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I would suggest anyone who is interested in reducing drug prices listen to this econtalk episode with Robin Feldman[0]. They discuss her book "Drug Wars how big pharma raises prices and keeps generics off the market"[1]

In the episode they discuss all sorts of shenanigans that pharmaceutical companies pull. If you want real reform you need to look at weak patents, eliminating "reverse payments" to generic companies, and obstruction to bioequivalence testing. Drug companies routinely manipulate the current laws, specifically Hatch-Waxman in order to stifle competition from generics.

[0] http://www.econtalk.org/archives/2017/06/robin_feldman_o.htm...

[1] https://www.amazon.com/Drug-Wars-Pharma-Raises-Generics/dp/1...

I'm going to go on a bit of a rant. I agree blocking access to drugs for bioequvalence is bullshit. Drug companies can do it by claiming that the law doesn't allow them, but it's BS.

The reverse payments I see nothing wrong with. Imagine you're a drug company holding a patent. A generic company decides to try and invalidate it. You think there is a 50% chance they'll win. The generic company agrees.

You have two options: 1) spend a ton of lawyers and still possible lose, 2) go to the generic company and agree to let them produce the generic 5 years before patent expiration.

With the 2nd option, you're basically agreeing to split up the pie evenly rather than risking it all.

In every case where reverse payments are made, the drug goes generic earlier then if they went to court and got the patent upheld.

Eliminate reverse payments and what you're doing is making lawyers rich. In many cases the branded drug company would win and block generics for many more years than if a reverse payment was made.

the US actually has more generic drugs as a % of total rx than many OECD countries. Yes pharma companies actively try to protect patents in ways that try to game the system, but it's actually much harder to do than it used to be bc payers are much more aggressive / consolidated. The bigger issue is probably generic drug price inflation and the high cost of developing innovative drugs. Very hard to solve the latter without stifling innovation


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