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I wonder how much this will cost? A drug you take 2 times a year could be much cheaper than one you take 365 times a year, and that's a big deal.
The existing daily pill is really expensive. Australia knew that PrEP would practically eliminate HIV transmission. Even so, the decision to pay for it took years and was fiercely contested. That was before COVID, and people are more willing to pay for public health today. But cheap PReP would make a big difference in the poor countries where HIV prevention really matters.
The shot will likely be exorbitant in the USA. Gilead charged almost $2k/month for Truvada (list price, of course) and Descovy is the same. Generic Truvada is like $30/month now, so the price was never about the cost to manufacture. Obviously Gilead is developing these new drugs/shots for when Descovy's patent expires.
They rely on the government mandating that health insurance companies cover the shots. This drives up the price.
The price is rarely ever about the manufacturing cost.
"A new study in 2020 estimated that the median cost of getting a new drug into the market was $985 million, and the average cost was $1.3 billion, which was much lower compared to previous studies, which have placed the average cost of drug development as $2.8 billion.[4]"
https://en.wikipedia.org/wiki/Cost_of_drug_development
It should be pointed out that looking at the average cost of developing a drug is misleading, since one has to include the cost of all the drugs that failed to make it to market. One also has to include the money spent by small companies that failed and were not bought out, not just the money the big companies spend buying the successful ones.
If you're looking at the total amount spent by "the economy" (drug development costs X% of GDP), sure. If you're looking at "why are drug prices so high", it probably doesn't make sense to to include costs funded from other places (which in this example I assume would be research grants ie taxes, and venture capital funds).
I'm not going to invest a drug company with a 90% chance of failure unless I can expect to get a 10x return if it succeeds.
The problem with this argument is it assumes the cost of a failure is the same as the cost of success, which it cannot be: the successful drug has to go through more rounds of testing and approvals than a failure.
In reality many failures are early or first round failures. Not free but a small fraction of the price of getting to market.
So to you example a 90% failure rate may only require a 2x or 3x return on your successes to “break even”.
Clinical trial failure rates (or inversely success rates) have been analyzed before.
https://www.nature.com/articles/nrd.2016.136
"They found that the probability of success was 63% in Phase I trials, 31% in Phase II trials, 58% in Phase III trials and 85% during the regulatory review process"
42% failure rates in phase 3 is enormously high. By then you've pretty much spent 90%+ of all the cost of getting a drug approved.
But it's 42% of 19%. So out of 1,000 drugs, you're looking at 805 being ruled out before you even get to that "most expensive phase", which is my point. At Phase 3, you're looking at 113 succeeding, so you're "only" eating the really expensive[1] costs of Phase 3 for 82[2] of 1,000 attempts.
[1] Which isn't to say there's zero cost for Phase 1 or Phase 2, but it's a lot lot less than Phase 3 trials.
[2] 1,000 drugs, 63%, 630 of which make it through Phase 1. In Phase 2, 195 drugs, 31% of 630 succeed and make it through to Phase 3, and then 82 drugs (58% of 195) make it to regulatory approval.
Right, but with the cost distribution for clinical trials, costs increase by 4x in phase 2, then 8x in phase 3 (relative to phase 1).
So despite attrition that reduces candidates by 9x by phase 3, costs have increased by 8x.
[1]https://www.sofpromed.com/how-much-does-a-clinical-trial-cos...
For the private parts of development, the costs are absolutely priced in. A large drug company needs to amortize the cost of all development attempts, not just the successful ones. Private investments into smaller firms price in a very large chance of failure, so the cost of capital is quite high.
That's not quite right. A drug company with a new product will charge whatever the market will bear. What the costs do is control the scope of the industry: if profits are high, the industry expands to try more kinds of drugs, stopping when the attempts on the margin are just profitable enough (on average). If profits are not expected to be adequate, the industry contracts.
That's close to what I tried to say.
Perhaps you prefer: A company must think it's likely that they'll have a good return on all development costs, not just the costs of drugs that happen to be successful, to continue to invest.
Of course, something like pharmaceutical products, with exclusive sales of specific products, few sellers, strategic conduct relative to other industries (insurers), and heavy regulatory influence is not guaranteed to converge to normal profit.
