NationStates

LimaUniformNovemberAlpha wrote:

USS Monitor wrote:Drug prices are so damn high because the healthcare system's payment structure is too convoluted, allowing people to just pass costs on rather than being held accountable by market pressures.

"Market pressures" do not apply to products where it's literally "buy or die."

Yes, they do. People die of treatable illnesses all the time because they were unable to afford treatment. This is a problem, but it probably would not be much more common under a free market because you would not have such inflated prices. For a parallel, look at colleges: Government subsidies to help people pay for college haven't made it easier for the average person to afford college. They've just allowed colleges to jack up prices.

Furthermore, not all prescriptions are literally "buy or die." Many people are on prescription drugs that they would not die if they stopped, cut back, or switched to a different medication. Perhaps the drug they are on is the most effective, or it's something they wanted to try because they were having trouble controlling the symptoms of a chronic condition, or it's something they nagged their doctor into prescribing after they saw a catchy ad on TV -- but it is not always the only option available.

USS Monitor wrote:Drug companies can price gouge insurance companies, and people will still demand that their insurance cover it. In a normal market, customers would look for cheaper alternatives

Which aren't always available if something is patented. Sounds to me like more of a case for abolishing medical patents; at least in the private sector; than anything else.

People hike prices on non-patented drugs too. Or drugs that are patented, but that drug is not the only existing treatment for the condition it treats.

What I was discussing is a separate issue from patents, and the issue would still exist if you abolished patents. The same type of price gouging also happens with medical devices, doctor's visits, and hospital stays -- not just prescriptions.

LimaUniformNovemberAlpha wrote:

USS Monitor wrote:Drug prices are so damn high because the healthcare system's payment structure is too convoluted, allowing people to just pass costs on rather than being held accountable by market pressures.

"Market pressures" do not apply to products where it's literally "buy or die."

USS Monitor wrote:Drug companies can price gouge insurance companies, and people will still demand that their insurance cover it. In a normal market, customers would look for cheaper alternatives

Which aren't always available if something is patented. Sounds to me like more of a case for abolishing medical patents; at least in the private sector; than anything else.

"Buy or die" doesn't spontaneously create money in the hands of the would be buyer.

USS Monitor wrote:

LimaUniformNovemberAlpha wrote:"Market pressures" do not apply to products where it's literally "buy or die."

Yes, they do. People die of treatable illnesses all the time because they were unable to afford treatment. This is a problem, but it probably would not be much more common under a free market because you would not have such inflated prices. For a parallel, look at colleges: Government subsidies to help people pay for college haven't made it easier for the average person to afford college. They've just allowed colleges to jack up prices.

The obvious solution being to control said prices.

Salandriagado wrote:

USS Monitor wrote:
Yes, they do. People die of treatable illnesses all the time because they were unable to afford treatment. This is a problem, but it probably would not be much more common under a free market because you would not have such inflated prices. For a parallel, look at colleges: Government subsidies to help people pay for college haven't made it easier for the average person to afford college. They've just allowed colleges to jack up prices.

The obvious solution being to control said prices.

Which the current system is not doing, and that's kind of my point.

A free market would hold them down more than the current mess.

A public health service offering reasonable prices would be cool too.

The current system is just the worst of both worlds. It has the uneven access of a free market, where poor people don't get the same quality of care as the rich, but all the bloat and waste of an overregulated system.

Salandriagado wrote:

USS Monitor wrote:
Yes, they do. People die of treatable illnesses all the time because they were unable to afford treatment. This is a problem, but it probably would not be much more common under a free market because you would not have such inflated prices. For a parallel, look at colleges: Government subsidies to help people pay for college haven't made it easier for the average person to afford college. They've just allowed colleges to jack up prices.

The obvious solution being to control said prices.

Which would solve some problems (pure profiteering) but raise others (drugs simply not being available because it's not worth anybody's time or money to make them). It's fun to pretend the problems are all price gouging, but that's not the case. Like everything else, making drugs costs money, and sometimes the costs go up. (And since inflation is an average, some costs/prices will go up faster than inflation, by definition.)

Northwest Slobovia wrote:

Salandriagado wrote:
The obvious solution being to control said prices.

