Cost of developing new drugs may be lower than industry claims: trial

Drugs may be overpriced.

There is probably some bloat in drug development. But then again, maybe not. I'm not an expert.

What I do know is that drugs have gotten dramatically better in the short amount of time I've been alive.

The other thing we all know is that the source of this article, The Guardian and their friends, have a shitlist of industries and institutions it loves to hate.

Ask yourself: will they ever write a positive article about a defense contractor, a bank, big pharma, a US billionaire, or a landlord, even if said entity walks on water and then saves a million babies and the penguins and the world?

People who don't like prices of new drugs are free to not use those drugs.

They want to have the benefits of the existence of drugs without paying the cost of discovering the drugs and bringing them to market. It's pernicious entitlement, made more outrageous by complaining about the greed of those actually providing the new drugs.

> What I do know is that drugs have gotten dramatically better in the short amount of time I've been alive.

How do you know this? How do you measure “better”? Something like QOL improvement per dollar? Have you done (or read) some large study on this or something?

Were curing forms of cancer that would have killed you decades ago.

HIV, in my life time was a death sentence. Now people are living almost full lives.

Less dead people is a pretty good metric for drug development.

The measure in healthcare is QALY, or quality-adjusted life year.

They've been marketed better. I wouldn't say they are more effective. Still, if you have a problem and your doctor prescribes you a drug, you should ask if it's the most tested, reliable drug, or just the latest.

Ah yes exciting new drugs like insulin[1] and epinephrine[2]. I'm also certain that someone going into anaphylactic shock is extremely well positioned to make a considered decision on whether they like the prices of new drugs like epinephrine or not.

[1] https://www.rand.org/pubs/articles/2021/the-astronomical-pri...

[2] https://www.vox.com/policy/23658275/epipen-cost-price-how-mu...

The advances in oncology are startling.

> People who don't like prices of new drugs are free to not use those drugs.

I recall in economics class, life saving/altering medicine being one of the genuinely few products that had a perfectly inelastic demand. Not all drugs are life saving or essential but then you do have Martin Shkreli's in the world.

No, we want people to have healthcare regardless of how much money they have. The research can be paid for by taxes as we all benefit from it as a society.

You forgot to mention that we can now effectively "cure" obesity with GLP-1 receptor agonists.

Oh, and as a nice little bonus they also curb substance use disorder!

That's a rather reductionist view of it. Companies don't exist in a vacuum, they have a social contract. It seems in your view there's nothing we can complain about them as we can always just not buy the drugs, freeing them of any scrutiny.

But society create rules for companies to exist within, many of which are broken, but without which the never ending search for profits would do more harm than good. Society even provides these companies with their intellectual labor, training them in high schools and universities, which is not paid back by them in full (maybe partly if that) either in grants or in compensation for these workers.

Maybe this is an offshoot of the anarcho-capitalism mindset that is popular these days where companies can do absolutely no wrong and we should all be thankful they exist to judge whether we're worthy enough to not die of diabetes.

I am of course talking about new drugs. There are lots of really great new ones.

That doesn't mean there aren't shitheads taking advantage of things like insulin etc.

But just because they're also being assholes with regards to insulin et al, doesn't mean that developing new drugs isn't genuinely very expensive, and that those drugs aren't genuinely very good.

The article is mostly not about drug development as a whole, merely the cost of trials. All that is being asked is that the cost of trials be public information.

People who don't like prices of food are free to starve.

They want to eay without paying the cost of bringing food to market. It's pernicious entitlement, made more outrageous by complaining about the greed of those actually providing the food.

I hope you never become a diabetic when you get older!

An old coworker of mine dropped dead on her lunch break because her insulin was unusable when it got too warm during shipment. Her insurance said they would not pay for another month's doses until the next month and she'd have to pay $2,000 out of pocket. Which isn't the kind of money a poor girl from the middle of nowhere South Carolina has.

And now she's dead...because she was $800 short of raising that money from a GoFundMe...

But I sure am happy that her insurance company beat their quarterly earnings estimates!

