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Old 28th December 2019, 09:04 AM   #1
RecoveringYuppy
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Cost of medical devices

From another thread where this would (and is already starting to be) a possibly inappropriate derail.

Originally Posted by Horhang View Post
The treatment, optune apparently has a price tag of 21,000$/ month.
I am at a total loss on this price. The electrodes and battery packs involved cannot in any way justify this price.
I hate to say it but this appears to be gouging the desperate for the last dime.
Price of the units cannot be more than at most a few 1000 dollars. Those units Do not appear to be one time use, or at least the battery packs are not, and those would be the most expensive component.
21,000 per month is extortion for people with this cancer.
The battery pack might be the most expensive part in the device but the most expensive component is the research that went in to to it. Stop paying for that and these devices don't get developed. The price has to cover the entire company of Novocure, any third parties that may have contributed to the development, and any external costs arising from the clinical trial and regulatory processes.

The only way the cost of the components could be relevant here is if absolutely no thought or testing went in to the creation of this device.

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Old 28th December 2019, 06:34 PM   #2
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Originally Posted by RecoveringYuppy View Post
From another thread where this would (and is already starting to be) a possibly inappropriate derail.



The battery pack might be the most expensive part in the device but the most expensive component is the research that went in to to it. Stop paying for that and these devices don't get developed. The price has to cover the entire company of Novocure, any third parties that may have contributed to the development, and any external costs arising from the clinical trial and regulatory processes.

The only way the cost of the components could be relevant here is if absolutely no thought or testing went in to the creation of this device.
There are a few other expenses too
1. R&D for stuff that ends up not working
2. Subsidies for countries that can demand better prices.

If the USA government negotiated the price for medical devices and that is the only price the manufacturer could sell the device for then the price would go down. This is what happens in many countries.
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Old 28th December 2019, 08:42 PM   #3
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I understand the rd component of the cost. The testing of this would be a minimal cost it seems to me. Even if the testing is a large component of the rd cost, the 21,000$/month is exorbitant. Cost of production and operation can not be anywhere close to this number. The units themselves would seem to be reusable and so reduce the cost. The numbers just make no sense to me.
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Old 29th December 2019, 01:29 PM   #4
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For medical devices liability has to be factored in.

For those who have not followed this what device is this about?
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Old 29th December 2019, 01:39 PM   #5
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Originally Posted by rjh01 View Post
There are a few other expenses too
1. R&D for stuff that ends up not working
2. Subsidies for countries that can demand better prices.

If the USA government negotiated the price for medical devices and that is the only price the manufacturer could sell the device for then the price would go down. This is what happens in many countries.
I am not sure in what way this is a subsidy?

In a market the price is what the market will bare. If people will pay more in the US then that is the price, in Namibia it is likely no one can afford it so none are sold. Elsewhere the device will sell above cost but the costs may be lower; liability is less outside of the US there is no to patient marketing. Health services can bulk purchase. Many drugs and devices are developed outside of the US, US prices are high because of the US health care system.
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Old 29th December 2019, 01:47 PM   #6
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Originally Posted by Planigale View Post
For those who have not followed this what device is this about?
"Optune" by https://www.novocure.com/.

As best I know now, this is a 600 person company in business for 19 years and just this year got approval to begin treating patients outside of clinical trials (at least in the US, they have an Israeli subsidiary). Apparently it is currently only approved for treating glioblastoma.

If they were at 600 employees since their founding, nineteen years could easily have been 1.5 billion of research investment. Their current operating costs could easily be 6 million per month.

In the US about 3,000 people per year are newly diagnosed with glioblastoma. Given that this device is new and controversial, how many new patients would be treated with this? At 21K per month covering their operating costs would require something around 300 patients at any given point in time. I don't know how long the treatment lasts.

That would be just to cover current operating costs and not recouping past investment. If my assumptions are correct, recouping the presumed billion+ investment over ten years would require another 600 patients at any time.

