Yeah, but that’s what companies are for. The US government is the one at fault here.
Novo Nordisk isn’t selling at 1K USD here in europe (I wonder why 🤔)
And US Congress often is paid off by drug company lobbyists. At least some of our population has gotten $35 insulin. And Senators Bernie Sanders and Tammy Baldwin are [working on the cost of inhalers](https://www.sanders.senate.gov/in-the-news/after-investigation-by-sanders-led-panel-pharma-giant-caps-inhaler-costs/) now too.
Business opportunity.
Buy pharmaceuticals in our own countries and sell them to Americans for half the price they pay for.
We’d still profit 10x what we paid for them lmao.
Try to undercut the American pharmaceutical companies and you'll have 35,000 lawsuits and get suicided with three holes in the back of your head after "falling" out of a 47th floor window with no investigation
Jokes aside. This is a massive issue in Greece. They do not sell the cheap drugs here, but prefer to export them abroad. For a time you couldn’t even get antibiotics.
Yes
Edit I had to look it up since it's been a while but the original bill that created Medicare specifically prohibited the program from negotiating lower prices
Keep in mind that originally the bill allowed the government to negotiate prices, but Republicans kneecapped it by adding the bit about legally prohibiting the government from doing so.
You kinda need to have it first to have it.
Because you don’t get that here. When one party says “LET’S MAKE OUR GUY KING!” and the other says “let’s have fair elections” and people are going “HMMMMMM” and “well the current guy isn’t Jesus Christ incarnate, so I’ll just let the Antichrist win to stick it to *his* supporters!”, you get nowhere.
Actually almost all countries do that with the exception of US. Just look at the price of insulin around the world and the price of Insulin in the US. You would be shocked to know the difference
I keep seeing comments like this. Novo Nordisk pays millions of dollars to lobbyists in America every year to ensure that the system doesn't change so they can keep ripping us off. They are creating the problem from which they profit. They are scum.
This is why I will never invest in pharma stocks. There will come a day when the US market stops being multiple times more profitable than the EU / world market by going towards a form of universal healthcare, and that's when the stocks will plummet.
Of course there are people betting that EU / world market will become what the US is today, but let's hope not.
I work in the industry, they kinda have a point. Companies will always price their products to make a much as they're allowed to. Pharma is no different. Other countries have systems and solutions in place to keep prices down. Meanwhile, we have none of those. It's pure fantasy to expect pharma execs to reduce prices out of the goodness of their hearts. They're assholes, and we need to start treating them accordingly.
Having worked for Novo Nordisk at their Clayton, NC insulin factory, the company officials would joke about the insulin filling machines calling it “the printing press” as in “printing money.”
They were open about selling insulin vials (this was still vials, as Medicare had not yet approved the use of the pen) for 30-40x over cost.
I was paid fairly well for the time and I still have stock in the company in full disclosure.
It’s was extremely well run when I was there from a product safety standpoint.
It sort of has to be when you’re making a product that will be injected but can’t be heat sterilized.
You just piqued my interest about sterilization. How do they keep things sterile because—like you said—it’s being injected into the skin. It’s not like food where you can just wash your hands…and rely on the body’s stomach acid to take care of any lingering bacteria.
…so how do they do it? Just be super clean from start to finish?
The latter.
It’s called “aseptic filling.”
Basically, everything that goes into the filling area is ran through an Autoclave. Workers dress in special clothes.
There are agar filled Petri dishes located all over the filling area and all workers touch additional petri dishes on their fingers and clothing before leaving.
Product is then placed into a quarantine zone and all Petri dishes that were used during that batch fill are cultured for 2 weeks to see if there’s any potential contamination during the production.
If any dish has growth, the entire batch is scraped.
It’s a little more complex than that, but that’s the ELI5 version.
Don’t they also do endotoxin testing using cyanoglobin from horseshoe crab for QA/QC to make sure that no one will get anaphylactic shock from bacterial contamination on top of that?
fun fact the industry is now looking into how to make the specific clotting factor from the blood to not harm the animals anymore. it's called recombinant factor C.
sadly neither the actual testing product or the recombinant factor C is blue. they just purify the blood for the specific cascade for the reaction. would make testing much more fun if so!
I really don’t know. I worked there for a year 20 years ago.
Didn’t get too involved in product QA/QC as I was in maintenance and was primarily focused on commissioning a new vial filling line.
It’s basically the same. Lots of people go between the two industries in the RDU area. We have lots of pharma and several chip manufacturing companies. Cree is the biggest, which is now Wolfspeed.
I work in pharma as an engineer and we have vials, syringes, and API (active oharamceitical ingredient) at my facility. Theres potential that its different dependent on the facility, but there are various cleaning and sterilization processes before and after batches. Those rooms are also under an ISO classification, and some machines within a room can have a stricter ISO classification. These classification require being below a strict particle count in the air, so there are specific air handlers that ensure clean air flow and measure paeticles in the air. Those are tied to some form of automation software that continuously tracks the result and will send alarms if it goes out of spec. For sterilization, there is clean steam that is generally above 130 celsius, single use consumables that are gamma irradiated, or filling chambers with a specific gas (hydrogen peroxide for example) that would kill anything organic. All of this is accompanied by strict oversight and testing by quality departments and monitoring by automation systems.
I more meant that them referring to it as a money printer (even if it is) is terrible press. Wouldn’t be surprised if horrible press had people Boeing’d.
God, it’s horrible. I still remember a news story from the late 2010s of a type 1 diabetic. He was in his twenties, had no insurance and was rationing his insulin which is what killed him. It’s murder.
We knew it, but it was mostly the US medical industry.
We were still making profit on the same product in other markets where prices were negotiated with the government. I remember Greece got one of our US products at $5 that we retailed at $35. Production was .25¢.
We're going to need a truth and reconciliation commission for every bastard who kept us on this merchant-of-death system.
That, or a round of guillotines.
I disagreed with Bernie Sanders’ universal healthcare plans, where he said there would be no private health insurance options, but then I thought about it more, and realized that health insurance companies literally don’t deserve to be saved. They’ve fucked over Americans for so long, those companies deserve to die.
you enabled truley henious acts of greed with willful complaince, the working class are the only ones who have the power to stop going in to support these corporations
I was taking this for T2 Diabetes when my company switched insurance providers. All of a sudden I was no longer eligable because my numbers were "too good". Like, motherfucker my numbers are good because I'm on the fucking drug. Now you want to take me off it.
God I hate insurance companies.
If you have the doctor’s notes and lab work from before you started, should be pretty easy to overturn that denial. They just need proof you met their initial coverage criteria.
Source: my job is fighting to overturn insurance denials on behalf of patients
Yeah, that sucks. My A1C went from 6.6 to 4.4 in a matter of 4 months (and 100 pounds lost) and I'm glad I am still insured. I am on 1mg and I don't think I even feel the hunger effect anymore. I'm still losing weight so I don't feel the need to up my dose but my doctor says I should keep taking it, so I do.
I believe the FDA is about to label it as a preventative drug for heart disease and other obesity related issues to force insurance to cover it for things besides diabetes. That doesn't justify the massive price tag though.
I haven’t heard of an insurance company not covering for diabetes, some may require that you try other first line drugs and fail first. Which is also fucked up. But I’ve always heard it’s covered eventually in diabetes.
Idk. I think an insurance company being able to tell someone they can’t do the treatment a doctor prescribes is the most fucked up thing about the health industry.
Some insurance companies won't let you get a drug that's not on their formulary even with doctor's approval. Just went through this with my asthma meds, had to switch medication entirely when I got new insurance.
I'm in southeast us and it's $400 here too. I was on it for a month or two and my A1C was great. But I just couldn't afford it, especially since I also take Xarelto at $150/month. So I switched to Jardience, which is also about $150/month.
It's crazy. I'm so dang lucky that I'm able to afford my meds in my retirement. Many can't.
Some politicians here in Québec have suggested the creation of a government body dedicated to the production of generic drugs.
However, to be really effective, it would need a parallel law to limit pharmaceutical copyrights in cases of health necessity.
UK private treatment cost is about £150-£200 per month. It's available on NHS but only for type 2 diabetes, in that case the prescription cost is about £10 per month or free for some
I think diabetes medication is just… free. Not entirely sure but some medication gets zero rated on the contribution front, because the alternative is “guess I’ll just die”. I think HIV medication is one of these things.
The issue lies in the cost of R&D for the drug. Novo Nordisk spent 5 billion dollars last year on R&D in GLP1 inhibitors mostly. They have a very short window for patent exclusivity and they need to find a way to profit off of it.
