
Bayer CEO: Nexavar cancer drug is for "western patients who can afford it.” - denzil_correa
http://keionline.org/node/1910
======
mullingitover
> Bayer Chief Executive Officer Marijn Dekkers called the compulsory license
> “essentially theft.”

He's a bit mixed up. Government enforcement of your temporary monopoly is a
_privilege_. Failing to give you the privilege you think you deserve is not
the same thing as stealing from you.

~~~
huhtenberg
Witty sarcasm much?

Without this "privilege" a company has no incentive to develop anything new,
leave alone anything that requires _massive_ R&D investments. What India did
is it effectively said that they don't want to participate in the development
of new drugs, so their stance on this matter is frankly quite ludicrous.

Try this for a comparison - Germany declares that all software sold in their
country should be priced at $1 or less. Would you still be talking about
software companies being crybabies for objecting this? Doubt it.

~~~
yequalsx
The scientists who develop such drugs generally do not do it to make billions
of dollars. Their salaries usually are in the 6 figures and I see no evidence
that fewer drugs would be developed if society paid for development through
universities and nonprofit research centers.

There are other incentives in life other than money.

~~~
chaz
That would be worth exploring, but the cost of developing a drug is
astronomically high: "The average drug developed by a major pharmaceutical
company costs at least $4 billion, and it can be as much as $11 billion."
[http://www.forbes.com/sites/matthewherper/2012/02/10/the-
tru...](http://www.forbes.com/sites/matthewherper/2012/02/10/the-truly-
staggering-cost-of-inventing-new-drugs/). The most expensive part is Phase III
Clinical Trials, and it's growing: "We examined drug development in four major
public health areas and discovered that for any given drug on the market,
typically 90 percent or more of that drug’s development costs are incurred in
Phase III trials." [http://www.manhattan-
institute.org/html/fda_05.htm](http://www.manhattan-
institute.org/html/fda_05.htm)

No university or nonprofit has that kind of budget, and even if they did, they
are unlikely to take on the risk of a failed drug.

~~~
henrikschroder
Pharmaceutical companies typically spend more money on advertising than drug
development which leads me to think that the patent system isn't that
necessary to the overall profitability.

~~~
refurb
Ridiculous argument.

Marketing spend is based on the idea you spend $X and get $X + Y back. This
doesn't always work, but it's the general premise.

This means without marketing dollars they'd be making less money.

~~~
warfangle
Or they'd be making drugs that actually matter, instead of drugs they can
market well to unassuming consumers.

~~~
chaz
Well, they're picking the drugs that they can sell the most of -- i.e. the
ones that will benefit the most people. That's not a bad thing.

However, the cost of human trials are still a problem. Because of the costs,
drug research to treat rare diseases aren't going to get funded by anyone.

------
nova
We need an alternative mechanism to fund medical research. Granting artificial
monopolies aka patents isn't cutting it, and it's getting highly unethical.

Given that what we currently have isn't a free-market approach at all I wonder
why we couldn't just fund it directly, via taxes. The cost could be shared
between countries AND the research could be directed. The companies could be
pure R/D labs, leaving the manufacturing to others.

~~~
fragsworth
I think it's really hard to say. The efficiency provided by companies trying
to make money can't be overlooked. They make every attempt to reduce costs and
increase development speed, and it's possible that in the long run, things are
better.

Also, if research is publicly funded, it would probably tend to focus on
whatever the public is more aware of. Public awareness of diseases doesn't do
correlate well to the severity of the problem. For instance:

[http://dailycaller.com/2010/10/05/breast-cancer-receives-
muc...](http://dailycaller.com/2010/10/05/breast-cancer-receives-much-more-
research-funding-publicity-than-prostate-cancer-despite-similar-number-of-
victims/)

If the market wasn't given any incentives to perform research on its own, then
I could see this problem becoming magnified.

~~~
canvia
Companies are also motivated by profits. This can create a perverse incentive
to focus on treatment methods and ignore prevention/cures. They might also
focus more on problems that effect "rich" people (blood pressure, cholesterol,
weight loss, depression) while ignoring things that kill many poor people like
malaria.

------
slaxman
I think one thing that India has got right is the patent system. As I
understand, you can't patent as product in India, you can only patent the
process. Thus multiple companies can have multiple process patent on the same
product. This actually encourages innovation and keep prices low (especially
for drugs). $65,000 is extremely expensive considering that the average annual
income in India is a mere $2000.

~~~
melling
Am I missing something because I'm not sure that a lot of new drug research is
coming out of India. It would be great if there was because we could probably
double the amount of new medicines.

~~~
Daishiman
You would have to prove that there would be more drug development in India
without the current process, and I really doubt it would change anything.

