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Comment by brandonmenc | Hacker News Reader

There are so many people on both insulin and government health insurance that it's probably in the taxpayers' interest to build an insulin factory to supply the low-end.

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I had a similar thought a few years ago that it would have been in the government's interest to buy Pharmasset when they sold for $11B to Gilead based on the future potential of Sovaldi (the infamous $1,000/pill, 12-week treatment for Hepatitis C). The government through Medicare / Medicaid is currently spending upwards of $4B/year on the drug and private insurers and international buyers are spending billions more. It would've been an absolute net-win for humanity had the USGov or someone else just bought the company rather than giving Gilead billions in annual profits.

The problem is deciding where to put your billions without the benefit of hindsight. If Sovaldi hadn't worked out, the purchase would be hailed as a disaster.

You're definitely right, but I think government should be taking more risk.. It's hard to fight off the 'Solyndra!' shouts when something goes wrong, and costs are hard to quantify when things go right (what's the $ return of all the USGov's investments in the early internet?) but braver politicians could pull it off and we'd all be better for it.

When it comes to Medicare, there is a much easier win: just allow the government to negotiate prices. The government should have massive bargaining power.

> When Congress created the Medicare drug benefit in 2003, it specifically prohibited the government from negotiating prices with drugmakers.

http://www.bloomberg.com/news/articles/2015-02-02/drug-price...

Imagine making a deal with a company where you are one of their largest clients but you are specifically prevented from negotiating any prices with them at any point in the future.

NHS does this in the UK, access to 60 million people through one customer is a hell of an incentive to negotiate, not perfect but then what is?

I'll take our system every single time though.

Hah, never happen since the people who would vote on this are all on the Pharma take. Both parties, an equal opportunity bribery, which means nothing will ever change.

The only way Medicare will have an negotiating leverage with respect to price is if they create a formulary and deny access to certain drugs.

I can't see Medicare doing that.

Well, it's more complicated than that though, economic considerations-wise. You can treat Hepatitis C now (and it's the rare case where the drug actually cures something like this with high probability), or you can treat liver disease in a terminally ill patient later. It's up for debate what's more expensive. That's one of the reasons why they can charge so much. The second reason is, they're just dicks.

That won't happen, the government is the one preventing it because of the patent restrictions. If the patents were limited then companies would spring up instantly to manufacture it cheaply.

They're also the ones holding back generics to a dramatic degree via the FDA approval process, which would stop a biosimilar insulin from making it through. The government has entirely rigged the game. The statistical change in approvals is so dramatic and inverted, as to be implausible to be anything but intentional fraud on the part of the FDA. (why fraud you might ask? deceit for monetary gain: user fees paid by big pharma)

http://www.statnews.com/2015/12/29/generic-drugs-backlog/

Or just enter into a long term contract with a generic manufacturer (hopefully striking a balance between a longer term that ensured the manufacturer covered their fixed costs and a shorter term that would invite more competition).

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