US Presidential Candidates

Starsaber wrote:

PeterZ wrote:Daryl,
http://www.fdareview.org/03_drug_development.php
http://www.forbes.com/sites/matthewherper/2012/02/10/the-truly-staggering-cost-of-inventing-new-drugs/

A major part of the cost of drugs are the R&D requirements. It takes 11-14 years to bring a new drug to market. The chart indicates only 8% of compounds are actually approved by the FDA. Yet testing all of them costs money. Who pays for that research if the pharmaceutical company is prohibited from charging for those expenses? The second link gives you some idea of average R&D investment and the number of drugs approved.

If there is no incentive to spend a decade and a half trying to find a new drug with a 92% of failure somewhere along the way, very few researchers would do it. Then if they succeed the company may have exclusivity for less than 10 years. The patent is often granted before clinical or even preclinical trials to prevent others from competing. So a 20 year patent may only provide less that 10 years of exclusive use of an approved drug.

R&D is a valid concern, but they could save money by not advertising so much. Prescription medicine decisions should be up to the doctor, but I can't watch a show without seeing an ad ending with "ask your doctor about..." some prescription drug that's supposed to help with a condition. If your doctor thought that was the right medicine for your situation, they'd already be prescribing it.

Perhaps, but likely not. Research suggests that advertising increases revenue. This is in part a relative measure to other similar drugs, but not totally. Some of the effects of advertising is to increase use in those that may receive only a moderate benefit from the drug. This is will tend to increase revenue and operating margin to pay for the R&D.

Trust me, if advertising did not increase revenue, they wouldn't do it. Notice how chemotherapy drugs are not advertised beyond pamphlets to oncologists. Advertising broadly for those drugs do not raise revenue.

PeterZ wrote:Perhaps, but likely not. Research suggests that advertising increases revenue. This is in part a relative measure to other similar drugs, but not totally. Some of the effects of advertising is to increase use in those that may receive only a moderate benefit from the drug. This is will tend to increase revenue and operating margin to pay for the R&D.

Trust me, if advertising did not increase revenue, they wouldn't do it. Notice how chemotherapy drugs are not advertised beyond pamphlets to oncologists. Advertising broadly for those drugs do not raise revenue.

Of course pharmaceutical advertising is a good thing if your goal is increasing revenue to the drug companies... it is a bad thing if your goal is lowering the cost of care or improving its quality (patients driving their own medication regimens based on a commercial they saw generally isn't an approach that's going to produce the best outcomes).


IMO, it's a net detriment to society every time one of those "ask your doctor about" commercials is played on the air.

gcomeau wrote:

PeterZ wrote:Perhaps, but likely not. Research suggests that advertising increases revenue. This is in part a relative measure to other similar drugs, but not totally. Some of the effects of advertising is to increase use in those that may receive only a moderate benefit from the drug. This is will tend to increase revenue and operating margin to pay for the R&D.

Trust me, if advertising did not increase revenue, they wouldn't do it. Notice how chemotherapy drugs are not advertised beyond pamphlets to oncologists. Advertising broadly for those drugs do not raise revenue.

Of course pharmaceutical advertising is a good thing if your goal is increasing revenue to the drug companies... it is a bad thing if your goal is lowering the cost of care or improving its quality (patients driving their own medication regimens based on a commercial they saw generally isn't an approach that's going to produce the best outcomes).


IMO, it's a net detriment to society every time one of those "ask your doctor about" commercials is played on the air.

It depends on the patient. There seems to be a love/hate relationship with the things in the medical community. On the plus side there are a lot of people that don't tell their Doctor about problems because "it's just a normal part of aging" or "they can't do anything about it anyway". These types of people tend to be more likely to discuss a concern with a Doctor if they see an ad. Doctors can't treat problems they don't know about.

On the negative side doctors waste a LOT of time convincing people that drug X is not for them.

I'm sort of neutral about the advertising, myself.

gcomeau wrote:

PeterZ wrote:Perhaps, but likely not. Research suggests that advertising increases revenue. This is in part a relative measure to other similar drugs, but not totally. Some of the effects of advertising is to increase use in those that may receive only a moderate benefit from the drug. This is will tend to increase revenue and operating margin to pay for the R&D.

Trust me, if advertising did not increase revenue, they wouldn't do it. Notice how chemotherapy drugs are not advertised beyond pamphlets to oncologists. Advertising broadly for those drugs do not raise revenue.

Of course pharmaceutical advertising is a good thing if your goal is increasing revenue to the drug companies... it is a bad thing if your goal is lowering the cost of care or improving its quality (patients driving their own medication regimens based on a commercial they saw generally isn't an approach that's going to produce the best outcomes).