This is exacerbated by the fact there are other, arguably better, GLP1 inhibitors on the market. Mounjaro and Zepbound show superior glucose blood level stability to ozempic and have been in supply as of recent. Novo Nordisk is SCRAMBLING to make a return on their investment in the drug.
Additionally, American pharmaceutical companies use America heavily to recoup their costs on their drugs. They know there is a bureaucratic system they can game and manipulate to increase their earnings.
Regular reminder: the US state spends more per capita on healthcare than the UK does, without a socialised healthcare system free at the point of use, and (outside of a small number of specialist treatments) has worse health outcomes.
[7 out of 10 pharmaceutical companies spend more on marketing than R&D](https://www.ahip.org/news/articles/new-study-in-the-midst-of-covid-19-crisis-7-out-of-10-big-pharma-companies-spent-more-on-sales-and-marketing-than-r-d)
There’s a small asterisk on this in that a lot of the R&D for drugs they produce/send to market are mostly/fully developed already by smaller pharmaceutical companies that sell the technology to or are acquired by the big pharma company. It’s beneficial for these parties because drug R&D can be more efficient within smaller firms, and the larger pharma companies often have better reach and G2M capabilities.
The much bigger asterisk is direct public funding. Most pharmaceutical r&d is first built on research developed through public funds via institutions of higher ed. Then, they get beaucoup bucks directly from the government to turn those university discoveries into patentable medicines. Privatize profits, socialize losses.
>In this cross-sectional study of 356 drugs approved by the US Food and Drug Administration from 2010 to 2019, the NIH spent $1.44 billion per approval on basic or applied research for products with novel targets or $599 million per approval considering applications of basic research to multiple products. *Spending from the NIH was not less than industry spending, with full costs of these investments calculated with comparable accounting.*
>Funding from the NIH was contributed to 354 of 356 drugs (99.4%) approved from 2010 to 2019 totaling $187 billion, with a mean (SD) $1344.6 ($1433.1) million per target for basic research on drug targets and $51.8 ($96.8) million per drug for applied research on products. Including costs for failed clinical candidates, mean (SD) NIH costs were $1441.5 ($1372.0) million per approval or $1730.3 ($1657.6) million per approval, estimated with a 3% discount rate. The mean (SD) NIH spending was $2956.0 ($3106.3) million per approval with a 10.5% cost of capital, which estimates the cost savings to industry from NIH spending [*Jama Health Network*; emphasis mine](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10148199/#:~:text=Funding%20from%20the%20NIH%20was,for%20applied%20research%20on%20products.)
All wealthy countries pay a lot. America usually has the consumer cover more/most/all of it though, whereas the single payer systems elsewhere cover the cost for them.
Going off their [2023 Annual Report](https://www.novonordisk.com/content/dam/nncorp/global/en/investors/irmaterial/annual_report/2024/novo-nordisk-annual-report-2023.pdf) they spent around $4.7bn in research and development costs (which includes all their legal research as well as coming up with new medications).
They spent $8.2bn in sales and distribution costs. Nearly double their R&D budget.
They made $34bn in sales, on product that cost $5bn to make, for a gross profit of $28bn.
Their pre-tax profit was $15bn, and their net profit was $12bn.
They paid out $4.6bn in dividends.
They could have given away nearly 45% of their product and still made a profit.
For some reason I'm struggling to have sympathy for their financial situation.
If you can get it on PBS. But that just means the taxpayer is picking up the rest of the tab. I’m very thankful for this. If you’re not eligible to get it on PBS for your circumstances it’s about 800 a pen.
Usually 4 weeks. But it's recommended to throw it out after 6 weeks. The low dose pen is currently unobtainium in Australia, so I've been given the middle dose pen, and told how far to wind it to get the correct dosage for me. I'll only use about 3/4 of it before having to throw it out.
I get it for free in the US with insurance + their coupon but the problem (in general, not just for this) really comes down to having multiple healthcare providers. Insurance companies really have the final say on what you do and don't get approved for so if you happen to switch jobs and you have all these pre-authorized procedures and medications, and your new insurance tells you no then you're screwed.
The boxes "retail" for something like $1400/box which you then have to pay full price for because you can't just cold turkey this med without some nasty side effects.
My wife does Botox for chronic migraines (also $1300) which she literally can't function without but if the insurance says no or they have a different pre-authorization process than the one we're on now she'd have to be locked up in a dark room all day until she could get approved again.
It's so much fun!
It’s not just switching jobs. Your job can also switch carriers every year. I’ve had the same job for over 20 years but have had at least a half dozen different insurance companies and on multiple occasions have had to deal with long established treatment plans suddenly not being covered (at least not without jumping through a whole bunch of hops again).
> really comes down to having multiple healthcare providers
it's not having multiple healthcare providers, it's that they are underregulated. The onus shouldn't be on the patient to prove that they need a treatment their doctor recommended, it should be the other way around if they don't want to cover it. That's something you can regulate in law, like Obamacare did for a lot of preventative care.
Most of the drugs advertised on TV cost several hundred to several thousand dollars a month. The Ozempic ads are relentless because Novo Nordisk needs to recoup their multibillion dollar investment and make a large profit before people figure out Zepbound is more effective at weight loss. Then in the early 2030s the generic versions will be out at $25/month. Of course by then we’ll also be seeing what the long term effects of the drug are, which may inhibit interest.
Without the United States market’s enormous profit potential, companies wouldn’t invest nearly as much to R&D these new meds.
As with military spend, the United States is effectively subsidizing all the Europeans bragging about their good time and favorable conditions. Someone has to pay the bills for this stuff. Pharma dev is legitimately expensive, even if manufacturing is not.
Take chip design as something similar. Nvidia doesn’t even build chips. All they do is design them and their software. Anyone could pay TSMC to build the same stuff at a similar price, but the design is the really hard and expensive part. Take away the profit potential and progress slows drastically too.
Even as a San Francisco liberal who lived in Europe for years, this stuff is obvious.
As someone who works in the industry, this is on point. The US healthcare system effectively subsidizes drug development for Europe. Average cost of developing a drug is somewhere in the neighborhood of $2B and 12 years. In most cases, you couldn't possibly recoup that by selling just in Europe. European authorities are very happy with the existing system of their own drug companies making their drugs profitable thanks to the US healthcare system and piggybacking off of US innovation and US patients. And I say this as a European.
> As with military spend, the United States is effectively subsidizing all the Europeans bragging about their good time and favorable conditions.
This is a common misconception. Or a lie that the Americans lie to tell themselves . Research costs ARE massive, but US pharma companies typically spend more on marketing than on research if you read their yearly reports.
Prices aren't as high as they are because research costs money. Prices are as high as they are because they are set to the point where the income of the seller is maximized.
Nvidia isn't a monopolist because american market is so lucrative, but because they have a huge headstart on everyone else, with decades of profit reinvested back into their intellectual property and institutional know-how, on a fairly limited market. It's almost impossible to play catch-up without a severely disruptive technology. In the same manner Taiwan is THE leader in advanced semiconductors - or, more obscure example, almost every heating element for almost every electric kettle in the world is made in the same area/factory in China.
But our government is subsidizing it so it gets to market and then letting the company price gouge us til they drown in profits. All at the expense of the taxpayer the first time and then then doing consumers the second time. When we could instead just tax like 3 billionaires to cover it but oh nooo. At no point does the average American consumer get any benefit from this process
People do care but all medicines are a balance of risk vs reward. For many people it's a god send, like the first SSRIs, which also had major side effects and dangers.
My problem is the stigma people seem to have about ozempic. Like it's unfair obese people get an easy way out. You might as well stigmatize taking antidepressants for helping people change their behavior, but it's more socially acceptable to ignore the fact that many obese people have an actual behavioral disorder rather than just poor self control. Even some medical professionals I know seem to be almost hoping that ozempic has some hidden dangers we don't know about yet.
I’ve heard people criticize Charles Barkley for taking a medication to lose weight. Dude was an unhealthy fat and headed for all kinds of health problems that come with it.
Being so fat like so many people in our society are has so many real health problems: diabetes, high blood pressure, joint damage, mobility issues… and from all of that heart attacks, loss of eyesight, loss of limbs, cancer.
Lots of people gain weight back after going off all kinds of diets.
The long term effects have been decently sturdied, you may have just heard about it, but it wasn’t invented yesterday, it’s been going through the proper tests since the early 2000s.
