The Peculiar Economics of Developing New Antibiotics 245
HughPickens.com writes Every year at least two million people are infected with bacteria that can't be wiped out with antibiotics but the number of F.D.A.-approved antibiotics has decreased steadily in the past two decades. Now.Ezekiel J. Emanuel writes at the NYT that the problem with the development of new antibiotics is profitability. "There's no profit in it, and therefore the research has dried up, but meanwhile bacterial resistance has increased inexorably and there's still a lot of inappropriate use of antibiotics out there," says Ken Harvey. Unlike drugs for cholesterol or high blood pressure, or insulin for diabetes, which are taken every day for life, antibiotics tend to be given for a short time so profits have to be made on brief usage. "Even though antibiotics are lifesaving, they do not command a premium price in the marketplace," says Emanuel. "As a society we seem willing to pay $100,000 or more for cancer drugs that cure no one and at best add weeks or a few months to life. We are willing to pay tens of thousands of dollars for knee surgery that, at best, improves function but is not lifesaving. So why won't we pay $10,000 for a lifesaving antibiotic?"
Emanuel says that we need to use prize money as an incentive. "What if the United States government — maybe in cooperation with the European Union and Japan — offered a $2 billion prize to the first five companies or academic centers that develop and get regulatory approval for a new class of antibiotics?" Because it costs at least $1 billion to develop a new drug, the prize money could provide a 100 percent return — even before sales. "From the government perspective, such a prize would be highly efficient: no payment for research that fizzles. Researchers win only with an approved product. Even if they generated just one new antibiotic class per year, the $2-billion-per-year payment would be a reasonable investment for a problem that costs the health care system $20 billion per year." Unless payers and governments are willing to provide favorable pricing for such a drug, the big companies are going to focus their R&D investments in areas like cancer, depression, and heart disease where the return-on-investments are much higher.
Emanuel says that we need to use prize money as an incentive. "What if the United States government — maybe in cooperation with the European Union and Japan — offered a $2 billion prize to the first five companies or academic centers that develop and get regulatory approval for a new class of antibiotics?" Because it costs at least $1 billion to develop a new drug, the prize money could provide a 100 percent return — even before sales. "From the government perspective, such a prize would be highly efficient: no payment for research that fizzles. Researchers win only with an approved product. Even if they generated just one new antibiotic class per year, the $2-billion-per-year payment would be a reasonable investment for a problem that costs the health care system $20 billion per year." Unless payers and governments are willing to provide favorable pricing for such a drug, the big companies are going to focus their R&D investments in areas like cancer, depression, and heart disease where the return-on-investments are much higher.
Already happening (Score:2)
It's a self-correcting problem. (Score:5, Insightful)
If antibiotic development wanes long enough, eventually some rich people will be threatened by new infections for which there are no cures.
Once that happens, antibiotic development will instantly become a top priority for governance and major industry players.
Re:It's a self-correcting problem. (Score:5, Interesting)
If antibiotic development wanes long enough, eventually some rich people will be threatened by new infections for which there are no cures.
Once that happens, antibiotic development will instantly become a top priority for governance and major industry players.
And how many of us proles have to die before our lords and masters decide to piss some new antibiotics into our water supplies for us to use?
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What is it with the "government bad" and "regulations bad" memes that seem so common among Slashdot commenters. There is no virtue in being rich. Being rich does not make you a better, more trustworthy person. You are not rich. Most of the rich enjoy a better material life than about 99.9999999% of the people in the world can ever hope for. It's incredible how cavalier the rich are with other people's lives. The problem is the oligarchy. Why should it take a billion dollars to lobby an elected repres
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Re:Already happening (Score:4, Informative)
No, not really... (Score:5, Interesting)
I work for a company that makes Orphan drugs. Yes, they're ridiculously expensive. The reason is that the number of patients for our drugs number in the couple of thousands globally. Our workforce to run the entire plant, do QA, maintenance, regulatory administration and production processes etc numbers in the several hundreds. Those people need to be paid every month by what a couple thousand people pay for their meds every month.
And that is without taking into account that this entire plant was built for making this drug, which was an investment of hundreds of millions of dollars, with several millions annually for upkeep and maintenance.
