
The drug industry wants us to think Martin Shkreli is a rogue CEO, but he isn't - rottyguy
http://www.washingtonpost.com/news/wonkblog/wp/2015/09/25/the-drug-industry-wants-us-to-think-martin-shkreli-is-a-rogue-ceo-he-isnt/
======
impostervt
My daughter, like many kids, has an allergy that requires us to have epipens
on hand. There was a good article the other day about how the owner of epipen
have raised the price of epipen from $57/pen in 2007 to over $400/two-pack of
pens today. I don't think you can get just one pen, btw.

I think the difference is they didn't raise the price in one fell swoop. Frogs
in boiling water, etc, etc.

[http://www.bloomberg.com/news/articles/2015-09-23/how-
market...](http://www.bloomberg.com/news/articles/2015-09-23/how-marketing-
turned-the-epipen-into-a-billion-dollar-business)

~~~
rexf
In my anecdotal experience, the price of asthma inhalers (Albuterol) have gone
up significantly, which sucks since they have a limited shelf-life & it's
common to have multiple (car, office, bedroom, etc). Like epipen-countered
allergies, asthma is a life & death situation.

From a quick web search, this site[1] shows:

> To go from inhalers that cost 5 dollars to 60 dollars especially for those
> who don’t have prescription drug coverage has been awful.

As a consumer, I can either forgo inhalers or use expired ones (instead of
spending $$$ to keep them current).

[1] [http://www.dailystrength.org/health_blogs/dr-
orrange/article...](http://www.dailystrength.org/health_blogs/dr-
orrange/article/your-inhaler-expensive-green-at-price)

~~~
grecy
Could you not buy them from another country? A quick trip across the border in
either direction will save you a ton of money, and I'm sure you can mail order
it too.

~~~
eli
Not that it is frequently prosecuted in the US, but in many (most?) countries
it is illegal to import pharmaceuticals without a license.

~~~
grecy
asthma inhalers are considered a pharmaceutical?

------
Spooky23
The entire health sector is rotten to the core. The fate of two of my friends
is a great example of where priories lay.

One is a registered nurse. She has seen her overall compensation shrink over
the last 5 years as hospitals merge into regional cartels and medical
practices consolidate. These cartel entities play rough, breaking unions and
shipping in visiting nurses to keep wages low. Fortunately, her husband got a
job with better insurance -- her family plan on his insurance costs less than
her individual coverage.

The other person is a pharma sales rep. She makes about 2-3x the nurse, gets a
car, and usually wins 1-2 vacations to beach resorts or Vegas every year. For
awhile it was peddling a viagra competitor, now she has a stable of different
drugs to push.

So when I hear about of the money needed for "research", from companies with
huge sales forces pulling down $100-150k plus cars, etc... My first thought is
"bullshit"

~~~
drewgross
A sales force amplifies what you are already doing. If a research company can
hire a salesman that brings in $1M in additional sales, it makes sense to pay
that salesman $900k in salary and benefits, because that's an additional $100k
the company can put towards it's research. If you agree with the research, you
should be happy they hired that salesman. Saying you agree with the mission of
a company as long as it pays it's salesman less than $x doesn't make any
sense, unless you somehow know that the salesman is bringing in less than $x.

~~~
eli_gottlieb
Why should the employment question for salesmen be, "How generous can we
afford to be?", when for everyone else it's "How stingy can we afford to be?"?
The whole reason a company hires any employee, at all, is because it's
profitable. The question is why employees who don't contribute to the core
mission of the firm should receive 90% of the revenue they generate, while
those who do receive a fixed salary irrespective of revenue (and also have to
work long hours and take few vacations).

~~~
aianus
Because to the CEO and the board and the shareholders the _salesman_
contributes to the core mission of the firm (bringing in dollars) and the
_engineer_ just contributes to the costs.

