of the original argument, and refine it a bit, the relevant point is, "If these are such easy profits from doing nothing, why doesn't the government get in on it?" Alternatively, why don't the universities themselves develop drugs to the point of FDA approval and mass marketing?

The unfortunate answer is: it's not actually easy profits. It's highly speculative and difficult work to turn a drug from "supported by university research" to "ready to market to the public". Sometimes universities do try to cover some of that ground though.

I see Pharma more like energy utilities in that they provide an essential service that citizens cannot live without. Therefore maybe they should be regulated like utilities (which are private, or can be private, but their margins are capped and set by the government).

And yet the human race managed to survive for millennia with no pharmaceutical industry at all. The industry as we know it has only existed for about 100 years. While it has been helpful in extending lifespans and improving quality of life, it is nowhere as important as utilities like electricity and water.

The human race also survived without electricity for just as long…

The same government that can't come up with sensible policies to regulate big pharma and gets played by all kinds of lobbyists suddenly is going to figure out how to develop drugs more efficiently than the industry does?

I'm suggesting the government take the role of investor, replacing (or rather, overshadowing) the financial firms & private owners who are the current investors, not taking over the way the companies work.

Could either give a body like the NIH a huge new budget to use for investing in pharma companies, or could pass a law that says any company that successfully raises X money with Y criteria (either in VC, or by IPO, or however) must automatically allow the government to buy x% at the same price (or a slight discount) as other buyers?

And sure, lobbyists, money in politics and quality of current US politicians are a problem to face with pretty much any aspect of improving the country, but I don't think that's a reason to never discuss ideas about how to do so. (Then again I'm not American so I don't have horse in this race, but I feel similarly about my UK.)

Pumping dumb money into a sector isn't likely to translate into profits. It will translate to a bubble and a lot of opportunists taking the money.

It isn't that it is impossible, but it would take a slow start, and sustained experimentation and organizational learning over many years, before the amount of money that could make a dent in the problem could reliably perform well.

All while VCs would be lobbying to end the incursion, and the easier money - therefore lower returns, it would inflict on their territory.

Hugely profitable is perhaps misleading. It’s hugely profitable in the sense that the aggregate profits are high, simply due to both the sheer number of products sold and their high prices. But in terms of profit to expense ratios the Pharma industry is actually at the low end of the spectrum. Most other industries, including tech, are far more profitable in this regard.

I wouldn't call it the low end of the spectrum [1]:

> Pharmaceutical companies had significantly higher annual profit margins than S&P 500 companies for the 3 primary outcome measures of gross profit, EBITDA, and net income (P < .001) (Table 1).

> For pharmaceutical companies, the median gross profit margin was 76.5% (95% CI, 70.3%-82.7%), the median EBITDA margin was 29.4% (95% CI, 26.3%-32.5%), and the median net income margin was 13.8% (95% CI, 10.2%-17.4%). For S&P 500 companies, the median gross profit margin was 37.4% (95% CI, 35.2%-39.6%), the median EBITDA margin was 19% (95% CI, 17.8%-20.3%), and the median net income margin was 7.7% (95% CI, 7.2%-8.2%) (Table 2).

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054843/

Now show me the Sharpe ratio. High risk, high reward

> 100s million dollars of R&D

It is worth noting that a significant portion of the D in R&D is money spent on direct to consumer advertising. This only happens in the USA, as I believe that it is not legal elsewhere.

edit: I am now not 100% sure about this, please see comments down-thread.

are you sure? usually this is counted as marketing costs.

Thanks for checking me on this. It was just what I recalled from memory, but I believe that the following links confirm this.

> The pharmaceutical industry devoted $83 billion to R&D expenditures in 2019. Those expenditures covered a variety of activities, including discovering and testing new drugs, developing incremental innovations such as product extensions, and clinical testing for safety-monitoring or marketing purposes [0]

> $6.56 billion spent on direct to consumer pharma advertising in 2019 [1], with nearly $8.1 billion spent in 2022. [2]

[0] https://www.cbo.gov/publication/57126#_idTextAnchor003

[1] https://www.statista.com/statistics/686906/pharma-ad-spend-u...

