But don't listen to those that say a regulated health care system is needed.
These companies are just looking out for their own like good Americans.
These companies are just looking out for their own like good Americans.
http://www.fiercepharma.com/special-reports/avastin
Until then it's off-label usage. When the time comes, expect an absolute feeding frenzy to make a similar equivalent (with incrementally higher efficacy or slightly fewer side effects) or an alternative formulation to regain those patent rights. I would expect Genentech is already hard at work here.
Outright bribery of generic companies to hold off on production (http://www.usatoday.com/story/news/nation/2013/06/17/supreme...), scaremongering over safety of the generic (the article being discussed in this thread), paying doctors for prescribing the more expensive versions, etc.
They likely can't in this situation, as the cheaper alternative is off-label.
Or look at Vyvanse, a prodrug of Adderall. Shire Plc has been intentionally manipulating the market (using government amphetamine quotas) for years in order to push patients away from cheaper generic Adderall (despite the fact that many people find Vyvanse to be substantially inferior).
Or take the case of adrafinil, which metabolizes into modafinil (provigil). Adrafinil is just fine (not quite as effective, but nearly so), but its patent ran out. At that point, Cephalon pulled strings to get its approval revoked (this was in France; adrafinil is unapproved and unregulated in the US), so that people would have to move to their newer, patented drug. (And yes, adrafinil does tax the liver some, but no more so than plenty of other drugs).
http://en.wikipedia.org/wiki/Dr._Reddy%27s_Laboratories
With up to 10M cases in the US alone, it seems like an excellent target for competition.
http://www.blindness.org/index.php?option=com_content&view=a...
I take the point that some of the motivation (I'm hedging here because I haven't looked into it...) for Nexium is a patent protected drug to market, but the tone of this thread would have me believe that Prilosec and equivalents are disappeared from the market.
It's their most commercially-successful medication, they did misleading studies in order to tout its comparative effectiveness, market it heavily and bribe docs to favour it.
Prilosec is still available, but if your doctor prescribes Nexium, you're unlikely to question it. Virtually all of the folks on it could likely be on Prilosec with equal effect and much less cost to the healthcare system.
It's not like the people criticizing them for it have been bashful or unqualified.
(I have a similar "Well, shit." reaction to all sorts of things, politics, etc.)
(This is a joke; when there are just two companies they price-fix rather than compete. Not with actual price-fixing agreements, instead tit for tat signaling as in the iterated prisoner's dilemma)
Eventually, generic manufacturers may be able to compete (the generic clones of biologic drugs are called biosimilars), but it will take a long time and significant resources, because they will need to run new clinical trials to show that the new drugs are equivalent:
Because different manufacturers may produce slightly different products, they consequently cannot guarantee that their version is exactly as safe and effective as the original manufacturer's version. So, unlike most drugs, generic versions of biologics were not authorized in the United States or the European Union through the simplified procedures allowed for small-molecule generics. As a result, nearly all biologics have been brand-name therapeutics and required very extensive testing. http://en.wikipedia.org/wiki/Biologic_medical_product#Biosim...
The FDA gained the authority to approve biosimilars (including interchangeables that are substitutable with their reference product) as part of the Patient Protection and Affordable Care Act signed by President Obama on March 23, 2010 - none have yet been approved. http://en.wikipedia.org/wiki/Biosimilar#Approval_processes
http://www.biopharma-reporter.com/Markets-Regulations/Dr-Red...
Because at $75M to $250M a pop, they're way cheaper than developing a new Biologic ($1B-$2B) and that's because while none have been approved yet, the pathway in the Patient Protection and Affordable Care Act is shorter than that for a new Biologic. I think Big Pharma will do what it takes to make this happen myself. Just like Google will apparently do just about anything for the bottom line despite their corporate motto.
Insurees are essentially paying a monthly cost for an effectively unlimited pool of medical funds. As long as the bill is above what their copay costs, they couldn't care less how much the drug costs - if anything, they will choose the drug that costs more than what the nearly identical drug costs so they can 'get their money back.' As long as the consumer is separated from the consequences of their choices, costs will continue to rise. Some kind of incentive for people to actually care about the cost of their decisions needs to be engineered into the system.
Suppose, perhaps, that instead of mandating that employers provide insurance to full-time employees, the government mandated that employers provide catastrophic insurance and contribute the remainder of the difference between the old system and the new to a kind of Health Savings Account: something that's tax-advantaged, and can only be used to pay for healthcare. Employees would then pay their medical bills directly from this fund, and funds will continuously build if they're not used. The kicker is that this HSA also doubles as a retirement fund, and any funds left over when retirement age is reached can be withdrawn without penalty. People will see the money as theirs, and will be much more careful about how they spend it, thus putting pressure on doctors and healthcare providers to reduce prices, rather than increasing them.
This took me ten minutes to think up. Give me half an hour, and I'll work out most of the kinks. Give a team of professionals a few weeks, and I'm sure that we could come up with something that makes infinitely more sense than the ridiculous hodgepodge of special interest legislation and twisted incentives that we have now.
For example. Someone will be paid a bonus to make sure the average retirement account is emptied. The average american woman has about 2 kids, so we'll charge about 40% of an average lifetime account "earnings". After all we can either directly or indirectly select any price we'd like.
Another example would be some weirdness with plastic surgery where the cost would now directly correlate solely with human emotional response to a procedure rather than difficulty of the surgery.
Finally I think you'd have some pretty weird and borderline inhumane situations with respect to just barely under retirement age patients getting sick... Feel a lump? Well your grandkids will never go to college, or your kids will never live in a house, etc, if you seek treatment before retirement. Just wait a couple months / years, after all what could possibly go wrong with untreated cancer or heart disease or diabetes?
Now if you could roll over the treatment fund directly to your kids, that sounds great until (grand)parents start offing themselves so their kid can afford treatment.
"Give a team of professionals a few weeks"
Fox guarding the henhouse, you'll end up with something at least as corrupt if not more so than the existing solution.