~~~
radmuzom
By that logic, just fire all the engineers - costs go down and the dollars
brought in remain constant or increases - hence the company makes more
profits.

~~~
manigandham
This happens all the time. Engineering is outsourced or team is moved to
another project and the same product is sold for a long time.

------
csense
There are lots of problems here:

(1) Medicine has a very inelastic demand function. If you need substance X to
stay alive, you'll pay anything to get it.

(2) Costs are hidden from consumers. If insurance / Medicare is paying for it,
it literally makes no difference to the end user if it's $5, $50, or $50,000.

(3) Free-market forces are distorted by patent monopolies and lack of
diversity in the supply chain. With a patent, you can crank up the price as
high as you want. Ditto if you're the only supplier and it'll take some time
for competitors to bring production online, or you can deny them access to
samples for the equivalence testing your competitors need to prove to
regulators that their drug is the same as your drug.

(4) Broken incentives for developing new drugs. A patient's going to be taking
a drug to treat their diabetes / ED / high blood pressure for the rest of
their life, whereas something like an antibiotic is only taken for a couple
weeks. Guess which one is more profitable, hence attracts more R&D money?

What's the solution? I don't know. Maybe market reforms to align the
incentives; perhaps even bounding pharmaceutical companies' profit margin to
some multiple of their costs (but of course you'd have to be careful about the
wording of the regulation and auditing for compliance, to make sure it can't
be gamed by e.g. deliberately inflating the costs). Or perhaps even some kind
of socialism where the government tells people what to produce or how much to
sell it for (agricultural subsidies might be regarded similarly -- the
government is deliberately manipulating the market to push down the price and
push up the supply of goods necessary to sustain life, so shocks don't result
in lethal shortages).

Bernie Sanders at one point talked about replacing patents for new drugs with
prizes, but I think he may have given up on that.

------
on_
This is a symptom, not a problem. Drug prices are a good measure of how we are
doing on healthcare policy and insurance regulation. It looks like poorly. It
costs 2.5B dollars to develop a new drug. The regulatory hurdles are MASSIVE.
We have a complicated and extremely compromised healthcare system that is
focused on providing insurance when it should have been providing better
healthcare. There is no easy answer here, but companies are going to want to
make profits and the system incentivizes them to spend money developing a few
critical drugs, holding on to the patent and pricing it as high as possible,
the dev costs are passed to the insurance companies which are passed on to you
in premiums as well as inflation, as insurance companies operate much like a
bank. This comes full circle into the role that banks play in lending and
increasing the money supply.

Possible answers. Tighter fiscal policy, patent reform, smarter testing,
looser regulations on known compounds, google x prize like gov't or private
funding for cures, distributed computing using algorithms to evolve a cure
(will be interesting to see what happens with that patent)

[0][http://www.scientificamerican.com/article/cost-to-develop-
ne...](http://www.scientificamerican.com/article/cost-to-develop-new-
pharmaceutical-drug-now-exceeds-2-5b/)

~~~
Thimothy
I dunno. I don't think that in Europe the development costs or regulatory
hurdles are smaller than in the US (if I had to make an uneducated guess I
would say bigger), and yet the prices are way lower.

I would add to that list "heavy government regulation on medicine prices",
they are not a common commodity and should not be left to the markets free
whims.

~~~
bko
That may be because the US is leading the way on drug development. After the
drug has been developed, the drug company will be able discriminate on price
to maximize revenue. I imagine the cost of getting approval to sell a drug in
European countries that has already been developed and tested for the US is
much smaller than the actual development.

It could be that without the US system, these drugs would not be available in
European countries as well.

Mandating lower prices for drugs is unlikely to work as it hasn't worked in
the past (Venezuela everything, US gasoline, etc).

~~~
on_
> Mandating lower prices for drugs is unlikely to work

Not sure if you are saying this generally, or you mean it as a response. I did
not mean to indicate this, I believe lowering regulations and dev. costs would
be beneficial but not mandating lower prices.

