Will Brilinta Be Approved Next Week or Not?

[Anonymous]

I am a far right wing conservative. I believe in free market competition. If it existed in pharmaceuticals, there would be some actual innovation. There has been none in decades.

It's interesting you mention Viagara. Viagara was STUMBLED upon. It was an experimental blood pressure medicine, and the subjects reported a side effect and presto. Then, the leaches swooped in, changed a methyl group, and patented Cialis, Levitra, and maybe other branded products, invented "ED" as a medical condition. Everybody charges astronomical prices for their product -- none of the companies compete on price. The corrupt industry normalized the treatment as a medical condition (it's not), bombarded us with ads at dinnertime, prompting our 6 year olds to ask "Dad, what's erectile disfunction" and convinced state medical programs to reimburse for this at best recreational product. At sky high prices.

I don't think life is unfair, I think the way pharmaceuticals are distributed and paid for is extremely corrupted and need to be redone. Either the government needs to get all the way in and socialize it, or the government needs to get out and allow free market forces to drive down prices and drive up innovation. As it stands, we get high prices and zero innovation.

Seriously, get off your high horse. Is there innovation in pharma? Not much right now. No big surprise there. Look around and see how few reps there are and you'll see that there isn't much to sell. Has there been innovation in pharma? Yep. Has it saved lives. Yep. Statins. PPI's. ACE inhibitors. etc etc etc.

Prices too high? Probably. But find me another industry where you come up with something- by chance or by design- and you get less than 17 years to sell it. Go find one. Huge corporations like Disney got copyrights extended to 120 YEARS after corporate creation. How many billions of Mickey dolls and stuff worth TRILLIONS of dollars will they rake in over generations?

Go to Disney and tell them to drop a few million on a movie that they'll only be able to sell for 17 years and see how quick they are to invest a penny in it.

So the industry spends x amount of money (whatever high or low number you want to assign) to find a drug. Gets at most 17 years. In the interim has to deal with the now prevalent at risk launches and lawsuits that come with and then hand over their product to a generic company that makes profit off no work.

Back to the Disney topic- think I could make a fortune selling Mickey merchandise that I pay some factory in China to make and then sell them here for half the price of the Disney stuff. Hell yeah! Heck- You could sell it for 20% of the Disney price and make a fortune. Think Disney's gonna sit back and watch you steal their cash cow?

The point is there are lots of reasons why drugs are expensive. Some of them legit, some not so much. But pharmas not the only one culpable and shouldn't be held to a higher standard than everyone else. Want to get cheaper drugs from Canada? Fine. Sign here that says you will only be able to sue by Canadian rules. Can't have your cake and eat it too.

Should iv pumps be 5 grand? Should Docs make 300k? Should a specialist make 700k? Should a 10 minute consult be billed to insurance at a couple hundred bucks?

 

[Anonymous]

Seriously, get off your high horse. Is there innovation in pharma? Not much right now. No big surprise there. Look around and see how few reps there are and you'll see that there isn't much to sell. Has there been innovation in pharma? Yep. Has it saved lives. Yep. Statins. PPI's. ACE inhibitors. etc etc etc.

Prices too high? Probably. But find me another industry where you come up with something- by chance or by design- and you get less than 17 years to sell it. Go find one. Huge corporations like Disney got copyrights extended to 120 YEARS after corporate creation. How many billions of Mickey dolls and stuff worth TRILLIONS of dollars will they rake in over generations?

Go to Disney and tell them to drop a few million on a movie that they'll only be able to sell for 17 years and see how quick they are to invest a penny in it.

So the industry spends x amount of money (whatever high or low number you want to assign) to find a drug. Gets at most 17 years. In the interim has to deal with the now prevalent at risk launches and lawsuits that come with and then hand over their product to a generic company that makes profit off no work.

Back to the Disney topic- think I could make a fortune selling Mickey merchandise that I pay some factory in China to make and then sell them here for half the price of the Disney stuff. Hell yeah! Heck- You could sell it for 20% of the Disney price and make a fortune. Think Disney's gonna sit back and watch you steal their cash cow?

The point is there are lots of reasons why drugs are expensive. Some of them legit, some not so much. But pharmas not the only one culpable and shouldn't be held to a higher standard than everyone else. Want to get cheaper drugs from Canada? Fine. Sign here that says you will only be able to sue by Canadian rules. Can't have your cake and eat it too.