Presumably the current staff is doing research to extend to other tumors, so that would be covered in the operating cost I estimated above.

Take all my numbers with a grain of salt for the moment, fair amount of assuming in some of the numbers.

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Old 29th December 2019, 01:55 PM   #7
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Just came across their financials.

https://3sj0u94bgxp33grbz1fkt62h-wpe...ntation_vF.pdf

They've only had one barely profitable quarter just recently.


ETA: If I'm reading it right (see page 5) they have just passed the 900 patient number I guesstimate above for being able to recoup investment and cover operating cost at 21K/month per current patient.

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Old 3rd January 2020, 09:49 PM   #8
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Saw my brother today and so have more information on how this works.
There is a print out of his head with notes on where the electrodes get placed. The electrodes need to be changed every 3-4 days. The electrodes are replaced by the user, so there is no medical service provider involved.
Basically he was given a duffle bag of medical supplies: electrodes, sterilizing wipes, gauze to cover the electrodes, a specialized razor to shave his head. All supplies replenished as used. No medical specialists involved after the mapping of the tumor, which was already done.
The batteries last about 2-3 hours. They have 4 batteries and a charging station that will hold and charge 3 batteries. When seated and stationary the system can be plugged in and run while charging the battery in use. It needs to be on for at least 18 hours/day. More is better apparently, but the minimum is 18 hrs.
Basically it is all a run it yourself system. How is that 21,000 $/month? Other than the set up, no medical personnel are involved in the use. It is user run.
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Old 3rd January 2020, 11:40 PM   #9
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As the consumer of many, many medical devices, I don't begrudge the companies the profits from new inventions, from the time put into dead end research, and from the cost of testing and paying the FDA for the chance at approval.

I do get a bit sore at the concept that the devices are being dumped outside our borders for cost because the US's largest medical insurer (the US itself) has limited ability to bargain down the price of the instrument.

Trump actually campaigned on this and, of all his insane promises and crazy xenophobias, this was the one thing I hoped he'd follow through on. He hasn't and he isn't going to.
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Old 4th January 2020, 03:42 AM   #10
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Originally Posted by Planigale View Post
I am not sure in what way this is a subsidy?

In a market the price is what the market will bare. If people will pay more in the US then that is the price, in Namibia it is likely no one can afford it so none are sold. Elsewhere the device will sell above cost but the costs may be lower; liability is less outside of the US there is no to patient marketing. Health services can bulk purchase. Many drugs and devices are developed outside of the US, US prices are high because of the US health care system.
And at least one study showed the productivity of drug companies outside the US was proportional to whether they sold into places like the US or not.

In any case, subsidy is more about other governments mandating lower costs, not what supply and demand could bring in there.

The choice isn't between high priced new drugs and low priced new drugs. That's a lie from politicians. The choice is between high priced new drugs and no new drugs, or fewer and on a much protracted development rate.


Proof: Let's try the same thing with iPhones and see if the new technical marvels come out apace with the price capped at $100 instead of $1000. Or $25. What? You ran that politician out of town on a rail?
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Old 4th January 2020, 06:05 AM   #11
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Originally Posted by Beerina View Post
The choice isn't between high priced new drugs and low priced new drugs. That's a lie from politicians. The choice is between high priced new drugs and no new drugs, or fewer and on a much protracted development rate.

Well, let's not aim for the ridiculous extremes. A pharmacy company builds a factory, the factory can make 1,000 units. Rather then sell each unit at a fair price, they frequently sell 100 units to the US at a very high price and dump the 900 units overseas for far less. In fact, the world may only need 800 units total, but the factory is most efficient at 1,000 units. Then they've got 200 units they can just give away

The US could demand that it not pay so high a price, but pay a fair price. This may raise costs around the world, but it won't raise them beyond a fair price, which is what the US pays.