This is critical, and exactly the sort of thing someone will gloss over, intentionally or not. The numerator is the total cost of developing ALL the drugs, even (especially) the failed ones, but the denominator is only those drugs that are successful.
On the contrary, often pharma proponents will gloss over the fact that most “failures” are discovered and canned at a small fraction of the investment of getting a drug to market (when it’s obvious it won’t do what you need or has other challenges).
Actually not in the contrary - you are right. It’s just that the failures often cost a small fraction. They don’t get to 95% testing and approval before “nope, not even close”.
I understand 60% of drug candidates fail in phase 3, the last and most expensive phase of testing.
There are of course lots of chemicals ruled out early, but that's before you have something you'd call a drug.
No, that's not quite accurate - the phases are effectively additive.
37% fail in Phase 1. Of those that make it through, 69% of those fail in Phase 2, and of those, 42% fail in Phase 3.
So, of 1,000 possibles, you have 630 make it through Phase 1, and 195 that make it through phase 2, i.e. 80.5% of your drug candidates didn't even make it to Phase 3, that "most expensive phase".
A more accurate phrasing would be that 42% of the drugs that made it through Phase 2 fail to make it through Phase 3.
Supposing the cost ramps up exponentially at each phase, e.g. it costs $10 million to get to Phase 1, $100 million to get to Phase 2, and $1 billion to get to Phase 3, then we see the total expenditure for 1000 possible drugs as:
This sums to a little over $242 billion spent against 113 successful drugs, or about $2.14 billion per successful drug, or more generally, accounting for failed drugs, the full cost of a successful drug is a little more than twice what was directly spent on its development.We do have some shaky and hard to interpret data.
Published estimates of trial costs from a 2011 systematic review ranged over an OOM.[1]
A 2017 report focused on 7 top-20 companies and 726 studies from 2010-2015 found " median cost of conducting a study from protocol approval to final clinical trial report was US$3.4 million for phase I trials involving patients, $8.6 million for phase II trials and $21.4 million for phase III trials". [2] These are not all that far off from another 2016 study on cost drivers of pharma clinical trials in the US using means and breaking down costs by therapeutic area. [3]
Plugging the first study's numbers into your 1000-drug profile, we'd have:
$ 1.3 billion for Phase 1 failures (370 drugs)
$ 3.7 billion for Phase 2 failures (435 drugs)
$ 1.8 billion for Phase 3 failures ( 82 drugs)
$ 2.4 billion for Phase 3 successes (113 drugs)
That sums to $9.2 billion spent against 113 successful drugs, or about $80 million per successful drug. This implies the full cost of a successful drug is almost 4x what was spend on its development.
One limit here is we're working with medians, not means, and I wouldn't be surprised if this is an underestimate of clinical trial costs.
Roche has had pretty stable net income (profit) of $9.2-$15.2B/year from 2011-2023 against revenue from $49.9-$72B/year in the same time period. Using this estimate, ignoring inflation, if they ran 1,000 clinical trials per year it would account for a maximum of about 18% of their costs and they'd get 113 new drugs out of it annually.
Obviously that is not what's happening: there are an average of 53 FDA new drug approvals per year across the entire industry. If Roche was the only pharma company running clinical trials, the total cost of those trials would be more like $4B, so a max of about 10% of their annual costs. In reality this estimate makes it seem like it must be substantially lower.
The Congressional Budget Office[4] says total pharma R&D spending in 2019 was $83 billion. With 53 new drug approvals per year on average, that implies about an average cost of about $600 million per drug in R&D spending, compared with the $80 million estimate obtained above.
So this makes it sound like running clinical trials account for only about 10% of total R&D spending. Given that Roche's costs alone look to be in the tens of billions per year, as compared to $83B or so annually for R&D across the industry, it also looks like R&D is only a part of the story on cost drivers for pharma companies. Google is not being helpful on this question (almost all the conversation is on R&D cost, it seems), but my guess is it's costs of manufacture, legal, sales, etc.
