This is a very interesting and contentious topic and it`s inevitable that many people will have strong views on the subject. We welcome lively and thoughtful discussions here as long as people show respect for the other person`s point of view. I think everyone has finished making their points so I`m closing this thread now.
In the end we`re all on the same side here, we all want as many people who are suffering with Hep C to have access to Sovaldi and other new drugs as soon as possible and at an affordable price and I`m sure we`ll all be following Gilead`s patent battles with great interest as the news unfolds.
Thanks to everyone for contributing your thoughts and comments, and thanks to Liam for starting the topic.
Cheers. ~ Jill
patiently_waiting said
May 28, 2014
Huey wrote:
About the Diane Rheem show, Patiently , Why don't you wright to her and see if she is interested
-- Edited by Huey on Wednesday 28th of May 2014 11:33:38 PM
I might do that. Though I have to wonder who she could get to speak to the various sides of the issue. It would probably be hard to find unbiased participants, but she usually does a great job moderating.
patiently_waiting said
May 28, 2014
Isiscat2011 wrote:
That wasn't a debate, PW.
Well, whatever you want to call it I hope you didn't take anything personally as I didn't intend it to be. You seem like a good person to me. We don't agree on this issue, but I know your heart is in the right place. I doubt you think mine is but that's ok. If you knew me better you'd know I'm not a bad guy. :)
Isiscat2011 said
May 28, 2014
patiently_waiting wrote:
It's been a fun little debate, Isiscat. Cheers.
That wasn't a debate, PW.
Huey said
May 28, 2014
About the Diane Rheem show, Patiently , Why don't you wright to her and see if she is interested
-- Edited by Huey on Wednesday 28th of May 2014 11:33:38 PM
patiently_waiting said
May 28, 2014
Isiscat2011 wrote:
Alternatives have been suggested, PW, but you stopped listening a long time ago. I don't think you ever really started.
I've been listening, but I haven't heard a reasonable solution. I have to agree with Tig. We're at an impasse. It's been a fun little debate, Isiscat. Cheers.
Isiscat2011 said
May 28, 2014
patiently_waiting wrote:
I think you know that's not what I've said. Maybe you should offer your ideas on who should pay for the drugs. Are you willing to get out your check book? Someone has to pay for them - that fact is indisputable. Who do you think it should be? Let's just say it cost $12Bn to bring this drug to market, which shouldn't be too far off. Where should that money come from?
Alternatives have been suggested, PW, but you stopped listening a long time ago. I don't think you ever really started.
patiently_waiting said
May 28, 2014
Huey wrote:
This would be a great topic for the Diane Rheem Show.
I agree. I like that show. I wouldn't be surprised if she covered it at some point, especially with all the news lately.
Tig said
May 28, 2014
A word comes to mind, "impasse"... Just my .02.
Tig
patiently_waiting said
May 28, 2014
Isiscat2011 wrote:
PW: I get it, I get it. The "freeloaders"must suffer and die if they can't afford the meds. It's Economics 101.
That is your argument no matter how you attempt to rationalize, justify, intellectualize, or disguise it.
I think you know that's not what I've said. Maybe you should offer your ideas on who should pay for the drugs. Are you willing to get out your check book? Someone has to pay for them - that fact is indisputable. Who do you think it should be? Let's just say it cost $12Bn to bring this drug to market, which shouldn't be too far off. Where should that money come from?
Huey said
May 28, 2014
This would be a great topic for the Diane Rheem Show.
Isiscat2011 said
May 28, 2014
PW: I get it, I get it. The "freeloaders"must suffer and die if they can't afford the meds. It's Economics 101.
That is your argument no matter how you attempt to rationalize, justify, intellectualize, or disguise it.
patiently_waiting said
May 28, 2014
Isiscat,
I respect your opinion as well, I just happen to disagree with it.
1) I never said the U.S. I was referring to capitalist, free market countries *who respect intellectual property*. This would include Europe, Japan, you get the idea. It's the respect for intellectual property that is at the heart of my argument, not the other things you're raising like education, etc. The Forbes article isn't really relevant, though as an aside the bullet "China has replaced the U.S. as the world's largest technology exporter" has nothing to do with innovation. Much of that technology they have stolen and just reproduce with cheap labor.
2) It was actually the Indian judicial system as opposed to elected representatives (I think), but in any case it is not me who is punishing anyone. I just take exception to getting stuck with the bill from freeloading countries who make ridiculous excuses like "old science". As I noted in my bullets about how a drug's cost is set, if there are more paying patients the price comes down. It's economics/marketing 101. Drug companies have shown they will reduce the cost of their drugs proportionally to various countries' ability to pay. That of course means countries with higher GDP per capita pay more, which I'm fine with. I'm not fine with outright theft. I think you're overlooking the fact that these drugs will be paid for one way or another. If some steal it then those who pay make up for that loss. When the cost rises for paying patients to make up for the freeloaders, this does make it less accessible and therefore can cost patient's their health and potentially their lives. Also, I'm not wealthy enough to pay other people's bills and I'm not a communist either so I don't believe I should have to. I am fine with my tax dollars going to help the disabled in my own country, but there are limits.
All that said, I am not opposed to price controls, so long as they don't inhibit investment into R&D. As I understand it there really isn't much oversight at all in the U.S. so it's tough to know what's fair and what isn't. I won't make that judgement based on uninformed public outcry nor from objections from insurance companies who are obviously biased. Unbiased and honest oversight would be a good thing I think, though.
-- Edited by patiently_waiting on Wednesday 28th of May 2014 09:21:44 PM
-- Edited by patiently_waiting on Wednesday 28th of May 2014 09:37:27 PM
Isiscat2011 said
May 28, 2014
PW: I certainly respect your right to your opinion but when your opinion is based on misinformation I feel compelled to correct such factual errors.
You argued that the US pharma system is the best in the world and that changing it would result in "a total death of innovation." The facts contradict this belief entirely. The US Institute of National Health has studied this very question and found that the US contribution to pharma innovation is not disproportionately high. In fact, it is less than some countries that institute profit controls:
"Critics of drug price regulation argue that free market pricing strategies and higher prices in the United States are instrumental to innovation.20,21 One might therefore expect the United States to be the most innovative given that it is the only country with a predominantly unregulated pharmaceutical market. However, US pharmaceutical innovation appeared to be roughly proportional to its national wealth and prescription drug spending. Our data suggest that the United States is important but not disproportionate in its contribution to pharmaceutical innovation. Interestingly, some countries with direct price control, profit control, or reference drug pricing appeared to innovate proportionally more than their contribution to the global GDP or prescription drug spending."
