[exelius]

I have a feeling that without the US market capable of paying a hundred thousand dollars a patient, many of those cost-ineffective treatments never get developed. People could still pay for them out of pocket, but without the guarantee of insurance payments the drug companies likely won’t take the risk.

And I don’t think that’s necessarily a bad thing — if a drug costs $500,000 and keeps my cancer at bay for 6 more months, it provides a high personal benefit from my selfish point of view; but at a high cost to society without much societal benefit. I think you’re right that Americans do lack the realism, but it may become easier if those treatments aren’t developed in the first place.

[andrekandre]

> People could still pay for them out of pocket, but without the guarantee of insurance payments the drug companies likely won’t take the risk.

this, in my opinion, points out a significant flaw in the rush to privatize just about everything:

there are many many “markets” that are either under-served or not served at all because the rate of profit would be (a) too low to “justify” or (b)none at all.

jmo but, there has to be a balance between for-profit and basic research that won’t necessarily be able to be monetized to the extent many in industry would want...

[exelius]

I’m not necessarily against a for-profit pharmaceutical industry... but I certainly am when the entire cost burden falls on us because the pharmaceutical companies band together to prevent our government from negotiating drug prices at the national level like pretty much every other wealthy nation...

[malandrew]

> but at a high cost to society without much societal benefit.

People are employed and knowledge is gained. That may be $500,000 treatment for 6 months now, but that treatment may be improved and democratized until it evolves into something that is $50,000 for 6 years.

[exelius]

A citizen science model — which is what we de-facto have for anything that isn’t cancer — is more efficient and cost effective.

As it is, if someone finds a new life-saving use for an 80 year old drug, there are suddenly shortages of the old drug while a new, patented analog is sent through clinical trials. See also ketamine and depression.