As an aside, I agree with you but would be interested to see if America can
continue to compete in the drug market long term. Obviously, it is a big
market, but with countries like China and India and their growing middle
classes, if they have a more attractive development cycle with less regulation
and tighter feedback I wonder if biotech would move overseas. America has
really great biotech and science sectors because engineers move out of those
countries here. If this stops, other markets become more attractive, and/or
the patent system remains broken I would be pretty concerned.

------
phkahler
The colchicine story reminds me of the Red Yeast / Lovastatin story. Red Yeast
is a traditional Chinese medicine that can lower cholesterol due to several
compounds it contains. Lovastatin was identified in it, put through trials and
is now the standard for lowering cholesterol. Meanwhile, the gov has said you
can't sell Red Yeast Rice with lovastatin in it, so they allegedly remove it.

As a single datum, I was told I needed to be on statins, and when I balked, my
heath care professional said I could try RYR for 3 months and if it didn't
work I'd need a prescription for statins. My cholesterol dropped 97 points in
3 months. I said "so I don't need statins?" She said shes never seen that kind
of drop with statins, so no.

So yeah, take stuff from nature, patent it, then get the natural version
banned, profit!

~~~
refurb
Red Yeast has not been banned, you just can't sell it as a treatment for high
cholesterol. Why? It hasn't gone through clinical trials.

You might argue what's the difference between a tablet of lovastatin and Red
Yeast? Well, I don't know and the FDA doesn't either that's why you can't make
medical claims about it.

I'm glad it worked for you! Also, lovastatin went generic a long time ago and
it now costs a few hundred dollars (if that) a year to treat a patient.

~~~
pmorici
"Red Yeast has not been banned, you just can't sell it as a treatment for high
cholesterol."

Wikipedia disagrees with you. It says, if a product has a measurable amount of
monacolin K, i.e., lovastatin in it the FDA will stop it's sale even if there
aren't any claims of cholesterol reduction.

[https://en.wikipedia.org/wiki/Red_yeast_rice#Regulatory_rest...](https://en.wikipedia.org/wiki/Red_yeast_rice#Regulatory_restrictions)

------
steve19
I am not arguing for or against the drug industry, but naming a few drugs with
price increases is meaningless.

Telling me some random generic has gone up in price means nothing to me . For
all I know, that might be an old fashioned drug hardly any doctors prescribe
and the price increases is required in order to keep it available for the few
people who require it... or it could just as easily mean the company has a
monopoly and is price gouging consumers.

There needs to be a weighted index, or multiple indexes, of drugs weighted by
how important they are. Not sure how to define importance in this context, but
quantity sold would be a good start, maybe another index weighted by average
expenditure per patient per year and another weighted by lives saved.

Edit: Downvoters, I did read the article. An unweighted group of any product
is not very useful from an economics perspective. That is why the CPI is
weighted.

[https://en.wikipedia.org/wiki/Consumer_price_index](https://en.wikipedia.org/wiki/Consumer_price_index)

~~~
refurb
You raise a good point and percentage increases can be deceiving. If a drug
cost $0.01/tablet and now it's $0.03/tablet, yes that's a 300% increase, but
it still costs pennies per day to treat someone.

Unfortunately I can't find it right now, but the Us gov't did a study into
generic drug price increases. There is no one reason why they went up. For
some drugs it was because a company decided to stop making it and there were
shortages. For other companies, they had manufacturing problems and shortages
resulted.

~~~
developer1
Shortages don't seem like they should a valid reason. Choosing to no longer
produce a needed drug shouldn't even be a legal option - free market shouldn't
be allowed to trump health. I don't know how you write laws to require a
corporation to produce a drug they own, and perhaps that isn't the right
approach; but it doesn't seem morally acceptable to let this happen.
Capitalism should be taking a back seat here compared to the common good.
"Manufacturing problems" just seems ripe for abuse. "Oh, we fired 90% of our
production line, and now we just can't seem to pump it out anymore".
Manufacture should have safeties and redundancies in place to prevent the
sudden inability to produce whatsoever. It's unfortunate that money trumps
all, even for the health industry.