[2] https://www.fiercepharma.com/special-reports/top-10-pharma-d...

In "clinical testing for safety-monitoring or marketing purposes", "marketing purposes" doesn't mean spending money on ads and stuff like that, it means doing clinical trials to see if a drug works for a certain disease or population, or to compare their drug against a competing drug, or whatever. This is the insanely expensive research that pharma companies do to see if drugs actually work, that everyone likes to ignore when talking about greedy pharma companies.

Results of clinical trials (if successful) can then be used in ads, but that would not be R&D expenditure.

In fact anything that pharma companies say about a drug must be information from a clinical trial. One of those little surprising but obvious in retrospect facts. Clinical trials must be designed not just to 1) find out whether the drug works, 2) find out whether it’s safe, 3) ideally avoid information that it’s not safe, but also 4) generate the numbers they can put on brochures to compare it against alternatives. Then all of those are balanced against the immense cost (to pharma) and complexity (to pharma, CROs, trial sites, and trial participants).

It’s a ludicrously complex business process.

Hmm, thanks. Now that I search more, I am not as sure of my original point.

However, could we agree that DTC pharma advertising has very controversial benefits for patient outcomes, at best?

I will agree with that, if we can also agree that pharma companies spend tons of money on clinical trials, and it's difficult to imagine where that money would come from if they didn't exist :)

Does it? What would those be?

A huge part of the expense of Pharma is compliance. A simple example of a PC connected some lab equipment. The PC and the equipment have to be validated which means that every step used to install the PC, equipment and software has be in an approved procedure that used to deploy them. Any deviation from that procedure will require a exception reports that will have their own approval process. Once in use every action is performed has a procedure. Any deviation from that procedure will result in an investigation that can be reportable to the FDA etc. Every task done on the system will have a log that has to be manually filled out by an analyst or an admin. There are regular system and user access reviews that are reviewed and approved. Once the system is no longer in use a formal decommissioning has to occur. Date may have to be kept for 25, 40 or even 100 years. Now picture a lab with 100s of systems.

And yet even with that, executive pays and dividends (meaning profits over development) are higher than R&D cost. plus the cost of compliance is still less than human cost in R&D.

Are there any public numbers available on how much of the drug companies expenses is compliance related? Is that bookkept with "cost-of-doing-business" or some other line item?

Current examples I have found:

[1] Eli Lilly, 2022 Annual Report: https://investor.lilly.com/static-files/2f9b7bb1-f955-448d-b...

Significant mentions of "compliance" (most are legal issues). However, a decent number of warning statements about how government compliance will require significant effort. No actual numbers I could find. Main Finanacial is pg 57.

[2] Merck, 2022 Annual Report: https://www.emdgroup.com/en/annualreport/2022/_assets/downlo...

200+ mentions of "compliance" (most are legal issues, it's a lot to check) Pg 148 has "number of self reported compliance violations. Most are fraud or "against company values". 79 reported with 28 confirmed. Main financials start pg 230. There was some about "compliance with audits", yet nothing I could find that was a line item for "government process compliance" or something similar.

[3] Johnson & Johnson, 2022 Annual Report: https://www.investor.jnj.com/files/doc_financials/2022/ar/20...

Significant mentions of "compliance" (most are legal issues, J&J has a "bunch" of lawsuits in Canada vs generics). Could not find a direct reference to cost of government compliance, although I did read a part that implied it seemed to be rolled into R&D somewhere. Financial Statement is at pg 54, although the $ numbers start quite a bit earlier.

[4] Bristol Myers Squibb, 2022 Annual Report: https://annual-report.bms.com/assets/bms-ar/documents/2022-b...

Notably, has a neat list of the main compounds currently under investigation with various groups, and "products in pipeline developments" (basically drug status updates). Only 2 mentions of compliance, both are officers. Financials are pg 40 in the pdf. Also, there is something wrong with their PDF format, because search is very obviously broken (at least on Firefox). So there might be something hiding in there that's just not being searched correctly.

Anyway, best effort for a half hour of avoiding working on anything, and did not find a number source.