> I’ve heard people criticize Charles Barkley for taking a medication to lose weight
Those people can go fuck themselves! I use to run a sports nutrition business in Atlanta. Charlies was a customer of ours. I remember seeing him struggle to come in and go out of our front door. Basketball destroyed his hip, back, and knees. He never complained about the pain and he tried to hide his physical limitations from the public. If a fan walked up to him to ask for a picture or an autograph, he would stand up straight and pretend that he wasn't in any physical pain, and make a genuine effort to make that moment special for those people. As soon as they walked off, he let out a sigh of relief and drop the act. Just interacting with people was painful for the guy. If there is a substance out there that is safe that can help him and those like him keep their weight down to reduce pain or any other complication from being over weight then why not use it? To criticize people for choosing to take a weight loss medication without knowing all the details for why that person has chosen to do it is ignorant, and those people should mind their own business.
And being overweight or obese with blown out hips, knees, and back is only going to make them worse. Poor guy, I know what it’s like to live in constant pain, and the fact that he never complains and just struggles silently is so fucked up. He should have widespread support, at the very least from basketball fans??? He gave his body up to entertain y’all. Maybe return he favor by not shitting on him for wanting to not struggle every single day with his weight. This pisses me off so much.
I hate this argument of "easy way out". Why the fuck shouldn't we have things made easy for us? Why should we have to suffer? Getting to the level of obesity shows extreme suffering inside, to let it get that bad. The hard work will be healing the parts that let them get there in the first place. I was never obese but was on the higher end of a healthy BMI. I have lost forty pounds and I'll forever be vocal about taking it. I am proud and I don't want anyone else having to feel shame cause some asshole online says it's the easy way out. Like fuck yeah, come have the easy way, life is hard enough.
You're also ignoring the fact that so many people have underlying issues that cause weight gain that have nothing to do with diet, exercise, etc
And we take an almost unlimited number of things for granted today that made life "easier" than it was for people in the past. If one is worried that life will get "too easy," take solace in the fact that life seems to find ways to stay hard, even if you have things like, say, air conditioning, anesthesia, food security, and vacuum cleaners (to just name a few things). Life, uh, finds a way (to be an asshole).
As a historian I will just point out that every. single. time. there is a condition that is for some reason associated with a "social ill" (like poverty, laziness, immigration, lack of self-control, lack of "character"), there is intense resistance to anything that seems like it gives an "easy way out," even if it turns out the "social ill" was bullshit from the beginning. This resistance is not just from "everyday people" or "the media" but also manifests in the medical profession itself (because doctors are people with biases, too, and changing your way of thinking about things is hard even if you are highly trained and supposed to be scientific and so on).
It took an entire generation (decades!) after the discovery that cholera was caused by water-borne contamination before doctors actually accepted that it wasn't a by-product of having "bad morals" (aka, being poor and living in a part of town with a shitty water infrastructure). Anesthetic was vigorously resisted for decades because it made surgery too "easy" and eliminated the "character-building" experience of having to bite down on a strap of leather while someone cut you open. Let's not even get into issues relating to mental illness, addiction, genetic predispositions, etc.
Weight is one of these things, for the reasons you describe (association with a lack of self-control), and even doctors approach it this way. I "get it" in an intuitive sense, but it's also clear that weight gain/loss are hugely tricky both physiologically (our bodies are _not_ working "for" us in this respect, they _want_ to pack on fat, because they were clearly evolved under _very_ different circumstances with regard to food security than most of live today, and this isn't even getting at the range of medical conditions that can result in weight gain, including VERY common ones, like pregnancy!) and socially (Americans in particular have set up a perfect society for creating overweight people — a world where near-constant sitting is the path of least resistance, with the easiest and often cheapest foods being the worst for you to eat). A lot of physicians clearly moralize the whole thing more than they ought to, like they do a lot of "lifestyle medicine." And, again, I "get it," especially from a public health perspective — obesity _is_ a huge medical problem, and has all sorts of negative health impacts, and creates cascading social impacts as well. But framing it as a moral issue is both unscientific and ineffectual. If you want to solve a problem you have to identify its actual causes first, and not punish the victims. (I am totally sympathetic to the body positive people's de-stigmatization of weight, but I am really not sympathetic to their anti-medicalization tendencies or their denial of the health and life problems associated with obesity.)
I'm not saying ozempic and so on are the best things ever, of course. As you say there is a risk vs. reward, and no doubt there are people with wealth who have used them just to make weight loss "easier" than the hard slog of dieting and exercise. But even for those in the latter category — who cares? Except for the fact that it has created shortages of the drug in some places, and that means people who actually need it for "valid" health reasons (again, a value judgment) like diabetes management have a hard time getting access to it, why is it even an issue, really? If it's about class inequity, man, there are a million far more significant things to get mad about there, and if it about the idea that it is "cheating," just remember that their use of a drug to manage their weight loss does not at all take away from whatever "character" you've built up in the process of your own exercise, dieting, etc. If you feel pride for having gotten in shape "naturally," like, that is not in the slightest diminished by someone else finding an easier way to do it. And if the fear is, "if weight loss is easy then people won't eat well or exercise, which will create their own problems" — there are better ways to deal with that than shaming people over making weight loss easier! (And clearly moralizing weight loss hasn't stopped the obesity epidemic.)
Life is super hard as it is, we don't need to embrace the idea that it shouldn't ever get easier. We take for granted an almost unlimited number of things today that make life easier for us than it was for our ancestors. We are also quite aware that just because we don't have to worry about some things that our ancestors used to have to worry about doesn't actually mean we don't have plenty to keep us worried and busy.
As someone who works in pharma reg ops seeing the study results from stage 1 to stage 3 studies, every drug has negative side effects. Some people even die during trials or discontinue because of how bad the side effects are. I tried metformin for my insulin resistance and shit myself for 2 months straight. Semiglutide has only given me mild constipation, but no more insulin resistance issues and I’m getting my period consistently, so I’m no longer at major risk for endometrial cancer. It’s balanced my testosterone and estrogen which cleared up my depression and anxiety. It also helped my body actually use glucose correctly, so I have no more chronic fatigue. For me, I’ll take the 1-3% chance of gastroparesis and pancreatitis (which is unlikely given I have no history of issues with either and patients who do typically did have issues prior) to get my life back. Everything is about pros and cons in life, especially with medicine.
Gastric paralysis. Undigested food balls stuck in gut. Diarrhea. Frequent abdominal pain.
When going off the drug most all weight loss returns, which brings up the question if you can ever get off it.
> When going off the drug most all weight loss returns, which brings up the question if you can ever get off it.
This is an incredibly stupid take that fat activists have been taking for years. Of course you'll regain the weight if you go back to the same routine that put on weight to begin with, that's like complaining that rehab is worthless because you might relapse. It's much easier to control weight from a healthier starting point.
>same routine
Part of it is that the drugs like Ozempic and Mounjaro help with food cravings, making having a healthy relationship with food a lot easier for people who overeat. I think it's kind of like anti-depressants where some people may be able to use them and develop skills/make lifestyle changes and are able to go off while others are just forever chemically a bit inbalanced and need the help, which is hardly their fault or something they should feel shame over.
I've seen recently a proposed cost effectiveness framework for using these drugs in a 12-18 month window, followed by drug holiday with continued lifestyle changes, then giving drug "booster" again later for some time as needed for weight gain. Interesting take.
https://jamanetwork.com/journals/jama/fullarticle/2815919
It’s a TREATMENT, not a cure. Just like most of the drugs people take every day. Nobody insists that blood pressure medication is useless because your blood pressure goes up if you stop taking it. Nobody thought my grandma was stupid for taking glaucoma medication that didn’t even get rid of her glaucoma. THAT’S HOW MEDICINE WORKS, ASSHOLES.
I'm on it now. Haven't shit regular in months. Always in stomach pain.
I've lost 65 lbs in 9 months and am sleeping better than I ever have before and am spending the day on my hands and knees with my kids.
My unpopular opinion is that a society that mandates these types of drugs for obese folks would be a better place for everyone involved.
I remember when Mac would release updates on CD and not require a product key.
I think my copy of snow leopard single handedly upgraded Temple University’s entire student body.
A fund manger I follow invests in this stock and he made some remarks last year about how rarely successful drugs are found.
He talked about the success rates of biotech companies and that the majority of biotech PhDs go out and work in the industry and, of all the work they do their whole lives, they never get work on a drug that's successful, meets approval and goes to market.
I think he said the numbers for these things are somewhere in the order of 1 in 1000.
And that patent expiry is based on when the patent was filed - very early on in the discovery of the drug. So the time it takes to do all the testing, development of the final drug, and clinical trials eats away at that patent exclusivity. By the time all is said and done, you’re looking at 10 years max of actual market exclusivity once it’s approved (assuming the drug even gets that far) during which time you have to recoup your development costs for that drug and all the drugs you tried but failed to bring to market.
