[vdance]

must me nice in your bubble that $84,000 as a one time payment is reasonable. normal people can't get a loan for something like this, and obviously don't have cash stored away for something like this, and like the article mentioned, the op won't get covered by insurance even though he's done his part and paid insurance premiums. he clearly had no other options. glad you drive a $33k car. seems like the op doesn't.

[rayiner]

Don't misinterpret my point: I think the government should absolutely pay for necessary medical treatment like this.

But, it's important not to confuse what are actually two different inquiries: what is the fair price for a Hep-C cure, and how do we make sure those who need get it. The first is a purely economic question, not a moral one. Otherwise you create a perverse incentive structure: people make lots of money creating things people don't need (a new iPhone model every year), while people make much less money creating things people do need (breakthrough cures).

[refurb]

Do you think charging $300K for a liver transplant is gouging too? Because that's what this $84K drug just replaced.

[tomc1985]

Yes, $300k is even more unconscionable.

Medicine in the US is wwaaaaaaaaaaay overpriced. Things that are critical for life needs to be priced at a reasonable flat rate above costs, and conducted with the attitude of public service and human actualization. Let big pharma reap their R&D costs some other way

[jrockway]

> Let big pharma reap their R&D costs some other way.

That's easy: they'll just cut R&D and manufacture generics or toothpaste or something that is cheaper.

[greeneggs]

> Let big pharma reap their R&D costs some other way

How?! You think they should create a social network for doctors? A billion dollars in ad sales is somehow morally better than a billion dollars from saving lives? They're making their money by saving lives, and being criticized for it. You're effectively saying that they shouldn't do any R&D, like the Indian generic drug companies.

Sorry for the exclamation points. I think that you have a particular system of morality, that is more important than saving lives. To me this is like arguing for abstinence-only sex education, which demonstrably does not work. I wish in general people would be more willing to look at data and outcomes.

[tomc1985]

I'm not in that industry, I'm sure my ideas aren't very good.

* massive step up in grant funding to front-load R&D costs so they're paid by the time the drug is out, or

* worldwide medical R&D fund, bounties for individual re-searchable issues, or

* move private R&D to universities, have profits gained pay back R&D, send any extras to researchers, and shutter R&D aspect of private medicine

At least I'm trying to think of alternatives, and not just trying to shoot other commenters down

[greeneggs]

I don't have a problem with your ideas. I think the vast majority of drug development costs are being borne by industry right now. So when you say "massive step up in grant funding," that might have to be something like a 100x funding increase. And the NIH budget has been flat (when adjusted for inflation) since 2002 [1], so there doesn't seem to be much political will for your suggestions. (And that's bad! Even if you could get your suggestions passed, long-term stagnant government funding for R&D would stall drug development.)

I think your ideas should be implemented first in another country, such as India or somewhere in Europe, so that we can see how well they work before throwing away the baby in the bathwater. Personally, I would prefer more gradual changes here in the US. For example, the cost of running drug trials has been increasing. Big pharma companies like this; going through the drug trial obstacle course is their specialty, and the huge barrier means that small drug companies that do the pre-trial drug research have to go through the big companies to get to market. Reducing these costs would lead to more competition.

[1] http://www.aaas.org/page/historical-trends-federal-rd#Agency

[tomc1985]

Indeed, lack of political will kills many things :/

[mhalle]

Minor correction: the total bill for a liver transplant is more like $700-800K, medical alone (not including personal costs such as loss of productivity or wages).

[themartorana]

And more importantly, much like student loans, even if OP was able to get a loan, it prevents him/her from taking other loans - say, for that car.

Economically crushing people (and removing them from normal economic activity by way of crushing debt) hurts the entire economy except for the pharma industry.