Should iv pumps be 5 grand? Should Docs make 300k? Should a specialist make 700k? Should a 10 minute consult be billed to insurance at a couple hundred bucks?

Finally -- finally -- a thoughtful response.

I saw Michael Moore's movie because a idiot date wanted to see it. I thought it sucked, but there was a point in the movie that Moore didn't even make that your post raises:

In the movie was a man who cut his finger off with a table saw and it cost $60,000 to sew it back on. Moore was on about the insurance companies, and he made a BS point. What struck me is WHY THE FUCK DOES IT COST $60,000 TO SEW A FINGER BACK ON? (A corollary point is why does society have to sew every dumbass' finger on if he cuts it off?)

But think about it: A doctor and staff in a hospital room work for maybe 4 hours and "poof" we've spent $60,000.00

Here's why -- it's one of the reasons why pharmaceuticals are so high: The guy holding his severed finger in his good hand is in no position to shop. They've got him. If the guy was spending $60,000.00 on a car he'd spend some time and get the most bang for his buck.

Oh and that's just one of the things I could list that you don't get to sell for 17 years because they don't last -- cars. Also computers, refrigerators, airplanes, practically everything is reinvented in that amount of time (your Disney copyright example is an exception, not the rule) Cause we understand refrigerators and airplanes. NOT pharmaceuticals. Ask the doctors doing the research and they'll claim to be in the know, and then dig into virtually any package insert and you'll find the phrase "the precise mechanism of action is unknown."

Oh but drugs cost so much here because of R & D. Right. Drugs cost so much here because there is no free market competative pressure to bring costs down and innovation up.

 

[Anonymous]

Seriously, get off your high horse. Is there innovation in pharma? Not much right now. No big surprise there. Look around and see how few reps there are and you'll see that there isn't much to sell. Has there been innovation in pharma? Yep. Has it saved lives. Yep. Statins. PPI's. ACE inhibitors. etc etc etc.

Prices too high? Probably. But find me another industry where you come up with something- by chance or by design- and you get less than 17 years to sell it. Go find one. Huge corporations like Disney got copyrights extended to 120 YEARS after corporate creation. How many billions of Mickey dolls and stuff worth TRILLIONS of dollars will they rake in over generations?

Go to Disney and tell them to drop a few million on a movie that they'll only be able to sell for 17 years and see how quick they are to invest a penny in it.

So the industry spends x amount of money (whatever high or low number you want to assign) to find a drug. Gets at most 17 years. In the interim has to deal with the now prevalent at risk launches and lawsuits that come with and then hand over their product to a generic company that makes profit off no work.

Back to the Disney topic- think I could make a fortune selling Mickey merchandise that I pay some factory in China to make and then sell them here for half the price of the Disney stuff. Hell yeah! Heck- You could sell it for 20% of the Disney price and make a fortune. Think Disney's gonna sit back and watch you steal their cash cow?

The point is there are lots of reasons why drugs are expensive. Some of them legit, some not so much. But pharmas not the only one culpable and shouldn't be held to a higher standard than everyone else. Want to get cheaper drugs from Canada? Fine. Sign here that says you will only be able to sue by Canadian rules. Can't have your cake and eat it too.

Should iv pumps be 5 grand? Should Docs make 300k? Should a specialist make 700k? Should a 10 minute consult be billed to insurance at a couple hundred bucks?

At your next performance review meeting, try that approach. Tell your manager to get off of his high horse. Should my sales by higher? Probably. But remember back in 2005 when I made President's Club?

There are lots of reasons why my sales are down. It's not my fault! Now pay me a really big bonus and STFU!

 

[Anonymous]

Ask the doctors doing the research and they'll claim to be in the know, and then dig into virtually any package insert and you'll find the phrase "the precise mechanism of action is unknown."

Oh but drugs cost so much here because of R & D. Right. Drugs cost so much here because there is no free market competative pressure to bring costs down and innovation up.

Go back to the suggestion of reading about oligopolies. It is the high cost of entering the market that keeps competition out. You are so blinded by your own conspiracies you can not or will not see the obvious. Grow up and get an education. Dude, you were schooled 50 post ago. What the researchers think they know and what the FDA allows in a PI is governed by law. If you knew anything about pharmacokinetics, pharmacodynamics, or pharmacoeconomics, you wouldn't sound so stupid.

But you do sound stupid!

