On 4 Jul 2004 09:46:45 -0700, (Dan Caster) wrote:
There does not seem to be any good solution. If the U.S. regulated
drug prices there would be less incentive to develop new drugs. And I
am sure no one would like to see all the drug developed in the last
twenty years say disappear.

Government price controls are probably not desirable. Opening up
the market to free competition, however, probably is a good idea. It
tends to work in other industries.

On the other hand the U.S. should not be the only developed country
that supports the development of new drugs. The Big Pharma companies
aren't stupid so there must be a good reason for the big expense on
marketing. Maybe what is needed is regulation on how the marketing is
done. No advertising to the public of drugs that require a
prescription?????????? No " hiring of doctors as consultants ".

Again, trampling on the companies' free commercial speech rights is
probably a bad idea. No one else seems to be informing the consumer
about what drugs are available, and what they do. Advertising does
serve the positive function of educating the consumer. But perhaps
all drug advertising could be required to prominently list the price per
dose. This would foster the sort of price competition which would drive
down consumer prices.

Not sure what else would be required to get the drug companies to cut
back on marketing and still work on new drugs.

A free competitive market has always spurred innovation.

I would be for letting the drug companies account for foreign sales
separately for third world countries, but not for countries as Canada,
Germany, France etc.
But how does one draw that line? Should it be a hard line or a
sliding scale.
Germany is different from France, France is different from Poland,
Poland is different from Kenya?

Now you're getting into the area of tax policy and government induced
income redistribution. I'd prefer to abolish the corporate income tax,
so such accounting dodges are unnecessary in the first place. The
drug companies would then do what any other free market company
would do, charge what any particular free and open market was willing
to bear.

I would like to pay less for drugs, but I also want drugs developed
for Alzheimers, Parkinsons, etc. If I get Alzheimers, I don't care
how much the drug costs, I want one that works.

The notion that there is, or ought to be, a pill for every ill basically
arose in the 1950s. But it isn't necessarily true. Drugs aren't the
answer to every medical problem. Many of the drugs currently on
the market wouldn't be there if good information about their cost
effectiveness, or lack of same, were widely available to the consumer.
Many drugs are only marginally effective, and often have side effects
worse than what they are touted to fix.

As concrete example, the statins that Gunner is trying to find cheaper
are now understood to be less effective, and more risky, than was previously
believed. The whole field of hormone replacement therapy has come into
question. Allergy drugs with life threatening side effects have become
popular, despite the fact that sneezing is rarely fatal. Recreational drugs
like Viagra are wildly popular, even though there are risks associated with
them, and many people don't actually need them. Etc.

But the "I don't care how much the drug costs, I want one that works"
attitude of the public is a prime reason why drugs cost so much. Desperate
people will accept any sort of gouging out of fear. The drug companies
exploit those fears. Doctors are *supposed* to be dispassionate third
parties who mitigate that exploitation. But in recent years, many doctors
have become defacto co-conspirators with the drug company marketing
people, to push dubious drugs on the public.

Reminds me of the story of the two dudes on a camping trip. One gets
bitten on the butt by a rattler. The other calls the doctor on his cell to
find out what to do. The bitten one asks, "What'd he say?" His friend
says, "He said you're going to die, Roy." Sometimes the cure is more
costly than society is willing to pay.

Gary