Criminal company charging arm and leg for hep c vaccine, i need a journal article

[arctica]

I wonder if you could get the Gates foundation to buy them out and open source it.

I would like to think that if I ever made a patent-worthy discovery in medical or pharma research that I would open source it, especially if it had the potential to do something as game-changing as ridding the world of a devastating disease like HCV. In non-game-changing ways, I already have, as I've made a (modest) living developing free open source software for medical research. I think that pharma is running into a lot of the same problems as the software industry with respect to the impossibility of maintaining control of intellectual property despite patent protection, and they have the added ethical and moral burden of controlling access to a product that can ease suffering. Perhaps a paradigm shift is in order.

Ten years ago, people said that open access medical journals couldn't work, were unfair, unprofitable, the journals would go under, etc. Things certainly aren't perfect, but journals made the change because they were forced to (by the NIH), yet they are still above water and still feeding their families. Researchers can budget the cost of publication into their grants. The NIH mandate for open access publication certainly was a game-changer. I would argue that there is a moral and ethical obligation to freely and widely disseminate medical and pharmaceutical information to the maximum extent possible. It's inconvenient. Don't get me wrong, I'm not out there pirating anyone's patents, but perhaps there's a better way?

 

[lovepsychadelics]

See those big numbers on the end of the drug code names? It sort of implies the database of compounds they screened is rather large... (before you say they're padding their stats... companies like glaxo smith kline and friends have probably millions of compounds screened... 300,000 is not out of reach today with combinatorial chemistry) I bet you they have made and screened at least 300,000 compounds, and out of them... 2 are active? So at a measly $100 per drug candidate that is still, conservatively, 30 million dollars on R&D alone... not counting approval/regulatory/marketing/human tox screening costs... or paying the researchers, or for the facility to work in, and electricity and property taxes...

If you want to open up shop in India and do better, go right ahead. Nobody is stopping you. The next time you invent a disease curing compound on the very first try you can sell it for $100 a dose, but otherwise I think you'll go hungry by the 30,000th compound you screen.

Or maybe you should write your congresscritters and demand they stop paying medical researchers so much. I'm sure that that will move us forward.

Reddit thread for more info.

Interesting thing here is Brazil actually said fuck you to big Pharma and has been producing it's own generic drugs to combat the spread of HIV and improve the life expectancy of the millions of people effected in it's country. Someplace an equilibrium between profit/covering cost and peoples lives need to come into play. Is the $150,000 for the entire treatment regime? At the moment they are the only company to have developed and patented this compound? At present the company is making financial gain and no doubt has a number of clients receiving treatment, let's say 20,000 each paying $150,000 equals $3,000,000,000. Not a bad windfall. This is complete speculation as to the actual money being made and number of clients being treated however it is not unrealistic. That is how pharmaceutical companies make billions of dollars profit every year.

Now take into account atara's comment basically "It's a horrid synthetic nightmare." In other words you need a well equipped modern lab with highly skilled professional. In other words production costs are not cheap, combined with over 300 000 failed substances this means there is an imperative to maintain profits and cover development costs. If this is a drug that will effectively combat the disease then once the recipient has completed their treatment they will no longer require any further pharmaceuticals that the company has to offer for this particular disease therefore they no longer can make money from each individual treated and therefore they will start cutting budgets such as R+D in area's that have shown lower profit margins etc. Economics is a bitch and democracy combined with capitalism is really about the rich getting richer however that has little to do with your question.

It is possible for some Chinese labs to make this substance however I'd not be willing to trial the first few "test runs" while they iron out any flaws in their synthesis. It would also probably cost a fairly large amount of money to develop this "custom synth" possibly more than the $150,000 you are theoretically currently having to possibly pay for treatment. Price will decrease as the product pays for itself and if a competitor develops a similar substance with similar efficacy. Alternatively if another country, in this case China, says screw you and develops a generic copy and starts treating it's infected population then you could order the substance in question like most RC's. In terms of humanitarianism it'd be great if a generic drug can be made and distributed to all those infected in the world.