I agree that we probably make a decent profit or we wouldn't be doing it.
However, if subsidizing we to stop, we'd just stop making it because with the numbers I mentioned above, it is impossible to make our drugs in a manner that would be affordable without it. And that would mean those people would simply die.
Yah, I think raising antibiotic prices sounds bad (Score:4, Interesting)
Because capitalism, idiots. (Score:4, Insightful)
The problem is structural. The problem is American capitalism. Medicine should not be a profit-driven industry.
You think the US Government itself couldn't set up an R&D arm to develop that same drug for less than a 1000% profit? Socialism is the ONLY answer to the problem of access to medicine.
Re:Because capitalism, idiots. (Score:4, Insightful)
And yet, no socialist country all over the world produces such a thing. Wonder why that could be ...
Re:Because capitalism, idiots. (Score:5, Interesting)
This (for quite a part) USED to be government work. Half/3 quarters of a a century ago, at least. Research, also into medicine, was university sponsored work and universities mainly got sponsored by government (at least in large swaths of Europe.... don't know how it was in the '50's/60's/70's in the U.S.A.) However in, 'first world' nations, those that actually 'have/had' resources to develop new drugs, things got privatized, subsidies got cut down because government spending had to be cut down because of .... because Republican/Liberals/howeveryouwanttonameit. Result: Drugs are left to the market and so only what the market sees as profitable gets developed.
Perfect, if you really like it that way, and according to election results, a lot of people in the developed nations think it's all roses (pun intended).
I'm not someone wanting everything and our lives state owned but I do vote socialist. Just because I see, time and again (and I'm not even fourty...), things the free market can not solve. Even in a 'perfect' capitalist system. Which, I'm afraid, we have not one of, in this world.
Public transport, Medicine, Communications/utilities/transportation infrastructure (emphasis on infrastructure, not services), Fundamental research/sciences, Nature development...
Some things you should do as a community, others you should leave to the free market.
And be damned, pay your f*cking taxes, all of you! Also the rich. Yes, I'm looking to you too. You should get enjoyment from living in a country where things are arranged properly. Your investments are worth double if you don't have to fear the troubles that come when a significant part of your fellow human beings live below the poverty line. Your spending into security should be insignificant in a well managed nation... How much extra does that dwelling in a gated community cost you? Talk about living in a cage...
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things got privatized, subsidies got cut down because government spending had to be cut down because of ...
The subsidies didn't get cut (well, maybe for a year or so during the last recession), they even increased faster than inflation most years. They just haven't grown nearly as fast as the cost of research. The concept of "low hanging fruit" applies big time to drug discovery, and the fruit that are left are much harder (and more expensive) to pick than the ones people chased in the 70's and the 80's. That said, year in, year out, about 25% of new drugs are invented in academia, principally through public fu
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Or as that notorious socialist Adam Smith said, those who benefit most from society should pay a disproportionate share of the costs of running society.
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You can go and set up your own not-for-profit pharmaceutical firm if you're that passionate about that. Show us how it's done or shut up.
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We had not-for-profit pharmaceutical firms. The New York City Department of Health developed its own vaccines. Even today, the Centers for Disease Control develops its own drugs for rare diseases.
There was an article in the New England Journal of Medicine about the guy who developed the PKU test for babies. He was working in an academic medical center. They contracted the manufacturing and marketing to a private company, because they were just academics and they didn't know how to sell a product in the real
Because Bureaucracy, stupid. (Score:4, Informative)
We can't make any decision until we see past the government/Medical bureaucracy and get complete audit of those "costs".
The Medical Industry is completely opaque when it comes to costs. They are shifted from one area of the business to another, they are obfuscated by accounting gimmicks, government regulations, and insurance practices. Of course that's all par for the course. But before you make policy decisions, you have to know the truth...what's driving the costs. there is no reason all thee issues can't be pushed back in an audit and reveal the truth. Changing the practices can only come after the causes are revealed.
I bet many would be surprised at the answers.
Re:Because Bureaucracy, stupid. (Score:4, Informative)
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If you look at any of the well-known names in the great advances in the science of medicine, rarely will you see a for-profit corporation listed.
But if you look at the big advances from over the past 30 years. PCR? Corporate. Cure for hepatitis? Corporate. Advances in DNA sequencing? Corporate.