Not only do companies not exist in a vacuum, but they have no inherent right to exist in the first place. Companies are graciously allowed to exist because the state (a proxy for the people) approves them, the state grants their charter, the state provides them the corporate veil and limited liability they often abuse... Companies only exist because we the people decided that the public good they are supposed to serve outweighs their downsides. And we the people should also be able to decide that a particular company should not exist, if that company operates against the public good.

>> Ah yes exciting new drugs like insulin

The older type of insulin is $35 a month. There are exciting newer types and delivery methods of insulin that are more expensive. The drug companies developed better versions because they expected it to be profitable to do so. They will develop even better versions in the future if they expect it to be profitable to do so.

Insulin is a bad example because the old formulation is very cheap. The expensive variant is a new, better drug that was recently developed.

People going into anaphylaxis aren't buying epi pens. You buy them in advance.

> "- Companies that profit from murder."

Holy conspiracy theory batman

> "- Companies that profit billions by charging poor people more money."

Would you prefer that companies that serve poor people stop doing so? Because that would only raise prices for products poor people use. Supply and demand - it's the only sure thing in economics.

> "- Companies that profit by (essentially) extorted thousands of dollars from people with the only other option being death."

The companies created an alternative option to literally dying, and you call this extortion? Would you prefer they not offer this option at all?

> "- A person who profits by underpaying labor and creating false supply/demand."

Underpayment is only possible in some dreamworld. If workers are being underpaid, then by definition they can get better pay by switching jobs. Why aren't they? And if they can't get better pay, then they aren't being underpaid - they're being paid market rates.

> "And get this bud, they don't care about you either! If Northrop Grumann could make $10,000,000 by turning you into a fine red mist they'd push that button before the ink on the check was dry."

The basics of survival are provided by greedy, psychopathic, for-profit cybernetic organisms called corporations.

And life has never been better, especially for the very poorest.

I would suggest that you look at some hard data in this regard, rather than defining your own parallel economic reality in which you can be so very satisfied in your anger.

If you want a hug, Northrop Grumman or your landlord or big pharma just don't do cuddly. Get a dog or a friend. If you want results that are measurable as housing provided, years of life added, or fighter jets built, or tons of wheat produced, then get a corporation.

That's fucked-up and I'm sorry that happened.

Clearly things could be much better.

But that doesn't mean the system as a whole isn't a huge net positive.

The right approach is tweaking, not destroying.

Tell me, what do defense contractors produce? Because I'm telling you right now Lockheed Martin doesn't make $1.5 billion this quarter by making friends.

I'd prefer that banks stop making billions each year with junk overdraft fees. It's not like $35 is going to change their quarterly earnings but $35 can buy cheap groceries for a week until their next payday.

If they use taxpayer grants and funds to research new drugs then I find that it's only fair to be treated like any other taxpayer-funded thing, make it free or cheap for the public like national parks, USPS, and the DMV. You don't get to socialize the funding and then privatize the profits.

I'm sorry that I dream and hope to work towards of a better future for everyone! Enjoy the "greedy, psychopathic" corporations you seem to fight so hard for. Maybe they'll let you live in their new "utopia" city in California if you bark enough for them.

IDK about your philosophy, but any death that is 100% unavoidable invalidates the entire system of business that has been built.

Nothing in this world is above a life. Not money, not profit, not a quarterly bonus. Zilch, nada, zero.

I'm biased, obviously, but by principle, I refuse to accept a system that accepts avoidable deaths as a "necessary" consequence of their business model.

In each case, you take the most negative aspect of the corporation and blow it out of proportion.

Lockheed Martin makes weapons. Weapons seem like a great thing to have when it's the only thing preventing your country from being invaded. (and by the way, we've never lived in a time with fewer battle deaths per 100k people).

Banks charge overdraft fees. But they also provide secure transactions, storage of value, and they pool capital. This is a critical service without which there'd be no economy at all.

Drug companies are not little angels with perfect behaviour. But without them, a lot of us would currently be dead.

And so on and so on.

We live in a complex world. If you only look for the worst, that's exactly what you'll find. If you look for hard facts, you'll see that there's never been a better time. Perhaps you would then ask - who benefits from keeping you continually outraged? Only the media, and a certain type of politician, and late-night comedy hosts. Certainly not you, and definitely not the rest of the world.