------
gkoberger
It's likely more nuanced than this, but at the end of the day, he's getting
paid a lot of money to be the bad guy. He'll be "fired", and then he'll go on
to do it again somewhere else. He even flat out admitted it (before deleting
the tweet):

"@matthewherper great question, I guess we will find out. I take the pain for
my investors"

-Martin Shkreli (@MartinShkreli) September 21, 2015

[http://www.independent.co.uk/news/people/hedge-fund-
trader-m...](http://www.independent.co.uk/news/people/hedge-fund-trader-
martin-shkreli-hits-back-at-critics-after-raising-price-of-hiv-drug-
by-5000-10511960.html)

~~~
rco8786
I fully agree with your notion but I'm note sure how that tweet "proves" it.

~~~
gkoberger
Ah yes, I meant that it "proves" the first part ("My job is to take the
heat"). You're right, the "being fired" part is just a theory.

~~~
hueving
Well every CEO's job is that, so it's not really proving anything.

------
digi_owl
Looking over the anecdotes here, i find myself thinking that big pharma is
just an example of the "profit uber alles" mentality that has been rampant in
the corporate world since at least the 80s (if not before).

An interesting set of documentaries in that regard may be The Mayfair Set:
[https://en.wikipedia.org/wiki/The_Mayfair_Set](https://en.wikipedia.org/wiki/The_Mayfair_Set)

It recounts, from a British point of view, the rise of a type of finance
capitalist that revolved around strip mining established companies.

I think part 3 touched on how by the time the people that started it got cold
feet about it all, it had become institutionalized thanks to pension funds and
similar.

------
refurb
I'm sorry, but I have to nitpick on the AARP graph showing the average annual
rate of price increases for 227 drugs.

Anytime I see data that is a _subset_ of the real data set, I have to wonder
why they did that. Why not the average annual rate of price increases over all
prescription drugs? Why only 227 of them?

Also, I disagree with this quote: _" Only when a 46 percent discount was
applied to a pricy Hepatitis C treatment, Harvoni, did it become a good health
care value -- at about $40,000 per year."_

That's patently untrue. Hell, CTAF (California technology assessment forum,
which assessed drugs for MediCal) found that Harvoni, at it's full price of
almost $90K _was_ cost effective. The real problem is that it would cost too
much to treat everyone.

~~~
mikeash
The drugs were chosen simply as the most significant ones for the AARP's
membership. The methodology is thoroughly discussed in Appendix A of the
study:

[http://member.aarp.org/content/dam/aarp/ppi/2014-11/rx-
price...](http://member.aarp.org/content/dam/aarp/ppi/2014-11/rx-price-watch-
report-AARP-ppi-health.pdf)

Also note that the drugs were chosen _before_ they started tracking prices.

I totally understand your skepticism, but rather than just wonder why they
chose those, why not find out?

~~~
verbin217
They did find out. Why go digging when you could just make a comment and get
all the work done for you.

~~~
mikeash
That's the internet for you. Ask a question and nobody answers, state the
wrong answer and you get the right answer instantly. It's not my fault, I'm a
victim of an oppressive system!

~~~
shalmanese
Cunningham's Law:
[https://meta.wikimedia.org/wiki/Cunningham%27s_Law](https://meta.wikimedia.org/wiki/Cunningham%27s_Law)

------
logn
Public utilities which have monopolies set prices according to a regulated
process:
[https://en.wikipedia.org/wiki/Utility_ratemaking](https://en.wikipedia.org/wiki/Utility_ratemaking)

Given the patents and difficult FDA approval processes, it might make sense to
regulate drug prices similarly to public utilities.

I'm all for free markets. But when there's zero competition, you can't still
treat things like a free market.