Great work, I'll try and take a look at some of the reports over the weekend, you've piqued my interest to dig further

Yeah still though, if we're going to be funding basic research (a necessary though not sufficient step in drug development) then drugs should be affordable, and the government should be able to negotiate on prices.

It's a really odd system at first blush. People pay taxes. Taxes fund research. Research is then developed by private corporations into products that are sold back to the people.

It does solve a few key problems though. If universities and other research institutions were encouraged to bring products to market, they'd change what they work on and how. Basic curiosity driven research would give way to commercially oriented research. Moon-shots that might take multiple decades to develop would be replaced with things that can be brought to trials in just a few years. Brilliant researchers that might have made multiple earth-shaking discoveries over the course of their careers might get bogged down bringing one product to market. There's a lot to be said for insulating academia from quarterly reports.

However, things go awry when corporations that turn government funded research into private profits start lobbying too much and regulatory capture occurs. Even if it takes a decade to turn novel research into something you can buy at a pharmacy, the debt pharma companies owe to taxpayers should not be lost sight of. There should be stringent regulations on how drugs based on public research are priced. Yes, pharma company investments, market size, projected sales, and all that should be factored in, but drugs based on public research should be made available to the public at reasonable prices. That's not happening in the U.S..

Bottom line, public money must come with strings attached that serve the public interest. Pharmaceutical companies should be under heightened scrutiny and regulation because of where they get their IP.

> Bottom line, public money must come with strings attached that serve the public interest. Pharmaceutical companies should be under heightened scrutiny and regulation because of where they get their IP.

Drugs go off patent, and generics don’t have to undergo clinical trials. Sounds like the public benefits quite a bit. After a relatively short period of time (usually 10 years post FDA approval) a generic comes in the market for a fraction of the price.

The problem is, once a drug gets approved everyone thinks they are entitled to it. It is fundamentally a selfish problem; “I deserve XYZ” as opposed to “everyone will benefit after it’s paid for”.

1. Drug companies do a complex song and dance to avoid/delay the release of equivalent generics. For many drugs, they continually release modified preparations that keep generic competitors locked out decades past when they should have been available.

2. Drug prices in Canada or other nations versus the U.S. should be paid attention to. I'm Canadian, and there's absolutely no way I'd go to a pharmacy when cross border shopping. Americans are being gouged to a massive degree, in large part because of the idiotic American medical insurance system. Drug prices in the U.S. are a complex issue and it's not solely the fault of drug companies, but they are taking every advantage of the situation.

1. There's nothing a drug company can do to avoid/delay the release of equivalent generics. Releasing modified preparations does not lock out competitors from copying the original preparation

2. You have no idea how drug prices work. You don't have health insurance so you should be using prices from goodrx, not the list prices at the pharmacy. Americans either have health insurance or use the cash discount. Simplifying this would be great, but drug companies are not making the massive profits that breathless journalists claim

1. They can trickle out improvements one at a time, ensuring that there is always demand for a non-generic.

2. Perhaps you should look into how other countries regulate drug prices[1]. This is related to why residents of Florida recently pushed the FDA to allow them to buy drugs from Canada. There is a massive price difference, yet pharmaceutical companies somehow manage to make money off the Canadian market.

I'd like to think the U.S. is subsidizing development costs for the rest of the world, as some big pharma executives have claimed in the past, but it's now evident that research would be easy to sustain at a lower price point.

[1]https://www.canada.ca/en/patented-medicine-prices-review/ser...

1. Which drugs have trickled out improvements?

2 That's about new drugs, not generics. Generics are dirt cheap in America. Again, look at goodrx prices not the fake retail prices

You can still make generics based on the original recipe. The only reason "modified preparations" would work are if they are legitimately more effective or if the public/doctors dont know about the generic options.

I love how circular neoliberals argue, lobbying and regulatory capture are a real problem with big pharma, to fix it the government really should put them under heightened scrutiny and regulation. These politicians are really corrupt, they should really stop being corrupt.

Here is a wild idea: Perhaps the core of the problem just simply IS for-profit health care itself. Perhaps if someone has cancer, nobody should profit?

>>Perhaps if someone has cancer, nobody should profit?

