[danielweber]

> In medicine, you often can't just wait it out. Healthcare is not a normal market

Then you pay.

I have family members who are only functional because of prescription drugs. When I see someone on HN talk about how "oh, it will probably be okay if we mess with this market, I read this really cool article online that said so," I see them no different than someone who decided on their own to start tinkering with grandpa's iron lung, because "oh, it will probably be okay." You don't know what you are messing with. Stop it.

>And for most new drugs, patents expire approximately 12 years after market introduction.

I don't know what the HBR's source is because they don't tell me. I am telling you to find any drug you see newly on the market, particularly one you see on tv since you worry about marketing budgets, and look up when its patent expires.

[frgtpsswrdlame]

>Then you pay.

And if you can't afford it? Does society pay? Do we let them die? I'm interested in your answer.

>I have family members who are only functional because of prescription drugs.

Me too.

>I don't know what the HBR's source is because they don't tell me.

And I don't know where your 5 year number comes from because you didn't provide a source.

When I see someone on HN talk about how "oh, it will probably be okay if we leave the market alone, I read this really cool article online that said so," I see them no different than someone who stood by a river and watched their grandfather struggle against the current, because "oh, it will probably be okay." You don't know what you are talking about. Stop it.

[danielweber]

> And if you can't afford it? Does society pay? Do we let them die? I'm interested in your answer.

The same thing that happens with the people whose lives could be saved right now if we stopped funding roads, or basic research, or investing in the city's water system, or educating first-graders, or researching drugs, or enforcing the property rights of rich people, or a bunch of other things that aren't going to pay off for years and are not associated with one's political party. It's not that the parties being funded are all completely honest and trustworthy, but that the money still needs to be spent. Drug research is one of the small number of things society does that actually add to the public good forever. Every year amazing drugs that do amazing things go off-patent. It's an amazing system and our children should be awed by how much stuff they will have. "Hepatitis C" will be like "polio" for them.

There is no reason to think the years 2010-2025 are some magic perfect ground where the drugs from pre-2010 are completely unsuitable and all the drugs that will be invented in year 2025 and beyond are unimportant or will still be found if a bunch of people who understand neither biochemistry nor economics rebuilt the economic system around it.

Every generation has the option to quit investing in the future. There are always people who want to stop all the painful sacrifices that are required right now, and just live off of yesterday's accumulated sacrifices and then go to sleep.

There will always be some procedure that keeps people alive but that costs Too Much Money. It's how most countries have kept their health care costs under control without noticeably impacting QALYs. There should be no doubt that there are people who died sooner because of these decisions, but the system works and doesn't bankrupt them. If "but we can't let someone die for a reason as stupid as money" is your terminal argument, be thankful you weren't in charge, or else society would have gone bankrupt a long time ago. These are hard decisions but adults need to make them, and generally adults do make them and things work out.

> When I see someone on HN talk about how "oh, it will probably be okay if we leave the market alone

I think there's a lot that can be improved about the market. I have a lot to say about that, but you are trying so hard to be cute and using children's arguments that goodwill can no longer be assumed. Good night and good luck.

[frgtpsswrdlame]

Unfortunately I'm one of those guys who just really enjoys having the last word lol.

>The same thing that happens with the people whose lives could be saved right now if we...

I'm just looking for an answer to the question. Right now society pays for treatments that can't be afforded. Furthermore, I'm actually pro drug development when most of your response seems to think I'm not. I actually think that the current system does not support R&D like it should.

>I think there's a lot that can be improved about the market. I have a lot to say about that, but you are trying so hard to be cute and using children's arguments that goodwill can no longer be assumed. Good night and good luck.

I'm a mirror, you're glue... :P But seriously, I am citing my sources, there's even a huge post in here a bit upstream you can read with all sorts of sources debunking a couple industry claims. The point of turning your quote around is to show that those sorts of diatribes aren't particularly useful.

[cmdrfred]

Why is one length of patent good for all drugs. Create the cure for cancer I can see you getting 30 years, add a antacid to an existing drug you should get 5.

[danielweber]

Perhaps they should be different, but people get most upset about the awesome drugs that cure things completely being under patent for so long. They don't care about that antacid drug so much. You would find yourself very short on allies with your proposal.

All the money going towards marketing would instead go towards lobbying, towards getting the government agency in charge of deciding "what really counts" for deciding that this drug should be one of them. When the US government was looking at how to create incentives for invention, they did look at rewards systems, and this was the common problem. Using the market system, for all its faults and ways it could be improved, at least sends proper price signals to producers and consumers.

[cmdrfred]

You are probably right. We might have to accept less innovation in order to make the products affordable.

[danielweber]

We are being asked to make the same hard decisions that each generation before us has made. And we are doing it while being far richer and having a greater repository of knowledge than them. Something's wrong with us if we quit where they preserved in worse conditions.

[grasshopperpurp]

WHO is far richer, and WHO should pay for it? Are we fine with these companies spending 1/4 of their combined profits and marketing on R & D, as J&J does? At best, this is a remarkably inefficient way to drive innovation.

The largest 10 pharmaceutical companies spent a combined $32.5B more on sales and marketing than R & D. No problem here? People are skipping dosing to stretch their meds further. Some people can't afford meds at all.