On 17 Oct 2003 23:26:41 -0500, "chad" <[email hidden]:7503>
Quoted message said:
Guy said:
In everything ---the sales price is set by what the market will bear.
The idea is to let natural restraints control the price. It works in much of our system.
But in the medical field that system fails because it is a pay or die situation. There is no
free system.
It is far worse then that. there is not 'feedback' mechanism in the price. There is essentially zero
price elasticity, because the people paying are not the people consuming or prescribing, so the
notion of cost effectiveness is completely foreign. The other problem is many seem to think it is a
pay or die system. Most of the time it isn't anywhere near that clear cut, and no effort is made at
determining cost effectiveness.
The public equates newest=best unfortunately newest=most expensive.
How many patients with uncomplicated hypertension are taking ACE or ACE II drugs? ARe these patients
any better off then if they were taking thiazides at a fraction of the price? The ALLHAT trials
strongly suggests they are NO better off at all...
Look at Humalog products for moment. Where does Lilly make Humalog? France. Where does the US
product come from? Where does the Canadian product come from? I'd bet you that if you turned over
samples of both products to a laboratory, they couldn't tell them apart except from the price tag.
Patient walks into his doctor and says, 'my knee seem to be sore, can you give me a prescription
for Vioxx?"
What at the odds that the physician will do so? At this stage is Vioxx likely to be any more
effective than Asprin (barring other complicating issues)? Probably not, but it probably costs 100
times as much. Even under the best of circumstances, it is probably no where near 100 times as
effective.
In much of the rest of the world, the Dr. would probably say, 'Well, why don't we try something
simple like Asprin first, if that doesn't help in a day or two, give me a call, and I'll get you
something that may be more effective..."
Where the money goes in the pharmacecutical industry isn't R&D, it is marketing, convincing patients
and doctors to ask for Vioxx instead of Asprin, and in so doing, increasing the cost by a factor of
100 or more.
I spent nearly a decade working in the ethical pharmaceuctical industry. I suggest that review of
the AMA budget and the advertising revenue JAMA and New England Journal of Medicine would be
enlightening, as would a number of other publications aimed at
Football were free?
Most of these companies are so overstaffed, you wouldn't believe. We chopped 10% in the late 1970's,
in fact we got rid of some whole departments, and I am not sure anyone noticed they were gone. At
many of these companies, if you got rid of the marketing operation, you could cut not millions of
dollars per year in expenses , but hundreds of millions of dollars per year EACH from the costs of
companies like Pfizer, Bristol-Myers, Pharmacia etc......
The real beneficiaries of any Medicare prescription drug program will not be medicare recipients, it
becomes another major welfare program for the Drug companies.
YOu don't see this kind of advertising for prescription drugs in Canada, the UK, Australia, or the
rest of the world. The companies don't have the advertising expense, which in the end, the consumer
ultimately pays for either directly at the pharmacy, or in higher prices because of higher health
insurance costs at the producer level.
I would add that the enormous portion of GNP that is spent on medical care in the USA is not
producing much of a return in longer life span. Is the life expectancy appreciably longer than it is
in say Australia? The truth is the average per capita health care cost is less than half of what it
is in the USA.
As long as we do not require any measure of cost effectiveness in treatment in the USA, we are going
to have huge costs, and very limited benefits.
The absurd margins that US pharmaceutical manufacturers have built in are what is driving the
illicit market. It is what drives every illicit market.
One of the striking things is you can buy Glucophage in Europe for a fraction of what it costs
in the USA. No, it isn't a generic, it the real thing, made by the patent holder. It is about
1/10th the cost.
What is it that Bristol Myers did to justify a ten fold increase in price. It certainly wasn't R&D.
the Truth is the that most interesting pharmaceutical R&D is done outside the USA, away from the
prying eyes of the FDA and US based human experiments and ethics committees. I know the company I
was with started building R&D facilities outside the USA for just that reason in the 1970's...
As for product costs. They are joke. Take a good look at the Indian pharmaceutical industry. India
has a small middle class, but you don't need a big per centage of a billion people to produce a huge
market. Drugs like Viagara are sold in the INdian market for less then 1/10 th US price. Given the
size of the Viagara Market, do you really think that Pfizer spent 10 billion dollar on R&D for the
product? The point is the production costs are usually trivial. The real money is in marketing and
executive compensation, not R&D and manufacturing.
Quoted message said:Quoted message said:
If any group has an advantage they will exploit it in the long run. Then will find reasons to
justify their actions.
The only correction is when they finally lose control and go to gross excess. Then something
causes a crackdown on these ???????.
The word is economic slavery. It covers much of our economy. Many of us have profited from some
aspect of this. We cry when it our turn at the bottom. I used to listen to the share cropper
owners make their case. concatenated Everyone cannot be rich or live like kings. The days of a
honest days work for a days pay is obsolete. Just convince the suckers you are doing them a big
favor. The real world.