IMO, it's a net detriment to society every time one of those "ask your doctor about" commercials is played on the air.

Not necessarily. Being aware of potential treatments for an issue one has is not a bad thing in itself. If one is not aware that there are treatments for some minor or not so minor ailments, one won't ask one's doctor.

There is a downside to being aware as Biochem mentions. Erring on the side of providing information, even if it is an advertisement is hardly anything nefarious. Asserting that it is assumes that most people have no business making up our own minds about something as critical as our health.

PeterZ wrote:Not necessarily. Being aware of potential treatments for an issue one has is not a bad thing in itself. If one is not aware that there are treatments for some minor or not so minor ailments, one won't ask one's doctor.

There is a downside to being aware as Biochem mentions. Erring on the side of providing information, even if it is an advertisement is hardly anything nefarious. Asserting that it is assumes that most people have no business making up our own minds about something as critical as our health.

That's only if you view the function of said advertising as informative... but those ads are not designed to be educational they're designed to be persuasive. To that end they twist the information they are providing to the greatest extent the regulatory agencies involved will let them get away with. Which can be a lot.

Advertising is, as often as not, an exercise in deception. Which is at odds with the ideal of erring on the side of "providing information".

Information is always good, even when the principal motive for its creation is puffery. Outright deception is illegal and will get a company fined for fraud. The legal term for what advertisers do is puffery. While puffery is framing information to best highlight a product, it still provides information that can help a patient in making a decision.

Would life be better if everyone just gave facts? Sure, but ours is not a perfect world. Since that is true, more information is better than less.

gcomeau wrote:

PeterZ wrote:Not necessarily. Being aware of potential treatments for an issue one has is not a bad thing in itself. If one is not aware that there are treatments for some minor or not so minor ailments, one won't ask one's doctor.

There is a downside to being aware as Biochem mentions. Erring on the side of providing information, even if it is an advertisement is hardly anything nefarious. Asserting that it is assumes that most people have no business making up our own minds about something as critical as our health.

That's only if you view the function of said advertising as informative... but those ads are not designed to be educational they're designed to be persuasive. To that end they twist the information they are providing to the greatest extent the regulatory agencies involved will let them get away with. Which can be a lot.

Advertising is, as often as not, an exercise in deception. Which is at odds with the ideal of erring on the side of "providing information".

PeterZ wrote:Information is always good, even when the principal motive for its creation is puffery.

No, it really isn't always good. Information can be twisted and manipulated and presented in ways that lead people to make very poor decisions and that is obviously not "good".

Outright deception is illegal and will get a company fined for fraud.

Depends on the threshold for calling something "outright deception".

Do you have any idea how involved the negotiations and shenanigans can get when pharmaceutical companies are wrangling with regulators about what has to be in a drug ad, what doesn't, what they can get away with claiming.... what they can get away with hiding...

And it doesn't matter how hard the regulators try, they're never going to be able to force these ads to be informative to a level that actually educates people sufficiently to make informed decisions about their own medication the way a trained physician can. But a bunch of them will march right down to their doctor's office and demand that pill they saw on TV that can fix "their problem" anyway. and in a lot of cases thy'll get it because the doctor doesn't want to fight with them about it even if they wouldn't necessarily have recommended prescribing it themselves.



Among other things, it's a major contributor to Americans over-spending on medical care.

Sorry, we are just going to have to disagree here. Adults can make up their minds with the help of their doctor what drugs to take for their conditions. Pharma companies trying to describe their products in the best light even using puffery is still better not having that information. The incentive to increase awareness for their is an acceptable incentive for companies to have.

If one believes in legalization of marijuana, one should be amenable to pharma companies hawking their products for adults to decide to purchase or not....with the advice from their doctors.

gcomeau wrote:

PeterZ wrote:Information is always good, even when the principal motive for its creation is puffery.

No, it really isn't always good. Information can be twisted and manipulated and presented in ways that lead people to make very poor decisions and that is obviously not "good".

Outright deception is illegal and will get a company fined for fraud.

Depends on the threshold for calling something "outright deception".

Do you have any idea how involved the negotiations and shenanigans can get when pharmaceutical companies are wrangling with regulators about what has to be in a drug ad, what doesn't, what they can get away with claiming.... what they can get away with hiding...

And it doesn't matter how hard the regulators try, they're never going to be able to force these ads to be informative to a level that actually educates people sufficiently to make informed decisions about their own medication the way a trained physician can. But a bunch of them will march right down to their doctor's office and demand that pill they saw on TV that can fix "their problem" anyway. and in a lot of cases thy'll get it because the doctor doesn't want to fight with them about it even if they wouldn't necessarily have recommended prescribing it themselves.



