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


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It only works that way on the tiny handed.


Dog forbid, someone actually wanting to do something for the good of humanity. Moralizing, probably. Good business model - a healthier society will then have more time to overcome whatever other obstacles are in the way of making life better for countless people. Better lives means more “profit” for those greedy, money grubbing bloodsuckers. So its in their best interests that companies do things like this for moral purposes.


These numbers really are misleading though since much of their research costs are buried in the acquisition costs of smaller drug companies that get themselves, on private investment, to a successful point in the clinical trials. Lots of cancer treatments are getting scooped up at Phase II for a billion or more. That’s research expense, even though they are paying for completed research.


So far the discussion here seems to be that pharma executives and Goldman Sachs executives are doing crappy things because they’re bad people.

Now it may be true that they are generally greedy sociopaths, but I don’t think it really matters.

Just yelling at them not to be greedy scumbags isn’t going to change anything, if you want to do good then figure out a system where they’re rewarded for doing good things. That’s the thing that capitalism is supposed to be really good at, it just doesn’t work well applied to healthcare.

Change the system and regulations so it’s more lucrative to develop a cure that can be used once than a treatment that needs to be used for a lifetime. Change it so they can maximize their profit without pricing people out of the market. Figure out a way where a company can spend 10 billion dollars developing a cure for AIDS and then a month later a homeless person in Africa gets that cure. Figuring out that new system and pushing for it can make a much bigger change.


I realize that many companies purchase their next product by providing an exit event to some private investors. Development costs are development costs, it doesn’t matter if you spend the money in-house, or in a lump sum. The typical startup with a good result in the early trial stage, isn’t bringing any significant manufacturing or distribution value for the billions forked over, that money all goes to the development pot.

Even with the correct assignment of acquisition to development, many companies still spend more on advertising than they do to develop or purchase the development of a new drug.



That’s exactly why we need universal health care. No argument there. Banks on the other hand - a little back story. I lost everything I had saved throughout my life in 2008 when the real estate bubble burst. Real estate was supposed to be a “no brainer” rising an average of 4 - 6% a year. “put your money in your house” was the advise I was given since forever. (never had a lot, but what I had was in equity in my house) Wells Fargo took all of that, and then when I lost the job I had, managed to ruin my credit because the guy I sold the house to (on a contract) suddenly decided to quit paying for it. They managed to hound me and destroy whatever credit rating I had until the lawsuits were finally settled. The next time I obtained a mortgage was only after 10 or so banks decided I was too much of a risk and denied lending me enough money to purchase again. When I finally did get a mortgage, it was at a higher rate than normal. I have since fixed all of that, but I will never be able to retire.
My office overlooks downtown Cleveland (not a pretty site) but of the four tall buildings in Cleveland - 3 of them are banks. Fuck them. I haven’ worked my ass off for 45 years so those MFers can get richer and sit on their collective “too big to fail” fat asses and decide how our government should work.
As Elizabeth Warren has said - "There are a lot of wealthy, successful Americans who agree with me – because they want to give something back. They know they didn’t – look, if you’ve been successful, you didn’t get there on your own. You didn’t get there on your own. I’m always struck by people who think, well, it must be because I was just so smart. There are a lot of smart people out there. It must be because I worked harder than everybody else. Let me tell you something – there are a whole bunch of hardworking people out there.
If you were successful, somebody along the line gave you some help. There was a great teacher somewhere in your life. Somebody helped to create this unbelievable American system that we have that allowed you to thrive. Somebody invested in roads and bridges. If you’ve got a business – you didn’t build that. Somebody else made that happen. The Internet didn’t get invented on its own. Government research created the Internet so that all the companies could make money off the Internet.
The point is, is that when we succeed, we succeed because of our individual initiative, but also because we do things together. "


I’d settle for ones that get you really high without fucking you up.


Why do you think that Bill Gates (for example) funds, with huge sums of money, a charitable foundation to give something (quite a lot) back?

Why doesn’t he just write a check to the US Government and let them decide how best to spend it?


Well-regulated capitalism, possibly, but the only thing badly- or loosely-regulated capitalism is good at is enriching the ‘haves’ at the expense of furthering the tragedy of the commons and screwing the rest of us - i.e. creating perverse incentives.
Do not expect a system that provides incentives and rewards for doing good things while ‘free market’ neo-liberal philosophy prevails. Social democracy (too often confused with socialism, often deliberately by the right) needs to come back into fashion - i.e. the voters need to be somehow persuaded to start voting in their own best interests, not the interests of the ‘haves’.


I’m confused by your statement, but appreciate the gyst of it!


MaaS? (Medicine-as-a-service)

This had been the model for a while methinks.


Because he isn’t required to, and feels he’s smarter than the government of, by and for the people.


That is normally the thing that comes out of “unreasonable” profits…funding all the research that doesn’t produce viable cures. So you really can both cap profits and not fund R&D.

Maybe you want to directly find the reasearch, and as a matter of public policy make such things unpatentable. Then for profit companies would just take viable cures produced by (say) University research (public funded) and turn them into commercial products. If none do that cheaply enough make that also a government funded process?


Oh, the HORRORS! That the public that funds the research should get some benefit from it. And what do you think the people that do the work do with their intellectual property?


You can count on Goldman Sachs to treat him like the bad guy because they might lose money


Isn’t the obvious capitalist answer here “more drug companies”? If there were 100 drug companies, and 99 made treatments for a chronic disease, and 1 made a permanent cure for it, then the 99 get nothing and only the cure makes money in the market once it is in widespread use. It only takes one defector to ruin the rent-seeking. Or at least, more start-ups competing for the few drug companies to buy them, with them spending even less on internal R&D.

It won’t be as much money made, but then the effect is “less money gets invested in developing new treatments because investors chase higher return opportunities instead until ROIs balance again.” But less spending is needed for a given societal benefit because the impact of each cure is much higher. Also, total spending on medical care goes way down because we aren’t managing so many chronic conditions freeing up resources for other priorities.


I would love to be in a position to dictate where my tax dollars go. I certainly wouldn’t fund dRumph’s golfing trips, or SS protection for his kids going to Italy for a concert (I think), or his military parade, or any of the other BS this administration has spent money on (Pruitt, et. al.) The only time I get a say is when a ballot comes around and I get to vote, and hopefully, the folks I’ve tried to have an impact on, will vote in agreement with me.


Because the economy isn’t run for your benefit but for theirs. The question is why they arn’t taxing you more heavily. And that will continue to be the question until a candidate who doesn’t take money from them wins an election.