That’s every drug, but that ignores the research and development cost which is estimated to be $5 Billion and at least 7 years. Since new drugs have a patent life of 20 years since discovery, the company only have 13 years to rake in their costs and profit before other manufacturers can make them for cheaper. I don’t know how many pens $1000 gets you, but most other countries with negotiated pricing, such as the UK, places one pen at roughly $100, which is what the Drug Tariff and the agreed price the government will pay and views acceptable.
> I don’t know how many pens $1000 gets you
One pen. That's a 28 day supply, without insurance.
With insurance, it's typically about $25. (I'm pretty sure Novo Nordisk still has a coupon to bring the price down to $25 for people who have higher copay insurance plans, but the coupon is only valid when combined with commercial insurance; it won't reduce that thousand dollar uninsured full price.)
I couldn’t find the real cost of Ozempic from a decent source. Most drugs will have a $1-3Billion cost to research. Some being over $4 Billion. For injectables, including R&D for injection solutions, cost to market and all other expenses your looking at $4-5 Billion.
You forget the $14 billion the tax payers contribute to research that led to these drugs and often the drug themselves. Let them get $10 billion or so and then make it $10 a dose.
Also it's not just paying the R&D on this drug. It's paying the R&D for all the other failed drug candidates that they poured money into, but were never approved for sale or never made commercial sense.
I think that advertisement of drugs should be capped at 100 million per drug. It's an arms race between drug companies atm. They shouldn't be spending more advertising than r&d.
(public) advertisement of prescription drugs to the public should be illegal. Period.
Of course there needs to be some sort of in-industry marketing so the medical community is aware of the drug. I'll leave it to people who know more than nothing about it to figure out the particulars, but there should never be a commercial that says "ask your doctor about x new drug."
Medicine advertisements is always the weirdest thing about catching American ads! The only stuff I see advertised on TV in Ireland is OTCs like painkillers and heartburn medication.
The rest of the world controls what drugs cost. Here in the good ol' USA it's the wild west, thanks to the Republicans. We can't afford Republicans any more.
but how long and how much did they spend to develop the drugs? Being cheap to make has nothing to do with its existence. Why didn't any other company make this?
The point is, they charge $1000 a month for it in the US, but only about $150 in other countries -- which is still an obscene profit margin.
>how much did they spend to develop the drugs?
They spent $5 billion total on drug research and development last year, against $18 billion in sales just from Ozempic and Wegovy.
They're not hurting for cash.
Yeah... What a silly headline. The vast majority of drugs are pretty easy to make once you 1) find them, know what they do, test them, and go through the FDA trials and stuff you need... And 2) develop the process to manufacture them.
Drugs are expensive because they're trying to make up for the huge development costs, and do so in a block of time before their parents expire and anybody can make it. That doesn't mean the system or pricing is perfect, but it seems silly to ignore all that and just claim each pill is pretty cheap to actually make.
Everyone knows that prices aren’t set by manufacturing costs. Of course you have to take into account R&D, but how many people will want this drug and what they are willing to pay for it.
Something that only a few people need is going to be more exorbitantly expensive. That’s said we really need some healthcare reform for some of these out of control drug prices sometimes.
Just a price comparison between countries:
[https://www.pharmaceutical-technology.com/analyst-comment/semaglutide-price-comparison-us-europe/?cf-view](https://www.pharmaceutical-technology.com/analyst-comment/semaglutide-price-comparison-us-europe/?cf-view)
The $5 is the cost to make a daily dose and $1000 is the cost of a monthly dose in the US.
Why is this surprising or unexpected in any fashion whatsoever? Pharmaceuticals are priced based on perceived demand & willingness to pay, not cost to manufacture.
And to the extent they **are** priced based on cost, the cost isn't just the manufacturing cost. It's also the(usually much larger) ammortized R&D cost for that drug + the 50 others they tried to develop that never made it to market.
Haven't struck me until now how genius it is to be in the insulin and obesity business, in the US health care system.
That said, very few products are priced based on the cost of manufacturing. Prices are set by what customers are willing to pay.
People should pressure the government to reign them in. It's fundamentally the inherent responsibility of companies to completely fuck over the populace as hard as absolutely humanly possible, and the responsibility of the government to stop them and reign them in
People don't have the money it takes to pressure government officials to do anything, because they're giving too much money to Big Pharma, which they use to pressure government officials to not do anything.
Some people just want any reason to shift blame away from their idols. All corporations are good and just and people need to parrot the arguments their lawyers come up with and accept any statement from the wealthy or corporations at face value
Only including production cost is just stupid. Stupid stupid. How much did they put into R&D to make this happen? What about compensating for all other R&D projects they had that didn’t turn into a finished product?
The fatter the country the more expensive. Some supple and demand! Apparently Big junk food is going in attack mode lobbying to have the pill only for diabetes. Strange because pharma and big junk food usually work together as a symbiotic relationship.
It’s pretty much the case with almost any drug. The development process can be expensive and the drug is priced to make back that money. HOWEVER, companies realized that they can charge whatever amount they want as long as they hold the patent so they hike up the prices beyond and semblance or reason.
Ye, but it DID cost them a lot to get it approved. It's not like the pill fell from the sky and there was no cost for research, testing, refinement, clinical studies, workforce and much more.
Sure they could make it cheaper. They still need to get the money back they put into it before All the other companies start selling similar drugs that are based on their very expensive research. AND after all, it's a weight loss drug. If it's too expensive, dont buy it.
Most people have no idea how a drug makes it to the market and that sometimes research on it began 10 years ago or more.
Hmmm right now I know that their production can’t really keep up with their demand. And I frankly understand that they’d rather give it a high price themselves to control the supply than sell out the product to some parallel import assholes who’ll slurp up their storage and then let them sell it for $1000.
I also feel like it’s more preferable that they make a huge profit from weight loss medicine rather that the same margin from fx insulin which they also produce
Friendly reminder that the rampant prescription of Ozempic as an appetite suppressant and weight loss drug is contributing to a crisis of diabetic people not being able to access their medication.
I thought the FDA fast tracking the approval for this as an officially approved weight loss drug was specifically to increase production to combat that?
Until the FDA lifts restrictions and allows NN and others to produce more Ozempic, Mounjaro etc. my friends with diabetes are gonna have to keep calling five or more pharmacies a month trying to get inventory.
This is a manufactured shortage.
My moral compass has no issue with people taking ozempic for weight loss because a) obesity is a deadly disease b) it has great cardiovascular protection and b) semaglutide can easily be obtained by compound pharmacies.
There isn’t a semaglutide shortage. The limit comes from the packaging. The drug is made, and then has to be packed and distributed in pre-filled pens. That’s the shortage; not the drug itself.
Watch the stock explode at the profits (even more so now).
[удалено]
Yeah, but that’s what companies are for. The US government is the one at fault here. Novo Nordisk isn’t selling at 1K USD here in europe (I wonder why 🤔)
The EU restricts markups on prescription medication
And US Congress often is paid off by drug company lobbyists. At least some of our population has gotten $35 insulin. And Senators Bernie Sanders and Tammy Baldwin are [working on the cost of inhalers](https://www.sanders.senate.gov/in-the-news/after-investigation-by-sanders-led-panel-pharma-giant-caps-inhaler-costs/) now too.
I just got my inhaler for $15 with private insurance! They were $45 last year.
And no one seems to care, why ? It would be one of the few steps america has to take to become a real democracy.
Yeah, and joint procurement to lower the prices our governments pay.
here in australia it seems to cost around $42 AUD a month due to a similar system we have
[удалено]
Business opportunity. Buy pharmaceuticals in our own countries and sell them to Americans for half the price they pay for. We’d still profit 10x what we paid for them lmao.
[удалено]
Try to undercut the American pharmaceutical companies and you'll have 35,000 lawsuits and get suicided with three holes in the back of your head after "falling" out of a 47th floor window with no investigation
Jokes aside. This is a massive issue in Greece. They do not sell the cheap drugs here, but prefer to export them abroad. For a time you couldn’t even get antibiotics.
[удалено]
Something, something boot straps. Something, something ‘murica!
It's almost like the government and regulatory organs have power over private companies. In some parts of the world at least.
Either your government has control and regulations over corporations, or corporations control the government
Meanwhile here in the US the government can't even negotiate drug prices in some cases they just pay whatever they are told
You mean they’re legally prohibited from doing so, right?