~~~
zurn
Nit: Patents are state-backed monopoly rights, patent supporters argue that
free market would result in too much competition.

~~~
throwawaykf05
I've never heard any patent supporters say anything about "too much"
competition. What they say is that anytime a competitor can freeride on your
investment of resources, it is not _fair_ competition.

------
WalterBright
Generally, when massive price oddities become commonplace, it's evidence of
government distortions of free market operation. Trying to blame it on 'rogue'
CEOs is an exercise in futility.

~~~
dimitar
In fact Daraprim/Pyrimethamine shows some interesting features of markets:

* the market in the United States is so small, that there is a single manufacturer

* Generic drug manufacturers try to come in the market, the brand-name holder has made it extremely hard for them to do equivalence testing by making the drug available only through a restricted channel that excludes them.

* Even if them manage to get the drug to the market, the brand-name manufacturer can lower prices temporarily, ensuring they exit.

* The same manufacturer can have doctors prescribe the expensive brand-name versions of the drug by buying them off.

Instead of leaving patients in the hands of such natural or almost natural
monopolies, the government can fix this situation in a variety of ways - price
ceilings, subsidies, even government production of drugs for rare diseases.

You can argue that, some regulation somewhere has given these companies a
monopoly, but without any regulation, there would be no market to speak of -
the off-NDA drug market isn't one I and assume most patients trust.

~~~
WalterBright
The way around the trust issue is to make the "and effective" part of FDA
regulation optional. Drug companies can only market "and effective" if they
get the FDA approval of it. The rest can only market it as "safe". This can
dramatically reduce the prices of drugs, and it is the user option whether
they want to pay extra for the "and effective" certification or not.

~~~
vonmoltke
It was optional until the 1960s. It was changed to be mandatory because the
market was full of safe but useless drugs. Considering how mere differences in
marketing requirements have not stopped a flood of useless homeopathic
remedies, I expect that useless drugs would come back in force if that change
were reversed.

~~~
WalterBright
Americans have paid a heavy price for this in terms of large reduction in the
number of new pharmaceuticals coming to market, long delays for new cures,
and, of course, huge price increases.

See "Regulation of Pharmaceutical Innovation" by Sam Peltzman.

------
crdoconnor
Meanwhile, Obama nominates Robert Califf as FDA chief. A guy who has been
feeding at the pharma trough for several years:

[http://hcrenewal.blogspot.sg/2015/09/turn-that-door-
around-p...](http://hcrenewal.blogspot.sg/2015/09/turn-that-door-around-
physician.html)

~~~
quaunaut
I'll just remind- remember everyone's skepticism of Wheeler. Judge each by
their actions, there is time to tear them to shreds.

~~~
crdoconnor
On what basis could you judge Wheeler favorably? Because he backed down after
a monumental backlash from the public combined with several very powerful and
wealthy corporations?

Wheeler can't claim credit for net neutrality after attempting to destroy net
neutrality and losing.

------
refurb
The colchicine case is an interesting one if you dig down into the details.

Colchicine has been used for hundreds (?) of years. It never went through
phase 3 trials and it was never officially approved by the FDA. Instead it was
grandfathered in.

This made the FDA pretty uncomfortable [1] and I can't blame them. How do you
properly regulate a drug where there is little to no data outlining it's
efficacy and safety? So, the FDA decide to dangle a carrot in front of drug
developers. If you formally take a grandfathered drug through the approval
process, you will be awarded with something call "data exclusivity" (it's not
a patent). For a period of 3 or 5 years (it depends on the filing), the FDA
will not approve another form of the drug. In addition, they will tell/force
all the other grandfathered manufacturers to stop selling their versions.

Statement from the FDA: _Colcrys is the only FDA-approved single-ingredient
oral colchicine product available on the U.S. market. Approved by the FDA in
2009, Colcrys’ prescribing information contains important safety data and
recommendations on drug interactions and dosing not available with unapproved
products._ [2]

Of course this is a pretty attractive carrot for a drug company. Spend $X now
and you've got a captive market where you can recoup your R&D spend and make a
profit over 5 years. Plus _the heavy hand of the FDA will help you get rid of
competitors!_.

Due to the the FDA regulatory process, it shouldn't be surprising that the
cost of colchicine went up, it's pretty much had to in order to pay for the
FDA approval. Did it have to go up 5000%? No, probably not. But it did have to
go up if the FDA wanted an approved version since producing a grandfathered,
unapproved drug is pretty cheap compared to an FDA approved one. What made the
colchicine case particularly unfair was that the company didn't actually run
any trials. They just collected all the trial data that already existed
(mostly published papers) and submitted that data.

Another great example is Mr. Mucus, the cold medicine, it was the exact same
play. In fact, a VC firm backed the entire process. The got the active
ingredient approved by the FDA (again, it had been grandfathered in) and the
FDA forced all other competitors off the market. This blog post has all the
details [3]. Suffice to say, Aisling Capital made a 15x return off that
investment. And that's why you see Mr. Mucus ads all over the place.

[1][http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulat...](http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/SelectedEnforcementActionsonUnapprovedDrugs/ucm119899.pdf)

[2][http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/uc...](http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm227796.htm)
[3][http://biotechtranslated.com/2011/08/09/how-to-make-the-
fda-...](http://biotechtranslated.com/2011/08/09/how-to-make-the-fda-your-
friend/)

