High Price of CAR-T Tx

Article today discusses costs of CAR-T therapies of both Novartis and KITE prior to the FDA approval decision scheduled for Oct 3. While the cost issues have already been discussed here, now the popular press is spotlighting both the cost and complexity of such therapies.
http://www.msn.com/en-us/health/medical/breakthrough-cancer-…

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I despise the prices charged for most branded drugs in the US, but…

If this CAR-T therapy is as revolutionary as many believe that it is, then I would allow the pioneering companies to charge the exorbitant costs in hopes that it will direct the efforts of other pharma competitors towards improving upon CAR-T therapy, and driving down cost over the long run. Assuming someone made me the benevolent despot making these decisions of course. :slight_smile:

Exorbitant drug costs are a problem - but I’d much rather see those charges for revolutionary therapies than some drug that has been on the market since 2001 and has 5 other substitutes available. Just my opinion.

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<<<Exorbitant drug costs are a problem - but I’d much rather see those charges for revolutionary therapies than some drug that has been on the market since 2001 and has 5 other substitutes available. Just my opinion.>>>

Are they a problem? This drug could not have been developed without the prospect of charging this much for it. It is not a problem, but a reality of what it takes to direct risk capital to invent and bring to market such a drug.

Language is such a powerful thing, it informs and creates our reality. Here you have the choice, either no such drug is ever invented because the cost is too prohibitive,or the market is willing to pay a price commensurate with the capital being invested, the risk involved, and the awful cost that it takes to bring such a drug to market.

Tinker

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Tufts Center for the Study of Drug Development-2014 study

Ratio of FDA approved drugs to researched drugs-approximately 1 in 7500 (This must include even the very early stage test tube stuff)

Total cost in 2013 dollars to bring drug through approval and including required post approval follow ups-$2.6 Bn (includes time value as well as hard dollars spent)

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Most pharma companies spend more on marketing than R&D. They hide behind the cost of R&D rubric whenever they are charged with overpriced drugs. Nowhere in the world do people pay more for medicine than in the US. Drug patents are allowed to expire in other countries while the pharma companies routinely get extensions in the US.

In short, yes generally speaking pharmaceuticals are overpriced in the US and they retain their prices longer in the US than anywhere else.

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In short, yes generally speaking pharmaceuticals are overpriced in the US and they retain their prices longer in the US than anywhere else.

Brittlerock is clearly correct. As an example, Nasonex nasal spray lists for over $150 in the US and the identical bottle sells for about 7 euros (or $8) in France. And they must be making money on selling it in France at $8 per bottle or they wouldn’t do it. I could give you a dozen examples like that.

Saul

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SaulR80683: Brittlerock is clearly correct. As an example, Nasonex nasal spray lists for over $150 in the US and the identical bottle sells for about 7 euros (or $8) in France. And they must be making money on selling it in France at $8 per bottle or they wouldn’t do it. I could give you a dozen examples like that.

Saul (and anyone else), do you have any deeper insight into this?

I have no knowledge of the industry, this is just from conversations during my world travels. My (likely flawed) understanding is that the more socialized medical systems often won’t pay costs sufficient to cover R&D. Yes, I am certain they still make a profit at $8 per bottle. However I would question: profit compared to what costs? Clearly the extra from the USA $150 per bottle is being used somewhere or the finances of those companies would look a lot better than they do today. I have a hard time believing the USA market gives a 95% or better profit margin.

End result (still to my flawed understanding): The USA pays the majority of research costs. The high marketing costs in seem an artifact of this. Not so much marketing the drug itself as marketing the reason R&D costs are being paid for.

This always feels to me like a bit of consumer abuse by those companies. But, end of the day, if those costs are the price for improving medical treatment I really can’t argue too much.

Any insights from a more knowledgeable perspective? All this is still a very murky to me, which is part of the reason why I distrust biopharmaceutical investments.

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I have no knowledge of the industry, this is just from conversations during my world travels. My (likely flawed) understanding is that the more socialized medical systems often won’t pay costs sufficient to cover R&D. Yes, I am certain they still make a profit at $8 per bottle. However I would question: profit compared to what costs? Clearly the extra from the USA $150 per bottle is being used somewhere or the finances of those companies would look a lot better than they do today. I have a hard time believing the USA market gives a 95% or better profit margin.

End result (still to my flawed understanding): The USA pays the majority of research costs. The high marketing costs in seem an artifact of this. Not so much marketing the drug itself as marketing the reason R&D costs are being paid for.

From that perspective, it makes it sound almost as if the U.S. might be subsidizing a great deal of medical R&D for the rest of the world. That would be an interesting subject for someone to delve deeply into. As a mechanical engineer, I am not the person for such a deep dive.

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Unlike America, the USSR was not noted for its pharmaceutical industry. The price of medicines was admirably low however, more or less as low in fact as life expectancy. The Politburo and their families found it convenient to arrange to receive their own medicines, via discreet routes, from…

Ah, you guessed it!

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From that perspective, it makes it sound almost as if the U.S. might be subsidizing a great deal of medical R&D for the rest of the world. That would be an interesting subject for someone to delve deeply into. As a mechanical engineer, I am not the person for such a deep dive.

No doubt. Sure some other places have research but no where else does the research have nearly the payoff. It’s (partly) why the US spends so much on health care without better outcomes. If we kept the research to ourselves the rest of the world would have much worse outcomes.

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