Does that mean the doctors and nurses and others should all work for free to? If individual people can 'profit' by providing care, i.e. a doctor, why can't a collection of people providing the same service, but as a company be allowed to profit as well?

"not profit from" != "work for free"

The healthcare system in Europe doesn't gauge its sick citizens the way the U.S. healthcare system does, and yet, last I checked, doctors in Europe, while certainly earning less than in the U.S., do not "work for free" or are unable to provide for themselves and their families.

Why aren’t the Europeans cranking out new medications at cost then?

No one is saying that drugs have to be provided "at cost" (that's very similar to the fallacy of the "do you expect us to work for free?" argument).

Is not the definition of profit the excess charge after removing costs? By definition “no one should profit” does mean “at cost”.

technically yes, but sometimes people think of "at cost" meaning that people aren't getting paid (the price covers the material costs).

But what I really meant "inordinately profit from" so I should have specified that

> Here is a wild idea: Perhaps the core of the problem just simply IS for-profit health care itself. Perhaps if someone has cancer, nobody should profit?

So your idea is, rather than address known issues in the system, replace the system with one that is known not to work?

Do you have proof that non-profit health care does not work? I’d say there are plenty country that show proof that nonprofit health care works better for the majority of people then for profit health care.

There are no countries with non-profit healthcare systems which develop as many new drugs as the USA on a per capita basis. Non-profit or socialized systems can work reasonably well for care delivery but no one has figured out how to productively develop new drugs under such systems. The profit motive is highly effective.

Maybe we don’t need all those new drugs? Are they helping patients, or are they just slightly changed existing drugs that allow the industry to ask for more money?

Good thing they have to go through some of the most extensive efficacy trials of virtually any products in existence. If they aren’t more effective, the generics are still available for cheaper.

This seems to be a common paradoxical argument made whenever drug prices get brought up, particularly insulin. I’ve seen people make the argument numerous times about how outrageous it was that Eli Lilly, which was sold the patent for insulin in the early 20th century for a dollar, is charging hundreds of dollars for insulin today. And yet when it is pointed out that they sell insulin for $20 at Walmart, and the insulin that costs hundreds are newer synthetic versions, the response is that people can’t be expected to use the old stuff because the new stuff is much safer, effective, and easy to use.

Which is it? If the new medicine is ineffective, then why do you need to buy it over the older, cheap options? If it is truly an improvement, then why is it wrong for the producers to charge more to account for the R&D costs required to create the new medicine?

maybe if someone is hungry, farmers and supermarkets shouldn't profit? maybe if someone needs a place to live, builders and realtors shouldn't profit? maybe if my gas tank is empty, oil companies shouldn't profit.

Where do you draw the line?

You draw the line when the basic requirements for a free market aren’t available: transparent pricing, customers that have a choice between different providers, customer that actually have the time to shop around.

That’s all fine, except those are all issues with our insurance model as opposed to the pharmaceutical industry. Why not fix the actual problem by addressing the labyrinth of middlemen in between the person consuming the medication, the doctor prescribing it, and the company producing it? That seems like a far better idea than making drug development non-profit, reducing the incentives for innovation and new discovery.

The vast majority of prescriptions are for treating chronic conditions. Those patients have time to shop around and consult with their physicians to decide on a course of treatment. There are multiple drugs available for most conditions, often including generics. Statins are some of the most heavily prescribed drugs and there are at least seven on the market now.

Hardly, often drugs treating same condition have different side effects, or different effect on patients. Physicians usually search for the drug that works best on a specific patient. Once you find a drug with the desired effect, it’s usually not a good idea to switch to another with different side effects.

You use cancer as an example, but what about other meds? Is it ok to profit off ED meds or ADHD meds? Note, just cherry picking a few that are arguably not life saving for most.

This is a problematic position, you can say that big tech profits are also funded by the taxpayers since they employ people trained through public resources(most people don't study %100 private).

Yes this is the classic Obama’s ‘You didn’t build that’ argument.

> Big Pharma's profits are a result of taxpayer funded research

The same can be said about any BigTech company, actually.

Yes this is the classic Obama’s ‘You didn’t build that’ argument.

Not just taxpayer, but also charity funded!

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