Republican Administration Maintains Exclusivity Stance in GLP-1 (Tirzepatide) Compounding Dispute

[hexagonal]

To side with the contrarian study aforementioned, if firms can’t charge whatever they want to cover their costs and satisfy investors, then Eli and Pfizer drugs like this won’t come to the market too often, or soon enough to matter for those who need them.

Moderna is another relevant example: one-trick covid vaccine pony who’ll fade into obscurity unless they hit again with life-changing product. Only difference is that governments paid for their products not patients.

https://www.wsj.com/health/healthcare/new-pancreatic-cancer-mutation-treatment-7b066368

Which just highlights that the current system is broken. Saving human lives is restricted by the ability for shareholders to profit.

 

[Windingroads06]

Anyone else having trouble keeping their mouth shut? 🤐 I am. I think it was Shakespeare who said something like “Discretion is the greater part of valor”

"Less is More"

 

[Windingroads06]

Which is frustrating because all the drug companies receive government money for research.

YES!!! THIS!!!

The pharmaceutical companies get $$$ Government sponsored grants to explore the feasibility of certain drug in the hope it will reduce government health care costs.

 

[Morbius]

1. Donate to cancer research.
2. Cancer is cured!
3. You get cancer.
4. You cannot afford the cure.

The system works!!1

 

[exploitedworkerbee]

If someone would run on actual solutions to healthcare and housing crises I will vote for them regardless of party affiliation, and I imagine lots of others would as well. I won’t care about their positions on any culture war issue at all.

 

[keangkong]

If someone would run on actual solutions to healthcare and housing crises I will vote for them regardless of party affiliation, and I imagine lots of others would as well. I won’t care about their positions on any culture war issue at all.

You expect our politicians to provide actual solutions? Have you been smoking crack?

 

[exploitedworkerbee]

You expect our politicians to provide actual solutions? Have you been smoking crack?

I thought it was impossible for this thread not to devolve into partisan bickering and yet here we are. Life is full of surprises.

 

[RestingGhostFace]

My solution remains that drug research should be funded globally by governments and that it is "open-source."


Curing disease is fundamentally a matter of public health. Public health is entirely within the scope of concern for government. Profit being a motive inherently puts tension between that goal and the goal of saving as many people as possible as cheaply as possible.

Agreed!

 

[keangkong]

My solution remains that drug research should be funded globally by governments and that it is "open-source."


Curing disease is fundamentally a matter of public health. Public health is entirely within the scope of concern for government. Profit being a motive inherently puts tension between that goal and the goal of saving as many people as possible as cheaply as possible.

Except what you described doesn't work. There is nothing right now prohibiting governments from funding that research and making it open source. Yet governments don't want to spend much on researching these drugs. When they do, the lack of profits helps guarantee that the money will be spent inefficiently. As is often the case, the cost of not allowing people to make a profit is far greater than the cost of permitting profit.

 

[hexagonal]

Except what you described doesn't work. There is nothing right now prohibiting governments from funding that research and making it open source. Yet governments don't want to spend much on researching these drugs. When they do, the lack of profits helps guarantee that the money will be spent inefficiently. As is often the case, the cost of not allowing people to make a profit is far greater than the cost of permitting profit.

We've had a global (or near-global) agreement to socialize pharmaceutical research and it didn't work?

TIL!

 

[hotdog!]

They should be able to profit, of course! But there must be a more sensible cap to the price gouging. $1000 a month? Even $550-650 is ridiculous. I'll bet they've long since recouped the money invested and made handsome profits to boot. After x years (not 2036) they should be forced to negotiate price caps similar to that other countries have negotiated for this drug. What does Tirzepatide cost in other developed European countries?

Google says in the UK, Mounjaro without insurance is 179 pounds sterling, or ~$230 USD. I imagine that's the 2.5 mg dose.

Reddit's Zepbound sub, someone visited London did a private doctor visit for 200 pounds, where a 3 month supply was 400 pounds ($515 USD). They got 3 months of 7.5 mg and 3 months of 10mg in the same visit.

 

[keangkong]

We've had a global (or near-global) agreement to socialize pharmaceutical research and it didn't work?

TIL!