Clearly, then, popular opinion is not "divorced from reality" as you have asserted.
Please consider also that drug innovation is dependent upon a number of factors including scientific innovations from products imported from foreign countries. The belief that the US exceeds all other countries in scientific innovation is misguided. Here is what Forbes recently wrote in an article entitled "Danger: America is Losing Its Edge in Innovation"
We're losing our edge. Innovation is something we've always been good at. Until now, we've been the undisputed leaders when it comes to finding new ideas through basic research, translating those ideas into products through world-class engineering, and getting to market first through aggressive entrepreneurship.
That's how we rose to prominence. And that's where we're falling behind now. The statistics tell the story.
U.S. consumers spend significantly more on potato chips than the U.S. government devotes to energy R&D.
In 2009, for the first time, over half of U.S. patents were awarded to non-U.S. companies.
China has replaced the U.S. as the world's number one high-technology exporter.
Between 1996 and 1999, 157 new drugs were approved in the U.S. Ten years later, that number had dropped to 74.
The World Economic Forum ranks the U.S. #48 in quality of math and science education.
Innovation is the key to survival in an increasingly global economy. Today we're living off the investments we made over the past 25 years. We've been eating our seed corn. And we're seeing an accelerating erosion of our ability to compete. Charles Darwin observed that it is not the strongest of the species that survives, nor the most intelligent, but rather the one most adaptable to change.
Additionally, you attempted to distinguish the Indian people from their elected representatives, arguing that the people are not thieves but their government is. Your distinction is absurd is this context. The Indian government is working on behalf of its people to bring the life saving drugs to its people. If you would punish the government you would punish the people.
Moreover, you argued that India's thefts of America's intellectual property rights will be responsible for the deaths of Americans. If this isn't fear based reasoning I don't know what is. It is also a mistaken belief. Americans (as well as many foreigners) will die because of the profit based system that has created unnecessary delays and cost prohibitions. The blame lies squarely at the feet of the greedy profiteers of human suffering.
patiently_waiting said
May 28, 2014
Isiscat2011 wrote:
Thanks for adding that context, Don. That just about covers it. To me it is inconceivable to view India as the thief and Gilead as the victimized hero. Just goes to show how upside down perspectives can become particularly when people are afraid. There really is a better way. Best regards.
My opinion isn't rooted in fear, Isiscat. I just perceive the world as it is and it's not a Disney movie. At no point have I called Gilead a hero and I haven't stated their pricing is fair. However, nobody posting in this thread including me knows what a fair price would be because we don't have all the facts. At a minimum all these things will go into a drug's price:
- Expenses for all the clinical trials and other expenses related to FDA approval
- Acquisition costs (in this case $11B)
- R&D (may not apply to Gilead since it was an acquisition, but Pharmasset spent money from investors on R&D which was reflected in the acquisition cost)
- RISK: Yes, there is a $ figure attached to this in order to attract investment. If you don't offer the potential for big profits investors will not put their money in a very risky endeavor like a novel drug to start with. Without investors the drug never gets to market/to patients.
- Drug manufacturing costs (typically insignificant)
- Potential market (i.e. total number of *paying* patients): the fewer this number, the higher the drug cost will be for *paying* patients/insurance companies (see India)
- Duration of market (i.e. how much time will the drug continue to sell): in this case there are many competitors just around the corner
- Other minor costs like marketing, etc. (the above is all that comes to me off the top of my head)
I don't think there's anyone here who has all the answers to the above. If not, nobody can call the pricing unfair. Maybe it is and maybe it isn't. I don't know. You may be right that there's a better way, but based on what I've heard so far your way would result in a total death of innovation.
I know defending drug companies is about as popular as defending Nazis, but popular opinion is very often divorced from reality. The system we have is far from perfect, but it's currently the best in the world in terms of developing new treatments. A much larger government investment in drug R&D *may* reduce costs as investors would not have to be paid so much on the risk they're taking. We're talking about a hell of a lot of money here though so I don't think we can count on tax dollars going to this any time soon.
I want to be very clear about this as well: I am not calling any patient anywhere a thief. I would do anything necessary to get medication to cure me and I don't fault anyone else for doing the same. I do fault foreign governments for stealing intellectual property, thus increasing costs for all of us who get stuck with the bill for that theft. If we did things their way many people posting in this very thread would probably live shorter lives.
Edit: PS. One thing to add: I do think an honest and thorough investigation should be done, though I doubt there is legal standing to do so. If an investigation was done which considered all the facts and it was found that Gilead is in fact abusing their near monopoly on a cure, I will grab my pitchfork along with everyone else. To my knowledge this has not been done so there isn't yet justification to cry foul. You can take any comments from politicians with a grain of salt as we all know they are saying things that play well to the public with truth being a distant second in priority.
-- Edited by patiently_waiting on Wednesday 28th of May 2014 05:17:32 PM
Isiscat2011 said
May 28, 2014
Thanks for adding that context, Don. That just about covers it. To me it is inconceivable to view India as the thief and Gilead as the victimized hero. Just goes to show how upside down perspectives can become particularly when people are afraid. There really is a better way. Best regards.
ET said
May 27, 2014
Yeah, to each their own. Trust taken out of context it's just oneupmanship, a waste of time. If you want to TRUST a greedy person with your wallet versus a benevolent or kind person, that's your choice. No one would say that money ind profit are not motivators for specific people, but greed denotes excess. When greed supersedes people, then its theft. For example, the S&L scandal, the 2000 Wall St., crash, the 2008 Wall St. crash where hundreds of thousands of people lost their entire savings, but the bankstas were rewarded. There are better alternative systems, than "trust me". India knows that their #1 responsibility is to their people, while they are not taking away monetary rewards for innovation, research, and development. I prefer to live in a world where I trust the honest people and either punish or restrain the dishonest people. But that is just me.
