Goldman Sachs report: "Is curing patients a sustainable business model?"

Originally published at: https://boingboing.net/2018/04/14/shared-microbial-destiny.html

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I know it’s commie hippie talk, but what if governments agreed to reimburse drug companies for their research costs, in exchange for the companies selling the drugs in question at 10% (or 20%, whatever) above cost?

Yeah, details like not paying for dead end research that didn’t produce any viable treatments, oversight and audits and review boards to make sure that the company isn’t ripping the government off, etc.

But basically, the company becomes a public utility, it does research into cures and treatments not because it’s going to make a boodle of money but because it’s for the public good. In return for paying for research costs, the government gets cheap drugs. Everybody except the financial parasite class, benefits.

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Someone should make sure to ask him this when his daughter is in the hospital.

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I think you’ve found the real flaw with your plan.

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Why aren’t we taxing companies like Goldman Sachs more heavily. Making $4+ billion a quarter last year should end up putting more coin for the US in tax income. Not sure how much they actually pay, but its not enough in my book. Maybe there’s enough there to actually fund our schools properly.

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Call the exterminator, we have a level five infestation of financial investor parasites!

I did say it was commie hippie talk. Step one, financial institutions need to be neutered, probably nationalized and turned into utilities. Proceed from there.

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Accurate, and half (50.5%) of what makes this good art, IMO.

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That would be UnAmerican®™

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Well we’ve successfully implemented the FIRST part…

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Surely this is short sighted. If you cure a patient of disease A, they will soon come down with disease B, and you can charge them for curing that. As Friedrich Nietzsche said, “That which doesn’t destroy you leaves you weakened and more susceptible to the next thing to come along.”

And, when medical science has cured all of the actual diseases, they can move on in to the profitable area of hypochondria and placebo cures, “Have you got an itching sensation in the backs of your knees? That’s the first sign of Superdemal Hypersensitivity. This is a serious affliction that requires immediate and expensive treatment with Advanced Woo-woo. Remember, modern science doesn’t even have a word for the back of your knees; it is part of your body that science knows nothing about!”

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Unless it’s a private company, you’re never going to get the investors to agree to it, so you’d need a new generation of drug companies–but that’s not hard to do.

You’ll get a lot of resistance from the libretarians who seem to be willing to cut off their own noses to spite their faces. “What do you mean this helps other people? Why would I do that?” “It helps you, too.” “But it also helps other people!!!”

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Exactly. The paper makes the flaw of thinking in terms of one specific condition. They also forget that any genetic condition will have a constant supply of people with that condition–unless you start doing germ line editing. Good luck doing that world wide.

Everyone has at least one condition that they’re going to want treated. And then, as you say, we get on to the superficial things.

The real challenge of this level of genetic interventions is not the business model, it’s the regulatory one. The regulatory bodies around the world have no idea how to deal with a treatment that is designed to be different for everyone. All of their testing and procedures are designed for things that can nicely be modeled statistically because they have similar effects on large numbers of people. Individualized treatments? Yeah, good luck getting the FDA to grok that.

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You want to fund the schools? Make it Federal law that no government funds/grants/or other tax dollars can go to any town/city/chartered entity that offers any tax reduction to commercial business.

Oh the wailing of teeth this would cause - but it’s illegal for the Gov’t to tell states they can’t do this - but it’s not illegal to withhold federal monies to places that do - and it’s the only way to correct this blight upon our tax base that currently has states and local governments unable to pay the bills.

Make local business pay a fair share - that’s step 1. Step 2 is to remove tax free status on all religions. Step 3 is to re-evaluate taxes and such after the fallout and results from the first two pan out.

Crap like that Amazon headquarters scheme or Foxconn where they are making cities engage in a hunger games style ‘cut your own throat to get us to move here’ show need to end.

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Drug companies when challenged about pricing, go on at length about development costs, which admittedly can be substantial. However if you look at the tiny numbers in the back of the annual report, you will find many that spend even more than the development budget on advertising and marketing.

And its more than the endless ED commercial on any TV show with an older male audience. I accompanied my partner to some medical conferences. It was clear that they employed people who visited the site of the upcoming conference, traveled the path of an attendee, and any surface their eyes lingered on, they arranged to rent it for advertising.

Not just the obvious things like all the billboards at the airport, banners from the street lights and the sides of the shuttle busses.

They did things like replacing the antimaccasar covers on headrests. They supplied the hotels with key cards and do-not-disturb tags printed with their ads. If we had ordered room service, I bet the paper on the food tray would have lauded the latest cholesterol control drug.

Strangest, was employing people to go to the hotels, and working from a list of room numbers in the conference block, would either shove pamphlets under the doors, or apply post-it stickers to the door. Come back to the room after dinner, to a door covered in ads, a knob with a bunch of hang tags, and dozens of booklets In the entryway to get crumpled, and present a tripping hazard when you forced the door over them.

There was one approach on the list of solutions, that could be seen in a positive note: to develop so many so fast, that you always have new ones in the pipeline.

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Goldman Sachs’s analysts suggest three “cures” for the problem of one-shot cures; and taxing the rich to fund socialized pharma research isn’t among them; rather, they propose eschewing rare diseases, to ensure that the pool of patients is large enough to produce a return on their investment, or developing one-shot cures fast enough to "offset the declining revenue trajectory of prior assets."

I count three responses claimed and two (bold) cited. What was the third?

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++ OUT OF CHEESE ERROR. REDO FINANCIAL SYSTEM FROM START ++

(Yes, it’s a sentence.)

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Better yet, have a countering tax at 100% of the specific preferences. City A offers Business B a sweetheart tax abatement not available to their competitors, and the recipients get the same tax collecte by the State, or by the Feds. Just the prospect will make those goodies less than worthless.

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Two of them are just variations on the theme of ‘rate diseases are for suckers’

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This is a very strong argument for heavily taxing the profits of pharma companies' investors and other one percenters, and then turning the money over to publicly funded scientific research that eschews all patents...

Be careful before you suggest giving money to publicly funded medical research. Here in Sweden we have something called professors privilege. Anything that a researcher (professor, associate professor, phd, phd student) invents is owned by them and not the university. (The argument given for this is so that these people will have an incentive to start companies.)

But this has lead to a complete cluster fuck when it comes to incentives. There are so many corruption scandals popping up almost every month here in Sweden related to the Karolinska Hospital and Karolinska Institute.

As a professor there are a bunch of different ways you can make money from this system. For example you can have consultants or technical administrative staff at the university write software and then transfer the copyright of that software the professors private company.

Another thing you can do is to use lab equipment at the university for you private company. There is no oversight and you can get rid of any employees that do not go along with it.

Also as a professor you can make your Phd students sign over the intellectual property rights (patents, copyright) of things they invent to the professors private company. You are supposed to compensate them for this. There are a couple different ways you can go about this compensation.

First you should make sure that there are two separate contracts. In one contract the student signs over all his or her intellectual property rights to the professor. In the second contract you give the student options in the company. Now if you are unethical you can have all of your students sign the first contract while you make the second contract out to be optional. In that case you might end up in a situation where some students have signed over the intellectual property rights to everything they develop while working on their Phd having spent nothing on compensating them. And that is just great business!

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I am betting harvesting Goldman Sachs employees could be profitable but normal people would tend not to consider it.

Well maybe people at Goldman Sach would.

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