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I am talking about the engine of survival, the thing that explains so much of why so many of us are alive today, and the thing that will keep you alive in the future.
This is also the thing that might eventually bring you immortality.
Destroy it, and we all lose.
Attacking pharmaceutical returns right now is also a form of redistribution of future returns to a state enemy, China.
The West should not forfeit the future to China.
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Crémieux
@cremieuxrecueil
Really great, really alarming piece, that shows us why China is going to beat America in pharma if reform doesn't happen *now*.
China reformed its trial procedures and now they have as many clinical trials as America, and they're bigger.
They'll be ahead in pharma very shortly. x.com/AsimovPress/st…
If your innovation model requires what amounts to rent extraction from US healthcare consumers to (barely) function, then perhaps it's time to reconsider the model? Regulations are 10x as onerous as they have to be with corresponding effects on clinical trial costs, etc.
Might some of this be due to more R&D moving into VC-funded private startups, later to be acquired by big pharma?
That’s Big Pharma, yes? They are notoriously bad at R&D - which is reason they buy external products. And even in external products we’ve clearly had too much $ chasing either too few ideas or too few competent managers. There are an immense amount of bio-trash or zombie biotech
Preaching to the choir, but MFN is a perfect example of the Political Monkey’s Paw: cheaper drugs today offered as burnt sacrifice for tomorrow’s cures that now won’t exist. We’re trading future lives for fleeting savings.
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Alex Kesin
@alexkesin
My 2¢: MFN turns drug pricing into a global game of chicken. Pharma holds back in cheap markets, HTA bodies don’t blink, and the U.S. pegs its price to the silence.
But the irony’s brutal: it kills the very drugs that might’ve saved the system—the next Lipitor, the next Ozempic, x.com/alexkesin/stat…
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There are so many issues causing this
1. Poor execution
2. Crowding of targets = lower returns given multiple similar agents approved
3. The "easy" targets found already
4. Rare disease = even if approved lower TAM
5. European Economic Statecraft
6. Illicit manufacturing
I know there are problems with Trump upcoming pharma EO but this seems like a great space to "shake the box" so to speak
We need to reduce the costs of bringing drugs to market, not insist US consumers bear artificially inflated R&D costs for the world.
Name a significant drug besides Viagra then that has been discovered by a private Rx corporation.
NIH and public labs take on the high-risk, early discovery. Pharma steps in after a path is clear, patents it, and charges thousands. This isn’t just “basic research” - it’s the
I’m sorry but I don’t know why I should personally pay an order of magnitude more than citizens of other countries for the same drug. What in your chart explains why I should?
I recently read that GLP-1s have been known for having weight loss properties for maybe decades now but pharma decided not to even bother trying to bring them to market *in the rest of the world* until the US FDA signaled willingness to approve one in the late 2010s.
Like a
Progress has stalled a lot anyway due to misalignment of incentives in academic circles where money was doled out based on social agenda instead of scientific merit.
We need a reset. Consolidation may need to occur for that to happen in a healthy way. I certainly don’t cheer on
The cost of capital currently is jacked up due to the costs of monetizing drugs and the return is jacked down because the market clearing price excludes most customers.
Buy patents under eminent domain and suddenly both problems go away. R&D explosion. We can just buy winners.
This is why we do what we do at to develop a new pathway for biotech R&D to commercialise
What surprises me is when people think this is "risky", when the traditional way looses them money with certainty.
Insane the mental gymnastics you gotta do to support people in crippling medical debt having to subsidize R&D which has proven to be unable to function or be efficient by your own graph even with current funding
I don't think it's obvious that Trump's actions will cause profitability/returns to fall. This action doesn't force the drug companies to cut our prices, but will force them to rather raise prices on the lowest payers. Equilibrium will be found somewhere in the profitable middle.
They can always stop spending almost half of their money on political operatives. It will help them a lot.
Another field US ceding to China ..
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DoctorDueDiligence
@DueDoctor
Replying to @JDVance
If you care about American Dominance in Biotech, which China is rapidly pursuing x.com/duedoctor/stat…
interesting. how do we square this with the obvious truth that US citizens should not disproportionately bear the cost of pharma R&D while the rest of the world widely coasts on the benefits?
I have a small investment in a medical device company. Despite successful trials, they could not raise any more funding.
Good riddance to bad rubbish
Until they have market incentives to create safe products (i.e. no liability immunity) they will continue making harmful products
It seems like we could target other massive corrupt inefficiencies in the system to get similar gains with fewer negatives, much like deregulation at scale could fix a good % of what tariffs are trying to address. PBMs for one.