Some historical context may be useful. It is scientists who do the research, while investors finance it, hoping to get a fair return on their money. I won't argue what is fair or not, but just to say that it is not money alone that makes these breakthroughs. Rather it is dedicated researchers. Take sovaldi i,for example. It was developed by a researcher at Pharmasett. He was not rewarded for his discovery. Rather Pharmasett owned the patent and it went along with the sale of the company to Gilead.What if this same research team was salaried and funded by the national laboratories or a philanthropic trust fund? I doubt if the results would cost the American people more.
To sum up, Pharmaset was a pharmaceutical company that developed many powerful antiviral drugs, not only for HCV (Sofosbuvir/gs7977/sovaldi), but also for HIV (including racivir), and hepatitis B (including clevudine, marketed as Levovir), not to mention many others. Pharmaset was sold to Gilead for $11 billion in November 2011. It has been reported that Gilead has made $4 billion from sovaldi alone in less than 6 months of sales. If we keep in mind that the $11 billion purchase of Pharmasett was for other high price patents as well, we can see how Gilead has come out as a bandit. Gilead also caused an international uproar in the medical community when it balked at the 99% cure rate using gs-7977 and bms-5885 together. That balk delayed effective DAA treatment for a full year wherein many who were not eligible for other options died. Just some history. Again I don't think it is necessary to make money over the dead bodies of others. We need balance in the medical arts in order to serve our people. [steps off soapbox]
Kudos again to India!
Don
patiently_waiting said
May 27, 2014
Isiscat2011 wrote:
I suppose this philosophy falls into the category of: "If you can't beat them, join them.
Bingo. I won't be joining any boycott if that's what you're getting at. Will you? ;)
Isiscat2011 wrote:
I disagree completely that greed is more reliable than kindness. That is simply an idea adopted and accepted by a dysfunctional society.
Let's make two lists: one of all the drugs that have been developed out of a desire for profit (i.e. by drug companies) and another of all the drugs that have been developed out of kindness. Let's see which is longer. :)
Isiscat2011 said
May 27, 2014
Don:
I just checked with my accountant and I'm pretty sure that, if I play my cards right, by the time my tx is over I'll have just enough money left to buy a nice, sturdy, rope with which to hang myself. Aahhh...the American Dream. Gotta love it.
Isiscat2011 said
May 27, 2014
OldenSlow wrote:
"Gilead Shrugged?"
LMAO!
Don: Only one? Gilead really underpriced their product. Those swell guys are so magnanimous. :)
ET said
May 27, 2014
Yes, it does seem that placing trust in greedy exploiters sets one up to be exploited in the end. Who would choose that? There is fair wages and profit, and there are excessive profits. One doesn't need to be a genius to understand the disparities today between the salaries and benefits of CEOs and the average man. In short, most of these drugs would be much cheaper and more widely available to those who need them without the greed. Most hepatologists and gastros have openly voiced their concern. My concern is for those who are going to die without it who don't have the dough. Me, all I had to do is sell one of my 3 yachts. No big deal :)
Don
OldenSlow said
May 27, 2014
Isiscat2011 wrote:
But, I'm sure Ayn Rand would have approved.
"Gilead Shrugged?"
Isiscat2011 said
May 27, 2014
patiently_waiting wrote:
If I'm sick (I am) and I'm depending on medical discoveries to make me well, I will put my faith in "greed" over altruism as the latter is not quite as reliable as the first. I would love to be able to depend upon people like Dr. Salk, but they don't seem to be the ones giving me the meds I'm about to start taking that will hopefully cure me. Sofosbuvir may have been invented by one young chemist, but his checks were being signed by somebody.
I suppose this philosophy falls into the category of: "If you can't beat them, join them. If you can't join them then support them in the hopes they will give you what you need." The problem is the greedy don't care about what you need. You are there to serve their needs.
I disagree completely that greed is more reliable than kindness. That is simply an idea adopted and accepted by a dysfunctional society. But, I'm sure Ayn Rand would have approved.
patiently_waiting said
May 27, 2014
Zlikster wrote:
Gilead did not invent Sofosbuvir. Young chemist Mr.Clark employed by Pharmasset (in a shady government employed contract) made compound called PSI-7977 (later to be named GS-7977>Sofosbuvir). After a first clinical trial they announced results @ one conference. 2 weeks later Gilead bought Pharmasset for 11bil $, although the value of Pharmasset was realistic round 2bil $. It was a pure smell the money acquisition biz move.
Chemist that invented PSI-7977 was sacked from his job, his patent stolen by his boss (Pharmasset owner). He sued hos former boss and lost (location/jurisdiction wrong?). 2 years without a proper job, while he boss pocketed 400mil $ from those 11bil $ Gilead spitted in a rush. American dream anyone?
I am not saying Gilead is bad. There are tons of good people doing research there, but their biz managment is obviously evil or just poisoned by money game. 1k$ per pill that costs few $ to produce? if you count in clinical trials/research/marketing, it's still can't add to 1k$ per pill price. It's that obvious. Insane amount of money was paid for Pharmasset just for that magical compound we know today as Sovaldi and Gilead plans to get ROI in first 3-4 years (from 20 years of patent validity) with biggest price in history per pill.
i will again mention Dr.Jonas Salk, inventor of first polio vaccine who refused to patent it. Some say he could have been 6bil $ richer on other hand who knows how many children has he saved? millions? can we quantify that value in money?
You make some good points. I was not aware of some of the specific background story on Gilead. I also think we can all agree Dr. Jonas Salk was noble and admirable person. He seems to be the exception rather than the rule, however. If I'm sick (I am) and I'm depending on medical discoveries to make me well, I will put my faith in "greed" over altruism as the latter is not quite as reliable as the first. I would love to be able to depend upon people like Dr. Salk, but they don't seem to be the ones giving me the meds I'm about to start taking that will hopefully cure me. Sofosbuvir may have been invented by one young chemist, but his checks were being signed by somebody. The lab he worked in was being paid for by somebody. And the thousands of other researchers like him were being paid by somebody. It may have been discovered by one man, but that doesn't mean it only took one man to discover it.
Look, I've said it before and I'll say it again, I would love to see more government and philanthropic investment into medical research. I just don't think we can rely on either.
EDIT: PS. The cost to manufacture a drug is typically insignificant when compared to other costs to bring a drug to market.