[1] https://www.sciencedirect.com/science/article/pii/S016885101... [2] https://www.nature.com/articles/nrd.2017.70.pdf [3] https://pubmed.ncbi.nlm.nih.gov/26908540/ [4] https://www.cbo.gov/publication/57126
Marketing. At least 7 of the top 10 pharma companies globally have marketing as a multiple of R&D for their spending (sometimes up to 7x). IIRC, at the other 3, it still exceeds R&D, less egregiously.
The big issue with "Marketing" spend is that though these numbers are global, there are only two countries in the world where you can advertise prescription medicines to consumers: the US, and New Zealand (and the latter, if I recall, is trying to phase it out, and only allowed it after being bullied by the US on a Trade Agreement).
So you end up with "US Marketing spend at many pharmaceutical companies grossly outpaces their global R&D spend" (and while a not insignificant portion of R&D happens in the US, most of those companies also have a notable R&D investment in Europe).
Marketing wouldn't go to zero without that, of course, but it'd be a huge sea change.
Certainly I do not mean to imply that Phase 1 and Phase 2 failures are cost-free. But it is challenging to measure. As seen elsewhere in this thread, Gilead essentially included the acquisition of another company who had a whole retinue of drugs and product lines as "R&D" for Truvada, I believe. That is creative accounting that would not pass an audit or SEC filing, which is why Gilead only counts it as an R&D cost in their press releases...
It certainly should count; that company didn't get delivered for nothing by the Drug Discovery Fairy. And even more: the companies that didn't get bought by Gilead should also count, since the funders of all those small companies could not tell ahead of time which would succeed enough to be bought out.
PrEP repurposed Truvada, an existing blockbuster drug that had already reaped immense profit for Gilead for use in HIV treatment by the time the trials for PrEP began. The trials for PrEP were funded by the government, not Gilead. Gilead, however, got to retain all profits earned from PrEP.
Did Gilead fund the R&D? There's a lot more to developing a new drug than just trials (though I think Gilead should have foot the bill for the trials too).
I don’t know if it’s the case here, but very, very, very often in biotech you’ve got the primary foundational research happening at university labs funded by grants, and it’s the productionization of the research (and then clinical trials, etc) that are what the biotech companies are doing. I’m not sure where that shifts the “who deserves what” conversation, but without university research labs, there’s no pharma industry.
"without university research labs, there’s no pharma industry." - I think you have it exactly backwards: Without the pharma industry, there's no medicine. Good research goes nowhere if you can't bring it to market.
The pharma industry COULD do their own foundational research, but the university system cannot bring a drug to market.
Citation neeeded - have they ever done so? Would the shareholders accept it? Would they be able to manage borderline autistic PHD types detached from reality, and would these scientists want to work there?
Pharma companies are chock full of PhD types, as are the tech companies and Wall Street.
What companies don’t have is PhD students. They are numerous, smart, very cheap, and work very hard.
You can't use an "in theory" argument for one side but not the other.
In theory governments could bring medicine to market, in practice they don't/can't.
In theory pharma industry could do foundational research, but in practice they don't/can't.
If there’s no pharma industry?
You act like the solution would be “oh well, no meds for anyone then!” and not “let’s expand university programs to meet that need”.
If the university owned the IP, then its value should have been reflected in what was bid for it.
If the knowledge was not restricted by IP law, then any drug company could use it, and compete for new drugs based on it. As such, it would not provide any of them with a competitive advantage, and so would not be reflected in what they could charge.
What universities typically produce is not a chemical that can serve as an actual drug, but is only a starting point for a long and expensive process of producing such a chemical. And then, it's often found that the target of the class of potential drugs isn't actually a good one. One can't determine that until drug candidates are available to test on real patients.
Remember you need to include all the failed attempts at finding useful things at university labs to see how much governments spend on research (just like you did failed pharma attempts), and if you add that up you see governments actually contribute a massive part of the cost to bring medicines to market.
What they produce is necessary to even begin the work pharma does, currently it is basically a gift from the people to the pharma industry.
i've always viewed big pharma as like pre-internet record labels. they pick up talent (that often comes from bohemia aka government funded research), vet it, run the trials and put up the money, do the engineering to deliver it at scale and then market it.
That’s also like any endeavor with tech.
