
This old drug was free. Now it’s $109,500 a year - zeep
https://www.washingtonpost.com/news/wonk/wp/2017/12/18/this-old-drug-was-free-now-its-109500-a-year/
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chroem-
This kind of insanity makes me wish we would just abolish the legal notion of
intellectual property already. It flies in the face of everything that the
free market stands for by actively blocking competition. Yes, you can come up
with all sorts of contrived allegories for why IP might be beneficial, but all
of those fail in practice and are vastly outweighed by IP being used
anticompetitively.

This article hits especially close to home since I have a very rare eye
condition that's destroying my sight, but the drug to adequately treat it
costs $67k a year and isn't covered by insurance because of the high cost. So
now I'm left making the most of my new life on significantly cheaper but less
effective drugs.

~~~
raguuu
The problem is not IP but your FDA. I could send it to you for much lower
price but it's not allowed.

Free market works truly great when there is a free market, but considering the
fact that medicine in general can never be a one unless we all take a risk of
snake oil and arsenic sellers, it's crazy to think people don't get pushed
over. It's some sort of crazy utopia of Americans, where the ideology is more
important than outcome. Capitalism is good because majority of the time it
works the best. Not with medicine.

~~~
chroem-
This is a separate issue from large emergency medical bills. You can get a
drug prescribed for a chronic condition just about anywhere, but if it's
produced by a monopolist then you're forced to pay whatever absurd price the
manufacturer demands. Adequate competition without IP restrictions can drive
drug prices very, very low. This can be seen in the Indian pharma industry.

~~~
HarryHirsch
There is no adequate competition, this is an orphan drug that will sustain at
most one producer. Fun fact: most generics are sourced to very few producers
because margins are so low, competition is working.

There are similarities to fine chemical shortages:
[http://blogs.sciencemag.org/pipeline/archives/2010/06/16/spa...](http://blogs.sciencemag.org/pipeline/archives/2010/06/16/sparteine_and_other_fine_chemical_shortages)

The world can do without sparteine, but orphan drugs call for regulation as
natural monopolies, or even government subsidies.

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perilunar
This is the problem right here: "Although Keveyis is actually a decades-old
drug, its federal approval for periodic paralysis came with a seven-year
period of exclusive marketing rights."

A decades-old drug should not have _any_ IP left.

~~~
notlob
The exclusivity period is intended to incentivize developing old drugs for new
indications. What would you suggest instead of the exclusivity window?

~~~
toomuchtodo
Government manufacturing of generics by the CDC or NSF. It is the only method
by which you can guarantee supply as well as ensure transparency in the
process.

~~~
notlob
I can't say I understand why you selected those two organizations: the CDC
doesn't have pharma manufacturing expertise that I am aware of (interested to
hear of what you know on that angle); the NSF is non-medical and it's a grant
agency, no labs. I should also note that even if they were chartered for this
sort of work and were working on it, they would face the same source material
supply problems facing commercial groups that result in some supply
interruptions, and the basket of problems associated with manufacturing small
amounts of drugs.

There are many non-profit and academic institutes that are working on the
problem of generic drug costs holistically, including figuring out how to
produce APIs (in pharma, API is active pharmaceutical ingredient) from
plentiful source materials and how to produce the APIs by flow processes so
that small quantities of drugs are more economical to produce. They're doing
good work but it's a hard problem, experienced execs and leaders are difficult
to come by, and getting funding in biotech is far more difficult than getting
funding in IT. They do receive support from NIH, FDA, DARPA (making drugs at a
CSH in the middle of Afghanistan is useful), big pharma (being able to make
drugs cheaper is generally of interest), and philanthropic groups. Many smart
and talented people are "on it!", good progress is being made, but it is a
hard problem.

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calvinbhai
Basically, this is the pharma - health insurance industry nexus, that jacksup
prices of drugs, making it looks like an amazing deal for those getting the
drugs through insurance.

For a new patient needing this drug, he/she would think "wow, I pay only $1000
a month of insurance, and I'm getting $109,500 a year worth of drugs for $5000
only."

Without fixing pharma+healthInsurnace nexus, healthcare in the US feels like a
ripoff, whether you are rich or poor.

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pnutjam
I'm not sure how Single payer could ever be less efficient then our current
system.

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RcouF1uZ4gsC
>Anderson, for example, pays nothing.

Buried in this article is the fact that the person they introduced at the
beginning of the article is still paying nothing for this drug. Seems like
much ado about nothing.

~~~
anigbrowl
Everyone else in the insurance pool is paying more than they need to as a
result.

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georgiecasey
[http://archive.is/BOf2k](http://archive.is/BOf2k)

if you get stuck behind the paywall like me