~~~
melling
How much drug research is done now? Can you quantify it in dollars or drugs
produced?

~~~
Daishiman
I'm asking you because evidently nobody knows, so all this speculation about
the disadvantages of their policy seems to me like smoke and mirrors.

------
icegreentea
Went digging through for past articles. This has been a long-running
situation. For context, Nexavar was patented in India in 2008 (it's first FDA
approval, for advanced liver cancer was granted in 2007, a process started in
2004). According to this article [1] from last year, Bayer was running a
program that gave ~70% of Nexavar users a 90% discount from their in India
market rate ($5500 USD monthly). The generic maker sells at $176 monthly, and
per licensing fees, pays Bayer 6% of net sales.

Also, about the nature of the drug. It's basically a treatment of last resort.
The initial study that granted it FDA approval for in advanced liver cancer
showed a 3-4 month increase in median survival time compared to placebo
(remember, this is with cases that have exhausted other options). Further
studies show some greater synergistic effects combined with other treatments.
Also, in a study with a smaller population, and slightly different subtype of
liver cancer showed an overall median survival time of 26 months (it's unclear
to me from reading the abstracts how the baseline conditions of the two
trial's patients compare, so it's difficult to directly compare their
results).

[1] [http://www.thehindubusinessline.com/companies/bayer-to-
appea...](http://www.thehindubusinessline.com/companies/bayer-to-appeal-
against-indias-patent-ruling-on-nexavar/article4484568.ece)

------
obblekk
I know most people will oppose this, but what about the massive financial
investment that Bayer took in development that the Indian company Natco didn't
take. Surely Bayer should get some sort of payback.

~~~
noonespecial
As long as we're talking about what ought to be: Should the model we have be
incentivizing the recoupment of investments using the threatpoint of death to
extract maximum resources from choiceless "customers"?

However we do it, the answer to "how much will it cost?" when it comes to
medicine needs to stop being "how much do you have?"

~~~
gaius
Maybe India could fund its own NHS instead of nuclear weapons and space
missions?

India is a country that likes to play poor when there's some advantage to be
had, but it's a facade.

~~~
ceejayoz
Nuclear weapons are arguably necessary with a nuclear armed neighbor they've
regularly been at war with, and the space missions have the potential to make
profits for India.

The US funds space missions with folks dying for want of medical care, but
people don't tend to complain about that.

I'm not sure funding their NHS is going to do all that much good when the drug
costs multiple times the per-capita income of Indians.

------
codegeek
"At a daily dose of 4 tablets, this comes to $5,637 per month,"

"..is for western patients who can afford it"

Oh the irony, at least in the US. How many can actually pay $5,637 per month
out of their _own_ pockets if not for health insurance which is mostly
subsidized by your employer if you are lucky enough to have a job. On the
other hand, India is still more of a "I pay you out of pocket, how much do you
charge" system.

Having said that, I am not necessarily saying that protecting your
IP/inventions is a bad thing. But before you start comparing
countries/markets, make sure you have enough knowledge of how a particular
market operates.

~~~
grecy
America is certainly nowhere near the top of Developed western countries, so
maybe they're not even talking about Americans when they say "..is for western
patients who can afford it"

~~~
scott_karana
Money is typically the criteria used for "if you can afford it".

American still has the greatest GDP, and the the greatest household income
(average _and_ median, as I recall).

~~~
grecy
> Money is typically the criteria used for "if you can afford it".

I would dispute that and say "spending money" is the criteria used for "if you
can afford it".

Income means nothing if you have to spend it all just to live.

I doubt the average American has has much spending money as people from
Developed countries.

~~~
scott_karana
It would be nice if you were less vague, so we could have a reasonable
conversation about cost of living, incoming, savings, disposable income, et
cetera.

As it stands, you've provided a dearth of information.

------
fragsworth
I'm not sure what exactly the history of this product is, but my guess is it's
a treatment that:

1) Cost a shitload to research

2) Is only applicable to a handful of patients

If this is true, then I don't see what else they should do. If they aren't
allowed to sell it at the price they want, then perhaps the research wouldn't
have been funded in the first place?

~~~
piyush_soni
It's a life saving drug of last resorts. And considering the population of
India, 'a handful' is too many :).

------
refurb
This is one hell of a hit piece. I'd love to see the actual quote from the CEO
since this has gotten ZERO press in the mainstream media. I'm assuming he
meant the drug was _priced_ for westerns who could afford it, not that the
company would prefer if Indians with cancer would just die.

The thing that makes me laugh about the IP struggle going on in India is that
Indian companies who have developed their own generic versions have often
priced their drugs not much lower than what western companies have[1]. This
isn't about providing access to medicines (since many western companies,
including Bayer, have patient assistance programs that offer free drug to
Indians), this is about protecting and supporting the Indian pharmaceutical
manufacturers.

[1] Biocon just launched their biosimilar version of Genentech's Herceptin.
Genentech's price in India is $1,366 per month while Biocon's is $933 per
month, still well out of the reach of most Indians.

[http://www.bloomberg.com/news/2014-01-20/roche-herceptin-
cop...](http://www.bloomberg.com/news/2014-01-20/roche-herceptin-copy-s-price-
still-out-of-reach-in-india.html)

------
liquidise
Legalities of all this aside, these comments perpetuate many of the worst
stereotypes of major pharmaceutical companies. This will not be smoothed over
lightly.