The direct role that university research plays in drug development is overstated. The majority of cost and difficulty in pharma is _drug development_ not _drug discovery_. Pharma can do the discovery and the development, academics can only do the development. Absent academia, we'd have less drugs. Absent pharma we'd have no drugs.
Academics focus on drug discovery because it's better aligned with academic incentives and timelines (see this commentary for a brief description [0]). Drug development costs (including clinical trials, extensive and repeated med chem, etc) are borne mostly by drug companies.
Fair data on this is hard to come by because the two main sources have clear conflicts of interest (academics and pharma industry publications). One study Derek covered before (data from 1995-2007) shows only 24% of drug scaffolds were first found at a university and transferred to a biotech or pharma for development [1]. You can break this down further to highlight any story you want to support ('university ID'd drugs more innovative' vs. 'pharma ID'd drugs help more people') but they key point is that combining all the US research leads to only 24% of drug scaffolds that make it to market.
I think everyone acknowledges that outside of finding the scaffolds and the basic biology, pharma is paying the vast majority of clinical trial costs. [2] gives a figure of total NIH funding of clinical trials at 10% of overall (e.g. pharma covers 90%).
I think an argument could be made that the NIH training grants (which pay grad students in the biomedical sciences) subsidize the work force substantially, and might have a higher impact than direct research grants. I couldn't find quantitative data on this with a quick search, but I think this is often overlooked in the discussion.
Finally, a less quantitative pieces make me think the impact of the NIH/government funding is overstated even given the above numbers. In my own field (microbiome), academic research has been almost inimical to the production of quality drugs. For every disease there exists a paper suggesting that a certain gut microbe changes the likelihood/severity/X about that disease. Academic labs have incentives to publish significant results fast, and in the microbiome this has led to a) abysmal signal to noise ratio with very high likelihood of failure to replicate, and b) an epistemic closure about what types of microbiome data matter and how they should be pursued as drugs that is totally divorced from the reality of how drugs are developed. Much of the knowledge base is polluted by low-quality research that has been done for the purpose of publishing. While the NIH spends ~40 billion a year on external research grants [3], I think you have to heavily discount this for the amount of just pure "grad student needs to graduate gotta publish" material that gets produced.
[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10812233/ [1] https://www.science.org/content/blog-post/where-drugs-come-n... [2] https://www.fiercebiotech.com/research/report-industry-not-n... [3] https://www.nih.gov/about-nih/what-we-do/budget
The usual story is that academia finds an interesting mechanism to produce the desired effect. Though occasionally this is done by industry instead.
Then industry turns that into a specific molecule that can enter the human body in a standard way and doesn't produce too many side effects.
Then industry figures out how to produce that molecule at scale reliably in a sufficiently pure form.
And at the same time industry is shepherding the drug through clinical trials.
A significant portion of the cost is the drug trials. Excedrin Extra Strength and Excedrin Migraine have identical formulations, but IIRC Bayer spent $300m on FDA approval for migraine treatment, which is why the migraine variant continues to be more expensive.
Your analogy would only be relevant if the US government paid $300M for the FDA approval and Bayer got to pocket 100% of the markup.
Talking of studies, from the same wiki
The Wikipedia editor was a bit naive to think such a basic study could invalidate that whole claim. They measured the correlation between the list price, adjusted for use amount, and development cost. As far as I can tell they didn't take into account number of customers each drug would have, how long the drug would stay on the market before profits are cannibalized by competitors (see e.g. Wegovy), and definitely not the cost of failed drug development.
Also the government, aka the public, subsidizes a lot of those costs
These original $3B numbers are highly misleading, to the extent that I deem them to be bordering on a straight up lie.
See: https://news.ycombinator.com/item?id=18693177
I'm no fan of pharma industry but there's an unfounded and troubling assumption embedded in this comment: that any drug price over cost-to-manufacture can only be extortion. How do people recoup R&D costs (which are the vast majority of costs in getting a new drug onto the market)?
Doesn't the government also fund a lot of pharma R&D?
Here's a 2019 article that came up in a Google search: Taxpayers funded this HIV research. The government patented it. Now a company profits https://www.latimes.com/business/la-fi-gilead-sciences-truva...
