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Comment by coldtea | Hacker News Reader

>Cost effectiveness... well ipillimumab costs 100k a year for 4 doses, and nivolumab is probably going to cost another 100k at least on top of that, and is generally continued indefinitely, and the medication to turn off overly vigorous immune responses can also be expensive...

I cannot imagine a chemical process to create those drugs that justifies the prices mentioned.

Is the price at least subsidising the costs of research, or is it an arbitrary price set by the drug company because "it can"?

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> I cannot imagine a chemical process to create those drugs that justifies the prices mentioned.

It's a Monoclonal antibody, they are currently by far the most expensive drugs ever made.

They are very difficult to make, and almost impossible to make in bulk. It's not a chemical process, it's a biological one.

Unfortunately monoclonal antibodies are also some of the most promising drugs currently available. They can do things no other drug can.

It's really too bad they are so expensive to make.

Could you give a brief explanation (in layman's terms) of why they are so difficult/expensive to make?

Wikipedia[1] is full of jargon, but one caption says "Monoclonal antibodies can be grown in unlimited quantities in the bottles shown in this picture". So the process at least looks scalable. What materials/constraints can possibly cost $25k per dose?

[1] http://en.wikipedia.org/wiki/Monoclonal_antibody#Production

The images are full of fluff. The bottles are only one step in the process described in the section after that, which includes a dozen or so complex steps, each of which must be executed perfectly. Doesn't look simple.

Actual c cost to produce is probably in the 50k range (still a huge markup). Its a biologic - There is lots of batch to batch variation and some batches have to be chucked if they don't meet QC.

Wouldn't insulin be considered a biologic? Would we ever see these drug prices come down to the price of insulin?

Yes it is, and insulin is hard, but antibodies are even harder, mostly to do with the manufacturing platform "CHO". Also insulin is still more expensive than it should be due to patent ever greening.

We would see prices of antibodies go down if the manufacturing could be switched to something "not CHO" but the IP landscape is locked up by a company! They will expire in 10 years or so.

Drug R+D plus approval processes are very expensive both in time (>10 years) and money (>2 American billions) [1]

[1] http://csdd.tufts.edu/news/complete_story/pr_tufts_csdd_2014...

Don't believe everything they say. Tufts is financed by the pharmaceutical industry AND is based on data provided by the industry.

In today's world it's hard to believe there are approval processes built to take > 10 years and > $2 billion.

I would bet if these processes were carried out "transparently" we would find alot of waste and inefficiencies.

I get the feeling things will change once Silicon Valley finally decides to get more invested in the pharmaceutical industry.

Little of column A, little of column B. The research is expensive. But living is effectively priceless.

There are solutions to this, and countries that are not mine will probably avail themselves of them sooner or later.

Aren't the prices for these drugs so high because they basically have to be made by hand? Since these small drug companies don't have any real manufacturing capabilities.

ipilimumab, *-umab; hUman Monoclonal Ab (antibody)

These aren't cheap to mass produce.

Edit: Not the best source I could find, but this cites costs (not at scale) :

http://www.immunochemistry.com/services/antibody-development

>These aren't cheap to mass produce.

Even still, $25k/pill seems steep. That's roughly 10x the cost of pure plutonium.

There's an "ounce of prevention, pound of cure" joke in here somewhere

Let's not forget some people look at curing people suffering form disease as just an Investment?

These biomedical companies are in business to make shareholders rich--it's just about the money. Maybe medicine has always been just about the money?

The prices most drug comapnies charge for their latest drug seem outrageous? Want a jaw dropper--look into Biomarin drug prices. Read their prospectus--it reads more like a hedge fund, rather than bio company. Oh, and one of their buildings is sitting on the San Andreas Fault. Found that last sentance interesting--I guess lawyers were being proactive?

But then again, I'm for government funded research, I would like to outlaw forprofit Insurance, and I have become a huge skeptic of modern medicine.

(As a side note; If you noticed your generic drug is not dropping in price like it did years past, you are not loosing your mind. Supposedly, large drug companies(companies whose drug patents are expiring, or expired) are buying smaller generic drug companies, and either shutting down the operation, or keeping the generic price, of the newly aqquireed company, artificially priced high. I believe congress, or the FDA is looking into this slick business tactic? It's completely legal now.)

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