Yes but when you talk about system-wide decisions, it's not really clear which one will save the most lives.

If drug companies are made to sell drug x cheaper, maybe they end up charging more for drug y, or now they can no longer afford to invent drug z.

So we can look at someone dying for lack of $800 and say that's clearly a big mistake, but it's not clear what trade-offs and adjustments would make the system solve this problem without also making even worse mistakes elsewhere.

To measure our system, the best you can probably do is population-wide stats, like life expectancy, infant mortality, maybe average height (healthier populations being taller). On those metrics, we're making tremendous progress.

> IDK about your philosophy, but any death that is 100% unavoidable invalidates the entire system of business that has been built.

Assuming you meant avoidable, I don't think there is ANY system of business that avoids EVERY avoidable death. Often saving each life may be 100% possible, but it may not be possible to save every life. As a real example, I would guess most civilians in Gaza that will die in the next month could have their death avoided if their singular life were the #1 priority of every around them. However, I do not think the humanitarian crisis in Gaza can be entirely solved within the next month so that no civilian will die (even assuming cooperation from both sides and massive external aid).

The absolutism in your comments is not conducive to productive conversation. I would guess there are many people on HN that are too pro capitalism and don't recognize how it fails many people, but being absolutist to the point of impossibilities does not make you convincing.

Sorry, yes I meant avoidable.

I'm aiming this in terms of businesses and corporations, not international conflicts and wars.

Ultimately, when it comes to businesses and corporations that are in direct connection with life and death (e.g., drug companies, architecture firms, power companies, water companies, etc), then everything must be done within their power to ensure that the risk of death is minimized as much as humanly possible. Either by de-prioritizing profits, ensuring equitable access, or any other measures that are necessary.

I understand that a company has to make a profit somewhere. But a drug company that manufactures a drug for $4/pill and then selling it for $10,000/month to treat a disease that will kill without it - all while using taxpayer funds/grants/federal money to fund the research is heinous, greedy, and antithetical to what it means to be a human in a society.

Private power companies (like my local one, Georgia Power) making $2bn/year charging $180/month for a 1 bedroom, 660sqft apartment is criminal. Especially as I understand and knew many families growing up that would spend half their month with no power until their next paycheck.

It's on me that my original comment was absolutist, but it's my principles.

In sane countries, HIV drugs cost dozens of dollars per month. In the US, those same HIV drugs retail for thousands of dollars for only a 30-day supply.

Similarly, companies that patent HIV drugs purposely hold off on bringing new, better drugs to market until the patents for their old drugs expire. For example, Gilead held on to Descovy and timed its launch to conveniently match up with the patent expiration of their drug Truvada. It's planned obsolescence in drug form.

Truvada had common complications like kidney damage and failure, and bone density loss, that Descovy mitigated. Had Gilead brought Descovy to market sooner, instead of holding on to it until Truvada's patent expiration, people could have had the option to choose between the two drugs, and those at risk of complications wouldn't have received needless kidney damage/failure and bone deterioration from their only option on the market.

During Truvada's patent period, Gilead raised prices practically every year, and a drug that already cost $2k a month suddenly cost over $4,500 a month towards the end of its patent protection period. In other countries, it cost $40.

Gilead is now doing the same thing with Descovy, charging $2,600 a month with rising prices for a drug that costs far less in sane countries.

Just because things might be "better", doesn't mean they're perfect, and doesn't mean they don't need to improve.

As an aside, these are drugs that prevent the acquisition of HIV in the first place. AIDS could virtually be eradicated in the US if HIV prophylaxis was widespread and affordable.

> I refuse to accept a system that accepts avoidable deaths as a "necessary" consequence of their business model.

Your first line doesn't just exclude systems that "accept" such things, it sounds like it excludes every system that isn't perfect.

In other words, it excludes all big systems. Your world would collapse immediately.

Though whether the line I quoted means the same thing depends on what you mean by "accepts". Is always striving for better enough? Or do you demand unrealistic expectations? Mistakes are inevitable; is "inevitable" different from "necessary"?

Bank overdraft fees are entirely optional and preventable. Consumers can turn off overdraft protection on their accounts.

https://www.nerdwallet.com/article/banking/avoid-overdraft-f...