Taxpayers fund all sorts of stuff that is ultimately commercialized!
So that's an argument that the government and the public should get a return on that investment, or profits should be constrained.
Or an argument against exclusive rights being in private hands.
The public gets access to a life-saving drug that otherwise would not exist, which is exactly what the government is paying for. You can reasonably argue they they should get more, but arguing that they should get some ROI is moot; they're already getting a tremendous ROI
Just a reminder that on-patent Truvada cost $4,500 for a 30 day supply of a drug that needs to be taken every day.
The public gets the privilege to be price gouged for stuff their taxes paid for. Doesn't sound like a good deal. Many will not have access at higher costs. Price gouging restricts access.
What do you mean by "gets access"?
If the R&D cost (including amortised failures and whatever) for some hypothetical drug is $1B and the manufacturing cost is $100M for 100M doses. The drug should cost about $11 + a reasonable markup in a fully private system.
If the R&D costs are fully funded by taxpayers, it should cost $1 + a reasonable markup.
The public doesn't "get" anything if it still costs $11 (+markup) and a company is allowed to take a 1000% profit margin because they're only risking the $100M for the manufacturing.
Universities certainly do. IP transfer is big business.
Subsidies for oil, not so much.
The outcome for taxpayer ROI should be about the benefit to the public at large regardless of who commercialized it. Commercialization should eventually lead to better and cheaper version of the technology, which increases benefit to the public.
Of course, the people who worked to commercialize it deserve pay for their work, so the question is exactly how much.
The government funds a lot of early stage preclinical research. These are the inexpensive stages of the pipeline.
As soon as you move into humans you can add another 2 or 3 zeros to your burn rate.
It is not politically feasible for the public sector to fund later stages. The numbers are just too big. Just think of the campaign ads that would run around $200M late stage failure funded by the government.
The reason why mega giant pharma companies exist is because they make enough money and are capitalized enough to withstand multiple $100M failures without going belly up.
Gilead's R&D costs for Truvada as PrEP were literally almost zero. They paid none of the costs for actually conducting the trials.
Their only contribution was that they donated the actual pills used in the trials - in other words, the unit price of 30 pills per person for the duration of the trial.
PrEP has been pure, risk-free profit for Gilead.
Gilead claims that is false and that they spent 1.1 billion on developing Truvada. https://www.gilead.com/news-and-press/company-statements/gil...
The $1.1 billion figure is for Truvada total, not for PrEP specifically. It’s perhaps notable that Gilead chose not to break that down, given that the original claim they were responding to was about PrEP specifically.
And even then it's a dishonest claim. Half of that $1.1 billion is the amount of money they paid to acquire another biotech company in a firesale. It's beyond disingenuous for them to claim all of that towards the amount they spent developing Truvada, since they received way more assets in that sale than just the patent for one drug.
You are quoting a corporate press release that was written in response to an editorial criticizing Gilead, which was based on my colleagues' work.
This is a great example of how easy it is to fall for propaganda, because not a single thing in your link refutes what I said! They spent money developing Truvada as a treatment for HIV, then made that money back in record profits for nearly a decade. Only then did clinical trials for PrEP begin, and for those, Gilead donated only the production costs of Truvada (which are minimal). They did not spend any money in actually conducting the trials - which, as pharmaceutical companies are generally very quick to point out - is where most of the costs of bringing a drug to market are.
Gilead is claiming that, when it spent half a billion dollars to acquire a biotech company that went bankrupt, 100% of the money in that transaction should as "R&D related to Truvada". This is preposterous. Neither the SEC nor the IRS would endorse that accounting, which is why you're seeing it in a press release and not their 10-K.
That's a ridiculous claim even when you're talking about the development of Truvada, but that's not even the question at hand. The actual topic is how much was paid for the development of PrEP, which came nearly a decade later, and for which Gilead paid nothing but the per-unit costs of production.
Although this is a discussion about costs
I just want to point out that the government has assumed the role of telling everyone how to take risks for its economy, and literally all you have to do is do that, successfully, and it will privilege your rewards by reducing risk on profits or reducing taxes
This is not controversial when you look at the state’s role in these outcomes
Debatable.
https://www.bu.edu/sph/files/2015/05/Pharmaceutical-Marketin...