 

[Anonymous]

Go back to the suggestion of reading about oligopolies. It is the high cost of entering the market that keeps competition out. You are so blinded by your own conspiracies you can not or will not see the obvious. Grow up and get an education. Dude, you were schooled 50 post ago. What the researchers think they know and what the FDA allows in a PI is governed by law. If you knew anything about pharmacokinetics, pharmacodynamics, or pharmacoeconomics, you wouldn't sound so stupid.

But you do sound stupid!

Click on the "company boards" link at the top of the page and you'll see lots and lots of pharma cos., all able and willing to compete on products in most categories. But they are not allowed to because the government issues patents and other forms of protection. There are plenty more companies who can compete than those listed here: the reason you cite is WRONG.

"Schooled?" Did you pick that one up on South Park? And you're telling me to grow up...

 

[Anonymous]

Click on the "company boards" link at the top of the page and you'll see ,lots and lots of pharma cos., all able and willing to compete on products in most categories. But they are not allowed to because the government issues patents and other forms of protection. There are plenty more companies who can compete than those listed here: the reason you cite is WRONG.

"Schooled?" Did you pick that one up on South Park? And you're telling me to grow up...

OMG did you really just say that??????? So it is the governments fault?????? for issuing patents?????? Dude, bawhahahahah. Please, please keep posting, your are providing entertainment for thousands and thousands of people that read these boards.

 

[Anonymous]

The reasons that drugs cost more in the US than anywhere else is becausethe US doesnt have price controls. Every other country's government has told the companies what you can charge for it. It's just like any other business, each step in the ladder takes a 50% margin.

 

[Anonymous]

OMG did you really just say that??????? So it is the governments fault?????? for issuing patents?????? Dude, bawhahahahah. Please, please keep posting, your are providing entertainment for thousands and thousands of people that read these boards.

Maybe if you were one of the people who read the board you could say that.

Go back up the string, we've covered this. The reason prices are high is because the government is 1/2 way in. If it got all the way in and controlled prices, that would help, but the best way to bring prices down would be for the government to stop requiring prescriptions for brands of products, rather the Dr. could Rx a class of product and the same person using it could buy it, with his or her own money.

Or, the government could eliminate the prescription requirement altogether and let people buy drugs the same way they buy everything else -- in the free market.


I'm glad you bumped the string up for me, though...

 

[Anonymous]

The reason this scheme would work to drive prices down is that the drug companies would have no option other than to finally compete with each other on price to the consumer. The prices wouldn't be buffered through an insurance plan, and if the Dr. wrote an Rx for a class of product, the consumer would opt for the most cost effective one for his money.

The reason this scheme would be safe if that pharmacists are already educated to be more than pill counters. Also, the FDA approves the safety of each product before it hits the shelves.


We're not doing this already because the Rx companies don't want to compete on price, like every other company in a free market. And the drug companies have enormous political (legislative) influence.

 

[Anonymous]

Maybe if you were one of the people who read the board you could say that.

Go back up the string, we've covered this. The reason prices are high is because the government is 1/2 way in. If it got all the way in and controlled prices, that would help, but the best way to bring prices down would be for the government to stop requiring prescriptions for brands of products, rather the Dr. could Rx a class of product and the same person using it could buy it, with his or her own money.

Or, the government could eliminate the prescription requirement altogether and let people buy drugs the same way they buy everything else -- in the free market.


I'm glad you bumped the string up for me, though...

You are one major league fuckwit.

So a Dr writes a script that says - blood pressure lowering medicine - or ACE inhibitor - and the patient takes it to a pharmacy - or better still a government supply store, or maybe a library? And the dispenser says " we have a nice little cheapy going here you can take?"

You have no idea about healthcare at all. You're probably a call service guy at an insurance company and figure that all the drugs look the same, are the same, and have the same reaction in every patient. Who seemingly are all the same.

Or your better plan is patient can just go and pick their own treatments out? They can do that now. They can stay away from Drs, and head out to the pharmacy or vitamin store, of the witch in the wood.

You are just an uneducated muffin top.

Just get away.

 

[Anonymous]

You are one major league fuckwit.

So a Dr writes a script that says - blood pressure lowering medicine - or ACE inhibitor - and the patient takes it to a pharmacy - or better still a government supply store, or maybe a library? And the dispenser says " we have a nice little cheapy going here you can take?"

You have no idea about healthcare at all. You're probably a call service guy at an insurance company and figure that all the drugs look the same, are the same, and have the same reaction in every patient. Who seemingly are all the same.