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Ha ha ha ha! In the USSR we invented 4 or 5 antibiotics over the life of the country (a country that lasted for 69 or 74 years, depends on how you count) and it was complete and total socialism and of-course it was complete and total failure. How many antibiotics did they invent in Cuba exactly? North Korea?
American capitalism in 19th century American Free Market is actually what created cheap accessible and effective medical and pharma systems as for profit businesses and for the last 100 years American
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isn't that better than swabbing us all down with toxic chemicals?
That would depend on whether you're a corporation that does chemical manufacturing or not.
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Probably because it's impractical as hell. Assuming that your own immune system doesn't destroy the phage first, most bacteria actually have very good resistance to that kind of thing. Unlike in the case of multi-cellular organisms with an immune system, they have mechanisms where they can shed bad RNA, and they can adapt to new virus strains within a single generation (anywhere from a day to a week, depending on the bacterium.)
Right now the technology for it just isn't there, and probably won't be there un
Re:Because capitalism, idiots. (Score:5, Informative)
In the 19th century, people were still taking blue mass (mercury) to treat miasms (bad vapors thought to cause sickness).
It wasn't until the 20th century that actual useful medicine got started, but the big blockbusters, sulfa drugs and penicillin came from Germany and France respectively. Meanwhile, the "American Free Market" gave us radium water and the deadly Elixir sulfanilamide.
So go ahead and wash your anti-freeze down with radioactive waste while the rest of us look for an actual solution.
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You must have slept through history class. There was no 'Soviet Russia' until the revolution in the 20th century.
I believe the market needs to be regulated to keep the con artists from taking over and killing people. You might not realize this but between black and white there is a vast spectrum of gray.
Before you quack on about irrelevancies, it's worth noting that I am not a fan of the FDA. The market needs regulation, not bad pseudo-regulation by stooges for the industry.
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DFTT, please. He's one of those lunatics who thinks all taxation is slavery; you can't win an argument with him, because you're not inhabiting the same reality.
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You are clearly over the deep end. Perhaps too much laudanum?
I'm still not sure how you jumped from early 20th century France to the Soviet Union.
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America does not have a cheap medical system.
My ex girlfriend worked as director in a quite big financial institution. She has kind of cyst at her womb. Was already removed once, in the USA, but not properly. (They actually wanted to remove her womb etc. but she refused)
Now she is about to either get it removed in France, where she is living right now but has no heathcare and the american healthcar _refuses_ to pay the operation in France or to let it be done in the states.
In France, as she has no healthcar
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Yeah, I was just talking to an Italian girl who broke her wrist in the U.S. An American hospital charged her $1,000 for an x-ray that would have cost $20 in Italy.
She said what the Europeans always say about American medical prices: You have to be kidding.
The New York Times had a series on American health care by Elisabeth Rosenthal. A guy went to France to get a year's supply of asthma inhalers, and the saving paid for the cost of his trip.
It's true about people getting rejected from hospitals because they
Re:Because capitalism, idiots. (Score:4, Informative)
First, the 19th century is the years between 1800 and 1899. In the 19th century, they had no effective medicine. They were still bloodletting. They could amputate limbs, although the patients often died of infection. I think you mean the 20th century, which is the years between 1900 and 1999. We are now in the 21st century.
Second, America never had a cheap, accessible free market capitalist system. I don't know where you get your ideas from. I live here, I work in the health care system, and I know the history and problems with the American health care system.
At the beginning of the 20th century, doctors couldn't do much. If you were shot in the leg, and the leg was infected, they could cut it off, and your chance of survival would go up from zero to maybe 50%. If you had heart disease, they couldn't do much to extend your life. If you had cancer they could give you morphine.
Things were going along like that without much progress until WWII, where the U.S. government (not free market capitalism) systematically studied the problems and came up with innovative new ways of handling surgery. Penicillin (from Alexander Flemming in England, an academic researcher) was a big breakthrough. Adriamycin, the first cancer drug, was discovered on -- guess where -- the Adriatic sea, by Italians.