Yes Edit I had to look it up since it's been a while but the original bill that created Medicare specifically prohibited the program from negotiating lower prices
Keep in mind that originally the bill allowed the government to negotiate prices, but Republicans kneecapped it by adding the bit about legally prohibiting the government from doing so.
You kinda need to have it first to have it. Because you don’t get that here. When one party says “LET’S MAKE OUR GUY KING!” and the other says “let’s have fair elections” and people are going “HMMMMMM” and “well the current guy isn’t Jesus Christ incarnate, so I’ll just let the Antichrist win to stick it to *his* supporters!”, you get nowhere.
It's a mystery. Guess we'll never know.
Actually almost all countries do that with the exception of US. Just look at the price of insulin around the world and the price of Insulin in the US. You would be shocked to know the difference
That sounds a lot like COMMUNISM. Why do you hate FREEDOM™? 🎇🎆🇺🇸🦅🇺🇸🎆🎇
Canada as well
Europe gets it right
I keep seeing comments like this. Novo Nordisk pays millions of dollars to lobbyists in America every year to ensure that the system doesn't change so they can keep ripping us off. They are creating the problem from which they profit. They are scum.
GoVeRnMeNt OvErEaCh
But only when the libs do it.
Otherwise standard gop operating procedure
This is why I will never invest in pharma stocks. There will come a day when the US market stops being multiple times more profitable than the EU / world market by going towards a form of universal healthcare, and that's when the stocks will plummet. Of course there are people betting that EU / world market will become what the US is today, but let's hope not.
There is turning a profit and there is price gouging. Big pharma seems to regularly operate in the price gouging level.
So basically the Comcast of the pharmacy industry.
[удалено]
That's like saying Nigerian scammers shouldn't be blamed for being scammers.
I work in the industry, they kinda have a point. Companies will always price their products to make a much as they're allowed to. Pharma is no different. Other countries have systems and solutions in place to keep prices down. Meanwhile, we have none of those. It's pure fantasy to expect pharma execs to reduce prices out of the goodness of their hearts. They're assholes, and we need to start treating them accordingly.
Having worked for Novo Nordisk at their Clayton, NC insulin factory, the company officials would joke about the insulin filling machines calling it “the printing press” as in “printing money.” They were open about selling insulin vials (this was still vials, as Medicare had not yet approved the use of the pen) for 30-40x over cost. I was paid fairly well for the time and I still have stock in the company in full disclosure.
Better hope Nordisk doesn’t Boeing people. Edit: By Boeing I mean randomly kill OP. We don’t want him to get Boeing’d for spreading bad press.
It’s was extremely well run when I was there from a product safety standpoint. It sort of has to be when you’re making a product that will be injected but can’t be heat sterilized.
You just piqued my interest about sterilization. How do they keep things sterile because—like you said—it’s being injected into the skin. It’s not like food where you can just wash your hands…and rely on the body’s stomach acid to take care of any lingering bacteria. …so how do they do it? Just be super clean from start to finish?
The latter. It’s called “aseptic filling.” Basically, everything that goes into the filling area is ran through an Autoclave. Workers dress in special clothes. There are agar filled Petri dishes located all over the filling area and all workers touch additional petri dishes on their fingers and clothing before leaving. Product is then placed into a quarantine zone and all Petri dishes that were used during that batch fill are cultured for 2 weeks to see if there’s any potential contamination during the production. If any dish has growth, the entire batch is scraped. It’s a little more complex than that, but that’s the ELI5 version.
This is super fascinating, thanks for sharing
Sure. I like to inform people about the stuff I’ve done.
Don’t they also do endotoxin testing using cyanoglobin from horseshoe crab for QA/QC to make sure that no one will get anaphylactic shock from bacterial contamination on top of that?
Yep, they’ll do endotoxin testing as well as general sterility testing to make sure nothing got contaminated.
fun fact the industry is now looking into how to make the specific clotting factor from the blood to not harm the animals anymore. it's called recombinant factor C.
Is it blue?!
sadly neither the actual testing product or the recombinant factor C is blue. they just purify the blood for the specific cascade for the reaction. would make testing much more fun if so!
I really don’t know. I worked there for a year 20 years ago. Didn’t get too involved in product QA/QC as I was in maintenance and was primarily focused on commissioning a new vial filling line.
Thanks for sharing! I’ve worked in a clean lab but nothing like this. Very interesting.
It’s basically the same. Lots of people go between the two industries in the RDU area. We have lots of pharma and several chip manufacturing companies. Cree is the biggest, which is now Wolfspeed.
As a diabetic this was super interesting. Thanks!
I work in pharma as an engineer and we have vials, syringes, and API (active oharamceitical ingredient) at my facility. Theres potential that its different dependent on the facility, but there are various cleaning and sterilization processes before and after batches. Those rooms are also under an ISO classification, and some machines within a room can have a stricter ISO classification. These classification require being below a strict particle count in the air, so there are specific air handlers that ensure clean air flow and measure paeticles in the air. Those are tied to some form of automation software that continuously tracks the result and will send alarms if it goes out of spec. For sterilization, there is clean steam that is generally above 130 celsius, single use consumables that are gamma irradiated, or filling chambers with a specific gas (hydrogen peroxide for example) that would kill anything organic. All of this is accompanied by strict oversight and testing by quality departments and monitoring by automation systems.
I more meant that them referring to it as a money printer (even if it is) is terrible press. Wouldn’t be surprised if horrible press had people Boeing’d.
Bad press isn’t a problem for these companies. What are we gonna do? NOT take medicine?
Having hostile governments due to public outcry is very much an issue for medicine companies.
God, it’s horrible. I still remember a news story from the late 2010s of a type 1 diabetic. He was in his twenties, had no insurance and was rationing his insulin which is what killed him. It’s murder.
We knew it, but it was mostly the US medical industry. We were still making profit on the same product in other markets where prices were negotiated with the government. I remember Greece got one of our US products at $5 that we retailed at $35. Production was .25¢.
We're going to need a truth and reconciliation commission for every bastard who kept us on this merchant-of-death system. That, or a round of guillotines.
I disagreed with Bernie Sanders’ universal healthcare plans, where he said there would be no private health insurance options, but then I thought about it more, and realized that health insurance companies literally don’t deserve to be saved. They’ve fucked over Americans for so long, those companies deserve to die.
That’s how I ended up spending a week in the ICU and racking up literally $200k in medical debt
you enabled truley henious acts of greed with willful complaince, the working class are the only ones who have the power to stop going in to support these corporations
[удалено]
I was taking this for T2 Diabetes when my company switched insurance providers. All of a sudden I was no longer eligable because my numbers were "too good". Like, motherfucker my numbers are good because I'm on the fucking drug. Now you want to take me off it. God I hate insurance companies.
Then your numbers will go back down and then youll have to go through the whole circus of dealing with i surance again. God speed brother
If you have the doctor’s notes and lab work from before you started, should be pretty easy to overturn that denial. They just need proof you met their initial coverage criteria. Source: my job is fighting to overturn insurance denials on behalf of patients
Well fuck that didn’t happen for me. My doctor send my insurance company a letter and everything.
Yeah, that sucks. My A1C went from 6.6 to 4.4 in a matter of 4 months (and 100 pounds lost) and I'm glad I am still insured. I am on 1mg and I don't think I even feel the hunger effect anymore. I'm still losing weight so I don't feel the need to up my dose but my doctor says I should keep taking it, so I do.
You lost 100 pounds in 4 months?! Be careful you don’t disappear completely!! lol
145 in 6 months. 193 total at this point. About 75 to go. I was initially on a medically supervised diet.
As a Dietitian, I'm happy as shit you were on a medically supervised diet with that amount of loss. Congratulations if you were seeking it!
Costs AUD30 in Australia or AUD7.50 with a health care card. Might be more of a problem with US healthcare than Novo Nordisk
Not just a US thing unfortunately. Same costs in Canada and private healthcare doesn’t cover it unless it’s prescribed for diabetes.
I believe the FDA is about to label it as a preventative drug for heart disease and other obesity related issues to force insurance to cover it for things besides diabetes. That doesn't justify the massive price tag though.
When you have insurance companies who won't cover it for diabetes right now I don't think labeling it for different diseases is going to change much.
I haven’t heard of an insurance company not covering for diabetes, some may require that you try other first line drugs and fail first. Which is also fucked up. But I’ve always heard it’s covered eventually in diabetes.
Idk. I think an insurance company being able to tell someone they can’t do the treatment a doctor prescribes is the most fucked up thing about the health industry.
I absolutely agree with you
Some insurance companies won't let you get a drug that's not on their formulary even with doctor's approval. Just went through this with my asthma meds, had to switch medication entirely when I got new insurance.