Or your better plan is patient can just go and pick their own treatments out? They can do that now. They can stay away from Drs, and head out to the pharmacy or vitamin store, of the witch in the wood.

You are just an uneducated muffin top.

Just get away.

I would not even give him that much credit. He knows absolutely nothing about business, government, FDA, research, pharmacology, health care, nothing about anything. Very sad really, that he/she/it has access to technology and is not smart enough to know how to use it.

 

[Anonymous]

You are one major league fuckwit.

So a Dr writes a script that says - blood pressure lowering medicine - or ACE inhibitor - and the patient takes it to a pharmacy - or better still a government supply store, or maybe a library? And the dispenser says " we have a nice little cheapy going here you can take?"

You have no idea about healthcare at all. You're probably a call service guy at an insurance company and figure that all the drugs look the same, are the same, and have the same reaction in every patient. Who seemingly are all the same.

Or your better plan is patient can just go and pick their own treatments out? They can do that now. They can stay away from Drs, and head out to the pharmacy or vitamin store, of the witch in the wood.

You are just an uneducated muffin top.

Just get away.

Plenty of personal crap (another sign you are losing the argument), but addressing the things that matter that you wrote about:

1) If a doctor writes a "PPI" the patient could pick and pay for, with his own money, Protonix, Nexium, or Aciphex, at a pharmacy, dispensed by a pharmacist like they do today. He wouldn't need a doctor for Prilosec OTC. A doctor wouldn't Rx "blood pressure lowering medicine." He would be the doctor and Rx "Calcium Channel Blocker", "Beta Blocker", or "ACE Inhibitor", etc., specifying anything particular about the class that needs specifying, and go from there. Possibly a call back when the product is selected for the proper dose. The same scheme would work for antibiotics, where he could Rx a "Macrolide," etc. and the patient makes the selection.

We all know that there's very little difference between Nexium, Prilosec, and Protinix. Hell they are all engineered versions of Prilosec anyway. There are drug classes with true differences in the products but the doctors and pharmacists could handle this change safely.

2) As to your point that the patient can stay away from the doctor all together, BULL! Today if he wants or needs an Rx product, he must have a note from his doctor to get it -- that's part of the problem. You can't buy it like you buy other things, and someone else decides what to get, and a third entity pays the bill. You call that a free market? Plus the buyer's health depends on it. He's not free to do without, so the drug industry has him, he's not a free agent in a free market at all.


Sorry this idea is so difficult for you to grasp. I think the idea could be made as safe as the current system -- even more so since it's the guy taking the product is deciding what to buy, and it would be an effective way to introduce price competition into the pharma marketplace. You guys don't talk about price on your calls, do you? Is that a common free market practice, for the salesman not to discuss price?

I wonder if what the insurance industry would think of this? I wonder how the direct ads on TV would change?

 

[Anonymous]

It would work for statins too. The reps could give the doctors a little chart showing the % reductions in LDL, the doctor could use that to explain the target numbers and what the products offer, write the script for a "statin," and let the patient decide which one to purchase. Crestor should command a price premium because it's better, right?

Well, in a free market the market decides if that's right. If the patient doesn't want to pay X dollars more than Lipitor for Crestor, he can buy Lipitor. Put the power where it belongs in a free market -- the buyer. If AZ wants to sell more Crestor, they can lower the price.


There are plenty of other medication classes that this would work for, including pain meds. You'd need a script to access the hard core meds, but there are plenty of them, and the patient could pick and choose from the available ones with price as a major part of the decision. You might end up buying aspirin and decide to live with a little pain.

The proposed reform would knock tens of billions of dollars off of our nation's health care tab. It would probably get the pharma companies off of their asses and stop them from submitting NDAs for products like Seroquel XR. Maybe they'd even come up with something new.

 

[Anonymous]

This should be fun.

 

[Anonymous]

There are plenty of other medication classes that this would work for, including pain meds. You'd need a script to access the hard core meds, but there are plenty of them, and the patient could pick and choose from the available ones with price as a major part of the decision. You might end up buying aspirin and decide to live with a little pain.

Man, where are you livin'? Utopia. Doctors prescribe a lot of pain medications and many of them are controlled substances. The PATIENT decides to go on aspirin? Do you understand WHY patients are on Rx drugs? You would have the patients prescribing for themselves and making the choices. Drugs ARE different, that's why we have physicians. Aspirin for example works great for me, probably better than most pain meds, but I would need to take a PPI everytime I took it and then some. In fact I ended up on a PPI for that very reason. Say my prescriber gives me the choice of nsaids and I take aspirin and end up with a bleeding ulcer. My attorney would love that.