You didn't mention an agreement previously. As to what you described previously, governments would contribute money to funding this research and it would be open source. Nothing stops governments from doing so already. But they don't. They obviously don't want to do so voluntarily. What you now envision is that all the governments, or most, would get together and agree to do what they don't do now. It's hard to imagine governments entering into such agreements. It's even harder to imagine them abiding by those agreements when they have previously chosen not to spend their money that way. You envision a selfless world where countries voluntarily spend money on these projects. But when it's pointed out that they don't do so, you then include an agreement. At best, what you propose would be completely ineffective. That's okay. We'd still have drugmakers. However, what worries me is that you refer to this as being part of an agreement to "socialize" things. That often means, and strictly meaning requires, that private companies be forced out of the market place. At that point, you'd be effective stopping most successful drug development in the world. I value human life too much to support what you advocate. Good intentions does not necessarily translate into good policy. Are modern drug companies full of warm and fuzzy people we'd all like to hug? No. However, they do a good job of getting the job done.

Communist countries don't have good track records in terms of advancing medical science.

 

[hexagonal]

You didn't mention an agreement previously. As to what you described previously, governments would contribute money to funding this research and it would be open source. Nothing stops governments from doing so already. But they don't. They obviously don't want to do so voluntarily. What you now envision is that all the governments, or most, would get together and agree to do what they don't do now. It's hard to imagine governments entering into such agreements. It's even harder to imagine them abiding by those agreements when they have previously chosen not to spend their money that way. You envision a selfless world where countries voluntarily spend money on these projects. But when it's pointed out that they don't do so, you then include an agreement. At best, what you propose would be completely ineffective. That's okay. We'd still have drugmakers. However, what worries me is that you refer to this as being part of an agreement to "socialize" things. That often means, and strictly meaning requires, that private companies be forced out of the market place. At that point, you'd be effective stopping most successful drug development in the world. I value human life too much to support what you advocate. Good intentions does not necessarily translate into good policy. Are modern drug companies full of warm and fuzzy people we'd all like to hug? No. However, they do a good job of getting the job done.

Communist countries don't have good track records in terms of advancing medical science.

It hasn't been tried because people haven't pushed them to do it. If the constituents don't demand it, the governments won't do it.

I suppose we could debate whether China is truly a communist country, but much of their pharmaceutical research is socialized, and they have been a heavyweight in the pharma research world for a while now. You'll find Chinese co-authors from Chinese universities all over all sorts of important research papers.

We spend a lot of money on a lot of things in the government. There's plenty I could suggest redirecting to make sure the actual scientists are getting rewarded just as handsomely with socialized pharmaceutical research as they are with private companies.

 

[ktg123]

It hasn't been tried because people haven't pushed them to do it. If the constituents don't demand it, the governments won't do it.

I suppose we could debate whether China is truly a communist country, but much of their pharmaceutical research is socialized, and they have been a heavyweight in the pharma research world for a while now. You'll find Chinese co-authors from Chinese universities all over all sorts of important research papers.

We spend a lot of money on a lot of things in the government. There's plenty I could suggest redirecting to make sure the actual scientists are getting rewarded just as handsomely with socialized pharmaceutical research as they are with private companies.

Frow what I know, a LOT of the info we have about bioregulators comes from Russia. Free market is great, unless the government steps in and says no, which then isn't really free market. Thus why we order our peps from the most communist country for pennies on the dollar instead of from the 'freest' country.

 

[keangkong]

Frow what I know, a LOT of the info we have about bioregulators comes from Russia. Free market is great, unless the government steps in and says no, which then isn't really free market. Thus why we order our peps from the most communist country for pennies on the dollar instead of from the 'freest' country.

Except China isn't really a communist country any more. Both India and China, in many ways, are more free economically, than the US. I will point out, however, that patent protections are expressly permitted by the US Constitution. "The Congress shall have Power . . . To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries . . ." (U.S. Const., art. I, sec. 8.)

 

[keangkong]

It hasn't been tried because people haven't pushed them to do it. If the constituents don't demand it, the governments won't do it.

I suppose we could debate whether China is truly a communist country, but much of their pharmaceutical research is socialized, and they have been a heavyweight in the pharma research world for a while now. You'll find Chinese co-authors from Chinese universities all over all sorts of important research papers.