The U.S. was a center of tremendous innovation after WWII, not because of free market capitalism, but because the U.S. government funded academic researchers, who provided a lot of the basic research that the private drug companies took and made money out of. The area with the most dramatic progress was heart disease, and much of the important research was done by the U.S. government's Veterans Affairs hospitals.
After WWII, there were private doctors, but people who couldn't afford their prices went to government hospitals, which were scattered around the country. What reason would capitalist doctors have to treat people who can't afford to pay a lot of money? By the 1980s, when doctors could finally do something useful, they got very expensive. People who can't afford health care are left to die http://www.wsj.com/articles/SB... [wsj.com]
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No idea where you have your numbers from:
As a first read I suggest: http://en.wikipedia.org/wiki/H... [wikipedia.org]
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it's not like we have publicly funded universities that were setup for basically this purpose (okay, for agriculture -- but same concept.)
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Most people who espouse socialism as the solution to a given humanitarian problem always seem to ignore that socialism tends to grant the most favors to whoever is best connected (read: best friends with) the resident politicians.
This is because socialism is defined by one fact: The state owns and controls the means of production. This means that nobody except for the politicians get to decide which people get to work on what. So unless your particular needs are at the forefront of Comrade Leader's attentio
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Most people who espouse socialism as the solution to a given humanitarian problem always seem to ignore that socialism tends to grant the most favors to whoever is best connected (read: best friends with) the resident politicians
This is a total fantasy. Paul Krugman said that conservatives read Fredrich Hayek's predictions about what government services would be like, they assume they're true, and they don't look at the actual facts in the real world which contradict Hayek.
The U.K. has a socialist health care system. I'd like you to tell me where anyone got a favor from the socialist U.K. health care system because he was connected with the politicians.
Sweden has a socialist health care system, perhaps the best health care system i
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It must be nice to live in Elysium.
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If you have air conditioning and have been malaria-free for any extended stint of your life, you know exactly what it's like.
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I'll tell my insurance company to get right on it. (Score:5, Insightful)
Congress might fund NIH, if they could agree on anything, including whether to have Coke or Pepsi in the Senate Dining Room.
the immediate beneficiaries would be medical insurance companies, but the short-term is all they think about. if they say NO! now, they don't have to say NO! a thousand times, ten thousand times, when somebody is rotting out from infection by the minute and a doctor tries to prescribe a new $10,000 antibiotic.
if we had single-payer insurance, and ponied up along with the other developed nations, all of which are single-payer, a share of the prize, we might get someplace. I like the idea, but not its chances.
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Congress might fund NIH, if they could agree on anything, including whether to have Coke or Pepsi in the Senate Dining Room.
the immediate beneficiaries would be medical insurance companies, but the short-term is all they think about. if they say NO! now, they don't have to say NO! a thousand times, ten thousand times, when somebody is rotting out from infection by the minute and a doctor tries to prescribe a new $10,000 antibiotic.
if we had single-payer insurance, and ponied up along with the other developed nations, all of which are single-payer, a share of the prize, we might get someplace. I like the idea, but not its chances.
So, um, quick question: Why are all of those other developed nations with single-payer not "getting someplace" on this? I mean, surely they're not (again) waiting for the US to do it, right?
Right?
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Setting aside socialism, if the system was working anything approaching optimum for the current configuration of third party payers and patent holders and everything else, insurance companies would already be inventing (and/or buying inventors of) drugs and practically giving them away to their members (or cross-licensing them with other insurers cheap to get their members the best drugs available in multiple categories). As a side effect, insurance companies would inherently aim to reduce side effects (gu
Re: I'll tell my insurance company to get right on (Score:2)
We fund the NIH to the tune of aprox. $100/head for every man, woman, and child in this country - $30 Billion in funding divided by a population of 300 Million...
That's a pretty hefty investment IMHO... How much per capita do other countries governments invest in medical health research?
i always thought this was a good idea (Score:3)
rather than depend upon the market to satisfy the costs of R&D, just put a bounty on drug discovery. it's cheaper for society
especially in the usa, where a new life saving drug can cost thousands a month. and even if you have insurance, that cost is being passed onto the rest of us. such that government paying a single huge bounty (to the actual discoverer and their university research dept, rather than some suit), paid for via taxes, would actually be cheaper for each of us
but there's always these hordes of morons who see taxes and government services as the ultimate evil. these fools seem to have no problem paying way more for lower quality, like american healthcare. just because it's not from the government? obviously single payer universal healthcare, without rent seeking insurance parasites, is far superior to the joke system in the USA. the ACA is a baby step in the right direction, we need to go a lot further
compare the usa to our social and economic peers in terms of quality of healthcare, and cost of healthcare, and we are getting a worse product for 10-100x the cost. all because "HURRR DURRR GUBMINT EVIL"
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A bounty? No. Just give the money as grants to academic research labs applying to do a search for new antibiotics.
