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  #231  
Old 05-30-2018, 11:46 AM
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twig93 twig93 is offline
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How many more do we need?
Well at the rate that viruses are mutating and becoming resistant to antibiotics, it's pretty important that we are continually developing new ones to replace the ones that no longer work.

And there are literally thousands of maladies which have no cure, or no treatment, or the only treatments either don't work all that well and/or have significant negative side effects. I couldn't possibly list them all. But there's always improvements to be made.

And then there's development of new vaccines. I hear there's work being done on a universal influenza vaccine, for example. If developed and safe & effective, that has the potential to save millions of lives.

The 1919 influenza pandemic resulted in roughly 40 million deaths worldwide against a population of roughly 1.8 billion... over 2% of the global population perished and 20% were infected.

Apply that to today's population and a similar pandemic would kill roughly 170 million people in one year and infect 1.5 billion.
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  #232  
Old 05-30-2018, 12:45 PM
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George Frankly George Frankly is offline
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Just lower the time frame on patents for drugs. 20 years is far too long.
One other approach would be to limit payment based on outcomes. You have a drug that cures cancer? Sure, we'll pay for that. You have a drug that improves overall survival by 30 days compared to other treatments? Sure, we'll pay you a bit more for that, but we aren't paying you $10k/month for that drug.

The CAR-T cell manufacturers are actually doing this. If the drug doesn't work, then they fully refund the cost. You (or your insurance company) would still be on the hook for costs associated with the treatment, but it's a pretty novel pricing model. Now, these drugs are $500k, so if they refund 20% of pts... it's still a high PMPM cost on average.

But this is a political mine field. CMS currently cannot negotiate drug prices, would require congress to act on something like this. And a lot of these drugs are released with fairly limited data, so it might take time to accrue credible data to set pricing. And I'm sure however the rubric is built to set prices, it would be imperfect. So it's my pipe dream, but it's not gonna happen anytime soon.
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