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Comment by gerhardi | Hacker News Reader

If/when the cure makes it through the final tests to the market, the sad thing is that they are probably going to rip off everyone who needs it, no matter what are the real costs.

But anyway, a life is worth everything(?)

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The "real" costs of making ordinary drugs are small in terms of manufacturing. It is very inexpensive to synthesize the chemicals that make up most drugs. You're paying for the R&D of the drug as well as all the ones that failed along the way. In the days when software used to be sold in cardboard boxes and came on CD's, nobody was making the argument that someone like Microsoft should charge a few dollars since CD's and cardboard are cheap.

All that said, in this specific case, the therapy is enormously complex, time consuming, and expensive. It's not a simple chemical compound that can be manufactured in bulk. Furthermore, it has to be tailor-made in a lab under highly controlled conditions for each individual receiving the treatment. As a result, it is likely to be extremely costly when it finally makes it out of the experimental phase.

"It is very inexpensive to synthesize the chemicals that make up most drugs"

Can I ask a stupid q? How exactly inexpensive is it? Thinking in line of 3d printing, how possible could it be to get the chemicals needed, and the machines needed to mix them appropriately, to make a known drug? Ie, how possible would be to "download a pill"? The recipe, and you make it yourself at home?

It depends on how complicated the drug is. Some drugs are actually kinda pricey to manufacture while others can be made for pennies a dose.

Yes, you can make many drugs at home with the right setup and technical knowledge. No, robots don't actually help that much.

I very much like the idea of open source medicines.

You mean like this?

http://www.theverge.com/2013/12/6/5184168/fda-approves-new-1...

That article indicates a 90% cure rate.

$84k for a 90% cure to Hep-C is peanuts when compared to the alternative of liver transplant and chronic hospitalizations.

Yes, but that's still sky high price for most of the world. And if they put price order of magnitude less, won't it bring around order of magnitude more people who can afford it and they money outcome will be pretty much the same? Look at pharma companies: https://en.wikipedia.org/wiki/List_of_pharmaceutical_compani... They are very profitable, maybe we should make them less profitable and more effective widespread-wise?

you mean by abolishing drugs patents?

check out the healthcare sector margins (notice major manufacturers, vs. generics manufacturers):

http://biz.yahoo.com/p/5qpmd.html

You know those "greedy insurance companies" that the US is struggling to wrangle with complicated legislation and broken website markets? They only make 3% margin.

> You know those "greedy insurance companies" that the US is struggling to wrangle with complicated legislation and broken website markets? They only make 3% margin.

Of course, that's after paying out executive salaries, including bonuses for "cost cutting".

Executive compensation is subject to market forces. You can't waive a magic wand and cut executive salaries without losing upper management talent and running the company into the ground.

You're missing the point entirely. Executive salaries can be a magic wand for insurance companies to go "look how low our margins are!" by funneling what would've been profits into the pockets of their already highly-paid execs.

I mean by all ways. Abolishing or shortening patents maybe part of it sure. There's a lot of people/scientists who want to work and help people. We just need more effective ways to let them do so.

By the way, it look even more interesting here: http://biz.yahoo.com/p/s_qpmd.html

Healthcare is the most profitable industry, even more profitable than banks. Insane...

I don't think you understood his point. Even though this drug costs $84K, it's still cheaper than current treatments that include prolonged hospitalization and liver transplants.

It's sort of like people complaining that Lipitor costs $5K/yr. The fact it prevents a number of heart attacks, means that it's actually a cost saving treatment.

This is exactly right. 84K is a drop in the bucket for cancer treatment. I have been going through cancer since 2008, and GVHD since my stimcell in 2011. I had no insurance when I was diagnosed at age 23 at top physical condition of my life. The financial aid program at North Side Hospital in Atlanta and Medicaid system of the US of A has kept me alive. But I know I probably have over 3 million in debt in my name alone. 84k would be nice.

On a side note, this is how every single zombie movie starts. Genetic Mutations to stop cancer.

Most of the world has socialized medical systems.

I know, I live in a country with socialized medical system. It doesn't matter. Socialized system means everybody pay collective check to those pharma companies. The issue I was talking about is more effective way of inventing and distributing drugs.

Your point illustrates exactly why the market fails society when it comes to healthcare:

Every penny you have is peanuts compared to a slow painful death.

The point is, it's a cost improvement over the current situation.

I'm a single-payer advocate. I too think market-based healthcare fails society. Within the context of it, though, this isn't as outrageous as the plain dollar amount seems.

Two issues:

- Many people don't spend every penny they have. They spend every penny they can get out of their health plan. That's not a "market failure" by any means agreed?

- If they must pay out of pocket, and they have no kids, then why not? If they do have kids, then that seems a bit selfish to me. Maybe the right thing to do is save the money and buy cheap painkillers.

Not every sad story is Oliver Twist. And the argument that single-payer health-care will be cheaper is a crap-shoot at best. The countries that do it well do many things well. I don't see dramatic savings from US single-payer education. Or from single-payer defense spending.

Not agreed. Health related debt is the largest cause of bankruptcy in the US, and most of those who go bankrupt this way are insured.

Compare that with the number of healthcare related bankruptcies in say, the UK.

Even in single payer systems, bankruptcy is often the result of medical issues. You have to remember that many conditions prevent you from working, so even if your medical bills are paid, you still can't afford your daily expense.

Interestingly, it turns out that research commissioned by the Canadian government shows that 15% of people over the age of 55 who declare bankruptcy cite a medical problem as the primary reason. Medical bankruptcies can, as I've been saying for a while, be driven by something other than the lack of free government provided medical care.

http://www.theatlantic.com/business/archive/2009/09/bankrupt...

True but irrelevant, since there is a huge difference between being bankrupted by the medical system itself, and bankrupted because you can't afford not to work (which can happen for many other reasons and is a separate problem to guard oneself against).

I don't think it's irrelevant at all. People throw out the statistic that X% of Americans go bankrupt because of medical problems inferring it's because we don't have single-payer healthcare.

The statistic about Canada backs up the idea that isn't true.

It doesn't back up the idea at all. The bankruptcies in Canada have nothing to do with medical costs.

Maybe a universal healthcare system based on taxation that would pay back the R&D costs to the pharma companies could solve that?

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