No hoping someone has the funding and inclination to try themselves, an if no, oh well. Give a job doing it directly to those interested in the project.
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A bounty? No. Just give the money as grants to academic research labs applying to do a search for new antibiotics.
No hoping someone has the funding and inclination to try themselves, an if no, oh well. Give a job doing it directly to those interested in the project.
No, that's how we fund the military. When you throw money out there in search of weapons, instead of getting weapons programs, we get jobs programs that produce weapons that nobody wants. Seems like it might work in principle, but in practice it often doesn't pan out as well as you hope...
Often to get results, you really have to get people invested in the outcome, not simply the process...
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A bounty? No. Just give the money as grants to academic research labs applying to do a search for new antibiotics.
Bounties are quite effective compared to long term grants just because of human nature. Which gets quicker results:
"Hello, research foundation, we'd like to give you a nice annual salary as long as you present annual reports on how well you're progressing"
Or: "Here's a whopping pile of cash that's all yours as soon as you come up with the goods."
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Bounties only work if they are absurdly high. And if people going for them actually have a chance to get the bounty or a part of it.
It does not work when you place a mere one billion bounty on the production of a new drug, when research cost is far bigger and five or more companies burn together tens of billions to compete over that single billion bounty.
One gets the bounty and has still to cover half of his costs by himself, the others have to write it off.
It would make much more sense to have something li
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Part of the problem is start up costs. To do serious research you need labs, equipment, researchers, staff, test subjects, etc. If you have that much money the bounty had better be huge so that you do not just decide to play the stock market or real estate instead. Government funding of reesearch is needed to overcome these inherent barriers. Government is probably the only real solution to the problem.
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Part of the problem is start up costs. To do serious research you need labs, equipment, researchers, staff, test subjects, etc. If you have that much money the bounty had better be huge so that you do not just decide to play the stock market or real estate instead.
And that is why biotech is funded by VC firms and eccentric rich folks.
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what really caught my attention was the plot of introduction and bacterial resistance over time. the newest antibiotics produced had a "shelf-life" of an order of magnitude less than their predecessors.
Some of that is because most new antibiotics aren't really all that new. The one on that list with the shortest "shelf life", levofloxacin, is a fluoroquinolone. We had already been using fluoroquinolones for 25 years by the time lefofloxacin came around.
Problem: breeding multiresistentcies brings money (Score:5, Informative)
The main point where multiresistencies are created is animals. When we give them antibiotics in order to enable "storing" them even denser, we enlarge the contact between patogen and antibiotics by a huge factor.
Our greed for cheap meat has brought us to the point where we destroy our own hardly-won victories against illnesses. And, the current system unfortunately even rewards you if you apply your antibiotics for animals -- by giving you money.
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Actually, they do use the same drugs on animals as they do in humans.
More and more humans are now resorting to buying fish drugs from the pet store to treat their conditions.
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Actually, they do use the same drugs on animals as they do in humans.
Actually, thry don't. No idea about the USA, but in most western countries classes of antibiotics exist that are strictly for animal treatment alone. And animals are forbidden to be treated with medicals that are strictly reserved for humans, so that humans still can be treated if bacteria are resistant to some of the stuff reserved for animals only. This praxis is done since the 1970s.
On top of that antibiotics treatments for lifestock is
Correction (Score:5, Insightful)
Antibiotics are profitable, even new ones. They're just not obscenely profitable compared to barely useful hair pills and boner pills.
It's too easy now for them to make money hand over fist for drugs that turn out to not even be helpful. It's killed their incentive to do something useful for a fair profit.
Address the cause (Score:5, Interesting)
Once an alternative approval process with sufficent credibility gets going, the story will change very fast.
