Tecfidera's Price

It looks like there's at least one other fan of stuff blowing up here. I heartily agree that you needn't be a chemist to get a laugh out of it. Anybody who has gotten through 2 years of high school chemistry or a year of college chemistry would probably raise their eyebrows looking at his diagram for hexanitrohexaazaisowurtzitane [1]. And if you haven't had that much chemistry background, he'll shortly explain why your eyebrows should be retreating towards your hairline at maximum speed when you look at it.

[1] http://pipeline.corante.com/archives/2011/11/11/things_i_won...

As a taster

Yep, [the stable-to-explosion sensitivity was] below the detection limits of a lab that specializes in the nastiest, most energetic stuff they can think up. When you read through both papers, you find that the group was lucky to get whatever data they could - the X-ray crystal structure, for example, must have come as a huge relief, because it meant that they didn't have to ever see a crystal again

It's a bit more surreal when it's general knowledge what to do with the hammer but you have to license your placement-of-hammer IP.

That sounds like a doctor's job - they might prescribe a fairly cheap medicine, but knowing what kind of medicine to use is a different art entirely.

Here the only reason why the company is able to charge a large amount of money is because they've gone through the whole process of tests and clinical trials to get the drug available for consumption. That's an entirely different kettle of fish than the expert knowledge $9999 you mention above.

The gist of the article isn't about expert knowledge, it's that a fairly simple chemical compound (the name itself gives the simplicity away - dimethyl fumerate is too short to be anything horrendously complicated) is jacked up in price, and that someone suffering from the disease could presumably get the drug made themselves for much less than $50,000 per annum.

That's interesting! I wonder if a charitable company decide to make say AIDS drugs and give them away without breaching patent law?

IANAL but US patent law does not have a personal use exception. 35 USC § 271 covers "makes, uses, offers to sell, or sells" (with some exceptions).

http://www.bpmlegal.com/patqa.html#1 http://www.iusmentis.com/patents/crashcourse/rights/ http://www.law.cornell.edu/uscode/text/35/271

As an added note, Biogen has a patient assistance program with no income limit. If you don't have insurance you get help and even if you do have insurance you pay nothing more than $10 per month.

I'd say that's a pretty good deal.

I'll grant you the ethics issue, but the entire healthcare industry is now riddled with so many perverse incentives that ethics barely even enter the picture anymore.

However, consider your question in the abstract: is a buyer entitled to the products or services of a seller on terms the buyer deems fair? (Solve for any values of 'buyer', 'seller', and 'fair').

Before I could formulate a reasonable answer to that question of whether this is "unreasonable" (leaving aside the complicated matter of what that exactly means), I'd be interested in a serious analysis of what the costs are; $50,000 may not be so obscene if their costs were $45,000/possible patient, for example. What's the floor here?

If the costs are $10,000s of dollars/patient even before the drug company needs to take profit (and have money to invest in their next drug, after all), then a full investigation of the "blame" for this very expensive very cheap drug must also be pointed at the processes that cost that much in the first place. If it's so bad that MS patients are paying $50,000/year, then perhaps the real problem (or at least a nontrivial part of it) is that the costs of certification have greatly exceeded the benefits.

(But people don't like to think in terms of costs/benefits when it comes to medicine and appear to be willing to incur enormous costs if it allows them to continue pretending they don't have to think about it....)

Agreed, I think that there is typically a balance between profit and ethics. One would hope that companies would follow a code of ethics, but many don’t.

As for insurance paying for the drug, that is a reasonable expectation in our current system here in the states. That system is broken on many levels. One example of where bad ethics in another company could potentially overlap with the costs of this drug, Wal-Mart. They do quite the opposite of what this company is doing. Sure they pass the savings onto the consumer, but at what cost. They pay their employee’s so little that many live below the poverty line, a situation that forces them to forgo health insurance. Then those employees without health insurance are forced to pay for drugs, such as this one, on their own. Where as other companies will subsidize health insurance (Whole Foods) and charge their consumers more.

The issue here is that it makes a really good headline and seems atrocious to us as readers. But this is just part of a bigger problem. So when we decide to regulate, we need to attempt to look at the system holistically, not just at this one very outrageous situation.

Also, some people may not be disingenuous, just greedy and immoral...

If you have a system where the developer isn't allowed to charge money because the people it could help are poor, you are setting up a system where the developers will only work on diseases of the rich.

You could say "well, they should have just done this one for free," but there's no more reason for them to it than for you. In fact, there are charities which go through all the funding of researching drugs for the poor. The Bill And Melinda Gates Foundation has paid for drug companies to get drugs approved, with the contract saying that they will be available at low cost once everything is done.

Please note that patents are not considered by the FDA as an compensation method in regard to investment in clinical trials. For clinical trials, FDA gives out a special monopole status to encourage further trials to be made. In this case, Tecfidera got exclusivity power in the market from both the FDA and the patent office.

3D printing != molecular synthesis. This may be an issue, say, next century, but we're nowhere close to it. If 3D printing an iPhone is going to the moon, 3D "printing" molecules from elemental sources is like going to Alpha Centauri.