[elektor]

"In 2037 the patent will run out, and the generic price will likely be 90% less."

Unfortunately, that's not guaranteed to bring a price drop. Humira is a good example of that; it recently went generic but much of the savings went to higher rebates to pharmacy benefits managers.

Some reading for anyone curious:

https://www.reuters.com/business/healthcare-pharmaceuticals/...

[amplicons4ever]

You're talking apples and oranges...

Humira is a monoclonal antibody (a biologic drug), not a small molecule. Biologics require cell culture systems and a completely different manufacturing process than small molecules, and are very complex drugs. The "generics" (called biosimilars) aren't significantly cheaper because they're simply very expensive to manufacture at scale. Humira or its "generics/biosimilars" will never be cheap. It's physically impossible with today's bio processing technology.

Trikafta is a mix of three small molecules, which are manufactured in large chemical batches and are the more traditional class of drugs. Many even have total synthesis pathways known which means you can basically make them by the train car scale for cheap.

When the patent on Trikafta runs out, it'll be very cheap.

I'll note that vanishingly few patients ever pay the full list price in the US--if you have insurance, the copay is small.

Your insurance pays (as they should, that's why you pay them premiums!). The company even pays the co-pay in most cases so the actual cost to patients in many cases is $0.

If you truly need it and don't have insurance, the company provides it for basically free with a patient assistance program, it's there on their website.

Kudos to the scientists who invented this, I don't feel bad for the insurance companies really, they charge their premiums and it's their responsibility to the policyholders to pay the applicable fees for care.

*edit: typo

[Scoundreller]

What I like to say about pharma, especially small-molecule, is that the first dose costs $billions, and the rest a few cents.

[pradn]

Humira's biosimilars are roughly 20% of the cost of name-brand Humira ($600/mo). It can even be down to 10% of the original cost, or lower, in some shops. You can buy a month's supply for ~75 from an Indian pharam supplier online, for example. The slight kicker is that the biosimilars are not 100% the same (fat) molecule as the original adalimumab.

Insurance companies are starting to say they wont cover name-brand Humira without a strong doctor's note.

Still, the price of the drug went down from being completely unaffordable without insurance to the price of an car payment. It's still expensive, but much better than before. You're not as tied to your company providing good insurance, for example.

[pradn]

Oops: Humira ($600/mo) -> Humira ($6000/mo)

[maxerickson]

I don't feel bad for the insurance companies either, but it is the case that they get their money from the people they cover, expensive treatments will drive up overall premiums.