Re: Address the cause (Score:2)
Right. Big pharma prefers the current billion dollar crap shoot that is the current regulatory approval process...
You have no idea how many potentially promising medicines Big Pharma abandons because they can't justify the billion dollar gamble.
No wonder (Score:2)
"What if the United States government — maybe in cooperation with the European Union and Japan — offered a $2 billion prize to the first five companies or academic centers that develop and get regulatory approval for a new class of antibiotics?"
No wonder Canadian health care is so cheap.
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You mean that Canadians have a nasty spending cap and get turned down for treatments that Americans take for granted? That kind of cheap?
Don't swim in the kool-aid.
Re:No wonder (Score:4, Informative)
You should check what you're swimming in first. You'd be surprised how many expensive treatments you can get in America that are denied in Canada because they've been shown to make things worse or to have no effect at all.
FDA (Score:3)
The FDA is part of the problem. They make obtaining FDA drug approval very expensive. If the FDA wants to improve the situation they just need to look at themselves.
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Although the multi billion dollar price tags often dragged out and pilloried are rather inflated (see 'Hollywood accounting') it is expensive to develop - and test - a new drug. The NIH certainly has the ability to organize the testing, various biochem labs or even start ups can do the development. I'm pretty sure that there are European groups that can help out at various stages.
India, Israel and a bunch on non US companies have shown they can manufacture the pharmaceuticals.
You don't need big Pharma at
Good idea but... (Score:2)
Otherwise I foresee a case where they take the $2 billion profit, then go ahead and charge $10,000 a pill, just like cancer drugs.
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they also need to put in a requirement that if you accept the prize money, then you give up the patent, allowing generic drugs.
Otherwise I foresee a case where they take the $2 billion profit, then go ahead and charge $10,000 a pill, just like cancer drugs.
In that situation where they cannot actually manufacture the drug in commercially viable situation, mostly likely they will never commercially manufacture the drug and there will only be generics. This will severely complicate the regulatory process as generics are generally licensed relative to their non-generic counterparts. Since there won't be any non-generics, there will little to benchmark the purity and efficacy of the generic drugs against. For some things this may not be a problem, but it seems
The free market does not solve everything (Score:4, Insightful)
PS (Score:3)
Simple Solution: Use the patent system (Score:5, Interesting)
If the US wants pharma to develop new classes of antibiotics then the simplest method is to extend the patent from 20 to 30 years **providing that the drug qualifies as an antibiotic**.
This has the effect of a) incentivising pharma to spend on research in these classes of drugs and b) discouraging widespread abuse by disallowing generic implementations for at least a generation.
Job done! Next?
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Only if the approval/development process from patent to market is already eating up 90% of the 20 year patent protection. Companies don't look that far into the future. A 30 year patent creates a profit incentive that will only benefit the company two CEOs and three changes of management in the future.
For a profitable cash flow, the return needs to be huge and far more immediate. Not trickled in over 30 years. It needs to pour in over 5 years or 10 years at most. This gives sufficient capital return and cas
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Penicillin was discovered by accident. Obviously its 'development' costed next to ZERO.
Eminent domain for IP (Score:3)
Re:Eminent domain for IP (Score:5, Insightful)
Side-steps an important question (Score:2)
WHY are antibiotics so unprofitable?
Me thinks the issue is because there are cheaper alternatives to any new and improved antibiotic that are considered 'good enough'.
Let's say big pharma developed a new wonder antibiotic, and it cost 5x what generic antibiotics currently cost - who would pay 5x the price of generic alternatives? Would your insurance company? Would you pay it out of pocket? Most people defer their medicine choices to their insurance company because of cost, rarely do patients opt to pay for
Really? (Score:2)
"The Peculiar Economics of Developing New Antibiotics"
If by "peculiar" you mean "completely expected".
They're making billions on other drugs already (Score:2)
These drug companies are already raking in $XX billions on other drugs, and the cost to develop a new antibiotic could be less than some of their advertising budgets. The $2 billion might not even be enough incentive.
How about a rule like for every non-antibiotic drug that is approved by the FDA, they also need to submit one antibiotic drug for approval? That would get their attention.