Marketing gets them more money, which then increases the amount they can put into R&D. They aren’t spending on marketing without expecting a return.
They shouldn't make tv ads; they should be in a white paper that doctors read.
R&D is still not where the vast majority of their money is spent.
I think it's perfectly fine to assume that it's a form of extortion to profit from life-saving products, which is why some people agree that pharmaceuticals shouldn't be a for-profit industry at all.
To find the correct pricing you just check how much shareholders make. If they get unreasonably high return on their investment that means the company is overcharging.
Tax shareholders on their gains and rebate customers if the company doesn't adjust the price.
It’s life-saving medication. It should be freely available to everyone, period.
If we’re not willing to question the degree to which big pharma ought to profit off of controlling access to scientific miracles, the least we could do is use taxes to subsidize the cost - “I can’t afford it” should not be a reason to not be on PrEP.
Anyone should be able to walk into a CVS and walk out with 2-1-1 dose, as easily as they’d pick up the morning after pill, or a bottle of aspirin.
Like the other commenters allude to, how would you like software mandated to cost just 10% margin over COGS? Do you think selling cloud services for 10% more than the cost of server parts is going to be a business when there's thousands of software engineers in R&D needed?
That would be amazing! More businesses need a costs-plus gun held to their head.
It's true. Harvard education costs $300k, so that engineer's lifetime earnings can be $300k plus some small margin so that he does not price gouge. Community college engineer can be paid $2k+small margin.
Businesses are not people (despite what the law tries to make you think), and people should not be bound by the same limits as businesses.
I see. So all software engineers can charge what they want until the moment they join another software engineer. The moment the two of them work together on a shared enterprise, their margin must be capped.
As an employer, hiring single-person LLCs provides such a strong advantage in this universe over hiring employees. The former can't charge you more than a small percentage. The latter can charge as much as they want. I suppose we would all be like Uber drivers.
Honestly, 10% above costs would put a lot of people far more into the black than they currently are, because you are failing to account for ongoing expenses which raises said cap by a lot. To say nothing that most folks are struggling to make rent and buy food; I think they would like such a deal.
Software devs in the US are not struggling to make rent and buy food. More likely for them to have one or two airbnb side hustles than be starving. Yes, some have it rough but I'd wager the bell curve puts professional devs in the better-off-than-most boat
Would you be willing to work for a cost-plus salary?
Figure out what a middle-class lifestyle costs and pay you 10% more?
You’re saying this ironically but yes, I would. If there was an accepted living standard and every job paid according to that that would be amazing.
That seems very anti-worker.
Only if you’re in the minority that makes more than they should
I would love that, as long as the cost includes that R&D and those engineers, the actual bits might be immaterial but the engineer salaries are part of the cost of the goods.
The problem is that we're being told that the cost of insulin is $270 per vial, or that Daraprim used to estimate its cost per dose at 90% of $13.50 and then Shkreli decided to raise it to $750.
The Shkreli case has nothing to do with the rest. He was playing the insurance companies and there isn't a single person that went without the medicine due to the cost. Almost nobody takes this medicine.
In fact, it still costs $750 today.
No one is suggesting it should be billed at only the cost of manufacturing. Recouping expenses incurred during R&D are perfectly reasonable.
If you poked at the data a bit, you might find it interesting to learn that drug companies spend more money on advertising than R&D
The patent system literally grants monopolies, on purpose. I don't know why people are surprised when patented things are priced like there's a monopoly exploiting their customers, because that's exactly what's happening and everyone knows it. But somehow people never seem to come to the conclusion that granting monopolies is not the ideal way to incentivize things.
Maybe it is if the alternative is those things you granted monopoly on wouldn't exist. With drugs especially it's a difficult proposition to spend time researching if the day after you make your pill and sell the first one the next guy can just sell it too. So we need a larger change than just modifying the patent system for medicines, we'd also need to change the way we fund pharma research and after having thought about it a lot I don't have a solution. I agree with the problem you mention, but the solution isn't simple.