-- Edited by patiently_waiting on Tuesday 27th of May 2014 09:16:01 PM
Zlikster said
May 27, 2014
Gilead did not invent Sofosbuvir. Young chemist Mr.Clark employed by Pharmasset (in a shady government employed contract) made compound called PSI-7977 (later to be named GS-7977>Sofosbuvir). After a first clinical trial they announced results @ one conference. 2 weeks later Gilead bought Pharmasset for 11bil $, although the value of Pharmasset was realistic round 2bil $. It was a pure smell the money acquisition biz move.
Chemist that invented PSI-7977 was sacked from his job, his patent stolen by his boss (Pharmasset owner). He sued hos former boss and lost (location/jurisdiction wrong?). 2 years without a proper job, while he boss pocketed 400mil $ from those 11bil $ Gilead spitted in a rush. American dream anyone?
I am not saying Gilead is bad. There are tons of good people doing research there, but their biz managment is obviously evil or just poisoned by money game. 1k$ per pill that costs few $ to produce? if you count in clinical trials/research/marketing, it's still can't add to 1k$ per pill price. It's that obvious. Insane amount of money was paid for Pharmasset just for that magical compound we know today as Sovaldi and Gilead plans to get ROI in first 3-4 years (from 20 years of patent validity) with biggest price in history per pill.
i will again mention Dr.Jonas Salk, inventor of first polio vaccine who refused to patent it. Some say he could have been 6bil $ richer on other hand who knows how many children has he saved? millions? can we quantify that value in money?
ET said
May 27, 2014
Well said, Isiscat! Sure it requires money to do research, but in a profit motivated disease care system makes no sense. How much profit is a question and why does more disease pay more profits is another. Just look at the billions of dollars spent by the VA, medicare, insurance companies, etc., on these meds, and one will realize that it would be far less expensive to put MEDICAL research in the hands of non-profit international research labs, universities, or others that serve people, not just moneyed investors. All of us can invest in that, seeing the forest despite the trees. India obviously cares about its people. I wish the US did so equally as well.
Don
Isiscat2011 said
May 27, 2014
PW: Comparing the US to civilizations that have existed for thousands of years is hardly realistic. America was the "fresh start" country. 200+ years later and our Empire is already in financial ruin. The middle class is rapidly disappearing and we are becoming a nation of have and have nots. The haves decide what medicines will be developed and to whom they will be distributed. That is the legacy we will leave to our children and grandchildren. We may just set a world record for self destructing.
Greed is Good, PW. Greed is good. Just keep believing it.
patiently_waiting said
May 27, 2014
Isiscat2011 wrote:
PW: You do realize that the heart of your argument is that massive profits for the few are more important than the suffering and loss of life for the many, don't you?
Whether or not India grants patent protection to Gilead is still an unresolved legal question. Your declaration that India, or other countries, are committing acts of theft is, therefore, not grounded in law.
Moreover, before you decide that the law trumps all other considerations you must understand that the law primarily supports the interests of the most powerful players. The law is only as honorable as the society that enacts the laws. There is no honor in depriving people of life saving drugs so others can make more money. Placing profits above human suffering and loss of life is immoral and inhumane.
Isiscat I think you are not thinking about how new drugs come to market. It is not out of charity. It's from investments from companies/people who put their capital at risk. It's a big risk as most drugs don't make it to market. The higher the risk the higher the return. It has to be this way or the investment will never happen to start with and there will never be any new drugs. If you value the new drugs we are all benefiting from I'm not sure how you rationalize demonizing those who brought it to you. We have discussed in other threads how the system might be improved, but stealing the results of a companies work is immoral and will do nothing but slow the development of new treatments. Drug companies usually negotiate with poorer countries to reduce the costs, so there's no justification for outright theft. Of course we could always just behave like India and China and toss intellectual property rights out the window. That seems to be working quite well for them considering all the new drugs coming from those countries.
In any case, I'm getting deja vu as I type this as it seems we've covered this before. We should probably just agree to disagree. :)
-- Edited by patiently_waiting on Tuesday 27th of May 2014 03:13:22 PM
Jaded said
May 27, 2014
Isiscat2011 wrote:
PW: You do realize that the heart of your argument is that massive profits for the few are more important than the suffering and loss of life for the many, don't you?
Whether or not India grants patent protection to Gilead is still an unresolved legal question. Your declaration that India, or other countries, are committing acts of theft is, therefore, not grounded in law.
Moreover, before you decide that the law trumps all other considerations you must understand that the law primarily supports the interests of the most powerful players. The law is only as honorable as the society that enacts the laws. There is no honor in depriving people of life saving drugs so others can make more money. Placing profits above human suffering and loss of life is immoral and inhumane.
Amen
Isiscat2011 said
May 26, 2014
PW: You do realize that the heart of your argument is that massive profits for the few are more important than the suffering and loss of life for the many, don't you?
Whether or not India grants patent protection to Gilead is still an unresolved legal question. Your declaration that India, or other countries, are committing acts of theft is, therefore, not grounded in law.
Moreover, before you decide that the law trumps all other considerations you must understand that the law primarily supports the interests of the most powerful players. The law is only as honorable as the society that enacts the laws. There is no honor in depriving people of life saving drugs so others can make more money. Placing profits above human suffering and loss of life is immoral and inhumane.
patiently_waiting said
May 26, 2014
It's intellectual property and it belongs to Gilead. For foreign companies to just steal their IP and reproduce it for their own profit is theft. The loss Gilead incurs by this theft is made up for by people in other countries who respect intellectual property (the West). China does it as does many others. I would never fault a patient for getting medication in any way they can, but Gilead spent invested money developing this drug and they own it. Should they be as reasonable as they can without losing money given it can save people's lives? Of course. But they shouldn't have it just taken from them.
-- Edited by patiently_waiting on Tuesday 27th of May 2014 03:33:47 AM
-- Edited by patiently_waiting on Tuesday 27th of May 2014 03:34:01 AM
-- Edited by patiently_waiting on Tuesday 27th of May 2014 03:34:22 AM
Isiscat2011 said
May 26, 2014
patiently_waiting wrote:
And people wonder why they charge so much in the U.S. Because half the world just steals it.
Steals it? Are you kidding me? They are just trying to stay alive. They are just as human and as deserving of life as we are
The reason they charge so much in the U.S. is because of the greed of the few supported by the brainwashed many.