Need for open source medical research (Score:2)
Well, that would help (Score:3)
Competitions like that can help. However, funding of basic research that can then lead to big breakthroughs later is also a good idea.
Here's a proposal: stop granting hugely profitable exclusive patents on university research funded by the federal government. Give the government a right to license broadly patents it helped fund and share the proceeds with the discovering professors and students. That way the cost to the pharma companies would be smaller.
Use the government's proceeds from licensing said patent to fund the FDA's evaluation of any drugs based on the research. This further cuts down on the costs to the drug company.
Make it a term in the research's patents that final drug patents based on it must be similarly licensed. Use those proceeds to subsidize Medicare and Medicaid.
Then, the drug research is more widely spread, the benefits and risks of the research are more widely spread, the risks are lower per company, the costs of the drugs are lower to bring to market. The market prices may even follow suit.
Then, tie the research funding to a certain amount of the funds across the country being used for classes of drugs the public really needs but are being underrepresented, like antibiotics.
Does this make sense economically? (Score:2)
If it costs $1B to get a drug through the FDA approval process, and your prize is $2B, you will only play the game if you think you'll get your first or possibly second try through the approval process. If you have to start half a dozen and have them fail at various points through the approval process, you've already spent the potential prize money without winning it.
We might need to look at how safe drugs have to be before they can be FDA-certified. I've harped on this before but I know people who though
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Been widely discussed (Score:2)
http://www.pbs.org/wgbh/pages/frontline/hunting-the-nightmare-bacteria/
My father was one of the first to use the then new 'sulfa' drugs, it saved his life. This was when they were brand new and no studies had been done. I would venture to say in the 1930s when this happened profit was low on the totem pole of motivators to find drugs that save lives.
Today the decision to find new science will be based predominately on profit not necessarily to benefit humanity.
How about direct government support? (Score:4, Insightful)
I don't have a billion bucks lying around to TRY to produce an antibiotic with! I doubt I could get someone to invest a billion in something that is probably more than 50% likely to fail to get $2B.
Who would go for this prize when there are actual WINNING investments to put $1B into?
The lack of new antibiotics is a perfect example of market failure. They're not particularly profitable, and if they WERE, as someone pointed out, ($1000 per pill) people would only take 5 of their 10 pills until they were feeling better and sell the last 5 on the black market.
No, the market is NOT the solution here. Direct government support of antibiotic development is what is needed. Sure, pick the best developers, but governnent funds the development, and then the PUBLIC reaps the benefit of a PUBLICLY owned antibiotic, which does NOT have to be fed to animals in order to generate enough volume to make a profit for the company that invested to develop it!
--PeterM
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If I raised money to start a new pharma company, why do you think the government would do anything to stop me? It would take a whole lot of money, because the government insists that a new drug be shown to be somewhat effective and not too dangerous, and that's expensive nowadays, so I'd probably start trying to make generics a bit cheaper than everybody else and then go into the research business once established. I'd think this would take more money than I could raise out of Kickstarter, though.
What
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Price controls in other countries are because the countries' health care systems negotiate for the entire country, something the US government is forbidden by law from doing. No action of the US government is going to raise what other countries pay for drugs significantly. Lowering the trade barriers is going to be bitterly opposed by the same people who pay lots of money to make sure the US government doesn't negotiate drug prices, so it isn't going to happen.
What the US government could do is reduce
Antibacterial phage therapy is 80% effective (Score:2)
Bacteriophages are being used to cure such infections in one of polish hospitals. For example MRSA is being cured in 80% of cases.
Therapy is safe and cheap:
http://www.aite.wroclaw.pl/pha... [wroclaw.pl]
If you know anyone who is struggling with some nasty staph-like infection, then please inform about this therapy availability. This information might save people lives.
Why you are not going to see such treatments in USA?? Phages are not patentable, so no way to earn hard cash here.
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Updated link:
https://www.iitd.pan.wroc.pl/e... [pan.wroc.pl]
How many $billions for Penicillin (Score:2)
I wonder how many $billions it cost to develop Penicillin. Half a dozen researchers for a couple of years. Maybe 0.001 billion.
There is something wrong with modern society.
