The Trump Drug Plan: Buy Canadian

[garbon]

There's very little innovation going on. No search for a cure kinda thing. It's mostly "let's add a hydrogen there, test it and see if it works". Out of the hundred different variations they'll find one where they can make the statistics say it's 1% better than the old drug. That's good enough to market it to doctors at their yearly conference in Honolulu and there ya go.

Sounds about right for a lot of studies we did when I was with a Contract Research Organization. Another big thing was off label uses - application of medication to conditions they weren't originally designed for, to increase market/customer base.

The horrors of using a drug to treat an additional issue?

[Syt]

It's generally a good thing (if working), but also comes across as, "We need to sell more of this, let's see what else it's good for."

[garbon]

It's generally a good thing (if working), but also comes across as, "We need to sell more of this, let's see what else it's good for."

Well yes, they are companies not non profits.

[Syt]

I guess my pre-caffeine point that I was trying to make, clumsily, was to tie into the low hanging R&D fruits described by Zoups.

[Zoupa]

There's very little innovation going on. No search for a cure kinda thing. It's mostly "let's add a hydrogen there, test it and see if it works". Out of the hundred different variations they'll find one where they can make the statistics say it's 1% better than the old drug. That's good enough to market it to doctors at their yearly conference in Honolulu and there ya go.

Sounds about right for a lot of studies we did when I was with a Contract Research Organization. Another big thing was off label uses - application of medication to conditions they weren't originally designed for, to increase market/customer base.

The horrors of using a drug to treat an additional issue?

The horrors of using your already limited r&d dollars to treat bullshit fringe crap with drugs whose IP you own instead of developing treatments for cancer, dementia, HIV etc.

[Admiral Yi]

The horrors of using your already limited r&d dollars to treat bullshit fringe crap with drugs whose IP you own instead of developing treatments for cancer, dementia, HIV etc.

If it's bullshit fringe crap, why are end users willing to pay a premium for the faster uptake insulin?  Do you know something they don't?

[garbon]

There's very little innovation going on. No search for a cure kinda thing. It's mostly "let's add a hydrogen there, test it and see if it works". Out of the hundred different variations they'll find one where they can make the statistics say it's 1% better than the old drug. That's good enough to market it to doctors at their yearly conference in Honolulu and there ya go.

Sounds about right for a lot of studies we did when I was with a Contract Research Organization. Another big thing was off label uses - application of medication to conditions they weren't originally designed for, to increase market/customer base.

The horrors of using a drug to treat an additional issue?

The horrors of using your already limited r&d dollars to treat bullshit fringe crap with drugs whose IP you own instead of developing treatments for cancer, dementia, HIV etc.

Yeah, no one is working in the fields of oncology and HIV these days....

On the broader point, costs of bringing a drug to market are very expensive. It shouldn't be a surprise that such costs can make some companies averse to forking over cash on risky developments leaving them out a significant amount of cash and time invested for naught.

At the same time, there is a lot of innovative stuff being done by biotech startups...which when pharma buys once trials are looking promising.

[Malthus]

The real innovative work (and the stuff that causes both biggest profits and worst moral dilemmas) is in the field of so-called "orphan" drugs - drugs used to treat very rare conditions.

Some of these are indeed "cures", even "miracle cures" (or in the terms used by our price regulatory agency, "breakthrough" drugs). Problem is that they are very, very expensive to develop - and the manufacturers naturally attempt to push the price envelope as much as they dare.

The dilemma is this: how much, as a society, are we willing to pay to cure (or at least control)  a very rare, debilitating or life-ending disease that affects only a handful of people? 

The following points make this situation difficult:

- these drugs are very expensive to develop - a small patient population makes everything difficult, and the regulatory and clinical trial costs have to be spread over and so recouped from a tiny number of sales.

- The price control methods used for other drugs don't work well for these products. "Reference pricing", such as used in Canada (comparing the drug to the price in other countries and against others in the same therapeutic class) won't bring the price down, because the same drug is also expensive elsewhere and there are often no others in the same therapeutic class. The PMPRB has responded by essentially ignoring its own Guidelines and the legislation and inventing new tests for such products (and so far, the lower court has allowed them to do so).