Quote:
Proof: Let's try the same thing with iPhones and see if the new technical marvels come out apace with the price capped at $100 instead of $1000. Or $25. What? You ran that politician out of town on a rail?

It doesn't have to be $100. It can be $800. That's 20% less and does nothing but force Apple to raise its prices slightly for the other 6,700,000,000,000 people on the earth who aren't Americans.
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Old 4th January 2020, 09:14 AM   #12
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I hate to say the obvious but it is complicated. It is often very expensive to develop new drugs and many fail at the late stages of testing. The costs of both the successes and failures have to be recouped somehow, now typically by charging incredible amounts for some of the successful drugs. Yet what of a patient facing $200,000 a year for their new anti-cancer drug? Especially if the manufacturer can still do fine financially even when steeply discounting that drug for certain insurance companies or overseas? And what of companies that suddenly increase the cost of long established drugs like insulin 4 or 5 fold despite no new research or costs?

Capitalism also fails to direct drug development to the most important needs. The best example is the lack of efforts to develop new drugs for antibiotic resistance, probably one the the biggest threats we face, because these drugs by their very nature will not generate substantial profits.

It is important to note that drug companies benefit immensely and essentially for free from all the basic research paid for by NIH and the federal government! They owe USA citizens for this.

Basically I think that pricing by the pharmaceutical industry needs to be more tightly regulated by the government and a mix of subsidies, taxes, and other incentives need to be put into place for the most critical drugs and devices.
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Old 4th January 2020, 09:44 AM   #13
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Originally Posted by Horhang View Post
I understand the rd component of the cost. The testing of this would be a minimal cost it seems to me. Even if the testing is a large component of the rd cost, the 21,000$/month is exorbitant. Cost of production and operation can not be anywhere close to this number. The units themselves would seem to be reusable and so reduce the cost. The numbers just make no sense to me.
Here, I'll print up an invoice for you.

Hitting the engine with a hammer: $1,000

Knowing where to hit the hit the engine: $20,000

You're not paying for the device. You're paying for a device that actually treats cancer with electromagnetic waves. That is a non-trivial achievement, and it cost some people a non-trivial amount of money to figure it out and package in a device that works.
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Old 4th January 2020, 12:22 PM   #14
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Originally Posted by theprestige View Post
Here, I'll print up an invoice for you.

Hitting the engine with a hammer: $1,000

Knowing where to hit the hit the engine: $20,000

My favorite story is about the guy who calls his lawyer to say the FBI is going through his files. The lawyer shouts, "Don't say anything," and bills him $400. The guy gets the bill and calls the lawyer angrily. "You charged me $400 for three words? Why should I even listen to you?" The lawyer answers, "Because I said so," and bills another $500.
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Old 4th January 2020, 01:24 PM   #15
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Once you have the mapping and electrode placements in hand, the actual device delivering the current shouldn't be that hard to reverse engineer. No need to even open the case. Put a scope on the electrodes, when not attached and then when attached. Look online for schematics that can generate the same signals.

Just sayin'. Of course no one should ever infringe on someone else's patent for their own personal use, even if their survival and their life's savings are at stake.
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Old 5th January 2020, 12:35 AM   #16
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Originally Posted by Loss Leader View Post
Well, let's not aim for the ridiculous extremes. A pharmacy company builds a factory, the factory can make 1,000 units. Rather then sell each unit at a fair price, they frequently sell 100 units to the US at a very high price and dump the 900 units overseas for far less. In fact, the world may only need 800 units total, but the factory is most efficient at 1,000 units. Then they've got 200 units they can just give away

The US could demand that it not pay so high a price, but pay a fair price. This may raise costs around the world, but it won't raise them beyond a fair price, which is what the US pays.




It doesn't have to be $100. It can be $800. That's 20% less and does nothing but force Apple to raise its prices slightly for the other 6,700,000,000,000 people on the earth who aren't Americans.