~~~
shill
This is the same company that sold off their stock of HIV contaminated
medicine to hemophiliacs in Asian and Latin America in the mid 1980s while a
newer version was sold to western patients.

~~~
jack-r-abbit
Also the same company that sued the European Commission over a ban on
pesticides that are killing bees.

------
veidr
India's setting a great precedent by granting exclusive rights granted by a
patent only in combination with a requirement that the result be reasonable.

I think this kind of tweak to the patent system should be extended beyond
medical life-or-death kind of products.

Our society grants these exclusive rights under certain conditions, because as
a society we believe doing so benefits us all. There is no inherent natural
right to have a patent (unlike what this bozo seems to believe), it is an
artificial construct humans made up to improve society.

There is no reason we shouldn't tweak the parameters of patentability and the
benefits received on an ongoing basis.

------
denzil_correa
In case, if people missed this part

    
    
        The U.S. government has weighed in on the side of Bayer in 
        the patent case, at the highest levels of the India and the 
        US governments.
    

What can be the possible reason?

~~~
sailfast
If United States patents can be discarded at will by global markets, it
creates serious intellectual property concerns for research and development
groups in the US.

Without a possible profit incentive, what will incentivize drug companies to
spend billions on cancer medication or other research if the compound will be
lifted from them the next day and sold at pill cost, not compounded R&D cost?

It's definitely in US interests (both public and private sector) to strengthen
the value of a US patent and US patent law globally.

Why would a government not argue in favor of this?

------
ExpendableGuy
Just thought I'd share this for context:

> "It takes about 10-15 years to develop one new medicine from the time it is
> discovered to when it is available for treating patients. The average cost
> to research and develop each successful drug is estimated to be $800 million
> to $1 billion. This number includes the cost of the thousands of failures:
> For every 5,000-10,000 compounds that enter the research and development
> (R&D) pipeline, ultimately only one receives approval."

Source:
[http://www.innovation.org/drug_discovery/objects/pdf/RD_Broc...](http://www.innovation.org/drug_discovery/objects/pdf/RD_Brochure.pdf)

------
jpttsn
Direct statements indeed. The honesty is refreshing, even if it will naturally
be countered for weeks by PR. It's interesting to gain some insight into how
this sort of person views the world.

------
joesmo
Basically, what Bayer is asking is for India to enforce US patent law and to
not enforce Indian patent law (which allows this exception). It doesn't help
that Bayer's CEO comes off as extremely racist: '“We did not develop this
medicine for Indians”.'

------
johngalt
It's interesting to see protectionism V2.0 play out via the patent system.

------
tokenadult
The first journalistic source to report the statement,[1] an article published
by Bloomberg Business Week, includes the statement near the end of a general
article on patent protection in India. Both the reporter and editor who put
the story together are based in India and (at a wild guess, based on their
names) are perhaps citizens of India. This sort of national policy issue, of
course, often results in different countries coming up with differing laws.
Then the countries have to resolve differences about their laws in
negotiations when they look at overall trade between their countries. And that
(nothing particularly nefarious) is all that is involved in the United States
negotiating with India about this issue.

I'm very glad that somebody is developing new medical treatments (both drugs
and medical devices). All of that work is very expensive, and much of it
results in products that never turn a profit. I can't think of any social
justice reason why my childhood best friend, a first-generation college
graduate from a working class family, who now develops medical devices, should
have to work for free. Nor can I think of any social justice reason why anyone
who needs effective medical treatment should be without it, in general, but
until new medical treatments are invented, wishing doesn't make that so.
India's approach to compulsory licensing on non-negotiated terms for new
treatments developed outside India may be very politically appealing in India,
but it's not completely clear that that is the best national policy for
responding to the grave health problems[2] that still exist in India.

[1] [http://www.businessweek.com/news/2014-01-21/merck-to-
bristol...](http://www.businessweek.com/news/2014-01-21/merck-to-bristol-
myers-face-more-threats-on-india-drug-patents)

[2]
[http://articles.economictimes.indiatimes.com/2013-06-23/news...](http://articles.economictimes.indiatimes.com/2013-06-23/news/40134749_1_stop-
tb-department-mario-raviglione-jmm-meeting)

[http://online.wsj.com/news/articles/SB1000142405270230344420...](http://online.wsj.com/news/articles/SB10001424052702303444204577460734274201756)

[http://www.iom.edu/Reports/2012/Facing-the-Reality-of-
Drug-R...](http://www.iom.edu/Reports/2012/Facing-the-Reality-of-Drug-
Resistant-Tuberculosis-Challenges-and-Potential-Solutions-in-India.aspx)

[http://www.tbcindia.nic.in/pdfs/RNTCP%20Response%20DR%20TB%2...](http://www.tbcindia.nic.in/pdfs/RNTCP%20Response%20DR%20TB%20in%20India%20-%20Jan%202012%20update.pdf)

AFTER EDIT: I see some wild karma swings on this comment, so feel free to tell
me what you really feel about this comment. India, of course, would have no
objection to how drug companies market drugs if only it had a country full of
companies that are already innovating affordably to solve all the health
problems of India.