Which would solve some problems (pure profiteering) but raise others (drugs simply not being available because it's not worth anybody's time or money to make them). It's fun to pretend the problems are all price gouging, but that's not the case. Like everything else, making drugs costs money, and sometimes the costs go up. (And since inflation is an average, some costs/prices will go up faster than inflation, by definition.)

Yeah, that's not a thing. Once the development done, drug sales are essentially pure profit, so it's worthwhile at basically any price level. The actual manufacturing costs of most drugs are tiny: the cost is all in the R&D, which has already happened by the time the question comes up.

I like how the mere mention of state branded generic drugs has riled people up because "think of the poor pharmaceutical companies".

Further proof the US isn't a properly civilised country.

Salandriagado wrote:

Northwest Slobovia wrote:Which would solve some problems (pure profiteering) but raise others (drugs simply not being available because it's not worth anybody's time or money to make them). It's fun to pretend the problems are all price gouging, but that's not the case. Like everything else, making drugs costs money, and sometimes the costs go up. (And since inflation is an average, some costs/prices will go up faster than inflation, by definition.)

Yeah, that's not a thing. Once the development done, drug sales are essentially pure profit, so it's worthwhile at basically any price level. The actual manufacturing costs of most drugs are tiny: the cost is all in the R&D, which has already happened by the time the question comes up.

You're overlooking one important thing though: new drugs are patented years before they reach the market, and that reduces the amount of time they have to recoup those R&D costs before they lose their monopoly, so they have to charge more for it to make up for that lost time.

Costa Fierro wrote:I like how the mere mention of state branded generic drugs has riled people up because "think of the poor pharmaceutical companies".

Further proof the US isn't a properly civilised country.

Pretty sure nobody has said that.

Salandriagado wrote:

Northwest Slobovia wrote:Which would solve some problems (pure profiteering) but raise others (drugs simply not being available because it's not worth anybody's time or money to make them). It's fun to pretend the problems are all price gouging, but that's not the case. Like everything else, making drugs costs money, and sometimes the costs go up. (And since inflation is an average, some costs/prices will go up faster than inflation, by definition.)

Yeah, that's not a thing. Once the development done, drug sales are essentially pure profit, so it's worthwhile at basically any price level. The actual manufacturing costs of most drugs are tiny: the cost is all in the R&D, which has already happened by the time the question comes up.

Bullshit.

Drugs don't just happen, they're made. People need to be paid to make them. For any given dosage of any given drug, some amount of labor went into making them. If a company can sell a lot of doses, the cost per dose is small. But drugs to treat rare diseases are made in small batches, so the labor cost per dose is high. It's a persistent problem. Is there gouging in there as well? You're damn right there is! But it's not all gouging, it's the cost of what amounts to artisanal work.

Drugs are made of stuff. In the end, sure, it's all just oil, but in the end, your phone is just sand, a little oil, a trace of gold, and a few other metals. Pharma companies start with stuff equivalent to integrated circuits: sophisticated products in their own right. Many of them are cheap. Some are not; it's the same difference as between memory and CPUs. Drugs that are made from expensive starting materials cost more; it's why "biologics" are so expensive; making them does cost thousands of dollars a shot with current technology.

Finally, complying with FDA regs for purity and safety costs. Again, the more stuff a company can make, the less the cost per dose. But it's not free, not by a long shot.

This is also a problem for the generics industry: getting a drug factory approved for operation and keeping it that way is a huge cost, and it keeps people from making generic drugs. Which is what allows the gouging in the first place. Drug regs are always a tradeoff between costs and risks; changing the regs is probably desirable, but doing so without getting more people killed isn't easy.

Mestovakia wrote:Why are the drug prices so high? Greedy drug manufacturer executives I bet. Shkreli Syndrome.

difficulty to import cheaper drugs from the RoW, R&D costs (america is a leading country on that regard afaik), possible high costs to get all the staffing of researchers and chemical engineers, FDA's insane bureaucracy to approve new drugs, IP laws, high capital barriers which stifle competition etc etc etc

Salandriagado wrote:

USS Monitor wrote:
Yes, they do. People die of treatable illnesses all the time because they were unable to afford treatment. This is a problem, but it probably would not be much more common under a free market because you would not have such inflated prices. For a parallel, look at colleges: Government subsidies to help people pay for college haven't made it easier for the average person to afford college. They've just allowed colleges to jack up prices.