This is not very accurate. See this YouTube for the correct answer
YouTube Video This video is not hosted by the ISF. The ISF can not be held responsible for the suitability or legality of this material. By clicking the link below you agree to view content from an external website.
I AGREE

Quote:
In the US drug companies sell to consumers at the price the consumer is willing to pay. In the rest of the world the price is determined by the local government.

...drugs are more expensive in the US because they're cheaper everywhere else.
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Old 5th January 2020, 05:44 AM   #17
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Originally Posted by Beerina View Post
And at least one study showed the productivity of drug companies outside the US was proportional to whether they sold into places like the US or not.

In any case, subsidy is more about other governments mandating lower costs, not what supply and demand could bring in there.

The choice isn't between high priced new drugs and low priced new drugs. That's a lie from politicians. The choice is between high priced new drugs and no new drugs, or fewer and on a much protracted development rate.


Proof: Let's try the same thing with iPhones and see if the new technical marvels come out apace with the price capped at $100 instead of $1000. Or $25. What? You ran that politician out of town on a rail?
Why not let the market decide?
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Old 5th January 2020, 07:58 AM   #18
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Originally Posted by Horhang View Post
Saw my brother today and so have more information on how this works.
There is a print out of his head with notes on where the electrodes get placed. The electrodes need to be changed every 3-4 days. The electrodes are replaced by the user, so there is no medical service provider involved.
Basically he was given a duffle bag of medical supplies: electrodes, sterilizing wipes, gauze to cover the electrodes, a specialized razor to shave his head. All supplies replenished as used. No medical specialists involved after the mapping of the tumor, which was already done.
The batteries last about 2-3 hours. They have 4 batteries and a charging station that will hold and charge 3 batteries. When seated and stationary the system can be plugged in and run while charging the battery in use. It needs to be on for at least 18 hours/day. More is better apparently, but the minimum is 18 hrs.
Basically it is all a run it yourself system. How is that 21,000 $/month? Other than the set up, no medical personnel are involved in the use. It is user run.
You're not paying for the set up. You're paying for the science behind it, that ensures that that it works, that it's safe for humans, and that it can be conducted easily by the patient in the convenience of their own home.

Why do you keep dismissing the years of effort that it took to make this treatment available to your brother, and the cost of that effort?
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Old 5th January 2020, 09:13 PM   #19
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Originally Posted by theprestige View Post
You're not paying for the set up. You're paying for the science behind it, that ensures that that it works, that it's safe for humans, and that it can be conducted easily by the patient in the convenience of their own home.

Why do you keep dismissing the years of effort that it took to make this treatment available to your brother, and the cost of that effort?
I am not dismissing the years of research to make the device available. I am questioning the cost. 21,000 per month is exorbitant.
It borders on extortion. Survival rate at 2 years moves from 31% to 43%.
At 5 years it is an increase in survival from 5% to 13%.
Given that this cancer is an almost certain death sentence, and that the increase in survival with the treatment is what I would consider small, any increase is obviously good. Still the cost seems exorbitant. Of course anyone who can will pay for and use the treatment, but the costs are prohibitive for most unless insurance is going to cover it.
My brother is on disability leave from work and so still covered by insurance. I do not know how long this can continue. If he runs out of time on disability and is released from his position at work he will lose his insurance. He then will have to find a way to pay for a 21,000$/month treatment that is the only thing between life and a certain death from his cancer.
I guess my main point in this is that medical treatments need to be affordable. A treatment that costs as much as some people earn in a year per month is not affordable. How we solve this problem I do not know. But this is a problem.
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Old 5th January 2020, 09:21 PM   #20
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Statistics on survival from the companies website:
https://www.optune.com/clinical-study-results

Last edited by Horhang; 5th January 2020 at 09:23 PM. Reason: In changed to on because I suck at typing on a tablet
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Old 5th January 2020, 09:37 PM   #21
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Originally Posted by Horhang View Post
I am not dismissing the years of research to make the device available.
Yes. You are. You've assessed the cost of this device multiple times now and every time you ignored the years of research. You also ignored every other actual cost of the device and focused on minor stuff that has virtually no bearing on the cost.