There’s no reason pharma research should be for profit. The researchers aren’t doing it for profit, they would do it either way, the only thing private pharma brings to the table is price gouging.
See, blaming private companies for the consequences of government-granted monopolies is exactly the kind of thing I don't understand. The government is handing out permission to price gouge. On purpose!
How did governments create pharmaceutical monopolies? And, if they did, why does that make the companies killing people by charging exorbitant amounts for drugs free of guilt?
Governments create pharmaceutical monopolies by granting parents that make competition illegal. They do this explicitly so that companies can raise prices, to incentivize and fund drug development (which other government regulations make more expensive). Companies are using the system as designed and intended by the government.
Nobody would develop drugs under today's ridiculously expensive process without some kind of very large incentive, so those life saving drugs wouldn't exist without those high prices. But obviously the system is terrible. Costs could be lower to reduce the need for the price gouging incentive, and there are other incentive structures that could be used instead of granting monopolies that wouldn't have as many terrible side effects. (Price gouging is far from the only issue with patents.)
Citation needed on "the researchers aren't doing it for profit". All drug companies have a bunch of them, more than wall street types running around. Most of them enrich themselves with biotech stock bets, insider trading, regulatory capture of national agencies etc. Why do you think somehow people that go into pharma research are different from people in any other industry?
Look, random example https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370755/ - explain why if they are not motivated by profit, how is it possible that the outcome of this paper happens?
If you speak to anyone in the field, their goal to get to a point where you having a patent or two giving you a passive income stream. You can't do it if you just public domain your work.
Maybe my understanding is wrong, you’re telling me researchers keep the rights to patents they develop under the employment of pharmaceutical companies, and profit off of licensing? If that’s the case I was wrong.
But as for your other point, yes, researchers are different from people in other industries because of the high barrier of entry into the field through years of schooling, and the uncertainty of the work. Anyone that’s motivated primarily by money wouldn’t go into pharma research, they’d go into CS or finance straight off university.
Of course, that doesn’t mean they don’t want money. If you can do a job you love and get rich off it that’s the dream. And there’s no reason the public sector can’t pay enough to motivate researchers.
I don’t know of any researcher not working for profit, none. Not only that, I would always want them to earn as much as possible, if they deserve it.
Researchers aren’t the ones profiting off of price gouging.
Of course they’re working for money, they live in society.
Same with software. I saw IntelliJ costs $250/year but it costs almost nothing to send that file (it's like maybe 1 GB max, cents). You can get it from generics manufacturer on TPB but updates are not as frequent.
Are you insinuating that the only expense the company behind intellij has is the data transfer?
It was clearly sarcastic
The difference here is that:
1. Pharmaceuticals actually don't do all their own research. Universities find the drugs and what they can treat, pharmaceuticals research the product viability. They make medicinal products, they're not research labs
2. The research is often majority funded by the government, i.e. your taxpayer dollars. So the costs are often socialized, but of course the revenue is not.
IntelliJ actually develops they're stuff, they don't just take existing code, test it a bit, and then make a product. And IntelliJ is a truly private company, pharmaceuticals are not because they get huge sums of money from the gov.
In the Netherlands until recently you could get it for ~$10/mo (now ~$20). We have a whole website naming prices in different pharmacies around the country.
https://prepnu.nl/users/price-list/
Crony capitalism at its best.
There is a two-month shot now (Apretude) and I was quoted $4K a shot when I asked about it.
Health insurances in the US mostly only cover Truvada. Some cover Descovy but not many.
Dosing doesn't impact price. Pharmaceuticals aren't based on "cost-plus" pricing.
If history is any guide, as much as it possibly can. Probably more.
Why would they give up the profit? What's your rationale here?
Cure = $X
If the treatment is daily then it's $X/365 if it's monthly the price is $X/12 if it's twice a year it's $X/2
Imagine being an exec at that company and being like "let's give up 50/52 of our profit because it's more convenient for the patient"? How many hours would it take between giving that speech and getting fired, do you think?
If it's like every other IP-encumbered drug, the price will be approximately "the value the recipient places on HIV resistance," which is probably close to what's being charged now.