Leave the post alone and get back to the original question, Brilinta.

 

[Anonymous]

Plenty of personal crap (another sign you are losing the argument), but addressing the things that matter that you wrote about:

1) If a doctor writes a "PPI" the patient could pick and pay for, with his own money, Protonix, Nexium, or Aciphex, at a pharmacy, dispensed by a pharmacist like they do today. He wouldn't need a doctor for Prilosec OTC. A doctor wouldn't Rx "blood pressure lowering medicine." He would be the doctor and Rx "Calcium Channel Blocker", "Beta Blocker", or "ACE Inhibitor", etc., specifying anything particular about the class that needs specifying, and go from there. Possibly a call back when the product is selected for the proper dose. The same scheme would work for antibiotics, where he could Rx a "Macrolide," etc. and the patient makes the selection.

We all know that there's very little difference between Nexium, Prilosec, and Protinix. Hell they are all engineered versions of Prilosec anyway. There are drug classes with true differences in the products but the doctors and pharmacists could handle this change safely.

2) As to your point that the patient can stay away from the doctor all together, BULL! Today if he wants or needs an Rx product, he must have a note from his doctor to get it -- that's part of the problem. You can't buy it like you buy other things, and someone else decides what to get, and a third entity pays the bill. You call that a free market? Plus the buyer's health depends on it. He's not free to do without, so the drug industry has him, he's not a free agent in a free market at all.


Sorry this idea is so difficult for you to grasp. I think the idea could be made as safe as the current system -- even more so since it's the guy taking the product is deciding what to buy, and it would be an effective way to introduce price competition into the pharma marketplace. You guys don't talk about price on your calls, do you? Is that a common free market practice, for the salesman not to discuss price?

I wonder if what the insurance industry would think of this? I wonder how the direct ads on TV would change?

I actually thinnk you are an idiot.

 

[Anonymous]

Likewise.

However I am able to present my ideas, you have none. All you've got is a bash of the poster. You remind me of the Iraqi Information Minister during the Operation Desert Storm. A lot of trash talk, but nothing to back it up.

 

[Anonymous]

Man, where are you livin'? Utopia. Doctors prescribe a lot of pain medications and many of them are controlled substances. The PATIENT decides to go on aspirin? Do you understand WHY patients are on Rx drugs? You would have the patients prescribing for themselves and making the choices. Drugs ARE different, that's why we have physicians. Aspirin for example works great for me, probably better than most pain meds, but I would need to take a PPI everytime I took it and then some. In fact I ended up on a PPI for that very reason. Say my prescriber gives me the choice of nsaids and I take aspirin and end up with a bleeding ulcer. My attorney would love that.

Leave the post alone and get back to the original question, Brilinta.

Plenty of people in the world still think the USA is a Utopia. The thing that made us great is the same thing that could bring us down -- economic strength. We got our economic strength from free market capitalism. I'd like to see it at work in the pharmaceutical arena, and have presented a viable, safe and effective way to do just that.

I'm composing a letter to our President and my State Senators with the idea and will mail it this week. (I'm so ashamed!)

 

[Anonymous]

Man, where are you livin'? Utopia. Doctors prescribe a lot of pain medications and many of them are controlled substances. The PATIENT decides to go on aspirin? Do you understand WHY patients are on Rx drugs? You would have the patients prescribing for themselves and making the choices. Drugs ARE different, that's why we have physicians. Aspirin for example works great for me, probably better than most pain meds, but I would need to take a PPI everytime I took it and then some. In fact I ended up on a PPI for that very reason. Say my prescriber gives me the choice of nsaids and I take aspirin and end up with a bleeding ulcer. My attorney would love that.

Leave the post alone and get back to the original question, Brilinta.

Who's living in Utopia, anyway? A big part of the WHY patients are on Rx drugs is that THEY'RE PRACTICALLY FREE. If the patients had to actually PAY FOR medicines, a lot less of them would be used. Of course.

 

[Anonymous]

Say my prescriber gives me the choice of nsaids and I take aspirin and end up with a bleeding ulcer. My attorney would love that.

Say somebody sells you a gun and you go and shoot yourself in the foot with it. How'd your attorney like that?