Originally Posted by Horhang View Post
Still the cost seems exorbitant. Of course anyone who can will pay for and use the treatment, but the costs are prohibitive for most unless insurance is going to cover it.
My brother is on disability leave from work and so still covered by insurance. I do not know how long this can continue.

This is the actual problem. We need rational health insurance.
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Old 10th January 2020, 02:38 AM   #22
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Originally Posted by Horhang View Post
I am not dismissing the years of research to make the device available. I am questioning the cost. 21,000 per month is exorbitant.
It borders on extortion. Survival rate at 2 years moves from 31% to 43%.
At 5 years it is an increase in survival from 5% to 13%.
Given that this cancer is an almost certain death sentence, and that the increase in survival with the treatment is what I would consider small, any increase is obviously good. Still the cost seems exorbitant. Of course anyone who can will pay for and use the treatment, but the costs are prohibitive for most unless insurance is going to cover it.
My brother is on disability leave from work and so still covered by insurance. I do not know how long this can continue. If he runs out of time on disability and is released from his position at work he will lose his insurance. He then will have to find a way to pay for a 21,000$/month treatment that is the only thing between life and a certain death from his cancer.
I guess my main point in this is that medical treatments need to be affordable. A treatment that costs as much as some people earn in a year per month is not affordable. How we solve this problem I do not know. But this is a problem.
One problem is that glioblastoma for which this is currently used is a fairly rare cancer so the number of units sold is small. The fixed costs of development and trials are high. It is being tried in more common cancers, e.g. lung cancer. If it is effective in lung cancer then the number of potential patients will be much greater and the fixed costs can be divided between many more units. So one might expect the price to fall. (Or it might not given this is the price the market will pay.) Certainly there is a tendency to pay a high price for something that is rare as treating a few people with something expensive does not total much. For the health care economy an expensive treatment for a common condition is unaffordable.
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Old 10th January 2020, 02:54 AM   #23
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Originally Posted by Horhang View Post
I am not dismissing the years of research to make the device available. I am questioning the cost. 21,000 per month is exorbitant.
It borders on extortion. Survival rate at 2 years moves from 31% to 43%.
At 5 years it is an increase in survival from 5% to 13%.
Given that this cancer is an almost certain death sentence, and that the increase in survival with the treatment is what I would consider small, any increase is obviously good. Still the cost seems exorbitant. Of course anyone who can will pay for and use the treatment, but the costs are prohibitive for most unless insurance is going to cover it.
My brother is on disability leave from work and so still covered by insurance. I do not know how long this can continue. If he runs out of time on disability and is released from his position at work he will lose his insurance. He then will have to find a way to pay for a 21,000$/month treatment that is the only thing between life and a certain death from his cancer.
I guess my main point in this is that medical treatments need to be affordable. A treatment that costs as much as some people earn in a year per month is not affordable. How we solve this problem I do not know. But this is a problem.
Separate post as addressing a different aspect.

In the UK there is an organisation called NICE (National Institute for Clinical Excellence). This assesses new drugs and technologies and makes recommendations on their use. They look at benefits in terms of DALYs - Disability adjusted life years. Essentially the quality and quantity of life gained from a treatment. They have an upper limit of how much a life is worth, I think it is £40,000 per DALY but this might have changed, the detail is unimportant for the argument. This means that they will approve a one year course of treatment that costs £400,000 if people gain ten years of good quality life. But if on average you gain 3 months of poor quality life then a course of treatment will not be recommended. This is a population based assessment not a per person.

This tends to put an upper limit on the price companies charge in the UK as they know what the market will bare.