- Patient advocacy groups are very effective at mobilizing popular support to pay for such products.

- Drug companies gamble on them - they fund many "losers" for every "winner", and so argue that they must charge the maximum for each "winner" to pay for all the "losers".

- The public simply can't spend an infinite amount on these products; their price is becoming impossible to pay.

- If the companies aren't able to make a substantial profit on these products, they won't develop them. 

[Legbiter]

The newer insulins offer marginal benefits at most.

It's part of a widespread pattern of "R&D" in pharmaceutical companies. Basically they tweak an existing molecule, test and market it as a new drug and get around patent expiration.

There's very little innovation going on. No search for a cure kinda thing. It's mostly "let's add a hydrogen there, test it and see if it works". Out of the hundred different variations they'll find one where they can make the statistics say it's 1% better than the old drug. That's good enough to market it to doctors at their yearly conference in Honolulu and there ya go.

"R&D"

It's why I gave up on research and went to work at a community pharmacy.

Good post Zoupa.

[Zoupa]

There's very little innovation going on. No search for a cure kinda thing. It's mostly "let's add a hydrogen there, test it and see if it works". Out of the hundred different variations they'll find one where they can make the statistics say it's 1% better than the old drug. That's good enough to market it to doctors at their yearly conference in Honolulu and there ya go.

Sounds about right for a lot of studies we did when I was with a Contract Research Organization. Another big thing was off label uses - application of medication to conditions they weren't originally designed for, to increase market/customer base.

The horrors of using a drug to treat an additional issue?

The horrors of using your already limited r&d dollars to treat bullshit fringe crap with drugs whose IP you own instead of developing treatments for cancer, dementia, HIV etc.

Yeah, no one is working in the fields of oncology and HIV these days....

[Zoupa]

The horrors of using your already limited r&d dollars to treat bullshit fringe crap with drugs whose IP you own instead of developing treatments for cancer, dementia, HIV etc.

If it's bullshit fringe crap, why are end users willing to pay a premium for the faster uptake insulin?  Do you know something they don't?

You can treat someone with diabetes using 1950s insulin and they have the same life expectancy as the control group. Same co-morbidity too.

I'm not saying the new insulins aren't "better". They are better in terms of number of injections per day for example. They usually also require less blood testing.

I'm saying that the millions invested into making an insulin that lasts 24 hours instead of 12 could have been invested in worthier fields.

[The Brain]

Your concern for the QoL of insulin-users warms the old heart.

[garbon]

There's very little innovation going on. No search for a cure kinda thing. It's mostly "let's add a hydrogen there, test it and see if it works". Out of the hundred different variations they'll find one where they can make the statistics say it's 1% better than the old drug. That's good enough to market it to doctors at their yearly conference in Honolulu and there ya go.

Sounds about right for a lot of studies we did when I was with a Contract Research Organization. Another big thing was off label uses - application of medication to conditions they weren't originally designed for, to increase market/customer base.

The horrors of using a drug to treat an additional issue?

The horrors of using your already limited r&d dollars to treat bullshit fringe crap with drugs whose IP you own instead of developing treatments for cancer, dementia, HIV etc.

Yeah, no one is working in the fields of oncology and HIV these days....

[garbon]

The horrors of using your already limited r&d dollars to treat bullshit fringe crap with drugs whose IP you own instead of developing treatments for cancer, dementia, HIV etc.

If it's bullshit fringe crap, why are end users willing to pay a premium for the faster uptake insulin?  Do you know something they don't?

You can treat someone with diabetes using 1950s insulin and they have the same life expectancy as the control group. Same co-morbidity too.

I'm not saying the new insulins aren't "better". They are better in terms of number of injections per day for example. They usually also require less blood testing.

I'm saying that the millions invested into making an insulin that lasts 24 hours instead of 12 could have been invested in worthier fields.

Like the other diabetes meds that didn't exist in the 50s?

[Zoupa]

Why do you keep moving the goal posts?