Problem is we don't exist in a society in which human life is really all that greatly valued unless you earn a great deal of money or have a great deal of fame or both. For a Hollywood movie star like Brad Pitt $150,000 is nothing, indeed if his production studio can waste $200,000,000 on World War Z do I need to elaborate? So the rich get stung and pay for the initial treatment and over time the drug becomes cheaper, more analogues or similar substances with comparable efficacy are developed and eventually it filters down over time to the poorer members of society but that may take a decade or more. Meanwhile the Pharmaceutical/vaccine developers make a profit and move on to developing something else they can sell. That is the economics of capitalism for you.

I have a question OP are you asking for information that is patent or requires payment to access for free? Just curious.

 

[endotropic]

Does anyone know how much a standard insurance policy would pay for a treatment like this? What about a really good insurance plan?

I assume the vast majority of people taking this drug currently don't pay anywhere near the price tag quoted in this thread, instead the insurance companies foot most of the bill. That way these ridiculous bills get spread around to everyone paying into health insurance.

What's to stop pharma companies from charging whatever they want for new products, the market doesn't dictate the price as long as insurance companies will eat the bill.

 

[sekio]

Someone pointed out, on Reddit I think, that even with the "astronomical" cost of therapy, it's still only a couple thousand dollars more expensive than the projected lifetime cost of living with HCV.

Given that there's 3 more drugs in the pipeline... let's wait and see?

 

[arctica]

Does anyone know how much a standard insurance policy would pay for a treatment like this? What about a really good insurance plan?

I assume the vast majority of people taking this drug currently don't pay anywhere near the price tag quoted in this thread, instead the insurance companies foot most of the bill. That way these ridiculous bills get spread around to everyone paying into health insurance.

What's to stop pharma companies from charging whatever they want for new products, the market doesn't dictate the price as long as insurance companies will eat the bill.

Based on my experience trying to get transcranial magnetic stimulation covered (which is viewed as semi-experimental), most insurance companies told me I was SOL and one offered to pay 40% if I picked up the remaining 60% out of pocket. One plan that told me I was SOL was a Blue Cross Blue Shield policy carried by most doctors and employees of a well-respected Harvard teaching hospital in Boston, and the plan that offered to pick up 40% was a plan offered by the state to patients unable to get health insurance because of preexisting conditions. I'm guessing that if any plan covers the treatment, they are unlikely to cover more than half, which while significant, still keeps this therapy well out of reach of most.

 

[cdin]

To answer the question, i really just wanted the journal article covering the synthesis because i wanted to see how hard something they charge that much for could possibly be to make and to stimulate the discussion above - which is when the moral imperative to treat individuals begins to trump corporate intellectual property laws. It's an interesting question, and one particularly applicable to hep-c because even in america the population is marginalized and poor - junkies mostly, with some rich rock stars and random people from blood transfusions. The vast majority of hep-c sufferers are in third world countries, so to my mind - even moor marginalized. I just wonder where this company thinks it's going, and how the world will react. I believe india has already started to say "fuck you" and if india goes, well, that's kinda the whole ball game. They probably have 50,000,000 people suffering from hep c currently(http://www.ncbi.nlm.nih.gov/pubmed/23073754) assuming an overall infection rate of 4%, although that study shows it more around 5 for punjab, though i understand that is a more poor area. Add china and whoa, that's a whole lot of suffering... dunno, just makes me think, i dont have much sympathy for companies raking in billions, specially when a little philanthropy on their part could go so far.

and wait, now i'm REALLY confused, i did some more math(not my strong suite), but it seems to me to actually recoup the 11.9 billion investment, at 150,000$, they would have to sell 80,000 treatments. 3.2 million people are estimated to have hepatitis-c in the united states. Now, they may have failed to recognize that a large portion of that demographic is poor, drug using and homeless. I feel like selling 80,000 is going to be REALLY tough, especially with insurance probably unwilling to foot the bill. By contrast, if you lowered the cost to $2500USD, but sold it worldwide, you would need to sell four million seven hundred sixty thousand out of a pool of 250 million. I think the problem may be that gillead acquired the property from pharmasset for too much money. ;( sucks for everyone i guess. anyone who know a lot about the economics i'd love to hear from...

and I think i've found the answer, i just looked at the wiki entry for gilead, THEY currently have 5 other hep-c drugs in their development pipeline. I think they themselves are making better drugs, know it and are just capitalizing off the property from pharmasset, they got 2 or 3 other drugs in the deal. wow. i still find it intensely distasteful.