Now that does not mean the treatment is unavailable if it is above the limit. You can buy it yourself, if you have private health insurance they may fund part or all of the cost. There are special funds for rare diseases which tend to have disproportionately high cost treatments. If your doctor feels you are an exceptional case they can request the treatment on an exceptional case basis. (An example of this might be a person with complex medical issues who cannot receive the standard treatment because of other medical conditions but who could be treated with the expensive treatment. One off expensive treatments do not bankrupt the national budget, but if everyone gets £100,000 / yr hypertensives that is a disaster.)
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Old 13th January 2020, 10:30 AM   #24
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Let's pretend there are only 4 countries in which a company can sell a medical device. 3 of those countries artificially cap the price they will pay per month at $5000, the 4th has no cap. Let's say the development and ongoing operational costs of the device company can be put at $5 million per month (to recoup development costs over a 5 year period) and there are about 500 patients in the world per month who need the device.

It stands to reason that the country without a cap is going to pay more. A lot more. If that 4th country institutes a $5000 cap as well, the company is not going to turn a profit anytime soon. That could very well mean that there is no company and no one benefits from the device.

We make it so damn difficult, expensive and time consuming to simply bring a medical product to market and all that effort might be wasted if the product isn't approved. Add to that, the cost of getting the word out about the product and convincing doctors to prescibe the new product over existing treatments -that's not easy either. We can't have it both ways: either we relax FDA standards and thereby the cost to come to market OR we accept that new products are going to be expensive for awhile.

We demonize these companies and sometimes it's valid -insulin, for example. But most of the time, I don't think we are thinking it through.
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Old 13th January 2020, 12:03 PM   #25
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Originally Posted by xjx388 View Post
Let's pretend there are only 4 countries in which a company can sell a medical device. 3 of those countries artificially cap the price they will pay per month at $5000, the 4th has no cap. Let's say the development and ongoing operational costs of the device company can be put at $5 million per month (to recoup development costs over a 5 year period) and there are about 500 patients in the world per month who need the device.

It stands to reason that the country without a cap is going to pay more. A lot more. If that 4th country institutes a $5000 cap as well, the company is not going to turn a profit anytime soon. That could very well mean that there is no company and no one benefits from the device.

We make it so damn difficult, expensive and time consuming to simply bring a medical product to market and all that effort might be wasted if the product isn't approved. Add to that, the cost of getting the word out about the product and convincing doctors to prescibe the new product over existing treatments -that's not easy either. We can't have it both ways: either we relax FDA standards and thereby the cost to come to market OR we accept that new products are going to be expensive for awhile.

We demonize these companies and sometimes it's valid -insulin, for example. But most of the time, I don't think we are thinking it through.
I am unsure why this is artificial. In the UK all that happens is the NHS says we will not buy drug X if your price is £8K, but we offer to buy it at £4K. The company selling the drug can take the offer or walk away. It may come back with a counter offer of £6K*. In the mean time if someone can afford £8K then they can buy it for that price. It may be better for the company to have a secure contract for 100 lots / yr for 5 years at £6K, rather than selling 10 lots at £8K and not knowing if the individuals will run out of money and not keep on paying for 5 years. That is a market, no more artificial than any other.

One of the problems about costs is the mechanism of financing differs from traditional biopharma. There you have a company with secure income from its extant stable of drugs that can invest that income in new drugs. Essentially their money is cheap. They just have to have some growth in share price and a moderate dividend.

A lot of start ups by in a molecule often from a university. The investors will then sell on a successful molecule to another group of financiers but have to make a massive return on the successful molecules to recoup the cost of unsuccessful ones. Venture capitalists are not fundamentally interested in the drug development, they are looking for large profits. Often these new start ups can be heavily loaded with expensive debt. My guess is if you look at the whole time course the cost of capital in a venture capital funded molecule may be greater than if it is developed through a traditional drug company.

* In addition other costs may be lower, selling to a single purchaser, lower liability risks than in say the US market and minimal marketing costs. Having the same price for the UK market and the US market might mean that the actual profit was higher in the UK than the US, so identical pricing might mean the UK was 'subsidising' the US.

