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Comment by rayiner | Hacker News Reader

> I trully think there should be a law on maximum margins at least for life saving drugs, or some kind of regulations preventing this phenomenon

This is exactly the opposite of what you want. Investment goes where the margins are. That’s why huge amounts of money gets invested in stuff like Facebook. Making it relatively unprofitable to create lifesaving drugs just ensures that investment won’t flow into that area.

Apple makes about the same profits as the total US pharma industry, and that amounts to a tiny fraction of US healthcare spending. Too much profit is not the problem.

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Understandable, but something like an EpiPen and a lot of other very well established things like say, insulin. They're well within the realm of a stable generic that can be managed as to maximize the amount of lifes it improves. Right?

Regarding insulin, we’ve made huge progress in so many ways, and there is still room for improvement. We have different forms of insulin with different lifespans that we can use to create insulin regimens for different kinds of diabetics. For example, we have lantus, which is a long acting insulin that helps give 24 hour coverage. We combine that with short acting insulin lispro at mealtimes. Lantus is a relatively new form of insulin that wasn’t available a few decades ago.

Different bodies also respond very differently to all the different kinds of insulin available. There is room for further improvement as the typical lantus/lispro regimen isn’t perfect for everyone.

The epi-pen auto injector is tricky to do right, so it took a few tries to make a good generic. But they’re on the market now: https://www.consumerreports.org/drugs/epipen-shortage-contin...

Insulin is hard to manufacture. The older versions are now generic, but the new, patented ones have measurable advantages. Because most people have insurance coverage, there is a limited market for the older, generic insulin.

Praise be to the corporations who were so margin-driven as to develop the cure I need, but can't afford.

If only parma had some kind of inherent motivating factor.

All R&D is the same, whether you’re building life saving drugs or web advertising platforms. You throw gobs of investor money at roomfuls of Stanford PHDs and progress comes out the other end. It’s the most effective engine for innovation humanity has ever conceived. The fact that life saving drugs are more important than web advertising platforms isn’t a reason to turn drug development into charity. It’s an even stronger reason not to fuck up the incentive structures.

But the people actually doing the research aren't the ones making a profit.

When I was working in Pharma, the PhDs in the lab were some of the highest paid PhDs in the US. They certainly share in the profit.

Do you mean they held shares in the company, or that they made a high salary?

Both.

Many are. Just like in tech, much of the pharma pipeline is startups that are acquired by big cos. And, like in tech, lots of skilled technical workers who don’t become founders are making big salaries.

There's a happy medium between turning drug development into a charity and pushing the profit margins as far as they go.

I'm just asking for recognition that although most people would pay an amount that would bankrupt them for a single dose of a lifesaving drug, doesn't mean that you should routinely charge that much.

Profit margins work when it's consumer goods. For example:

Scenario #1: Sell 10 TVs at $1,000 each. Profit=$10,000.

Scenario #2: Sell 20 TVs at $100 each. Profit=$2,000.

I don't care how many people have TVs, so I'm happy for you to choose scenario #1. However, if instead of TVs, it was a lifesaving drug, Scenario #1 is a huge tragedy, where 10 people die in the process.

Repeat, there must be a happy medium between pure charity and price gouging.

The issue with finding a "happy medium" in one segment of the market is that investment capital will immediately start to flow towards other segments of the market without such constraints.

In your example where TVs are a lifesaving drug, you could argue that we should find a happy medium where TV manufacturers are only making 3-4k in profit. In the short term this would increase the accessibility of TVs, saving lives. In the long term this would cripple future investment in better TVs, reducing lives saved in the future.

Investment is distributed in response to expectation of future returns. If you want more lifesaving drugs you should incentivize their creation, not penalize the field relative to less important pursuits.

Some people will pursue medical research (or invest in it) for its own sake out of an admirable desire to help others. Many more will work for whoever will pay the most, or invest in whatever business has the most potential for profit. You don't have to admire those people, but it's not rational to actively push them away from fields where their work could benefit others.

All I'm asking is for people to consider saving lives as having a non-zero value .

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