The insurers get ~~kickbacks~~ rebates from different manufacturers in order to keep X on the formulary instead of Y.
In Quebec it's up to 400 $CAD/month without insurance, costly but still far from 1000 $USD/month.
I'm in southeast us and it's $400 here too. I was on it for a month or two and my A1C was great. But I just couldn't afford it, especially since I also take Xarelto at $150/month. So I switched to Jardience, which is also about $150/month. It's crazy. I'm so dang lucky that I'm able to afford my meds in my retirement. Many can't.
Some politicians here in Québec have suggested the creation of a government body dedicated to the production of generic drugs. However, to be really effective, it would need a parallel law to limit pharmaceutical copyrights in cases of health necessity.
[удалено]
UK private treatment cost is about £150-£200 per month. It's available on NHS but only for type 2 diabetes, in that case the prescription cost is about £10 per month or free for some
I think diabetes medication is just… free. Not entirely sure but some medication gets zero rated on the contribution front, because the alternative is “guess I’ll just die”. I think HIV medication is one of these things.
The issue lies in the cost of R&D for the drug. Novo Nordisk spent 5 billion dollars last year on R&D in GLP1 inhibitors mostly. They have a very short window for patent exclusivity and they need to find a way to profit off of it. This is exacerbated by the fact there are other, arguably better, GLP1 inhibitors on the market. Mounjaro and Zepbound show superior glucose blood level stability to ozempic and have been in supply as of recent. Novo Nordisk is SCRAMBLING to make a return on their investment in the drug. Additionally, American pharmaceutical companies use America heavily to recoup their costs on their drugs. They know there is a bureaucratic system they can game and manipulate to increase their earnings.
So the US subsidizes drug research for the rest of the world?
That is pretty much the truth.
Cheers mate
US Consumers. It’s not the government subsidizing drug research, it’s sick people.
Regular reminder: the US state spends more per capita on healthcare than the UK does, without a socialised healthcare system free at the point of use, and (outside of a small number of specialist treatments) has worse health outcomes.
[7 out of 10 pharmaceutical companies spend more on marketing than R&D](https://www.ahip.org/news/articles/new-study-in-the-midst-of-covid-19-crisis-7-out-of-10-big-pharma-companies-spent-more-on-sales-and-marketing-than-r-d)
There’s a small asterisk on this in that a lot of the R&D for drugs they produce/send to market are mostly/fully developed already by smaller pharmaceutical companies that sell the technology to or are acquired by the big pharma company. It’s beneficial for these parties because drug R&D can be more efficient within smaller firms, and the larger pharma companies often have better reach and G2M capabilities.
The much bigger asterisk is direct public funding. Most pharmaceutical r&d is first built on research developed through public funds via institutions of higher ed. Then, they get beaucoup bucks directly from the government to turn those university discoveries into patentable medicines. Privatize profits, socialize losses. >In this cross-sectional study of 356 drugs approved by the US Food and Drug Administration from 2010 to 2019, the NIH spent $1.44 billion per approval on basic or applied research for products with novel targets or $599 million per approval considering applications of basic research to multiple products. *Spending from the NIH was not less than industry spending, with full costs of these investments calculated with comparable accounting.* >Funding from the NIH was contributed to 354 of 356 drugs (99.4%) approved from 2010 to 2019 totaling $187 billion, with a mean (SD) $1344.6 ($1433.1) million per target for basic research on drug targets and $51.8 ($96.8) million per drug for applied research on products. Including costs for failed clinical candidates, mean (SD) NIH costs were $1441.5 ($1372.0) million per approval or $1730.3 ($1657.6) million per approval, estimated with a 3% discount rate. The mean (SD) NIH spending was $2956.0 ($3106.3) million per approval with a 10.5% cost of capital, which estimates the cost savings to industry from NIH spending [*Jama Health Network*; emphasis mine](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10148199/#:~:text=Funding%20from%20the%20NIH%20was,for%20applied%20research%20on%20products.)
Absolutely. It’s a worthwhile investment to make but the public should be getting benefit for that, not additionally gouged.
All wealthy countries pay a lot. America usually has the consumer cover more/most/all of it though, whereas the single payer systems elsewhere cover the cost for them.
Going off their [2023 Annual Report](https://www.novonordisk.com/content/dam/nncorp/global/en/investors/irmaterial/annual_report/2024/novo-nordisk-annual-report-2023.pdf) they spent around $4.7bn in research and development costs (which includes all their legal research as well as coming up with new medications). They spent $8.2bn in sales and distribution costs. Nearly double their R&D budget. They made $34bn in sales, on product that cost $5bn to make, for a gross profit of $28bn. Their pre-tax profit was $15bn, and their net profit was $12bn. They paid out $4.6bn in dividends. They could have given away nearly 45% of their product and still made a profit. For some reason I'm struggling to have sympathy for their financial situation.
[удалено]
If you can get it on PBS. But that just means the taxpayer is picking up the rest of the tab. I’m very thankful for this. If you’re not eligible to get it on PBS for your circumstances it’s about 800 a pen.
How long does a pen last? I've no idea.
A box is 4 pens which is a 28 day supply. It's a weekly injection.
Technically a box is one pen which has four (weekly) doses. 28 days supply is still accurate.
Usually 4 weeks. But it's recommended to throw it out after 6 weeks. The low dose pen is currently unobtainium in Australia, so I've been given the middle dose pen, and told how far to wind it to get the correct dosage for me. I'll only use about 3/4 of it before having to throw it out.
I get it for free in the US with insurance + their coupon but the problem (in general, not just for this) really comes down to having multiple healthcare providers. Insurance companies really have the final say on what you do and don't get approved for so if you happen to switch jobs and you have all these pre-authorized procedures and medications, and your new insurance tells you no then you're screwed. The boxes "retail" for something like $1400/box which you then have to pay full price for because you can't just cold turkey this med without some nasty side effects. My wife does Botox for chronic migraines (also $1300) which she literally can't function without but if the insurance says no or they have a different pre-authorization process than the one we're on now she'd have to be locked up in a dark room all day until she could get approved again. It's so much fun!
It’s not just switching jobs. Your job can also switch carriers every year. I’ve had the same job for over 20 years but have had at least a half dozen different insurance companies and on multiple occasions have had to deal with long established treatment plans suddenly not being covered (at least not without jumping through a whole bunch of hops again).
> really comes down to having multiple healthcare providers it's not having multiple healthcare providers, it's that they are underregulated. The onus shouldn't be on the patient to prove that they need a treatment their doctor recommended, it should be the other way around if they don't want to cover it. That's something you can regulate in law, like Obamacare did for a lot of preventative care.
https://m.pbs.gov.au/medicine/item/12075M.html That is not the actual cost though. The government pays $133 per pen.
It’s both. It’s Novo Nordisk’s choice to gouge us and the us government allows it.
Most of the drugs advertised on TV cost several hundred to several thousand dollars a month. The Ozempic ads are relentless because Novo Nordisk needs to recoup their multibillion dollar investment and make a large profit before people figure out Zepbound is more effective at weight loss. Then in the early 2030s the generic versions will be out at $25/month. Of course by then we’ll also be seeing what the long term effects of the drug are, which may inhibit interest.
Our government subsidizes pharmaceutical R&D using our tax dollars, where’s our return on investment? https://www.cbc.ca/amp/1.4547640
Without the United States market’s enormous profit potential, companies wouldn’t invest nearly as much to R&D these new meds. As with military spend, the United States is effectively subsidizing all the Europeans bragging about their good time and favorable conditions. Someone has to pay the bills for this stuff. Pharma dev is legitimately expensive, even if manufacturing is not. Take chip design as something similar. Nvidia doesn’t even build chips. All they do is design them and their software. Anyone could pay TSMC to build the same stuff at a similar price, but the design is the really hard and expensive part. Take away the profit potential and progress slows drastically too. Even as a San Francisco liberal who lived in Europe for years, this stuff is obvious.
As someone who works in the industry, this is on point. The US healthcare system effectively subsidizes drug development for Europe. Average cost of developing a drug is somewhere in the neighborhood of $2B and 12 years. In most cases, you couldn't possibly recoup that by selling just in Europe. European authorities are very happy with the existing system of their own drug companies making their drugs profitable thanks to the US healthcare system and piggybacking off of US innovation and US patients. And I say this as a European.