We spend a lot of money on a lot of things in the government. There's plenty I could suggest redirecting to make sure the actual scientists are getting rewarded just as handsomely with socialized pharmaceutical research as they are with private companies.

China is a communist country. I'm fine with people pressing their governments to research pharmaceuticals so long as the governments do not seek to restrict private companies from researching and developing drugs.

 

[hexagonal]

China is a communist country. I'm fine with people pressing their governments to research pharmaceuticals so long as the governments do not seek to restrict private companies from researching and developing drugs.

I'm fine with them researching and developing drugs.

If they receive any government grants for research that drug should be considered part of the public domain as well, though.

 

[keangkong]

I'm fine with them researching and developing drugs.

If they receive any government grants for research that drug should be considered part of the public domain as well, though.

If the government says so at the beginning, sure, that's fine. That way the company can decide whether to make use of that funding or not. Practically speaking, I doubt there are many grants for research that don't impose disclosure obligations.

 

[Superfluous]

They should be able to profit, of course! But there must be a more sensible cap to the price gouging. $1000 a month? Even $550-650 is ridiculous. I'll bet they've long since recouped the money invested and made handsome profits to boot. After x years (not 2036) they should be forced to negotiate price caps similar to that other countries have negotiated for this drug. What does Tirzepatide cost in other developed European countries?

Google says in the UK, Mounjaro without insurance is 179 pounds sterling, or ~$230 USD. I imagine that's the 2.5 mg dose.

Reddit's Zepbound sub, someone visited London did a private doctor visit for 200 pounds, where a 3 month supply was 400 pounds ($515 USD). They got 3 months of 7.5 mg and 3 months of 10mg in the same visit.

I was paying £150 a month in the UK for brand name Mounjaro (4 x) 15mg per month before I went grey. The genuine reason I went grey was I don't actually live in the UK - I fly back and forth for work a lot and was struggling to maintain supplies because the pharmacists blocked you bulk buying. I can't get a local supplier where I live, so I was forced to be creative.

And that's the thing £150 a month is not cheap to most people in the UK but it's still affordable to most and I'd still be paying that if it wasn't for administrative blockers. US prices are just extortionate I think partly because Americans are used to paying stupid amounts of money for drugs and the companies can get away with it (especially with the insurance system).

 

[Imnotkidn]

That really is the conundrum though; they aren't making these medications for altruistic reasons. They're making them to make money. It's why so many potential medications get dropped in research- they simply aren't profitable.

I'm sure there are ways around that; I'm sure there's a brilliant solution that makes everyone happy. Unfortunately, none of us are smart enough or well connected enough to enact change on the pharmaceutical industry. All we can do is grumble and buy grey and be glad we've got enough of a brain to do math and (hopefully) not kill ourselves.

It makes sense for them to protect their investment. It also makes sense for us to call them greedy motherfuckers holding our health over our heads to squeeze out our capital.

Edit: Bee I'm calling EL and NN motherfuckers, not politicians. Don't ban me.

Please allow me to call the latter motherfuckers for you. With a plea for leniency as well.

 

[AndyPanda]

They should be able to profit, of course! But there must be a more sensible cap to the price gouging. $1000 a month? Even $550-650 is ridiculous. I'll bet they've long since recouped the money invested and made handsome profits to boot. After x years (not 2036) they should be forced to negotiate price caps similar to that other countries have negotiated for this drug. What does Tirzepatide cost in other developed European countries?

Google says in the UK, Mounjaro without insurance is 179 pounds sterling, or ~$230 USD. I imagine that's the 2.5 mg dose.

Reddit's Zepbound sub, someone visited London did a private doctor visit for 200 pounds, where a 3 month supply was 400 pounds ($515 USD). They got 3 months of 7.5 mg and 3 months of 10mg in the same visit.

The US is 4% of the world’s population and we are 70% of worldwide pharmaceutical profits. Additionally, we are 60th in life expectancy. I really don’t care much about other countries at this point. We are getting raped by pharmaceutical companies and healthcare is the fastest growing industry in the US. They want us to be sick.

 

[keangkong]

The US is 4% of the world’s population and we are 70% of worldwide pharmaceutical profits. Additionally, we are 60th in life expectancy. I really don’t care much about other countries at this point. We are getting raped by pharmaceutical companies and healthcare is the fastest growing industry in the US. They want us to be sick.