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Mark Cuban
@mcuban
If you are a CEO of a self insured companies and you want to know what the problem with pricing on medications do this:
Call your PBM and ask for
1. A list of all your pharmacy claims the last month and the net price for each
2. A price list of all net prices
3. Why a drug that
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Then why aren't wide scale, high variable, whole genome, medical gwas' sponsored by governments?
This data gathering has an incredible amount of value-add for both drug design, identifying drug targets, and to develop diagnostic tools.
The United States functions as the primary source of pharmaceutical innovation precisely because it permits firms to recoup the immense costs of research and development. The global pharmaceutical market depends disproportionately on revenues generated in the U.S. to sustain
So we just keep subsidizing 50% of studies for the rest of the world, customers pay ten times more, while incomes continue to fail to compete with housing costs or even come close and we need to make an additional 70% more, and no security in the supply chain for our medicine?
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This is a false premise.
The pharma companies arent doing genetic research, ai research etc are they?
Did pharma companies invent mris, ct scans, and related tech?
It could very likely be that drugs are just NOT THE ANSWER and never were.
Its common sense biologically that any
NSF, NIH & DOD fund university research. Papers get published. PhDs are granted. Treatments are proposed. Knowledge is privatized. Companies are formed. Trials are conducted. Drugs are patented. Fortunes are made. Look up Cox-2 Enzymes & Vioxx.
Great, so the rest of the world should pay the same prices for the same drugs as the US does. We're in agreement.
So, that’s why we had Covid and the lockdowns, so they could try to break even on their portfolio
I agree. It’s imperative that we get the socialized medicine nations to pay vastly more for cutting edge drugs.
You don’t think AI will pickup the slack? Especially when partnered with quantum computing within the next decade?
In my lifetime Big Pharma hasn’t cured a damn thing.
Just a flood of garbage pills.
Lifespans are falling.
We’ve never spent more for less.
So much for this wonderful progress.
Do you think the price matching in the US will lower returns? Like surely that will mean drug makers won't offer cheap prices anywhere right?
Shows what a risky venture discovering new drugs can be. It’s not like you go just dip the sh*t out of a creek. Research, trials & studies, safety data collected, FDA compliances to meet, if you finally get a drug approved & to market, most research drugs don’t, you have about
False. Look at their advertising and lobbying spend. It’s way more than R&D. They have plenty of money for
It if they elect to do so.
Hopefully isomorphic labs can drastically reduce the cost of drug discovery
When most drugs seem to have more side effects than benefits, maybe they'll focus on designing more effective drugs
They could make R&D cheaper by cutting back on requirements to get drugs approved.
But that would have its own political problems.
Perhaps they should put some of those record breaking profits they had back into the r&d. Or put some of that lobbying budget in.
Progress? Like what?
The COVID Death Shot?
The Autism SIDS Shots?
The Trans Puberty Blockers?
The SSRI Mass Shooter drugs?
Name ONE THING Big Pharma has CURED?
Progress my ass. Profits only.
Good. I’m not very impressed with their progress outside the massive list of side effects and long term health concerns so many of these new discoveries present.
people survived for thousands of years without it, this might be a bit of an exaggeration
Good thing that AI is coming to pharmaceutical R&D, maybe it could help with this.
Take out the excessive waste is the process. Elon’s approach would be to fire half the people. Watch profit rise. Accelerate development. Watch profit rise.
We'll see how well your take ages considering the rise of AI and the advent of quantum computing.
Maybe other countries should be paying more then
The 74% of Americans living paycheck to paycheck can't afford to subsidize drugs for Euro bros and chicks, maybe they should start working 40+ hours/week so they can pay their own way
Just to be clear. You’re on board subsidizing the entire world’s socialized healthcare?
Boohoo I’m tired of europoors and Canadians bragging they get “free healthcare” when I’M THE ONE PAYING FOR IT
Good I hope they go bankrupt. They have been ripping people off for years...
The rest of the world better pay more for their medicine then
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Eli Lilly's profit margin was over 24% last year. How do we reconcile that fact with this data...?
Btw I'm not saying there's anything "wrong" with them earning 24% margin -- it hardly seems like they're going to stop investing.
Because Big Pharma turned into a me-too maker after huge progress on one of the Big 3 (cardiovascular). Lots of failure in dementia and cancer.
Meanwhile lots of progress on orphan drugs.
Wouldn't it be a more stable equilibrium to just lower the costs of development via less onerous regulation?
Or we could change how it's funded. We're trying to shove an exclusionary, rivalrous good model onto a largely non-rivalrous product (knowledge)
First they raised interest rates. Then Trump cut funding for NIH and NSF. Then Trump attacked the universities. Now Trump is fucking with the funding model of Biotech research. There will be a brief hiatus in biotech funding, once conditions improve, off to the races.
