
To Sell a $1,000 Pill for $10 Without Losing Money - jakobsbiz
http://www.bloomberg.com/news/articles/2016-02-29/his-job-is-to-sell-a-1-000-pill-for-10-without-losing-money
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erg45g4trh34
I was born with Hepatitis C. The whole situation is frustrating to me. For me
in the US, insurance won't cover the drug unless I am in a category that is
considered to be in great need of it (liver damage, etc.). So at this point I
have to wait until my liver starts being damaged or the price comes down.

I understand the need for rationing given the pricing, but it's still
difficult for me knowing that a cure exists but there's no way for me to
obtain it. Perhaps I should consider medical tourism...

EDIT: After reading the prior authorization guidelines more, looks like I
would be approved if I took up intravenous drug abuse or sex with high-risk
males! Looks like I have other options :)

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joveian
Looking at Pharmacy Checker, Offshore, which I believe ships from India, seems
to have it for $74/pill (in odd quantities that don't seem to evenly divide
what would be needed). Still lots of money and you have to worry about customs
arbitrarily deciding to cause trouble (my impression is that is rare but can
happen).

It looks like round trip airfare to India is available for under $1000, so
that seems like the least expensive option. Wow, so travel to India costs less
than what they sell one pill for in the US, and you can get the full 12 week
supply for less than the second pill (the least expensive version of the full
supply would get you just over half a pill in the US).

Good luck, I hope something works out for you.

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refurb
Beware that Gilead is requiring doctors to check passports before treating
people in India. Not sure how much it's enforced, but that was reported a few
months ago.

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EwanG
Short version - The fellow responsible for licensing the $1K Hepatitis C
treatment to generic companies in poorer countries talks about the challenges
in getting them out there, and making sure they don't cut into business back
home. IOW, keeping control of a patent by making sure the folks who are likely
to rip you off anyway make more money by working with you.

~~~
refurb
That's actually a really good summary.

Gilead has a lot of experience with differential pricing for developing
countries. They have a large HIV portfolio and started doing this a long time
ago.

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bahro
"According to Doctors Without Borders, which is critical of drug-pricing
policies, it costs Gilead $100 to manufacture the 90 pills in the 12-week
course."

Sounds more like a $1.11 pill to me. And it seems pretty straightforward to
sell something at (a minimum) 90% margin and make money.

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refurb
That's purely the cost of goods. It completely ignore the cost of R&D.

It's like saying "oh, that CD I just bought only costs $0.30 to press, so $3
is a 90% margin". It's not. You can't ignore the millions that went into
recording the music.

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auggierose
Very interesting. So, can China not just reverse engineer this pill, and
distribute a generic version of it anyway?

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gravypod
I was wondering the same thing? Why couldn't another company just make a
generic and sell it if there is such a high demand.

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MichalSikora
May be they have good know-how how do this in good level of cost and price. Or
may be this is completely unnecessary for them (the china government).
Normally if you have pharmaceutical generics comapnies they have big portfolio
of many generics drugs ("they do not keep eggs in one basket and
diversification also). Create company which have only one product and sell
only to China market in my opinion is pointless.

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refurb
Well, I assume Gilead is allowing Chinese companies to manufacturer authorized
generics at a price in line with average wages. So people in China already
have access.

The other concern emerging economies like China have is they are already
developing their own brand name/patented drugs. If they don't respect the
US/EU patents, they can't really complain when the US/EU doesn't respect
theirs. The US market makes up almost 2/3 of the western drug market, so it
would be a huge lose for China.

~~~
MichalSikora
Yes, that could be also good explanation. I assume also that China, India etc.
have completely different genetic population than europe populationes. This is
important at clinical trials or bioequivalence study because some drugs
substances could work differently for peoples form Asia and Europe. Pharma
companies run trailes e.g in China and sell drugs only for regional area
(because it work) this drug will be ineffective in Europe or could to do more
damage.

