A better story focuses on what appears to be a decline in some kinds of medical innovation — in particular, an absence of expensive new blockbuster drugs, even as existing drugs go off-patent and can be replaced with cheaper generic brands. This is a real phenomenon; it is, in fact, the main reason the Medicare drug program has ended up costing less than originally projected.
Friday, November 29, 2013
Krugman: Drug Innovation Declining
Paul Krugman somehow thinks the decline in drug innovation that is occurring is a good thing:
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"an absence of expensive new blockbuster drugs, even as existing drugs go off-patent and can be replaced with cheaper generic brands"
ReplyDeleteIf non-prescription drugs and the prescription drug varieties were legal to buy and sell without the paternalism of the medical state, drug prices would most assuredly fall over time.
Requiring a prescription makes the drug cheaper because the cost has to be shared with a doctor who writes the prescription. If you want to get rid of the paternalism, then you attack patents, not prescriptions.
DeleteIt is hard to fathom how silly Krugman has become. According to his logic, there never was the need for any new "expensive" name brand drug.
DeleteWhat on earth are you talking about? Please elaborate on how the cost of a drug is shared with a doctor, and provide the relevant CPT codes to document your assertion.
Delete"Requiring a prescription makes the drug cheaper because the cost has to be shared with a doctor who writes the prescription. If you want to get rid of the paternalism, then you attack patents, not prescriptions. "
DeleteLOL!! Any other jokes?
Nothing quite like an intellectual pointing out the presumed benefits from the lack of innovation. Has Krugman thought about the fact that through innovation could also come cost reductions? His thinking is so simplistic here as he points out only the fact that the prescription drug program cost less, so therefore as simple as that, lack of innovation must have provided a benefit in holding costs down, never mind of course that even if the block buster drug is expensive overall costs (which is what matters) could go down if treatment times and side effects were also reduced as a result. I know he's not stupid, so I can only think that he writes such intellectually dishonest crap for the sake of his economically illiterate ideologically bound audience.
ReplyDeleteThere would have been unbelievable progress if the stranglehold of regulation was absent. The need to protect certain interests has hurt all. Maybe we get a break.
ReplyDeleteTop Aussie biologist offers stem cell hope
A WORLD-RENOWNED Australian scientist is optimistic stem cell cures are on the way for some of the most dreadful illnesses.
Several promising clinical trials are taking place, says Professor Alan Trounson, who now heads California's multi-billion dollar stem cell agency.
He believes stem-cell cures for inherited blood disorders and HIV/AIDS are close.
"We are three, four, five years away," said Prof Trounson, who made the opening address to a NSW Stem Cell Network conference via video link on Friday.
A correction or cure for type 1 diabetes was almost certain, he told AAP in a telephone interview.
"Therapies are being trialled that are going to change things."
These included therapies for macular degeneration and there was important progress with some forms of cancer, he said.
"There are going to be big changes in the next five years."
- See more at: http://www.theaustralian.com.au/news/latest-news/top-aussie-biologist-offers-stem-cell-hope/story-fn3dxiwe-1226771514097#sthash.4mKbaYap.dpuf
Krugman's view is also very short-sighted (I guess he's keeping continuity with the rest of his beliefs).
ReplyDeleteThe pharmaceutical industry is going through a transition at the moment. Medicines have traditionally been what are referred to as "small molecules". You make these with a series of chemical reactions, then you make a solid that you can incorporate into a tablet.
Unfortunately, companies are starting to find fewer variations of these small molecules that have therapeutic effect.
Concurrently, there is a huge push for what's referred to as "large molecule" drugs. These tend to be produced through engineered cell cultures (to our eyes, it looks like they're making beer), and a whole new set of unit operations are needed to separate the drug (can be a protein, enzyme, antibody, etc) and prepare it for delivery.
The problem is that the technology for making these is far behind small molecules and still very costly. The driver is that once they get good at making these, there will be plenty of blockbusters in the future.
Some problems that they have now:
1) Most of the products are delivered by injection. Except for only a few compounds (such as insulin), researchers are having a hard time making a solid product from these large molecules. They're getting better at it, though, and a tablet is a hell of a lot easier than an injection.
2) Costs of production: Purifying the correct protein can be extremely difficult, for example. The analytic methods for identifying the product protein aren't there yet, and therefore costly trial and error is often required to isolate the product from a fermentation broth. Keeping cells alive as they create your product can also be difficult. You can have issues such as sparge bubbles ripping their delicate cell membranes apart, or they can clump together and starve.
3) Regulatory: industry always moves more quickly than regulatory. As they develop these drugs, the first companies to succeed will handhold the FDA to establish the guidelines on what needs to happen for a large molecule drug to be approved. This will limit newcomers to the market space.
It's only a matter of time before they bring the costs down and enable all of these different therapies to happen. Patience is the watchword.