Raped? These drugs would not exist if the US profits didn't motivate their development. Voluntary intercourse might be a better term. If you don't like it, then you don't have to take these drugs, which wouldn't exist with US money.

 

[Morbius]

Thought experiment:

If every drug that currently exists was made very affordable by law, but the price was no new drugs were ever developed because the pharma was damaged and could not afford research ... Would we be better off, or worse off in terms of life expectancy and quality of life?

This isn't an oblique attempt to stir the pot. I think it's an interesting question that's worth thinking about given how our healthcare system works.

 

[AndyPanda]

Raped? These drugs would not exist if the US profits didn't motivate their development. Voluntary intercourse might be a better term. If you don't like it, then you don't have to take these drugs, which wouldn't exist with US money.

I assume you mean without? You are slipping, council!

 

[exploitedworkerbee]

Raped? These drugs would not exist if the US profits didn't motivate their development.

False dichotomy. We both know that it’s much more complicated than this simplistic AM talk radio host explanation.

 

[AndyPanda]

Thought experiment:

If every drug that currently exists was made very affordable by law, but the price was no new drugs were ever developed because the pharma was damaged and could not afford research ... Would we be better off, or worse off in terms of life expectancy and quality of life?

This isn't an oblique attempt to stir the pot. I think it's an interesting question that's worth thinking about given how our healthcare system works.

I don’t think there is anything wrong with companies turning a profit. I think capitalism is generally a good thing. Where I become frustrated is when it appears the US foots the bill and it also seems as if we are punished for being a successful country. It goes far beyond the pharmaceutical industry, but then it starts to become far too political and it is better to keep that and religion to ourselves. 😂

 

[hexagonal]

Thought experiment:

If every drug that currently exists was made very affordable by law, but the price was no new drugs were ever developed because the pharma was damaged and could not afford research ... Would we be better off, or worse off in terms of life expectancy and quality of life?

This isn't an oblique attempt to stir the pot. I think it's an interesting question that's worth thinking about given how our healthcare system works.

I think there is plenty of money available to adequately reward all of the scientists and researchers in the pharma industry that actually develop these new drugs even without the obscene profits.

Fundamentally it boils down to the fact that I believe public health is covered under that whole 'Life, liberty, and pursuit of happiness' bit, and as such the funding should be a high priority for the government. The massive profits for drug research are going to the shareholders - by definition the money is not being reinvested into R&D if it's being taken as a profit.

There is a tension inherent to the system when the people in charge of making our new medications have a profit incentive - does money get spent on more drug research or go back to line pockets? Private corporations need funding and people give that funding in exchange for a return on their investment. A government funded institution does not have that same concern - the shareholders are the taxpayers and the collective return is the lifesaving and quality of life improving medications that result from the research.

I don't know that there's any reason to have a false dichotomy though experiment.

 

[exploitedworkerbee]

it starts to become far too political and it is better to keep that and religion to ourselves. 😂

Honestly religion is less contentious than politics these days. If you want to discuss the various sects of Protestantism have at it.

 

[Valerie]

Lilly expanding their cash for vials program does provide an off ramp for many that were paying for compound. It is only about $100-$200 more per month than compound if on a dose <=10mg.

Still super expensive compared to gray but for many this could be an option. With insurance my Zepbound co-pay is just over $200 (for any dose) so $500 without insurance isn't as crazy as it sounds, especially if you don't have access to, or don't want to go gray.

Your co pay is $200 a month or a year ? Mine is $25.

 

[keangkong]

I assume you mean without? You are slipping, council!

Your are correct.

 

[AndyPanda]

Honestly religion is less contentious than politics these days. If you want to discuss the various sects of Protestantism have at it.

Nope! 😂

 

[keangkong]

False dichotomy. We both know that it’s much more complicated than this simplistic AM talk radio host explanation.

Am I oversimplifying? Definitely. If you wanted a more detailed explanation, you'd have to ask a person with more knowledge. I have never taken an economics course. Is it a false dichotomy? Although this is speculation, it's my opinion that without companies making huge profits, these drugs and many others wouldn't have been developed. This is speculative because our current system produced these drugs. Can I say with certainty that a truly socialist system wouldn't have produced drugs as effective as these? I cannot. My own economic beliefs tend towards support for capitalism. I'm toying with the idea that the US should limit the amounts that people can be charged for drugs. The amounts would be based upon some conception of a reasonable return. Such restrictions would reduce the amount invested in pharmaceutical development. That's why it's important not to cut too much. I also worry that once government takes this over that it will create a worse system that what we have now.

