[photochemsyn]

The main issue is not even mentioned - cheap anti-HIV drugs require escape from patents and promotion of generic manufacturing to reduce costs to the level that poor countries can afford to buy or produce the necessary retrovirals.

https://academic.oup.com/cid/article/75/Supplement_4/S557/68...

> "Critical to the therapeutics market has been the role of generic drug manufacturers’ ability to supply low- and middle-income (LMIC) markets with off-patent and licensed products at a high volume and relatively low cost."

HIV patients in wealthy countries are a cash cow for the pharmaceutical industry, at least for as long as a permanent one-shot cure is not discovered, but there's no profit in making drugs for people who can't afford to pay for them. As Goldman Sachs noted, discovery of a cure would destroy the market. Isn't capitalism great?

https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patie...

[XorNot]

Technology happens when the environment is right for it, not randomly.

A breakthrough happens because the research community, available technology and it's economics are pointing in that direction anyway, even if the exact moment can't be known: i.e. Newton and Leibniz both inventing calculus around the same time.

If you're a pharma company and you find the cure for AIDS, then the race is on: someone else is very likely to find it within the same time frame (you know, if none of your thousands of employees decides to just leak it in its entirety).

There will be no market for for product if you don't get to market first: because anyone else will conclude the same.

"Suppressing the cure" doesn't happen. There are too many people involved, and no one goes into bioscience to not help people - the actual scientists don't get paid enough for that.

[mnau]

When a cure for hepatitis c was discovered (solvating iirc), everyone started screaming give it away for free instead of paying the price (~$100k).

That price was half the cost of existing treatment and very high chance of success.

If capitalism actually worked, they would sell their cheaper and better pill. No shocker there, it didn’t happen (generics in India and so in).

If I was CEO of a drug company, I would certainly incorporate that (I won’t reap benefits) in research budget allocations.

[mistrial9]

drug research overall falls into a "natural oligopoly" .. the research is lengthy and expensive, yet the occasional "winner" can be generations of income. IIR a book on the industry is called "The Billion Dollar Molecule"

meanwhile, some of the obnoxiously, obscenely wealthy individuals in the USA are running small pharm brands, either supplements or critical medicines. This wealth-crowbar was exposed to the public by the "pharma-bro" guy not long ago

[mnau]

> Pyrimethamine has been available since 1953.[20] In 2010, GlaxoSmithKline sold the marketing rights for Daraprim to CorePharma.

If Wikipedia is correct, that drug was long ago out of patent doghouse. I don’t know why USA (government, nonprofit, bill gates I don’t care who) doesn’t just make generics. Ditto insulin, that is another glaring example of that insanity.

You could argue (very reasonably) that one of key requirements for free market is a freedom not to buy. That is a potential choice, but few billion of years of evolution says a very bad choice. Thus rather special status of healthcare in pretty much every country.

Back to the issue of capitalist drug research: maybe it’s just me, but most of the new drugs seem to come from USA. Other countries with less insane healthcare (not even sure if care is the correct word in USA context) system (e.g. NHS in UK) don’t seem to produce new drugs.

Ergo, this bad system seems less bad than others, at least as producing new stuff goes.

[DanBC]

> maybe it’s just me, but most of the new drugs seem to come from USA.

It's just you.

What we see from the US is re-patenting. Citalopram gets a minor change and becomes escitalopram, it gets a new patent and some bullshit sales pitch to make doctors switch from a cheap generic to a more expensive branded med. Or ketamine infusion becomes eskatamine nasal spray - moved from a generic and tricky to administer med to a branded and easy to administer med (and, it turns out, much less effective).

The other thing the US does is "Me too" drugs - someone develops an SSRI and the US is then able to spin up 8 different versions of SSRIs that are different enough to get their own names and patents.

Most of the funding in the US doesn't come from big pharmaceutical companies, but is government funding.

For the new meds that are developed in the US the funding normally comes from Government (NIHR) funding, and not direct from pharmaceutical companies.

It's also difficult to work out what to measure: do we look at GERD (gross expenditure on research and development) or do we look at GDP too? DO we look at the quantity of new meds, or the impact on quality of life or years of life lost to disability? Do we focus on meds aimed at diseases that affect wealthy countries (diabetes, breast cancer, etc) or on disease that mostly affects poorer countries? Because three meds that have moderate impact for a small population are "less" than one med that has a good strong impact on a large population.

[goodluckchuck]

Im sorry, but I don’t understand what you’re saying. There’s no identifiable subjects.

Who screamed to give it away when who invented it? Who wanted to pay / set a $100k price?

Who made the existing treatment?

If capitalism worked who would sell the new pill for less? If it’s better, couldn’t you charge more?

[mnau]

The brand name was Sovaldi, feel free to set filter on Google to the time of release and read various newspapers.

https://en.m.wikipedia.org/wiki/Sofosbuvir#Society_and_cultu...

> In April 2014, U.S. House Democrats Henry Waxman, Frank Pallone Jr., and Diana DeGette wrote Gilead Sciences Inc. questioning the $84,000 price for sofosbuvir. They specifically asked Gilead CEO John Martin to "explain how the drug was priced, what discounts are being made available to low-income patients and government health programs, and the potential impact to public health by insurers blocking or delaying access to the medicine because of its cost."

[maxerickson]

The existing standard of care was a liver transplant. The price that the manufacturers set for the drug was based on what they thought various insurers would be willing to pay for it.

People definitely caterwauled about a $100,000 drug regimen, nevermind that it is often a cure and a lot better than an organ transplant.