[Politics] The price of medicines

[beorhthelm]

This to me makes a lot more sence a drug company owned in part or full by the UK and linked to the requirements of the NHS from the research of UK Universities a not for profit organisation poring any income back into research and development no need for advertising as its customer is also it's supplier and designer.

As an aside it would be great if it developed a preventative vaccine for Marella and gave it design free to the world just think of the hundreads of millions of lives it could save, it's always been do able but the drug companies have not been that interested as the profit margins are low when selling drugs to the poorest 90%

there are billions spent in universities and other labs on medical and drug research by not for profits. if it were "doable" it would have been done. companies make a lot of money selling low margin to 90% of the population too.

 

[schmunk]

A demonstration of the nature of private pharma - in 2015 a hedge fund bought the marketing rights to a drug called Daraprim - overnight the price of a tablet in the US went from $13.50 to $750 (in the UK this drug costs £13 for 30 tablets - in Brazil it costs 1p).

Ah, Martin Shkreli, one of the world's most punchable faces...

"boy genius", hedge fund CEO, serial investment klutz and now serving 7 years in Federal prison for securities fraud.

For anyone unfamiliar with his story, it's well worth a read - https://en.wikipedia.org/wiki/Martin_Shkreli.

You just know he'd be a Palace fan.

 

[Uter]

With a drug you get only 10 or 12 year's patent protection.

Isn't it 20 years?

 

[Herr Tubthumper]

Isn't it 20 years?

It is. Maybe the poster meant the period when the product finally hits the market place?

 

[Tom Hark Preston Park]

Ah, Martin Shkreli, one of the world's most punchable faces...

"boy genius", hedge fund CEO, serial investment klutz and now serving 7 years in Federal prison for securities fraud.

For anyone unfamiliar with his story, it's well worth a read - https://en.wikipedia.org/wiki/Martin_Shkreli.

You just know he'd be a Palace fan.

Could do a job - for the Tories

 

[brakespear]

Ah, Martin Shkreli, one of the world's most punchable faces...

"boy genius", hedge fund CEO, serial investment klutz and now serving 7 years in Federal prison for securities fraud.

For anyone unfamiliar with his story, it's well worth a read - https://en.wikipedia.org/wiki/Martin_Shkreli.

You just know he'd be a Palace fan.

Thanks - been trying to remember his name since I started reading the thread

 

[Uter]

They closed Sandwich as a cost cutting measure, and for no other reason.

Yeah, I don't think it was anything other than a restructuring to appease shareholders that tend to happen every two or three years in large pharma companies.

Technically they didn't close completely as they still have a much reduced presence on the site.

I was there around 2000-2003 and I saw them invest hundreds of millions in several new buildings. I forget the numbers, maybe 500, 503 and 509? Then shortly after I left they made the decision to close down. I don't think they ever even used the top floor of the new building I was moved to. I am not sure the new lab building was EVER used in the end. It seemed insane to me, but the sums they invested were a drop in the ocean to them.

I've been in the industry a while now and whilst mergers and site closures are fairly common, they are not typically driven by losses. They happen to sustain profit growth. I don't think I've ever been at a company that has posted a loss. Sometimes they have what they describe as "disappointing" results, but they are only disappointing by the standard of the industry. They are still healthy profits by any other standard. Pfizer in particular seemed to be swimming in money.

20 years seems a reasonable time to me to bring a new drug to market and still make a handsome profit. I cannot see a case for extending it.

 

[Tom Hark Preston Park]

I'd just like to know why an asthma inhaler costs about 2 euros over the counter in Greece or Spain, whereas the exact same inhaler costs more than 8 quid with all the prescription hoops to jump through and associated admin costs in the UK.

 

[Coalburner]

This has to be one of longest threads that has kept to the original topic all the way through. Well done to all contributors

 

[Harry Wilson's tackle]

It is. Maybe the poster meant the period when the product finally hits the market place?

Yes. The patent is sought to protect the IP long before the chemical becomes a drug. The chemical/drug I am involved with developing is patent protected (this has cost around £40K, and will cost more if there are challenges - protection has to be global). We can only get investment (to prove the drug is worth trying in humans, and then to fund the clinical trial) if we have patent protection. At present we are dealing with hairy-arsed investors who want max control with no risk (who knew?). This is just to get into a position where we can go 'first in human' (FIH). I tried to get 'conventional' funding but was told my drug and target are 'counterintuitive' (i.e., eff off, we are only interested in low risk low benefit projects). Meanwhile the clock is ticking. I am trying to make a drug because I want to do something decent with my life in research not to get rich (if I make money I'm not going to complain, obviously), but dealing with business and investors is unavoidable because everything costs, and nobody will invest until they can see a path to profit. The patent protection is frankly too short to make 'speculative' investment in research viable, and attempts to make the climate even harsher are wrong. BUT it is the counterintuitive ideas that are the most 'disruptive'.