~~~
joezydeco
Mr Mucus? You mean Mucinex/guaifenesin?

I'm confused about this example since guifenesin has been approved by the FDA
since the 1950s. But it was the _time-release_ formulation of the molecule
that was given data exclusivity to Reckitt in 2002 (after purchasing it from
Adams). There was no "unknown efficacy" tag attached to this medicine.

I asked a similar question about Ambroxol a while back (Europeans know this as
Mucosolvan). For some reason nobody will take up this one in the USA? I find
ambxorol works _way_ better than guifenesin on my kids.

~~~
refurb
No, you're correct, it was the time released version of guifenesin.

The problem was, all the current time-release products were not FDA approved.
You can't just create a time-released version and keep your fingers crossed,
you need a clinical trial to actually show how it is time released. You
wouldn't want a time-released version to release 24 hours of drug in 5
minutes!

~~~
joezydeco
So, by induction, I can take any currently approved molecule and apply a new
formulation to it (time-release, liquid vs tablet vs aerosol, etc) and get
exclusivity this way?

I thought the point was to take old drugs with no clinical data and get them
back into the mainstream - this exclusivity was the carrot on the stick. But
this seems more like a twist on that idea.

~~~
refurb
To your first question, the answer is yes. You could take any approved
molecule and apply a new formulation and get exclusivity on it. There are many
companies that are trying to do just that.

Of course, your new formulation actually has to add some value (1 tablet per
day instead of 1 table three times per day).

To your second point, the Mucinex example is "taking an old drug with no
clinical data and getting them back into the mainstream". The difference is
that instead of it just being the active ingredient, it's a time released
version of the active ingredient. Prior to Mucinex being approved, there were
unapproved versions of long-acting guifenesin out on the market.

You're right it's not exactly the same as "no one has tested this drug at
all", but rather "no one has tested this formulation of this drug".

------
mercurial
Wouldn't all these problems disappear if the entire drug industry was
nationalized? Once you remove the profit angle, there is no more incentive to
raise prices dramatically, make minute changes to a molecule to extend your
patents, or only focus research on medicine which is the most likely to make
money.

~~~
on_
I suspect the opposite. The Scientific American estimates the cost of rbinging
a new drug to market is 2.5B and that number has doubled over the past 10
years[1]. We need to find a way to allow tighter feedback loops, better data
flow and less regulation without purpose. We have amazing technology that
allows continual monitoring of vital signs and rapid blood tests etc. If our
laws could evolve with our technology we would be in great shape. That would,
of course, require elected officials to be qualified in various disciplines,
act in the public's best interest and not accept money from lobbyists.