 

[hexagonal]

I am generally a full-throated capitalist. I think a fair market in a fair system (though I think that corporatism is dangerous) is the right thing in most cases.

However, I think there are some areas where it produces sub-optimal solutions on the whole - pharmaceutical research being one of them, but other areas being things that most of us are perfectly happy to socialize - police officers, firefighters, etc. Areas where the general goal should be "the public good" rather than "shareholder profits."

And I mean, I'm a shareholder. Both in my retirement fund tracking the S&P 500 and in more active investments in individual companies. I don't think that shareholders are inherently evil. I just think that if I am the shareholder of a pharmaceutical company my incentives are not aligned in such a way that generates the best possible outcomes for individuals that need medication.

 

[oguard]

I think that there should be some level of conscientious capitalism in a free society. We are still all in this thing together and should as a society have some degree of obligation towards one another if we are to prosper as a nation. The mark ups on these drugs is simply insane. Probably it is thousands of percent considering how cheap we can buy it from China and I know the Chinese are still making a hearty profit from their sales. We are fed the myth that these drugs are so expensive due to research. The reality is those non stop drug ads every day and during the Super Bowl have to be paid for and we foot the bill. They can make a huge profit of their drugs, but don’t have to gouge patients either.

 

[exploitedworkerbee]

I for one look forward to seeing our “price controls are communism” friends in this thread pivot on the news that Trump is attempting to align drug costs with other countries’ pricing. I’m not a fan of the man but i support any effort to bring those prices down aggressively.

If you change sides on this now then you have to step back and consider whether it’s not about policies, and perhaps you’re in a personality cult. If you stick with your original principles then good on ya, if it makes you feel better this probably wont work anyway.

 

[Batscout]

Taking emotion out of it. It is Eli Lilly and Novo's patents for both tirzepatide and semaglutide and compound medications were never meant to be permanent. NO, I am not shilling for Lilly, just saying. I mix and match both compound, grey and brand. It all works the same. I will say Eli Lilly expanding their Cash Pay program so vials up to 10mg are now under $499 a month is a start, and more affordable for the general public.

Of course, this was a tactic to showcase availability and the medication not being in shortage.

I am not shilling for Lilly either, they are a for profit company whose goal is to profit. That being said, drug patents always last 20 years. Sometimes this seems to vary because the patent is filed before clinical trials and before the drug hits the market. The molecule patent for mounjaro/zepbound expires in 2036 with the delivery system patent expiring in 2039. No pharmaceutical companies give up patent protection early so we likely won’t see generic versions earlier than 2037. I agree with all that the costs are ridiculous and that they could still make plenty of money if the costs were much lower.

There have been few instances where a newly patented, marketed, and widely appealing drug has faced such a severe shortage. In fact, compounding of tirzepatide may be singularly unique drug given the shortage, cost and long running compounding exception. The vial program is a good step but it would be easy for someone to mess up the opportunity if they don’t refill precisely every 45 days.

 

[Superfluous]

As a European who is very much not a fan of Trump I do support what he'd like to do in the scenario - reduce drug prices for Americans. All of us should have affordable health care. I just wish the method he was choosing to do it was not blame it on the likes of Europeans and suggest the answer is for foreign public health services to pay more to private corporations...

92% of all drugs sold in the US are generics - not patent protected super drugs which need a return for their investments - but drugs that are sold in Europe for much cheaper also - and also manufactured and sold in India for pennies. The fact that Americans can't buy these fully tested cheap drugs from abroad and have to pay expensive local pharmacies is because American laws prevent them from doing so...

 

[Morbius]

As a European who is very much not a fan of Trump I do support what he'd like to do in the scenario - reduce drug prices for Americans. All of us should have affordable health care. I just wish the method he was choosing to do it was not blame it on the likes of Europeans and suggest the answer is for foreign public health services to pay more to private corporations...

I do not see how our government's stated goal of harming your healthcare system can help our system. I'd be more upset if I were you, but thank you for your sacrifice!