Zlikster said
May 26, 2014
I do not wonder why Gilead charges that much in USA/west, since they overpaid (11bil $) acquisition of Pharmasset (Sofosbuvir "inventors"), so no wonder we have situation like this (1k$ per pill). Pharmacology in free market economy is in one way pure evil. Clinical trials, research etc is just a tiny fraction of the final product price in Sofosbuvir's case.
More than 40% of HIV patients use generic drugs made in India, you could say those generic drugs manufacturers are saving millions of lives.
I don't have any sympathy for pharma greed. As i mentioned, what my hepa told me as she is pretty desperate to treat her patients best she can. Vertex asked for almost a 60k$ per therapy of Incivek from state owned medicare like insurance. So who knows when we will get here in Bosnia triple therapy for HCV and all these new DAAs sound like distant SciFi. Average salary here is 500-600$. Gilead's regional manager, when my hepa asked for 6 bottles of Sovaldi for me, said it's manageable (since it's not yet on sale in EU), but hospital must pay (full price) for it. Yeah like my hospital has 168k$ just for me. I could get from my savings 5-10k$ and thats what i plan to do as soon as i see some generic Sofosbuvir in Egypt, India, wherever. Oh yeah, i guess i have to get generic Ribavirin too ;)
So, go Cipla, do it. I don't wanna wait 20 years until Gilead's patent on Sofosbuvir expires, so i can be "legal". Cheers Malcolm for that rumor :)
patiently_waiting said
May 26, 2014
mallani wrote:
The word is that Cipla, established in 1935 in Mumbai, has already started production of it's generic Sovaldi. That should take care of SE Asia and Africa, with no royalties for Gilead.
And people wonder why they charge so much in the U.S. Because half the world just steals it.
skewedButNotBroken said
May 26, 2014
You could probably get a round-trip ticket to India for a couple of grand and then stay outside of the big cities for 3 months for a few thousand dollars, get a local doctor to write you a script for the generic versions of Sovaldi and Olysio (assuming there is a generic equivalent for Olysio) for a few hundred dollars and come back to the states cured for less than 10K.
I could come up with 10K relatively easy, but 160k--- that would be impossible for me.
OldenSlow said
May 26, 2014
Additional to this, looks like Egypt may reject Gilead's patent application as well.
Taking into account the fact that this drug was put through the FDA in the fast lane, So maybe being Old Science is relay a Good thing!
Good thing it wasn't in the slow lane. The lawyers and scientists would have been calling it "ancient history" by now! lol
mallani said
May 25, 2014
The word is that Cipla, established in 1935 in Mumbai, has already started production of it's generic Sovaldi. That should take care of SE Asia and Africa, with no royalties for Gilead.
Huey said
May 25, 2014
Taking into account the fact that this drug was put through the FDA in the fast lane, So maybe being Old Science is relay a Good thing!
Isiscat2011 said
May 25, 2014
Below is an excerpt from the first article you cited to, Tig. Apparently, Sovaldi is "not inventive enough" and it is already "old science." Sometimes we just have to sit back and laugh at all this craziness.
"Natco has opposed the patent on the same grounds as New York-based Initiative for Medicines, Access & Knowledge (I-MAK), arguing that Sovaldi is not "inventive" enough, the source told Reuters.
I-MAK, a group of lawyers and scientists, filed an opposition in November 2013 to the grant of a patent in India on Sovaldi, chemically called sofosbuvir, saying the drug uses "old science"."
This is a very interesting and contentious topic and it`s inevitable that many people will have strong views on the subject. We welcome lively and thoughtful discussions here as long as people show respect for the other person`s point of view. I think everyone has finished making their points so I`m closing this thread now.
In the end we`re all on the same side here, we all want as many people who are suffering with Hep C to have access to Sovaldi and other new drugs as soon as possible and at an affordable price and I`m sure we`ll all be following Gilead`s patent battles with great interest as the news unfolds.
Thanks to everyone for contributing your thoughts and comments, and thanks to Liam for starting the topic.
Cheers. ~ Jill
I might do that. Though I have to wonder who she could get to speak to the various sides of the issue. It would probably be hard to find unbiased participants, but she usually does a great job moderating.
Well, whatever you want to call it I hope you didn't take anything personally as I didn't intend it to be. You seem like a good person to me. We don't agree on this issue, but I know your heart is in the right place. I doubt you think mine is but that's ok. If you knew me better you'd know I'm not a bad guy. :)
That wasn't a debate, PW.
About the Diane Rheem show, Patiently , Why don't you wright to her and see if she is interested
-- Edited by Huey on Wednesday 28th of May 2014 11:33:38 PM
I've been listening, but I haven't heard a reasonable solution. I have to agree with Tig. We're at an impasse. It's been a fun little debate, Isiscat. Cheers.
Alternatives have been suggested, PW, but you stopped listening a long time ago. I don't think you ever really started.
I agree. I like that show. I wouldn't be surprised if she covered it at some point, especially with all the news lately.
A word comes to mind, "impasse"... Just my .02.
Tig
I think you know that's not what I've said. Maybe you should offer your ideas on who should pay for the drugs. Are you willing to get out your check book? Someone has to pay for them - that fact is indisputable. Who do you think it should be? Let's just say it cost $12Bn to bring this drug to market, which shouldn't be too far off. Where should that money come from?
This would be a great topic for the Diane Rheem Show.
PW: I get it, I get it. The "freeloaders"must suffer and die if they can't afford the meds. It's Economics 101.
That is your argument no matter how you attempt to rationalize, justify, intellectualize, or disguise it.
Isiscat,
I respect your opinion as well, I just happen to disagree with it.
1) I never said the U.S. I was referring to capitalist, free market countries *who respect intellectual property*. This would include Europe, Japan, you get the idea. It's the respect for intellectual property that is at the heart of my argument, not the other things you're raising like education, etc. The Forbes article isn't really relevant, though as an aside the bullet "China has replaced the U.S. as the world's largest technology exporter" has nothing to do with innovation. Much of that technology they have stolen and just reproduce with cheap labor.
