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this is not just synthesizing a chemical - this is using an engineered virus to deliver a newly functional gene.

There is a reality here that these therapies are really fucking expensive to produce. If we want them to be cheap or free their discovery needs to be subsidized and funded in a non-profit driven manner




Actually, tzakrajs is correct. These therapies are just like any other medication as far as their discovery and production are concerned. It requires enormous amounts of resources to discover them. The problem is that once you know the process for an effective therapy, it's relatively easy. So it's critical that access to any information regarding the process used to produce the therapies be as restricted as humanly possible. This is not because drug companies are dastardly profit mongers. (Although that is certainly part of it.) But it's more because we have to fund the research that found that process somehow.

People laud places like Cuba because their health care is head and shoulders above the rest of Latin America. (Above even the US in some cases.) But here's the thing, the Cubans simply take all of the research that everyone has done and give it away for free. I understand. Their duty is to their people, not Pfizer. I get that. Here's the thing is though, if everyone does that then the research funding dries up, and the rate of discovery slows. (And yes, I understand that Cuba does its own research and contributes drugs to the global knowledge base as well. Drugs for Hep being a notable example.) But the balance of value is in the drugs researched and discovered by everyone in the world, not just the drugs researched and discovered in Cuba. So what happens when the rest of the world slows down? Well, Cuba gets less overall value too. That, eventually, would hurt the Cuban people just as much as it hurts everyone else.

It's relatively easy to take any therapy and use it on your own if you are a state level actor. As someone who had to do business in the health care sector for a long time, I can tell you that with authority. If the Cubans, for example, want to use this badly enough, they will. No amount of complexity will confound Cuban researchers. That's just life. At the same time, it's a very destructive practice under the present circumstances that drug research finds itself in. A more responsible approach would be some sort of global conventions on how to proceed if we want such a system.


The socioeconomic benefits from stopping drug companies from acquiring a larger and larger chunk of the economy would mean greater equality & more societal resources that could be directed towards other purposes than medicine exclusively for the rich.

If rich people don't want to die they can always subsidize medicine for the poor more than they are now. Then everybody could be a winner!


> if everyone does that then the research funding dries up, and the rate of discovery slows.

Does it? Or do we go back to the system where universities use government money to do drug research with no profit motive?


Well it took $8.7 billion to build this drug (granted, most of that was for any viral genetic treatment, and so probably can be amortized in the future. I would point out that that doesn't change that that money was required to get to this treatment). How long until government university research amasses that kind of money ?

We all know the answer: more than a century.

And now you might say "yes, but half the research was done at universities". That's true, probably more than half, but a significant portion of that was still paid by Novartis. Furthermore Novartis helps professors coordinate, pays for conferences, ...

Novartis profit margin is about 20%. In their best years it was 30%. So even in a communist system, this drug would only be 20%-30% cheaper, and take another century before it became available. That would bring it from 1.2 million to, let's round off and say a million.

Would that solve your problem with this drug ?


I never actually said I had a problem with this drug or the price. (I do, but I never said that)

Imagine we live in a world where all drug research must be given away freely. Chances are private companies would no longer do the research, since any of their competitors could pick up the research and make it. In which case almost all funding for drug research would revert to universities and drug companies would simply be manufacturers, and would have to compete on manufacturing efficiency.

Now, we know that the 8 billion came from somewhere in our economy, so at this point it would be an academic exercise to figure out how to extract that from the economy and transfer it to universities to do the research.

What I'm saying is that we need to remove the profit motive in health care, because there is no elasticity in the market. People will pay infinity to keep living. There is no price point where someone says, "that's too much" when it comes to health care, so the market doesn't operate like any other.


It did not take $8.7B to develop this drug. Novartis paid that amount (a huge premium over what was expected) to purchase the company that actually did the work. As another poster has noted, if you include the cost of clinical trials this cost closer to $700M.

One can make various claims regarding what value private enterprise made in the process of getting this drug to market, but none of that value proposition was provided by Novartis. Novartis is just the one who saw something shiny and new and who (over)paid a ton of money to get the right to be the gatekeeper for this treatment and set the toll.


> The problem is that once you know the process for an effective therapy, it's relatively easy.

Do you have any source for that?




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