Both a Carrot and a Stick (Score:2)
Tort reform would help (Score:2)
Drug companies pretty much expect to get sued by the likes of the law offices of James Suck-a-glove and lose every penny they made thanks to a jury in east Texas. And it doesn't matter that the side effect warnings are well disclosed. Take a look at pretty much every drug ad on TV. They basically say, "If you have such-and-such condition, ask your doctor about Fartseeguh. Meanwhile, here's a 45-second long list of things that might happen to you even if you didn't take this drug because we're expecting
the math doesn't work (Score:2)
The success rate for drug development is about 10-15%. [nature.com]
Now, you're probably spending $1B cumulative on all the failed drugs to get one hit. They key here is that you're not actually guaranteed to get a drug that works. You could easily spend more than $2B on a program like this, with a little bad luck.
Let's look at this differently. About 250 million antibiotics prescriptions are given out in the US every year. Let's have every one of t
The costs the costs.. (Score:2)
Drug approval requires so much heavy lifting in the US that costs to develop new drugs skyrocket, and the only drugs that get developed are those that are taken routinely for high profit. Boner pills flourish, antibiotics stagnate. The solution here isn't to jack the price of antibiotics to an astronomical level that a very small percent of the population could possibly afford - drugs and surgeries in the US are already way overpriced with major corporations snorting all of that profit up - the solution is
Wrong on many concerns (Score:2)
a) antibiotics are usually expensive. A packet with 7 pills for 7 days easy costs $100, so there is plenty of money to make considering production costs of such chemicals is lower than the cost of the paper and plastic box they are sold in.
b) antibiotics are not 'developed' like software or engineered like a house or an engine. You basically only find them by trial and error, either by trying new substances or by modifying existing ones. Yes, there ar more modern approaches as we know more about cell biolog
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I have HIV, more funding goes into 1 years worth of funding for my university sports team than has gone into HIV cure R&D funding over the past 5 years COMBINED.
Big pharma don't want to make you better, they want your money.
Why cure something when you can keep it under "control" and earn 100x more?
Why help more people more often and improve quality of life, when you can help less people and earn more?
You are wrong.
Research averages 2.7 billion dollars a year of the $25 - $30 billion yearly total funding for AIDS in the USA.
Over the last five years? R&D = $13.5 billion; total spending over $130 billion.
Here's the actual numbers:
http://kff.org/global-health-p... [kff.org]
Or are you comparing the sports funding at your University to the HIV research funding at your University?
That would be a pointless comparison. We already know that University of Phoenix doesn't have much of a research program in anything.
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That cuts both ways. HIV/AIDS research gets far more funding than things like heart diesease, diabetes, mental health despite the later affecting a far larger portion of the population. Why? Because HIV/AIDS has a huge political movement attached to it.
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Be fair. Only one of the things you list is infectious.
Which isn't to say that lobbying for diseases produces good outcomes.
Re: Not unique to antibiotics (Score:2)
Horseshit.
You are quite simply unequivocally wrong.
How many billions does your 'school team' get in funding each year?
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Because it costs at least $1 billion to develop a new drug The problem with those numbers is that it costs a billion to even get your drug to the point where it might be accepted by the FDA. This means that you're asking companies to pony up a billion dollars and hope that their drug works and hope it's first to market. How many people would buy a 1 dollar lottery ticket if they knew their was less than a 10% chance that they might win the grand prize of 2 dollars.
Exactly. These prizes only work where there's low material costs (eg design and programming) or where the costs can be justified by ego anyway (billionaires and their space rockets). And there's another problem -- the goal should be "the best antibiotics possible", but now we're aiming for "the quickest antibiotic you can come up with" in order to be first. Not to mention that FDA approval is not a neutral, unbiased, pure scientific step -- with all the favours and bri--"consultancies" going on in pharmaceu
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BTW those same $10,000 IV antibiotics are a lot cheaper in Europe, because the national health systems negotiate with the drug companies.
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Are you being facetious?
The USA government bans importation or re-importation of prescription drugs. After all the R&D and regulatory stuff, the marginal cost of producing one extra pill is almost negligible. Therefore, a place like Canada can impose price controls without a US-based drug company refusing to sell them the product. At the margin, it's all profit, so they don't care. However, those drugs can't come back into the US, so prices remain artificially inflated in the US market.
Why should an