2) It was actually the Indian judicial system as opposed to elected representatives (I think), but in any case it is not me who is punishing anyone. I just take exception to getting stuck with the bill from freeloading countries who make ridiculous excuses like "old science". As I noted in my bullets about how a drug's cost is set, if there are more paying patients the price comes down. It's economics/marketing 101. Drug companies have shown they will reduce the cost of their drugs proportionally to various countries' ability to pay. That of course means countries with higher GDP per capita pay more, which I'm fine with. I'm not fine with outright theft. I think you're overlooking the fact that these drugs will be paid for one way or another. If some steal it then those who pay make up for that loss. When the cost rises for paying patients to make up for the freeloaders, this does make it less accessible and therefore can cost patient's their health and potentially their lives. Also, I'm not wealthy enough to pay other people's bills and I'm not a communist either so I don't believe I should have to. I am fine with my tax dollars going to help the disabled in my own country, but there are limits.
All that said, I am not opposed to price controls, so long as they don't inhibit investment into R&D. As I understand it there really isn't much oversight at all in the U.S. so it's tough to know what's fair and what isn't. I won't make that judgement based on uninformed public outcry nor from objections from insurance companies who are obviously biased. Unbiased and honest oversight would be a good thing I think, though.
-- Edited by patiently_waiting on Wednesday 28th of May 2014 09:21:44 PM
-- Edited by patiently_waiting on Wednesday 28th of May 2014 09:37:27 PM
PW: I certainly respect your right to your opinion but when your opinion is based on misinformation I feel compelled to correct such factual errors.
You argued that the US pharma system is the best in the world and that changing it would result in "a total death of innovation." The facts contradict this belief entirely. The US Institute of National Health has studied this very question and found that the US contribution to pharma innovation is not disproportionately high. In fact, it is less than some countries that institute profit controls:
"Critics of drug price regulation argue that free market pricing strategies and higher prices in the United States are instrumental to innovation.20,21 One might therefore expect the United States to be the most innovative given that it is the only country with a predominantly unregulated pharmaceutical market. However, US pharmaceutical innovation appeared to be roughly proportional to its national wealth and prescription drug spending. Our data suggest that the United States is important but not disproportionate in its contribution to pharmaceutical innovation. Interestingly, some countries with direct price control, profit control, or reference drug pricing appeared to innovate proportionally more than their contribution to the global GDP or prescription drug spending."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/
Clearly, then, popular opinion is not "divorced from reality" as you have asserted.
Please consider also that drug innovation is dependent upon a number of factors including scientific innovations from products imported from foreign countries. The belief that the US exceeds all other countries in scientific innovation is misguided. Here is what Forbes recently wrote in an article entitled "Danger: America is Losing Its Edge in Innovation"
We're losing our edge. Innovation is something we've always been good at. Until now, we've been the undisputed leaders when it comes to finding new ideas through basic research, translating those ideas into products through world-class engineering, and getting to market first through aggressive entrepreneurship.
That's how we rose to prominence. And that's where we're falling behind now. The statistics tell the story.
Innovation is the key to survival in an increasingly global economy. Today we're living off the investments we made over the past 25 years. We've been eating our seed corn. And we're seeing an accelerating erosion of our ability to compete. Charles Darwin observed that it is not the strongest of the species that survives, nor the most intelligent, but rather the one most adaptable to change.
Additionally, you attempted to distinguish the Indian people from their elected representatives, arguing that the people are not thieves but their government is. Your distinction is absurd is this context. The Indian government is working on behalf of its people to bring the life saving drugs to its people. If you would punish the government you would punish the people.
Moreover, you argued that India's thefts of America's intellectual property rights will be responsible for the deaths of Americans. If this isn't fear based reasoning I don't know what is. It is also a mistaken belief. Americans (as well as many foreigners) will die because of the profit based system that has created unnecessary delays and cost prohibitions. The blame lies squarely at the feet of the greedy profiteers of human suffering.
My opinion isn't rooted in fear, Isiscat. I just perceive the world as it is and it's not a Disney movie. At no point have I called Gilead a hero and I haven't stated their pricing is fair. However, nobody posting in this thread including me knows what a fair price would be because we don't have all the facts. At a minimum all these things will go into a drug's price:
- Expenses for all the clinical trials and other expenses related to FDA approval
- Acquisition costs (in this case $11B)
- R&D (may not apply to Gilead since it was an acquisition, but Pharmasset spent money from investors on R&D which was reflected in the acquisition cost)
- RISK: Yes, there is a $ figure attached to this in order to attract investment. If you don't offer the potential for big profits investors will not put their money in a very risky endeavor like a novel drug to start with. Without investors the drug never gets to market/to patients.
- Drug manufacturing costs (typically insignificant)
- Potential market (i.e. total number of *paying* patients): the fewer this number, the higher the drug cost will be for *paying* patients/insurance companies (see India)
- Duration of market (i.e. how much time will the drug continue to sell): in this case there are many competitors just around the corner
- Other minor costs like marketing, etc. (the above is all that comes to me off the top of my head)
I don't think there's anyone here who has all the answers to the above. If not, nobody can call the pricing unfair. Maybe it is and maybe it isn't. I don't know. You may be right that there's a better way, but based on what I've heard so far your way would result in a total death of innovation.
I know defending drug companies is about as popular as defending Nazis, but popular opinion is very often divorced from reality. The system we have is far from perfect, but it's currently the best in the world in terms of developing new treatments. A much larger government investment in drug R&D *may* reduce costs as investors would not have to be paid so much on the risk they're taking. We're talking about a hell of a lot of money here though so I don't think we can count on tax dollars going to this any time soon.
I want to be very clear about this as well: I am not calling any patient anywhere a thief. I would do anything necessary to get medication to cure me and I don't fault anyone else for doing the same. I do fault foreign governments for stealing intellectual property, thus increasing costs for all of us who get stuck with the bill for that theft. If we did things their way many people posting in this very thread would probably live shorter lives.
Edit: PS. One thing to add: I do think an honest and thorough investigation should be done, though I doubt there is legal standing to do so. If an investigation was done which considered all the facts and it was found that Gilead is in fact abusing their near monopoly on a cure, I will grab my pitchfork along with everyone else. To my knowledge this has not been done so there isn't yet justification to cry foul. You can take any comments from politicians with a grain of salt as we all know they are saying things that play well to the public with truth being a distant second in priority.
