Hacker News Reader

Comment by rayiner | Hacker News Reader

In litigation, the cost of a decade of life can be valued at a million dollars or more. Saving the life of a 45 year old for $85,000 isn’t “price gouging” it’s a huge bargain. And taxing industries that create those outcomes, like we do with industries we want to discourage (such as alcohol or tobacco) is economically irrational.

Of course you expect the pitchfork-toting mobs to be irrational. But that’s not a basis for arguing in favor of something as a matter of sound policy.

Trying to set drug policy ignoring the economics of human life is like trying to design an airplane while ignoring gravity. You can’t will physics into submission through moral outrage. There is, as far as I can tell, no proven correlation between scientific talent and altruism. If you make it so you can’t get rich saving lives, many of the best and brightest will go work making better advertising technology instead.

View on HN

You're making this very hand-wavy calculation. Hardly any 45 year olds were dying of hep C, even the older ones had lots of comorbidities & other risk factors, which is what one would expect for a disease acquired through intravenous drug use, and often transmitted in prisons or unsanitary tattoo parlors, and the drugs don't have a perfect cure rate.

In any case it's nearly irrelevant because this was a completely post-hoc rationale for pricing this drug. I am not opposed to large cash bounties for major advances but our current system is not remotely designed around that principle. Forgive me for thinking you are defending the wrong system.

In one study, 60% of the people who died of Hep-C were between 45 and 59: https://www.hepmag.com/article/death-risk-24659-138388084. More than half of cases aren't the result of intravenous drug use: https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/cl....

> In any case it's nearly irrelevant because this was completely post-hoc rationale for pricing this drug

Drug development, like tech startups, is high risk, but every now and then creates a lot of economic value. To make the system sustainable, there must be a way of capturing a significant chunk of that value from those "unicorns." So yes, it's post hoc in the sense that you don't know until after you roll the decide whether a particular drug is going to create a lot of value or not. That's the case with most high risk investments.

> Forgive me for thinking you are defending the wrong system.

Forgive me for thinking that people are completely nuts for thinking it's a good idea to lower the potential rewards to investment for industries that are "more important." It's completely ass-backward.

Those studies don't say what you're claiming.

I meant the pricing was post-hoc in the sense that they came up with a story like yours for why it was worth $84,000 when they were bringing it to market. There was no precedent for a pill that costly when the research was undertaken. Even in the case of HCV--the best case to be discussing if you're an advocate of for-profit medicine--it's not a good example of an incentive structure.

You need to do a bit more reading. The latest Hep C drugs have cure rates of over 99%. Even NICE, the UK's cost-effectiveness committee said that Sovaldi is cost-effective.

Reply on news.ycombinator.com