Trump is simultaneous damaging BOTH academic and industry biomed research.
What's their advertising budget? Probably less than their R&D budget.
If I had a bad case of CovidAIDS I wouldn't need a mixed race same sex couple on CNN living their best lives possible as a way to convince me into buying the antidote.
Yes, all of that pharmaceutical R&D has really been paying off. Not sure for who.
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Science Is Strategic
@scienceisstrat1
In 2021, life expectancy in the US fell to 76.1 years — a figure that hasn’t been seen since 1996.
The issue is that people demand new drugs, but also expect them to be 100% safe, so now it costs decades and billions of dollars to develop. Listen, I want safe medications, too, but I'm not going blame pharma if something comes up 10 years down the line they weren't aware of.
You're using terms that indicate you have some technical knowledge here. You should know that the truly innovative R&D is extremely small. Most of it goes to repackaging existing stuff into new stuff so they can keep the patent protection.
Isn’t ‘biomedical progress’ just a euphemism for a transhumanist project to engineer the human animal into an asexual species of self-replicating gender goblins?
how does Trump's pharmaceutical policy impact your vision of the bio/acc movement?
Counterpoint, AI (more DeepMind, not LLMs) will drastically lessen the cost of drug trials but basically eliminating phase I due to rapid massive scale simulation. Hopefully growing the success rate of expensive Phase II and III trials
Dang, sounds like the rest of the modern world should help shoulder the cost besides Americans then
So, they need to charge more to everyone to cover the extra expense for proof of efficacy for each disease they claim.
Why should that cost be borne ONLY by the U.S. market?
Great points they have the option of extracting all the rent they need from the rest of the world to make up for the US shortfalls. Clearly if it’s worthwhile to pay those prices those markets can bear a fraction of that. If the value is there the prices will meet it
Its been hurt by DEI worse than most fields. The field of biology is absolutely flooded with women and jeets and they are not competent. Even the notorious video of people comparing their IQs had a white marine IQ moging the vaccine researchers.
Also as if you can’t rely on the private sector to consistently devote resources to areas that aren’t immediately profitable
Let the Global South do medical research instead. They can do it cheaper, because they have fewer ethical scruples.
This is due to the strategy of abandoning its own R&D and betting on billion-dollar acquisitions of small R&D institutes.
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Exactly. I don't understand how they can always pick the literal worst way to approach every single problem.
It's just unrelenting incompetence that even a modicum of common sense would cure.
But even that is too much to ask.
Get fucked. China has already taken the lead on this, for the better of all mankind. Cheap drugs and cheap treatments are coming to all. If American companies can’t survive, it’s their own fault.
As if they are interested in developing cures.
Their focus lies completely in treating symptoms and getting lifetime subscribers hooked on their drugs.
Well, since the only time they seem to be making money is when they are scamming or poisoning humanity, I say let em all go broke. It’s the most vile and corrupt industry on the planet after politics, imho
Too bad Trump and Elon are destroying all scientific research funded by the government, from which many of the pharmaceutical breakthroughs actually come.
Hardly - you are forgetting the billions in profit each year. So now going forward it will only be billion or three in profit. Boo-hoo. They've been raping us for years with their prices.
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Derya Unutmaz, MD
@DeryaTR_
The claim that drug development must cost over a billion dollars is totally indefensible. With AI now able to streamline everything from target discovery to clinical trials we should already be seeing at least a 10x cost reduction & a 100x reduction within 5-10 years. So yes, do x.com/eperlste/statu…
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Copyright is authors life plus 70 years.
IP protection for drugs is 20 years from first disclosure.
20 years might have been OK before the FDA made everything in the development cycle slow.
These guy have a permanent bid from gov, not just for drugs but all through the R and d pipeline. They are bloated beasts. Need massive cuts.
Health care is close to 20 percent of gdp. Grossly over what it should be. Used to be 5 per cent of gdp. Too much government
Other treatments are gaining traction for health, like eating real food.
Maybe we don't need more drugs.
What I told you, "I'll give you a miracle drug that will reduce death in the USA by 50% and raises life expectancy by 5 years. But in return you have to stop all drug research for 10 years."
Would you do it?
What if that drug is exercise?
correct. populist morons don’t understand that big pharma is a massive good and that paying high prices accelerates innovation
what I don't understand is why this should be exclusively the problem of the United States taxpayer.
It’s nice to have fancy drugs and everything, but there’s simply no way to logically get over the hump of why drug X is a fraction of the price in Y country compared to the USA. US consumers being perpetual paypigs isn’t sustainable. Reforms must happen.
How did we make medical advances before commercializing them? Magic?
Let’s spread the pain around the world then and not just dump the costs on US consumers.