-- Edited by patiently_waiting on Wednesday 28th of May 2014 05:17:32 PM
Thanks for adding that context, Don. That just about covers it. To me it is inconceivable to view India as the thief and Gilead as the victimized hero. Just goes to show how upside down perspectives can become particularly when people are afraid. There really is a better way. Best regards.
Yeah, to each their own. Trust taken out of context it's just oneupmanship, a waste of time. If you want to TRUST a greedy person with your wallet versus a benevolent or kind person, that's your choice. No one would say that money ind profit are not motivators for specific people, but greed denotes excess. When greed supersedes people, then its theft. For example, the S&L scandal, the 2000 Wall St., crash, the 2008 Wall St. crash where hundreds of thousands of people lost their entire savings, but the bankstas were rewarded. There are better alternative systems, than "trust me". India knows that their #1 responsibility is to their people, while they are not taking away monetary rewards for innovation, research, and development. I prefer to live in a world where I trust the honest people and either punish or restrain the dishonest people. But that is just me.
Some historical context may be useful. It is scientists who do the research, while investors finance it, hoping to get a fair return on their money. I won't argue what is fair or not, but just to say that it is not money alone that makes these breakthroughs. Rather it is dedicated researchers. Take sovaldi i,for example. It was developed by a researcher at Pharmasett. He was not rewarded for his discovery. Rather Pharmasett owned the patent and it went along with the sale of the company to Gilead.What if this same research team was salaried and funded by the national laboratories or a philanthropic trust fund? I doubt if the results would cost the American people more.
To sum up, Pharmaset was a pharmaceutical company that developed many powerful antiviral drugs, not only for HCV (Sofosbuvir/gs7977/sovaldi), but also for HIV (including racivir), and hepatitis B (including clevudine, marketed as Levovir), not to mention many others. Pharmaset was sold to Gilead for $11 billion in November 2011. It has been reported that Gilead has made $4 billion from sovaldi alone in less than 6 months of sales. If we keep in mind that the $11 billion purchase of Pharmasett was for other high price patents as well, we can see how Gilead has come out as a bandit. Gilead also caused an international uproar in the medical community when it balked at the 99% cure rate using gs-7977 and bms-5885 together. That balk delayed effective DAA treatment for a full year wherein many who were not eligible for other options died. Just some history. Again I don't think it is necessary to make money over the dead bodies of others. We need balance in the medical arts in order to serve our people. [steps off soapbox]
Kudos again to India!
Don
Bingo. I won't be joining any boycott if that's what you're getting at. Will you? ;)
Let's make two lists: one of all the drugs that have been developed out of a desire for profit (i.e. by drug companies) and another of all the drugs that have been developed out of kindness. Let's see which is longer. :)
Don:
I just checked with my accountant and I'm pretty sure that, if I play my cards right, by the time my tx is over I'll have just enough money left to buy a nice, sturdy, rope with which to hang myself. Aahhh...the American Dream. Gotta love it.
LMAO!
Don: Only one? Gilead really underpriced their product. Those swell guys are so magnanimous. :)
Yes, it does seem that placing trust in greedy exploiters sets one up to be exploited in the end. Who would choose that? There is fair wages and profit, and there are excessive profits. One doesn't need to be a genius to understand the disparities today between the salaries and benefits of CEOs and the average man. In short, most of these drugs would be much cheaper and more widely available to those who need them without the greed. Most hepatologists and gastros have openly voiced their concern. My concern is for those who are going to die without it who don't have the dough. Me, all I had to do is sell one of my 3 yachts. No big deal :)
Don
"Gilead Shrugged?"
You make some good points. I was not aware of some of the specific background story on Gilead. I also think we can all agree Dr. Jonas Salk was noble and admirable person. He seems to be the exception rather than the rule, however. If I'm sick (I am) and I'm depending on medical discoveries to make me well, I will put my faith in "greed" over altruism as the latter is not quite as reliable as the first. I would love to be able to depend upon people like Dr. Salk, but they don't seem to be the ones giving me the meds I'm about to start taking that will hopefully cure me. Sofosbuvir may have been invented by one young chemist, but his checks were being signed by somebody. The lab he worked in was being paid for by somebody. And the thousands of other researchers like him were being paid by somebody. It may have been discovered by one man, but that doesn't mean it only took one man to discover it.
Look, I've said it before and I'll say it again, I would love to see more government and philanthropic investment into medical research. I just don't think we can rely on either.
EDIT: PS. The cost to manufacture a drug is typically insignificant when compared to other costs to bring a drug to market.
-- Edited by patiently_waiting on Tuesday 27th of May 2014 09:16:01 PM
Gilead did not invent Sofosbuvir. Young chemist Mr.Clark employed by Pharmasset (in a shady government employed contract) made compound called PSI-7977 (later to be named GS-7977>Sofosbuvir). After a first clinical trial they announced results @ one conference. 2 weeks later Gilead bought Pharmasset for 11bil $, although the value of Pharmasset was realistic round 2bil $. It was a pure smell the money acquisition biz move.
Chemist that invented PSI-7977 was sacked from his job, his patent stolen by his boss (Pharmasset owner). He sued hos former boss and lost (location/jurisdiction wrong?). 2 years without a proper job, while he boss pocketed 400mil $ from those 11bil $ Gilead spitted in a rush. American dream anyone?
I am not saying Gilead is bad. There are tons of good people doing research there, but their biz managment is obviously evil or just poisoned by money game. 1k$ per pill that costs few $ to produce? if you count in clinical trials/research/marketing, it's still can't add to 1k$ per pill price. It's that obvious. Insane amount of money was paid for Pharmasset just for that magical compound we know today as Sovaldi and Gilead plans to get ROI in first 3-4 years (from 20 years of patent validity) with biggest price in history per pill.
i will again mention Dr.Jonas Salk, inventor of first polio vaccine who refused to patent it. Some say he could have been 6bil $ richer on other hand who knows how many children has he saved? millions? can we quantify that value in money?
Well said, Isiscat! Sure it requires money to do research, but in a profit motivated disease care system makes no sense. How much profit is a question and why does more disease pay more profits is another. Just look at the billions of dollars spent by the VA, medicare, insurance companies, etc., on these meds, and one will realize that it would be far less expensive to put MEDICAL research in the hands of non-profit international research labs, universities, or others that serve people, not just moneyed investors. All of us can invest in that, seeing the forest despite the trees. India obviously cares about its people. I wish the US did so equally as well.