Among other things, it's a major contributor to Americans over-spending on medical care.

PeterZ wrote:The US had the best healthcare available before the move to government run system. We had doctors available where there were people and didn't need insurance to pay for the healthcare. Enter regulations and all of a sudden at became too expensive for a doctor to run his own practice. he needed all sorts of record keepers and billers and lord knows what just to practice medicine. My father was a doctor since the 60's. The intrusion of government made the US healthcare far less efficient since then.

That´s complete rubbish. The US system ISN`T govt run, end of story. The govt has barely any actual control or influence in your system.

PeterZ wrote:Germany is the size of Texas. You 80 million are located in an area a tithe the land area of the US. Its easy to concentrate doctors, nurses and medical services for that size of a population located in such a dense conditions. Try to spread out the services provided to areas as parsley populated as many parts of the US. Not the same at all.

And again with that horribly pathetic excuse.

Seriously, look at the northern parts of Sweden, Norway and Finland, where healthcare might be over 200km away and where population density extremely low.

And hell, Australia and Canada are WAAAAY worse of in that kind, you´re just making a fool of yourself trying to use that excuse.

Not much choice in that, but cost of the treatments would depend on system in place. Why create a system that makes the costs much higher than they should be?

And has been proven again and again, the US system is one of the most spectacularly ineffective in the world.
And has been that for many decades.

While my own nation, have lost greatly in efficiency by privatisation during the last 2 decades.
Horribly, by now we are merely half as expensive as USA! Instead of being closer to Japan, whose healthcare average cost is slightly below 1/3 of USAs.

And as an addition, i might add that USAs average healthcare quality is lower than both my own nation and that of Japan. While costing twice or thrice as much.

In USA you can find some of the best healthcare anywhere in the world, but at the same time, you can also find healthcare that is worse than in 3rd world nations. And the latter is far too prominent. And costly.

They didn't used to be. We had great healthcare at modest prices before the move to government healthcare in the past 50-60 years.

USA doesn´t have "government healthcare", end of story. It has a bundle of more or less improvisations to plug the gaps exactly because you DON`T have that.
And they mostly suck BECAUSE they´re NOT govt healthcare, but pseudoprivatised bastardisations with the worst from both govt and private healthcare.

I am getting seriously tired of these #NeverTrump Republican elites! They are making themselves look bad (and the Republican party with them). Trump is a jerk and the majority of the people voting for him don't like him. BUT what the clueless elites don't seem to be getting because "he's not our kind", is that the voters are mad. They have legitimate grievances with those in power and are willing to support a jerk whom they dislike because they feel it is their best option. The elites need to be looking in the mirror. They have made people so desperate that they will support and obnoxious jerk over them. By spending more time attacking their own party's candidate they look 1) like sore losers and 2) totally clueless about their own culpability.

To elites:

1. It's the economy stupid!!! Not your economy of Wall Street and Silicon Valley. But the main street economy. The working class and the middle class are still in a recession. You don't count it as one because the economic indicators you care about say it's not. But the economic indicators Main street cares about say that the every day economy is still bad.

2. The elites broke the economy, got rich, never paid for it and the normal people suffered. The regulatory changes by both parties since the 1990s, the cozy relationships and back room deals, the unethical though legal deceptions on wall street all played roles. Those at the top raked in millions. They still have those millions, while normal people lost jobs, careers etc.

3. The lousy one-sided trade deals that the US keeps signing are outsourcing normal people's jobs while making the elites rich. Most of them are technically GDP neutral, but they shift wealth from one segment of the economy to another i.e. from normal people to the elites. And the spirit of free trade deals isn't honored by other countries. They cheat, get away with it and prosper while the US worker suffers. Plus many of the deals were designed to be one-sided from the start to gain the US some sort of nebulous influence at the expense our own economy. The elites feel that we are a rich country and should spread the wealth around, but the wealth they are spreading isn't theirs but that of the normal people. They basically are giving away other people's livelyhoods to support their ideology.

4. Immigration. When the economy is good, few care. But in this bad economy, people don't want the competition. It's like the lousy trade deals just insourced instead of outsourced. Good paying construction jobs have been replaced by Mexican workers. Those unemployed workers aren't happy. STEM jobs are being replaced by H1B workers from India and China. Sure the elites claim they need those visas to grow the economy but if there were truly a shortage, salaries would be skyrocketing. Currently the average salaries are going DOWN not UP. These are supposed to be top jobs! If there were spare jobs to go around, no one would care about immigration and salaries would be skyrocketing.