[1][http://www.scientificamerican.com/article/cost-to-develop-
ne...](http://www.scientificamerican.com/article/cost-to-develop-new-
pharmaceutical-drug-now-exceeds-2-5b/)

~~~
dragonwriter
> less regulation without purpose

Everyone agrees with that; all regulation that actually exists or has been
proposed has/had a purpose behind it.

Individuals may disagree with whether the purpose is desirable, whether the
regulation effectively serves the purpose, and whether (assuming they agree
that the purpose is beneficial and it is actually served in effect by the
regulation) the beneficial effect of serving the purpose is worth any costs
that the regulation creates, but those are different issues than "regulation
without purpose".

~~~
on_
of course. I was implying that regulation without a purpose:

1)That is logical, and makes sane tradeoffs.

2)Is in the publics interest instead of lobbyists.

3)Is divined using evidence.

We need unbiased medical experts to propose a system that works which has the
following charachteristics:

1) Promotes the creation and development of drugs and the advancement of
medical science.

2) Allows for a tight feedback loop and quick sceintific evaluation of new
drugs, possibly allowing less dangerous drugs quicker feedback cycles.

3) Lowers the cost to get to market.

This is a VERY hard problem to solve as an exercise, but particularly
difficult within the current political framework.

~~~
dragonwriter
> We need unbiased medical experts to propose a system that works which has
> the following charachteristics:

Unbiased medical experts are not particularly likely to be experts on three
points you suggest are critical, since none of those are actually even
remotely medical questions.

------
wiz21c
I worked for Johnson&Johnson in Belgium years ago. On each desk of the open
space I was on, there was a small "manifesto". The title was : "we work for
the good of our patients and investors". Yes, patients and investors put on
the very same level.

------
zaidf
Me and my siblings have a genetic mutation that requires us to take Colchicine
3 times/day for the rest of our lives so needless to say I am glad to see the
drug industry being exposed.

------
pbreit
It's refreshingly that we are losing our appeal for pure moneymaking. I'm not
sure the attempted t was to portray him as a rogue so much as a jerk. And the
article doesn't refute that.

------
rokhayakebe
I, for one, would like to see drugs increase very sharply similarly to what
this guy did.

Reason is we need a consumer reform, and not a government reform which is a
temporary solution.

The entirety of pharmaceutical R&D is $161 B globaly. If half of Americans
were contributing $100 monthly to a pool, we could fund it entirely and make
every drug available for free.I would love to see this done outside of the
government.

We MUST stop depending on government for Health, and Education. While they
intend well (I truly believe they do individually as people), as an aggregate
they are not able to solve these issues at scale.

~~~
mikeash
What sort of organization do you propose would obtain and manage those
$100/month contributions, and how would that organization differ from "a
government"?

~~~
rokhayakebe
Your tax dollars do not fund drug R&D. Think KickStarter for issues that
matter to us.

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mikeash
Regardless of whether the government currently funds drug R&D, your idea
sounds a lot like government-funded R&D, thus my question of how it would be
different.

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rokhayakebe
1) We can dictate price: $0.00. 2) We can decide what drugs to develop (i.e.
do we need Ibuprofen, Advil, Tylenol, This, That, or do we need the best). 3)
When the price is $0.00 we ensure no one dies because they can't afford a
drug. 4) When the price is $0.00 well physician can focus on providing you
with the best drug, and not the one they get kick back from.

Shall I continue?

This idea does not stop at Pharma. Wherever Gov fails, we can try this.

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mikeash
Sounds just like a government medication R&D scheme plus a government
medication purchase plan.

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roflchoppa
people are jerks, they justify it by saying its business. Have I had an option
for medicine provider I would go with the one thats not abusive to its
employees.

but i grow all my medicine out of the ground.

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jqm
If you really "grow all your medicine out of the ground" it's more than likely
if you ever get truly ill or injured you yourself will be in the place you
grow your medicine out of. Accept science. It works.

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roflchoppa
Not sure about that brother, I mean people have been growing this stuff for
thousands of years man. I got mine on that good good extra potent ja feel?