Don
PW: Comparing the US to civilizations that have existed for thousands of years is hardly realistic. America was the "fresh start" country. 200+ years later and our Empire is already in financial ruin. The middle class is rapidly disappearing and we are becoming a nation of have and have nots. The haves decide what medicines will be developed and to whom they will be distributed. That is the legacy we will leave to our children and grandchildren. We may just set a world record for self destructing.
Greed is Good, PW. Greed is good. Just keep believing it.
Isiscat I think you are not thinking about how new drugs come to market. It is not out of charity. It's from investments from companies/people who put their capital at risk. It's a big risk as most drugs don't make it to market. The higher the risk the higher the return. It has to be this way or the investment will never happen to start with and there will never be any new drugs. If you value the new drugs we are all benefiting from I'm not sure how you rationalize demonizing those who brought it to you. We have discussed in other threads how the system might be improved, but stealing the results of a companies work is immoral and will do nothing but slow the development of new treatments. Drug companies usually negotiate with poorer countries to reduce the costs, so there's no justification for outright theft. Of course we could always just behave like India and China and toss intellectual property rights out the window. That seems to be working quite well for them considering all the new drugs coming from those countries.
In any case, I'm getting deja vu as I type this as it seems we've covered this before. We should probably just agree to disagree. :)
-- Edited by patiently_waiting on Tuesday 27th of May 2014 03:13:22 PM
Amen
PW: You do realize that the heart of your argument is that massive profits for the few are more important than the suffering and loss of life for the many, don't you?
Whether or not India grants patent protection to Gilead is still an unresolved legal question. Your declaration that India, or other countries, are committing acts of theft is, therefore, not grounded in law.
Moreover, before you decide that the law trumps all other considerations you must understand that the law primarily supports the interests of the most powerful players. The law is only as honorable as the society that enacts the laws. There is no honor in depriving people of life saving drugs so others can make more money. Placing profits above human suffering and loss of life is immoral and inhumane.
It's intellectual property and it belongs to Gilead. For foreign companies to just steal their IP and reproduce it for their own profit is theft. The loss Gilead incurs by this theft is made up for by people in other countries who respect intellectual property (the West). China does it as does many others. I would never fault a patient for getting medication in any way they can, but Gilead spent invested money developing this drug and they own it. Should they be as reasonable as they can without losing money given it can save people's lives? Of course. But they shouldn't have it just taken from them.
-- Edited by patiently_waiting on Tuesday 27th of May 2014 03:33:47 AM
-- Edited by patiently_waiting on Tuesday 27th of May 2014 03:34:01 AM
-- Edited by patiently_waiting on Tuesday 27th of May 2014 03:34:22 AM
Steals it? Are you kidding me? They are just trying to stay alive. They are just as human and as deserving of life as we are
The reason they charge so much in the U.S. is because of the greed of the few supported by the brainwashed many.
I do not wonder why Gilead charges that much in USA/west, since they overpaid (11bil $) acquisition of Pharmasset (Sofosbuvir "inventors"), so no wonder we have situation like this (1k$ per pill). Pharmacology in free market economy is in one way pure evil. Clinical trials, research etc is just a tiny fraction of the final product price in Sofosbuvir's case.
More than 40% of HIV patients use generic drugs made in India, you could say those generic drugs manufacturers are saving millions of lives.
I don't have any sympathy for pharma greed. As i mentioned, what my hepa told me as she is pretty desperate to treat her patients best she can. Vertex asked for almost a 60k$ per therapy of Incivek from state owned medicare like insurance. So who knows when we will get here in Bosnia triple therapy for HCV and all these new DAAs sound like distant SciFi. Average salary here is 500-600$. Gilead's regional manager, when my hepa asked for 6 bottles of Sovaldi for me, said it's manageable (since it's not yet on sale in EU), but hospital must pay (full price) for it. Yeah like my hospital has 168k$ just for me. I could get from my savings 5-10k$ and thats what i plan to do as soon as i see some generic Sofosbuvir in Egypt, India, wherever. Oh yeah, i guess i have to get generic Ribavirin too ;)
So, go Cipla, do it. I don't wanna wait 20 years until Gilead's patent on Sofosbuvir expires, so i can be "legal". Cheers Malcolm for that rumor :)
And people wonder why they charge so much in the U.S. Because half the world just steals it.
You could probably get a round-trip ticket to India for a couple of grand and then stay outside of the big cities for 3 months for a few thousand dollars, get a local doctor to write you a script for the generic versions of Sovaldi and Olysio (assuming there is a generic equivalent for Olysio) for a few hundred dollars and come back to the states cured for less than 10K.
I could come up with 10K relatively easy, but 160k--- that would be impossible for me.
Additional to this, looks like Egypt may reject Gilead's patent application as well.
http://hepatitiscnewdrugs.blogspot.com/2014/05/weekend-reading-hcv-in-egypt-and.html
Good thing it wasn't in the slow lane. The lawyers and scientists would have been calling it "ancient history" by now! lol
The word is that Cipla, established in 1935 in Mumbai, has already started production of it's generic Sovaldi. That should take care of SE Asia and Africa, with no royalties for Gilead.
Taking into account the fact that this drug was put through the FDA in the fast lane, So maybe being Old Science is relay a Good thing!
Below is an excerpt from the first article you cited to, Tig. Apparently, Sovaldi is "not inventive enough" and it is already "old science." Sometimes we just have to sit back and laugh at all this craziness.
"Natco has opposed the patent on the same grounds as New York-based Initiative for Medicines, Access & Knowledge (I-MAK), arguing that Sovaldi is not "inventive" enough, the source told Reuters.
I-MAK, a group of lawyers and scientists, filed an opposition in November 2013 to the grant of a patent in India on Sovaldi, chemically called sofosbuvir, saying the drug uses "old science"."
Looks like India wants no part of it!
http://www.reuters.com/article/2014/04/10/us-natco-pharma-sovaldi-idUSBREA390VK20140410
http://www.msfaccess.org/about-us/media-room/press-releases/gilead-attempt-secure-patent-hepatitis-c-drug-opposed-india
The only thing I know is that Gilead ask for a patten and India refused.
Has any one heard anything more about indian drug companies partnering up with Gilead to produce cheap sovaldi?
Cheers
liam