Last edited by Planigale; 13th January 2020 at 12:05 PM.
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Old 15th January 2020, 12:38 AM   #26
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Originally Posted by xjx388 View Post
Let's pretend there are only 4 countries in which a company can sell a medical device. 3 of those countries artificially cap the price they will pay per month at $5000, the 4th has no cap. Let's say the development and ongoing operational costs of the device company can be put at $5 million per month (to recoup development costs over a 5 year period) and there are about 500 patients in the world per month who need the device.

It stands to reason that the country without a cap is going to pay more. A lot more. If that 4th country institutes a $5000 cap as well, the company is not going to turn a profit anytime soon. That could very well mean that there is no company and no one benefits from the device.

We make it so damn difficult, expensive and time consuming to simply bring a medical product to market and all that effort might be wasted if the product isn't approved. Add to that, the cost of getting the word out about the product and convincing doctors to prescibe the new product over existing treatments -that's not easy either. We can't have it both ways: either we relax FDA standards and thereby the cost to come to market OR we accept that new products are going to be expensive for awhile.

We demonize these companies and sometimes it's valid -insulin, for example. But most of the time, I don't think we are thinking it through.
If the USA had the same arrangements as most of the rest of the world then most countries would be paying about the same for the drugs. This would be slightly higher than the current non USA price. If one country refuses to pay that price then they would not have that drug.

NB: The above is grossly simplified. For example poor countries should be able to buy the same drug far cheaper than the rich countries as everyone knows that is all they can afford and a small profit is better than none.
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Old 15th January 2020, 05:08 AM   #27
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I am not familiar with the system, but presumably the true artificial market is what keeps drug prices high in the US, there must be some sort of barrier in the market otherwise people would just buy the drug at a lower price in Mexico or Canada or Cuba rather than at a high price in the US.
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Old 15th January 2020, 05:34 AM   #28
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Originally Posted by Planigale View Post
I am not familiar with the system, but presumably the true artificial market is what keeps drug prices high in the US, there must be some sort of barrier in the market otherwise people would just buy the drug at a lower price in Mexico or Canada or Cuba rather than at a high price in the US.
It took the combined trade pressure of the EU to open the market up so if drugs are being sold in one EU country cheaper than another they can be shipped around the EU.

Sounds like the USA market is working as it should be I.e. USA folk are paying what the market will bear.

There is nothing "anti capitalist " about how (for example) the NHSs in the UK negotiate better prices than what the USA tends to pay. The USA already spends the same amount per head to cover people's healthcare on the various social benefit plans it runs so it should be able to negotiate equally as good prices as the UK NHSs can.

It seems crazy that the USA has decided to use the government to prevent a free market.
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Old 17th January 2020, 02:04 PM   #29
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Originally Posted by Darat View Post
It took the combined trade pressure of the EU to open the market up so if drugs are being sold in one EU country cheaper than another they can be shipped around the EU.

Sounds like the USA market is working as it should be I.e. USA folk are paying what the market will bear.

There is nothing "anti capitalist " about how (for example) the NHSs in the UK negotiate better prices than what the USA tends to pay. The USA already spends the same amount per head to cover people's healthcare on the various social benefit plans it runs so it should be able to negotiate equally as good prices as the UK NHSs can.

It seems crazy that the USA has decided to use the government to prevent a free market.


This seems backwards. In the UK, the State owns the medical industry for the most part and is setting a limit on what they will pay for a drug. That price may be at a loss to the company making the drug. If the UK were the only nation in which a company could operate, they would be disincentivized from spending too much money developing drugs OR the UK would have to pay much higher prices.

I never said that the USA drug market was particularly Capitalist -we have the FDA creating a very difficult barrier to market entry. However, the US market is definitely more free than the UK market because drug companies can negotiate with various insurance companies and the insurance companies can raise their premiums (somewhat) in response. Still, the US market isnít a true free market.
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