The obvious solution being to control said prices.

yes because price controls are very effective and will definitely not cause distortions since they aren't applied on a case by case basis, very good logic right there

Telconi wrote:

Costa Fierro wrote:I like how the mere mention of state branded generic drugs has riled people up because "think of the poor pharmaceutical companies".

Further proof the US isn't a properly civilised country.

Pretty sure nobody has said that.

Pretty sure you don't need to say something to believe it.

Costa Fierro wrote:

Telconi wrote:
Pretty sure nobody has said that.

Pretty sure you don't need to say something to believe it.

And does anyone believe it?

Northwest Slobovia wrote:Is there gouging in there as well? You're damn right there is! But it's not all gouging, it's the cost of what amounts to artisanal work.

Hmm, if only there were a way to test that theory, such as, let's say, institutions accountable to the voters that could be made to open the books on the process of R&D so we can actually find out how much it really cost to make them in the first place...

Costa Fierro wrote:

Telconi wrote:
Pretty sure nobody has said that.

Pretty sure you don't need to say something to believe it.

"yeah people are saying it"
"where"
"i dont have to cite it!"

LimaUniformNovemberAlpha wrote:

Northwest Slobovia wrote:Is there gouging in there as well? You're damn right there is! But it's not all gouging, it's the cost of what amounts to artisanal work.

Hmm, if only there were a way to test that theory, such as, let's say, institutions accountable to the voters that could be made to open the books on the process of R&D so we can actually find out how much it really cost to make them in the first place...

given the increasingly diminishing returns over R&D despite soaring drug prices, probably a lot

Great Minarchistan wrote:

LimaUniformNovemberAlpha wrote:Hmm, if only there were a way to test that theory, such as, let's say, institutions accountable to the voters that could be made to open the books on the process of R&D so we can actually find out how much it really cost to make them in the first place...

given the increasingly diminishing returns over R&D despite soaring drug prices, probably a lot

^ actually as a friendly reminder i recommend taking a read on the link provided by the citation above, somewhat relevant to the topic

Samadhi wrote:

The New California Republic wrote:The fuck? Why?

The state is bad.
Anything the state does is bad.
Wanting the state to do more is bad.

Must be nice living wealthy in Smurf Village being able to afford the exorbitant prices of proprietary drugs.

Gormwood wrote:

Samadhi wrote:
The state is bad.
Anything the state does is bad.
Wanting the state to do more is bad.

Must be nice living wealthy in Smurf Village being able to afford the exorbitant prices of proprietary drugs.

Are people living in Smurf Village stereotypically wealthy? I'd heard that it's now heavily afflicted by homelessness and poverty, particularly connected with the opioid crisis.

Cekoviu wrote:

Gormwood wrote:Must be nice living wealthy in Smurf Village being able to afford the exorbitant prices of proprietary drugs.

Are people living in Smurf Village stereotypically wealthy? I'd heard that it's now heavily afflicted by homelessness and poverty, particularly connected with the opioid crisis.

Damn Smurfberries are natural opiates.

Gormwood wrote:

Samadhi wrote:
The state is bad.
Anything the state does is bad.
Wanting the state to do more is bad.

Must be nice living wealthy in Smurf Village being able to afford the exorbitant prices of proprietary drugs.

Literally what?

Telconi wrote:

Gormwood wrote:Must be nice living wealthy in Smurf Village being able to afford the exorbitant prices of proprietary drugs.

Literally what?

don't worry about that, gauth may as well be using fentanyl while complaining about pharma prices

Great Minarchistan wrote:

Telconi wrote:
Literally what?

don't worry about that, gauth may as well be using fentanyl while complaining about pharma prices

Calling me an opioid addict, classy.

Gormwood wrote:

Great Minarchistan wrote:don't worry about that, gauth may as well be using fentanyl while complaining about pharma prices

Calling me an opioid addict, classy.

not at all, maybe you have some sort of medical condition which makes you need to take in fentanyl to have pain relief -- which is what i assumed given your previous comments on kidney failure