I accept all the stuff about companies making massive incomes, but these are only the ones making the massive incomes. Others crash and burn (or merge and 'rationalise'). And the type of stuff coming online is biologics - immunoglobulins, monoclonals and the like, for very particular conditions and a great cost for each treatment. What we need is cheap safe old school drugs like propranolol, ranitidine etc. Nobody is going down this route these days though, partly because of the patent landscape. Monoclonals are easier to protect because they are hard to make, hard to make pure, and very hard to patent-challenge owing to the extreme specificity of the structure (you can make a similar analogue to an old school small chemical entity that will do much the same thing - often better - but it is much harder to create an active analogue of a biologic).

Anyway, this was a rather personal rant about stuff related to the election - some interesting comments all round - thanks for that folks

 

[Harry Wilson's tackle]

I am going to have to take you up on this - anywhere between 30%-40% of the medicines produced (depending on which meta analysis you accept) come from academia - not from drug companies - and it is the drug companies that get these drugs on the cheap before making a financial killing on them (you briefly gloss over this in your comments)..

You have made some interesting points and I'll try to respond, time permitting.

Regarding this particular comment, it conflates different things. (For the sake of other readers - you sound like you know this already - I'll elaborate that) a new drug is a chemical (or biologic, which is still a chemical) that is invented, synthesized, tested, manufactured and sold. Academics can play a part in that process (I have all my working life) but the owner is the inventor. That was, in the past, usually a drug company. I would be given, or would ask for drugs to test for academic reasons, with any IP being owned and used by the company.

When it is an academic who does the inventing, he/she must patent protect the invention if it is to be developed into a drug. I tried to do this some years ago with an invention I made with a small drug compamy (who have little with no money - I am not giving the details). I tried to get my uni to pay for patent protection (we estimated £10K - it has turned into £40K). They refused. However they did tell me that since the initial work had been done in my lab, they (the institution - my employer, or at least the 'money guys' in the 'enterprise' department) owned the invention. Righty ho.

Academia is shit house for drug hunting. The money guys are all over it. Who are the money guys? I won't give a named example (each uni has them) but they are people who could not cut it in real industry, and have taken a pay cut for a salary and an easy life in a university. They still earn more than I do. Where I work we have invented, named, then dissolved, reinvented and renamed our 'enterprise' team four times in the last 15 years. "X Business", X innovations", "X enterprises"....same old outcome.

I am not going to say how I have got around all this old bollocks, but needless to say the centre of gravity of the project, the patent and the (ongoing attempts to secure next stage) investment have been reconstituted away from my workplace, and the patent does not contain any of the excellent data generated in my lab.

As for companies getting the fruits of my labour on the cheap, they certainly might have done had I not had collaborators with the balls to spend some money to protect the invention with a patent. Forty grand. Why so much? As Gussy would have said, ees complicated. Companies could buy the ownership of drugs at a fair price from uni academics if the unis had the brains to help the academic rather than push them around. You would not believe the stonewalling old bollocks I have had to put up with. Even so, at some point someone has to stump up the billion quid to to the large scale clinical trial to prove the drug works and is safe. He who pays the piper (and takes the financial risk) calls the tune. That has to be Big Pharma. If the taxpaye paid for a trial of my drug and it didn't meet targets, I would be handing out hankies to dry eyes and extra absorbant mattress protection. This is a hight risk high reward business. Don't ignore the high risk bit! If a company has the balls to invest a billion in my little old invention, they deserve the lion's share of the reward (if there is any). And I say that as a labour voter and sentimental old communist (ish).

The bottom line is that if our drug ever does make money, the uni may come back and say 'hey, didn't 'we' invent that?'. In which case the patent owner (of which I am a minor party) would say, no, but here is ten million quid, now **** off (which is what one of my collaborators, from another uni, did when his invention was sold for a sum 20 years ago). The uni, needless to say, took the money and ran.

No, uni academics find it bloody hard to drug hunt. It is a racket, and the unis are only interested in low hanging fruit. You need balls of steel to run with it to the sweet or bitter end (not sure I have that; not prepared to risk remortgaging my house at my age, with dependents, time will tell).

