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275 points swores | 1 comments | | HN request time: 0s | source
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tompccs ◴[] No.40174095[source]
You can't compare running a clinical trial for a drug targeting a communicable disease in the developing world to trials for treatments of complex diseases in rich countries where you need serology, histopathology and radiological endpoints.

Worth noting as well that J&J have shut down their entire division in communicable diseases because it was so unprofitable for them.

(Source: I work in this industry)

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thomassmith65 ◴[] No.40174444[source]
Was it 'unprofitable' as in 'losing money', or 'unprofitable' as in 'not worth the time'? If it's the latter, I don't have enough information about the rest of J&J to draw any conclusions.
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s1artibartfast ◴[] No.40174593[source]
Financially, they are the same.

If you can make more money by not doing X, than doing X, it doesnt matter.

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kurthr ◴[] No.40175414[source]
I guess all doctors should be cosmetic surgeons then?

Seriously, the argument is that drug companies should only do the most profitable thing? If that's the case, they deserve to have all subsidies removed, and be regulated into oblivion, because they will serve no purpose, but profit.

Just see what happened with the opioid epidemic. If you're only looking at next quarters profits and destroy public trust, while skirting the legal boundaries you'll make bank until you're not.

https://www.bbc.com/news/world-us-canada-60610707

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s1artibartfast ◴[] No.40175621[source]
>Seriously, the argument is that drug companies should only do the most profitable thing?

You're the first one to make any kind of suggestion for what they should do, so I'm not sure why you're jumping to that conclusion

>If that's the case, they deserve to have all subsidies removed, and be regulated into oblivion, because they will serve no purpose, but profit.

The purpose that they serve is to save your life with drugs. If that doesn't mean anything to you and isn't worth any money then I don't think we will find much common ground.

In your analogy, drug companies are the doctors. They want to make money for saving your life. Why would you want to regulate them out of existence?

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kurthr ◴[] No.40175743[source]
Your response to:

    >Was it 'unprofitable' as in 'losing money', or 'unprofitable' as in 'not worth 
   the time'?
was:

   >If you can make more money by not doing X, than doing X, it doesnt matter.
It's confusing, because you certainly seem to imply only doing the most profitable things.

   >The purpose that they serve is to save your life with drugs. If that doesn't mean anything to you and isn't worth any money then I don't think we will find much common ground.
My point was that if their purpose is only to do the things that make marginally more money (while killing significant numbers of people or allowing them to die) such as the Sacklers and Purdue with Oxy, they deserve to be regulated into oblivion. If you think the heavy marketing and distribution of known addictive drugs into disadvantaged areas of the country is in the public interest, then I don't think we will find much common ground.

Frankly, most doctors, biochemists, and pharma-chemists I know have little difficulty seeing this. It is about helping people not just making money, and doing otherwise while selling it as the former, is unethical.

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s1artibartfast ◴[] No.40176047[source]
>It's confusing, because you certainly seem to imply only doing the most profitable things.

I thought I was clear, but I will try again. The financial calculus is the same between "losing money" and "not worth it". It doesnt matter if the J&J division of communicable disease is running a positive or negative balance if J&J (or its owners) can more doing something entirely different. The question is do we want to be losing money on this. That is not to say they can't or shouldnt keep doing it as a public service or out of altruism, but the question is the same.

>My point was that if their purpose is only to do the things that make marginally more money.

I dont think that is a valid assumption to make about the industry. 99.9% of the time, the way to make more money is to make a product that saves or cures more people. If your product saves fewer people, People would by the old thing instead of the new thing for 2x the price.

Now, everyone is free to say they dont like the price, which is fair. However, the price is high because rich American customers dont care about the price. IF they did, they could always buy the cheap old thing.

It is like someone who is angry at the butcher for the price of filet minion, but keeps paying ever higher prices, and refuses to buy the tri-tip.

Europeans prices are half the US simply because they stop buying filet minion and get tri-tip when the price gets too high. US prices are twice that because we pay it!

It is crazy to blame the butcher for raising the price when you willingly keep throwing more money at ever higher prices!

No industry anywhere in the world expects the seller to keep prices low when customers keep throwing money at them.

The fundamental problem with US healthcare costs is that not one party in the system is willing to control spending. Nobody will say no to a treatment 1% better for 200% the cost.

Patients will pay anything for the latest drug because they want it, and the costs get spread over everyone's premium. Insurance is happy to see medical costs balloon because their profit is capped as a % of healthcare costs. manufacturers are happy to see costs go up, because that's what they are selling.

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shkkmo ◴[] No.40176246[source]
> 99.9% of the time, the way to make more money is to make a product that saves or cures more people.

That is laughably optimistic.

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s1artibartfast ◴[] No.40177800[source]
so you think newer more expensive products are usually worse?
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shkkmo ◴[] No.40199634[source]
Did I say that? Putting words in people's mouths is a juvenile debate tactic.

I do think that newer more expensive products provide worse patient outcomes at rates significantly higher than 1 / 1000 times.

However, the comment I objected is discussing "ways to make money" as a pharmacutical company. Which is a generalization that is laughably naive at best. We have plenty of examples of drug companies trying to make money in ways that harm patients from how they fostered the opiod epidemic.

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s1artibartfast ◴[] No.40204462{3}[source]
I don't think it is naive, and it matches my experience. It is very rare for a company to try to develop an inferior product for many reasons, but most of all it is impractical.

Without superiority, it you will struggle with investors, trials, approval,and then convincing doctors to to switch to it.

Everyone can come up with an example, and point to per due, but the FDA processes 10s of thousands of device and drug submissions per year. Most are in cutthroat markets with competitors.

If we are talking about individual company actions or statements, and not products, then the numbers are even worse. There are literally millions of actions associated with a product, and I would again argue that >99.9 are made in the favor of patient interest.

Making a inferior product and scamming your way to profit is an exceedingly rare strategy because it is both extremely difficult execute successfully.

I think it is clear that new product development doesn't prioritize optimal patient benefit, but that is a different topic. It needs to be good enough to sell, then it becomes a question of how good vs how much money.

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1. shkkmo ◴[] No.40205551{4}[source]
> There are literally millions of actions associated with a product, and I would again argue that >99.9 are made in the favor of patient interest.

That isn't even true at non-profits, let alone for profit companies. You seem to have no idea how the world works.