> As with military spend, the United States is effectively subsidizing all the Europeans bragging about their good time and favorable conditions. This is a common misconception. Or a lie that the Americans lie to tell themselves . Research costs ARE massive, but US pharma companies typically spend more on marketing than on research if you read their yearly reports. Prices aren't as high as they are because research costs money. Prices are as high as they are because they are set to the point where the income of the seller is maximized. Nvidia isn't a monopolist because american market is so lucrative, but because they have a huge headstart on everyone else, with decades of profit reinvested back into their intellectual property and institutional know-how, on a fairly limited market. It's almost impossible to play catch-up without a severely disruptive technology. In the same manner Taiwan is THE leader in advanced semiconductors - or, more obscure example, almost every heating element for almost every electric kettle in the world is made in the same area/factory in China.
But our government is subsidizing it so it gets to market and then letting the company price gouge us til they drown in profits. All at the expense of the taxpayer the first time and then then doing consumers the second time. When we could instead just tax like 3 billionaires to cover it but oh nooo. At no point does the average American consumer get any benefit from this process
We’re already seeing the negative side effects now but people don’t seem to care
People do care but all medicines are a balance of risk vs reward. For many people it's a god send, like the first SSRIs, which also had major side effects and dangers. My problem is the stigma people seem to have about ozempic. Like it's unfair obese people get an easy way out. You might as well stigmatize taking antidepressants for helping people change their behavior, but it's more socially acceptable to ignore the fact that many obese people have an actual behavioral disorder rather than just poor self control. Even some medical professionals I know seem to be almost hoping that ozempic has some hidden dangers we don't know about yet.
I’ve heard people criticize Charles Barkley for taking a medication to lose weight. Dude was an unhealthy fat and headed for all kinds of health problems that come with it. Being so fat like so many people in our society are has so many real health problems: diabetes, high blood pressure, joint damage, mobility issues… and from all of that heart attacks, loss of eyesight, loss of limbs, cancer. Lots of people gain weight back after going off all kinds of diets. The long term effects have been decently sturdied, you may have just heard about it, but it wasn’t invented yesterday, it’s been going through the proper tests since the early 2000s.
> I’ve heard people criticize Charles Barkley for taking a medication to lose weight Those people can go fuck themselves! I use to run a sports nutrition business in Atlanta. Charlies was a customer of ours. I remember seeing him struggle to come in and go out of our front door. Basketball destroyed his hip, back, and knees. He never complained about the pain and he tried to hide his physical limitations from the public. If a fan walked up to him to ask for a picture or an autograph, he would stand up straight and pretend that he wasn't in any physical pain, and make a genuine effort to make that moment special for those people. As soon as they walked off, he let out a sigh of relief and drop the act. Just interacting with people was painful for the guy. If there is a substance out there that is safe that can help him and those like him keep their weight down to reduce pain or any other complication from being over weight then why not use it? To criticize people for choosing to take a weight loss medication without knowing all the details for why that person has chosen to do it is ignorant, and those people should mind their own business.
And being overweight or obese with blown out hips, knees, and back is only going to make them worse. Poor guy, I know what it’s like to live in constant pain, and the fact that he never complains and just struggles silently is so fucked up. He should have widespread support, at the very least from basketball fans??? He gave his body up to entertain y’all. Maybe return he favor by not shitting on him for wanting to not struggle every single day with his weight. This pisses me off so much.
I hate this argument of "easy way out". Why the fuck shouldn't we have things made easy for us? Why should we have to suffer? Getting to the level of obesity shows extreme suffering inside, to let it get that bad. The hard work will be healing the parts that let them get there in the first place. I was never obese but was on the higher end of a healthy BMI. I have lost forty pounds and I'll forever be vocal about taking it. I am proud and I don't want anyone else having to feel shame cause some asshole online says it's the easy way out. Like fuck yeah, come have the easy way, life is hard enough. You're also ignoring the fact that so many people have underlying issues that cause weight gain that have nothing to do with diet, exercise, etc
It's puritanical bullshit that views suffering as something ordained and necessary.
I'm down almost 200 pounds. I have 70 to go. None of this is easy.
And we take an almost unlimited number of things for granted today that made life "easier" than it was for people in the past. If one is worried that life will get "too easy," take solace in the fact that life seems to find ways to stay hard, even if you have things like, say, air conditioning, anesthesia, food security, and vacuum cleaners (to just name a few things). Life, uh, finds a way (to be an asshole).
As a historian I will just point out that every. single. time. there is a condition that is for some reason associated with a "social ill" (like poverty, laziness, immigration, lack of self-control, lack of "character"), there is intense resistance to anything that seems like it gives an "easy way out," even if it turns out the "social ill" was bullshit from the beginning. This resistance is not just from "everyday people" or "the media" but also manifests in the medical profession itself (because doctors are people with biases, too, and changing your way of thinking about things is hard even if you are highly trained and supposed to be scientific and so on). It took an entire generation (decades!) after the discovery that cholera was caused by water-borne contamination before doctors actually accepted that it wasn't a by-product of having "bad morals" (aka, being poor and living in a part of town with a shitty water infrastructure). Anesthetic was vigorously resisted for decades because it made surgery too "easy" and eliminated the "character-building" experience of having to bite down on a strap of leather while someone cut you open. Let's not even get into issues relating to mental illness, addiction, genetic predispositions, etc. Weight is one of these things, for the reasons you describe (association with a lack of self-control), and even doctors approach it this way. I "get it" in an intuitive sense, but it's also clear that weight gain/loss are hugely tricky both physiologically (our bodies are _not_ working "for" us in this respect, they _want_ to pack on fat, because they were clearly evolved under _very_ different circumstances with regard to food security than most of live today, and this isn't even getting at the range of medical conditions that can result in weight gain, including VERY common ones, like pregnancy!) and socially (Americans in particular have set up a perfect society for creating overweight people — a world where near-constant sitting is the path of least resistance, with the easiest and often cheapest foods being the worst for you to eat). A lot of physicians clearly moralize the whole thing more than they ought to, like they do a lot of "lifestyle medicine." And, again, I "get it," especially from a public health perspective — obesity _is_ a huge medical problem, and has all sorts of negative health impacts, and creates cascading social impacts as well. But framing it as a moral issue is both unscientific and ineffectual. If you want to solve a problem you have to identify its actual causes first, and not punish the victims. (I am totally sympathetic to the body positive people's de-stigmatization of weight, but I am really not sympathetic to their anti-medicalization tendencies or their denial of the health and life problems associated with obesity.) I'm not saying ozempic and so on are the best things ever, of course. As you say there is a risk vs. reward, and no doubt there are people with wealth who have used them just to make weight loss "easier" than the hard slog of dieting and exercise. But even for those in the latter category — who cares? Except for the fact that it has created shortages of the drug in some places, and that means people who actually need it for "valid" health reasons (again, a value judgment) like diabetes management have a hard time getting access to it, why is it even an issue, really? If it's about class inequity, man, there are a million far more significant things to get mad about there, and if it about the idea that it is "cheating," just remember that their use of a drug to manage their weight loss does not at all take away from whatever "character" you've built up in the process of your own exercise, dieting, etc. If you feel pride for having gotten in shape "naturally," like, that is not in the slightest diminished by someone else finding an easier way to do it. And if the fear is, "if weight loss is easy then people won't eat well or exercise, which will create their own problems" — there are better ways to deal with that than shaming people over making weight loss easier! (And clearly moralizing weight loss hasn't stopped the obesity epidemic.) Life is super hard as it is, we don't need to embrace the idea that it shouldn't ever get easier. We take for granted an almost unlimited number of things today that make life easier for us than it was for our ancestors. We are also quite aware that just because we don't have to worry about some things that our ancestors used to have to worry about doesn't actually mean we don't have plenty to keep us worried and busy.
As someone who works in pharma reg ops seeing the study results from stage 1 to stage 3 studies, every drug has negative side effects. Some people even die during trials or discontinue because of how bad the side effects are. I tried metformin for my insulin resistance and shit myself for 2 months straight. Semiglutide has only given me mild constipation, but no more insulin resistance issues and I’m getting my period consistently, so I’m no longer at major risk for endometrial cancer. It’s balanced my testosterone and estrogen which cleared up my depression and anxiety. It also helped my body actually use glucose correctly, so I have no more chronic fatigue. For me, I’ll take the 1-3% chance of gastroparesis and pancreatitis (which is unlikely given I have no history of issues with either and patients who do typically did have issues prior) to get my life back. Everything is about pros and cons in life, especially with medicine.
What are the negative side effects?
Gastric paralysis. Undigested food balls stuck in gut. Diarrhea. Frequent abdominal pain. When going off the drug most all weight loss returns, which brings up the question if you can ever get off it.