 

[FatSuperman]

I genuinely don't believe that extending the patent protection will do anything other than give the big pharma companies more money. They well probably spend a bit more on research, and marketing etc, but only as a side effect. They won't change their behaviour in any way and go after different, lower reward, higher benefit drugs. They'll carry on as they are, but just be more profitable. I don't know what the solution is, but giving those firms more isn't it.

Yes it is a risky industry, but apart from the sums involved, how is it any different from any other product-based industry? They have made massive profits, every year, for decades and decades. They clearly have the risks well understood and mitigated.

They merge and take over other firms to get their IP, their pipeline, their staff and often their tax benefits. Go back and look through the details of when Pfier tried to take over Glaxo. They were going to save a fortune on their US tax bill. That was the SOLE reason. They may very well have shut ops in the UK after they'd done it, because they just wanted that multi-billion tax saving - they would have asset stripped and rationalised everything. That would lead to less competition and more risk for us as consumers.

Their needs to be better protections and incentives for the independent researchers, labs and universities.

 

[Harry Wilson's tackle]

I genuinely don't believe that extending the patent protection will do anything other than give the big pharma companies more money. They well probably spend a bit more on research, and marketing etc, but only as a side effect. They won't change their behaviour in any way and go after different, lower reward, higher benefit drugs. They'll carry on as they are, but just be more profitable. I don't know what the solution is, but giving those firms more isn't it.

Yes it is a risky industry, but apart from the sums involved, how is it any different from any other product-based industry? They have made massive profits, every year, for decades and decades. They clearly have the risks well understood and mitigated.

They merge and take over other firms to get their IP, their pipeline, their staff and often their tax benefits. Go back and look through the details of when Pfier tried to take over Glaxo. They were going to save a fortune on their US tax bill. That was the SOLE reason. They may very well have shut ops in the UK after they'd done it, because they just wanted that multi-billion tax saving - they would have asset stripped and rationalised everything. That would lead to less competition and more risk for us as consumers.

Their needs to be better protections and incentives for the independent researchers, labs and universities.

The answer is attrition. Can't think of another industry where you can spend a billion on a product only to find that it doesn't work.

That said I suspect you are right, and that extending patent life won't change the behaviour of big pharma, because it is run by madmen who don't understand how to invent drugs.

I was at a meeting at the Royal Society a few years ago and Dave Allen, head of respiratory at GSK was banging on about how they were using all the latest market modeling and management infratizing, with applied Shatner's Bassoon, to invent new drugs. He mentioned 100s of drugs in the pipeline. I asked him how many actual drugs they had brought successfully to market in the previous 5 years. He blustered. Someone told me afterwards he was so annoyed he'd been overheard saying he was now out to 'get me'.

I found out later that GSK were using an incentivisation model whereby all the bonuses were paid to the preclinical guys as soon as the drug went FIH. So they were not that fussed if the thing actually worked - it didn't need to work for the bonuses to be paid.....they have changed that model subsequently but, WFT? Knowhow in Pharma....

Anyway, if the guys themselves don't know what they are doing, and just get lucky from time to time (with massive rewards possible but not guaranteed) it is no surprise politicians know even less about how it works, and the perils of overzealous patent laws (which I still maintain should be shifted in the opposite direction of travel). This may not do much, but it may loosen a few ties, increasing blood flow to the head. Tightening things down even further won't help at all.

This paper is open access, and in my view is wildly optimistic, but that's how folk always seem to sound. I spoke about the difficulty of drug hunting in my area at a meeting a few years ago and was accused of 'nihilism' by the session chair

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725284/

 

[FatSuperman]

"We're nihilists, Lebowski. We care about nothing"

Of course, not having any commercial success in 5... 10... etc years would be concerning. But as per the evidence in their annual reports, they still seem to be muddling through ok. Long-term, awful management and policies may well bring them down. Or at least, down to a level where a hostile takeover can't be fought off.

It's true in any industry that if you are not very careful what you measure people on, you may end up with the wrong outcome. Often seen when people are tasked with doing things as quickly as possible. Quality / safety goes out the window.

I wish you luck in your quest HWT!

 

[BensGrandad]

I wonder how much money is wasted when people on prescribed drugs have them changed and have a store which even if in sealed packets cannot be returned to the chemist for redistribution There is no way that open packets can be re used but some in sealed blister packs that are unopened surely could be.