For a detailed write-up without the hype, check the latest from In the Pipeline, the Internet’s best pharma chemist blog.
Derek is best known for his series of articles in the category “Things I won’t work with”.
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You guys know the summarized synthetic pathway is on Wikipedia, right? These are gifted high school students who pulled off a great project. Good for them, I mean it. I wouldn’t have been able to pull that off in high school. But as anything other than pedagogy, this doesn’t mean anything. Any remotely competent- scratch that, even an incompetent chemist like me, could tell you that it’s not synthetically sophisticated and that the starting materials are NOT very expensive. It’s not a secret, it’s not hard, but more importantly we already knew that.
Daraprim costs what it does due to regulation and economics. And when people say “regulation caused this,” please understand that it’s not necessarily advocating the abolition of regulation. Government policies set up significant barriers to new entrants to drug markets. Sometimes it’s well-intentioned with unintended consequences. Sometimes it’s regulatory capture. Sometimes it’s both. I hate to quote Bush Sr., but it’s not the chemistry, it’s the economy, stupid.
Edited: Starting materials are NOT very expensive.
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Children? Hardly! Grade 11 and I think they’ve earned some Awesome medals.
But… better keep an eye on what else they’re cooking up.
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Well good, that was my main concern. I mean, let’s be honest, the US doesn’t have a malaria problem. While this is still a dick move, at least the millions of people malaria effects around the world aren’t affected.
Though it does highlight the fact that the US does have higher drug prices than most other countries. I am sure some countries have less strict rules than the US, but even Canada has cheaper drugs, generally.
Thanks for sharing your knowledge.
Probably a good thing, as we have so much snake oil sold as medicine in homeopathy and natural supplements, that I can’t imagine the harm caused by people allowed to sell it as actual medicine.
Still, is it just the regulation for the reason our prices tend to be higher? I would think it is also partly because 1) Americans have more money that most places, and 2) probably the bigger reason - the healthcare and insurance is fucked up where everything is over price.
I have to see a pain doc every month. If he bills my insurance - which in turn comes back to me because I haven’t met my deductible - it’s $200. Cash prices is $80. I realize the cost is somewhat higher because someone has to deal with the paper work and filing, but even 2 hrs at $20/hr for that, it is still a crazy high price.
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The tendency for third-party payer to hide prices and functionally inflate them is a problem, but right now the problem is that only one company can sell Daraprim on the US. Price is a function of supply and demand( something that everyone forgets, incidentally, when it comes to increasing the minimum wage ), even for insurance companies and one company controls the supply.
What if one were to smash their faces into one another? Y’know, for science*
* and then charge $750 for the privilege.
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What about other drugs? Like I realize name brand drugs where you can’t get a generic are going to be higher. But assuming this image below is correct (though it seems off to me, as some of those drugs I have gotten before, and they were much cheaper - although maybe insurance paid the other amount. But the question remains, why is the same drug much cheaper in other countries?
Though what is even more crazy, maybe some of it is also just pricing from the pharmacies. Generic Tramadol I was quoted at CVS for $80. At Costco it is like $12.
Fun tip - if you need drugs and don’t have insurance, try Costco - you don’t need a membership for the pharmacy and they seem pretty awesome in what they can do with prices.
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Punchstarter!
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It seriously, seriously helps to have a single-payer program in places like the UK, Spain, and Canada. You get a lot of bargaining power. Want to do any business here? Set a reasonable price. This applies to generics, too. But when it comes to generics, there are specific regulations around generics in the specific country. The US actually has some nice regulations that help, but then it has weird loopholes and issues that make things difficult. For example, if you have a drug which has an expired patent, you still need the FDA to certify bioequivalence, but in order to test for bioequivalence, you need a sample of the original approved drug. And it’s not like a private company might drag their feet on providing samples, riiight?"
As for different pharmacies with different prices? Some of it is again, bargaining power, some of it is markup. But look around your typical pharmacy… as you pick up a $5 bag of chips on your way out the door. You think they’re making money hand over fist on drugs? Next you’ll tell me gas stations make most of their money on gasoline. Any other country in the world, pharmacies basically sell nothing but healthcare related items for various reasons. In the US pharmacies often offer the lowest price they can, they rely on convenience items to make their profits. And they leap on government incentive programs where they can make an extra buck. Ever wonder why your pharmacist is desperate to know if you’ve had a flu shot?
Walmart and Costco charge less than a lot of dedicated pharmacies because they can afford to lose money and draw in customers. And they do lose money.
Honestly, the morass of regulations and economic considerations are difficult to untangle, and that’s part of why it doesn’t change. You think politicians understand this stuff? Sure, about as much as they understand our monetary policy and banking system.
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I think we’ll find the morass of regulations quite easy to untangle in the industry self-regulation that is to come.
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Here here
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I don’t think insurance agents are actually human.
Anyway, welcome to earth 
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Jacking up the price on a drug that some people need is pretty shitty too.
This is why the healthcare system should not be for profit. Period. Ever. People’s lives are at stake and making a mint off that, whether it’s the pharma cos, insurance agents, or whoever is blatantly anti-human.
And yes, I’m on earth too. And I do think we can do things differently, in a way that doesn’t destroy lives.
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Did you miss something?? Nobody is missing out on the drug because of its
price.
High prices that limit people’s ability to make lengthy long-distance phone calls isn’t remotely comparable to allowing them to die from malaria.
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Capitalists are human beings with agency, not allegorical scorpions hitching rides across the river on frogs’ backs. It’s not “nature,” it’s a conscious decision. They don’t get to shrug off their shitty choices by pointing at evolution or game theory.
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Where did I say it was? The context of my post was someone’s assertion that companies don’t jack up current prices to cover development of new and improved products. Of course they do, and often it has been an important funding source for critical research that benefits us all.
No, we’re all just paying higher premiums because of it. Do you really think the insurance companies are going to just swallow that cost?
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Pretty much what @L_Mariachi said here. This is about shifts to the system. I’m arguing here that decisions that could impact people’s health shouldn’t be made with the bottom line as the overriding concern. It’s dehumanizing. [quote=“Auld_Lang_Syne, post:59, topic:90406”]
No, we’re all just paying higher premiums because of it.
[/quote]
Premiums keep going up and up, and they pay for less and. They were of course doing so before ACA and they will continue to do so, because the heart of the problem is that the insurance companies need to make returns for their shareholders and so they charge more and cover less. You’re spot on here.
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Generally, everyone is paying more for most things than they used to (thanks to capitalism).
People always seem to attack other people they don’t understand.
I rent a house and have watched the prices of houses in my neighbourhood climb by over 200,000 in the last 2 years. Unfortunately, the capitalist housing developers are buying them up and turning them over for a profit, making it harder and harder for the average guy to buy a house.
At the same time, I wish I had enough for a house deposit back in 2014 - could have made a large chunk of money. Damn right I’d do it, because I would like a large chunk of money, thanks!
Watch a few interviews of Martin Shkreli (ok, don’t look at his face, but listen to what he says).
He’s making bank doing what he is good at, but he’s not depriving anyone of anything. If you don’t have insurance, he will give you the drug free.
People like to single out others as scapegoats, when what they fail to see the larger picture
-i.e. the price of living just keeps going up - it always has.
If you think life on Earth is hard, wait til you have to be evacuated to Mars! (Oh, and btw, capitalism is likely to follow you there too).
