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by phtrivier 1110 days ago
The pricing of drugs is always weird to me. Is there a good book / article / primer on why a drug can cost the price of a good house per person ? Is it just about recouping R&D, does manufacturing requires very rare raw materials, is the bill going up because of regulation, etc... ?

How big a check would a government have to do to just "buy" the rights to a drug ? (Both in the "legal" and in the "an offer the CEO can't refuse" version ?)
2 comments
evandijk70 1110 days ago
All of the above, but my guess would be that the most expensive part is usually running the phase III clinical trial. You have to pay data managers to perform the randomization, train doctors and nurses to administer it, and the hospital for the added time it takes them to run the trial, pay the statisticians that perform the analysis, an agency that helps prepare the application, etcetera. You have to recruit patients, gather informed consent (though that is sometimes done by doctors and nurses). Also, you have to give the drug for free, since insurance companies do not cover experimental drugs. Sometimes patients also receive a fee for participating in the trial. All in all, the median cost of pivotal trials is 50 million dollars. This is the cost after you already did studies to discover the drug, and determine the dosage. Half of these trials fail, and all the previous investments are lost in that case.

[1] https://bmjopen.bmj.com/content/10/6/e038863

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yieldcrv 1110 days ago
the pricing is partially due to a lack of collective negotiation

the government programs carry a lot of weight as a large client but are currently barred from negotiating on prices

part of some US universal healthcare proposals are to just allow existing government programs to negotiate on prices, while simultaneously extending coverage to more people

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qwytw 1110 days ago
It costs about $7000 in Europe (the price seems to be similar in different country even though there is no EU wide collective negotiation).

The price in the US seems to be around double in the US. But maybe that just pharma companies do PPP adjusted pricing? e.g. it seems to cost ~1500 in India for instance. Americans are simply much richer and also significantly more on healthcare than people in other countries.

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haldujai 1110 days ago
> It costs about $7000 in Europe (the price seems to be similar in different country even though there is no EU wide collective negotiation).

That seems like a monthly price? The treatment regimen in this study is daily for 3 years.

It's hard to find out what drug prices really cost as there are a lot of discounts and negotiations behind the scenes but the best source in this instance would be a cost-effectiveness study which uses local data and happens to be a hot-topic in every national cancer society so is widely available.

EU and US pricing isn't too far off with both being ~130k USD a year give or take.

> it seems to cost ~1500 in India for instance.

There were generics, and there probably still are in parts of the world but they're technically "illegal". AstraZeneca shut down a few and there are pending countersuits against them.

https://www.fiercepharma.com/pharma/astrazeneca-staves-last-...

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