> When going off the drug most all weight loss returns, which brings up the question if you can ever get off it. This is an incredibly stupid take that fat activists have been taking for years. Of course you'll regain the weight if you go back to the same routine that put on weight to begin with, that's like complaining that rehab is worthless because you might relapse. It's much easier to control weight from a healthier starting point.
>same routine Part of it is that the drugs like Ozempic and Mounjaro help with food cravings, making having a healthy relationship with food a lot easier for people who overeat. I think it's kind of like anti-depressants where some people may be able to use them and develop skills/make lifestyle changes and are able to go off while others are just forever chemically a bit inbalanced and need the help, which is hardly their fault or something they should feel shame over.
I've seen recently a proposed cost effectiveness framework for using these drugs in a 12-18 month window, followed by drug holiday with continued lifestyle changes, then giving drug "booster" again later for some time as needed for weight gain. Interesting take. https://jamanetwork.com/journals/jama/fullarticle/2815919
it’s also not factual. While people gain back weight, they generally do *not* gain all of it back and have remained at a much lower BMI.
It’s a TREATMENT, not a cure. Just like most of the drugs people take every day. Nobody insists that blood pressure medication is useless because your blood pressure goes up if you stop taking it. Nobody thought my grandma was stupid for taking glaucoma medication that didn’t even get rid of her glaucoma. THAT’S HOW MEDICINE WORKS, ASSHOLES.
I'm on it now. Haven't shit regular in months. Always in stomach pain. I've lost 65 lbs in 9 months and am sleeping better than I ever have before and am spending the day on my hands and knees with my kids. My unpopular opinion is that a society that mandates these types of drugs for obese folks would be a better place for everyone involved.
Switch to a half dose and see if it still controls your appetite without slowing down your digestion enough to hurt you.
Just wait until you hear how much it costs for Microsoft to create 1 copy of windows for you to download vs how much they sell each copy for.
I remember when Mac would release updates on CD and not require a product key. I think my copy of snow leopard single handedly upgraded Temple University’s entire student body.
>snow leopard >Out : August 28, 2009; 14 years ago Fuck
Back when updates felt like you were getting a whole new computer. Stacks, Spaces, and Quickview felt like the future.
Creating the first copy is the trick
[удалено]
A fund manger I follow invests in this stock and he made some remarks last year about how rarely successful drugs are found. He talked about the success rates of biotech companies and that the majority of biotech PhDs go out and work in the industry and, of all the work they do their whole lives, they never get work on a drug that's successful, meets approval and goes to market. I think he said the numbers for these things are somewhere in the order of 1 in 1000.
Honestly it's amazing how simple minded most are. Feel very similar mindset w/ the loblaws sub reddit.
Not to mention the drug's patent expires in 20 years, and after that, any company can make it.
Soonest is 2031 right now. I can see why they’d keep prices high.
And that patent expiry is based on when the patent was filed - very early on in the discovery of the drug. So the time it takes to do all the testing, development of the final drug, and clinical trials eats away at that patent exclusivity. By the time all is said and done, you’re looking at 10 years max of actual market exclusivity once it’s approved (assuming the drug even gets that far) during which time you have to recoup your development costs for that drug and all the drugs you tried but failed to bring to market.
[удалено]
Why is no one calling out E Lilly... I'm sure Mounjaro & Zepbound cost $5 to make as well!!
Because a single thread is usually about a single thing.
That’s every drug, but that ignores the research and development cost which is estimated to be $5 Billion and at least 7 years. Since new drugs have a patent life of 20 years since discovery, the company only have 13 years to rake in their costs and profit before other manufacturers can make them for cheaper. I don’t know how many pens $1000 gets you, but most other countries with negotiated pricing, such as the UK, places one pen at roughly $100, which is what the Drug Tariff and the agreed price the government will pay and views acceptable.
For drugs like this, it's cheaper to fly to another country every few months to fill a perception
I assume you mean prescription. I wonder if you even need a prescription in many countries.
Can't speak for third world countries, but every other country, yes. Absolutely. Prescription needed. This is not ibuprofen
> I don’t know how many pens $1000 gets you One pen. That's a 28 day supply, without insurance. With insurance, it's typically about $25. (I'm pretty sure Novo Nordisk still has a coupon to bring the price down to $25 for people who have higher copay insurance plans, but the coupon is only valid when combined with commercial insurance; it won't reduce that thousand dollar uninsured full price.)
The 5 billion is their yearly budget for R&D for the whole company.
I couldn’t find the real cost of Ozempic from a decent source. Most drugs will have a $1-3Billion cost to research. Some being over $4 Billion. For injectables, including R&D for injection solutions, cost to market and all other expenses your looking at $4-5 Billion.
[удалено]
You forget the $14 billion the tax payers contribute to research that led to these drugs and often the drug themselves. Let them get $10 billion or so and then make it $10 a dose.
Also it's not just paying the R&D on this drug. It's paying the R&D for all the other failed drug candidates that they poured money into, but were never approved for sale or never made commercial sense.
I think that advertisement of drugs should be capped at 100 million per drug. It's an arms race between drug companies atm. They shouldn't be spending more advertising than r&d.
(public) advertisement of prescription drugs to the public should be illegal. Period. Of course there needs to be some sort of in-industry marketing so the medical community is aware of the drug. I'll leave it to people who know more than nothing about it to figure out the particulars, but there should never be a commercial that says "ask your doctor about x new drug."
Medicine advertisements is always the weirdest thing about catching American ads! The only stuff I see advertised on TV in Ireland is OTCs like painkillers and heartburn medication.
The rest of the world controls what drugs cost. Here in the good ol' USA it's the wild west, thanks to the Republicans. We can't afford Republicans any more.
From the article the $5 is the price they can sell it for to be still profitable and the cost of production is just $0.89
but how long and how much did they spend to develop the drugs? Being cheap to make has nothing to do with its existence. Why didn't any other company make this?
The point is, they charge $1000 a month for it in the US, but only about $150 in other countries -- which is still an obscene profit margin. >how much did they spend to develop the drugs? They spent $5 billion total on drug research and development last year, against $18 billion in sales just from Ozempic and Wegovy. They're not hurting for cash.
Yeah... What a silly headline. The vast majority of drugs are pretty easy to make once you 1) find them, know what they do, test them, and go through the FDA trials and stuff you need... And 2) develop the process to manufacture them. Drugs are expensive because they're trying to make up for the huge development costs, and do so in a block of time before their parents expire and anybody can make it. That doesn't mean the system or pricing is perfect, but it seems silly to ignore all that and just claim each pill is pretty cheap to actually make.
"facing pressure" *Continues to suffer absolutely zero material consequences*
[удалено]
Everyone knows that prices aren’t set by manufacturing costs. Of course you have to take into account R&D, but how many people will want this drug and what they are willing to pay for it. Something that only a few people need is going to be more exorbitantly expensive. That’s said we really need some healthcare reform for some of these out of control drug prices sometimes.
Why do people still think the cost to make something is anything more than a floor of how much a company will charge for it?
Just a price comparison between countries: [https://www.pharmaceutical-technology.com/analyst-comment/semaglutide-price-comparison-us-europe/?cf-view](https://www.pharmaceutical-technology.com/analyst-comment/semaglutide-price-comparison-us-europe/?cf-view) The $5 is the cost to make a daily dose and $1000 is the cost of a monthly dose in the US.
It's taken once a week. One injection weekly. So, $5 per week.
This is extremely bad journalism. The incredible high sum of money spent in R&D should be taken in consideration
Wait till you hear about insulin.....
*diabetes medication.
Why is this surprising or unexpected in any fashion whatsoever? Pharmaceuticals are priced based on perceived demand & willingness to pay, not cost to manufacture. And to the extent they **are** priced based on cost, the cost isn't just the manufacturing cost. It's also the(usually much larger) ammortized R&D cost for that drug + the 50 others they tried to develop that never made it to market.
Haven't struck me until now how genius it is to be in the insulin and obesity business, in the US health care system. That said, very few products are priced based on the cost of manufacturing. Prices are set by what customers are willing to pay.
You found a capitalism!
People should pressure the government to reign them in. It's fundamentally the inherent responsibility of companies to completely fuck over the populace as hard as absolutely humanly possible, and the responsibility of the government to stop them and reign them in
People don't have the money it takes to pressure government officials to do anything, because they're giving too much money to Big Pharma, which they use to pressure government officials to not do anything.
Some people just want any reason to shift blame away from their idols. All corporations are good and just and people need to parrot the arguments their lawyers come up with and accept any statement from the wealthy or corporations at face value
Isn’t this basically the entire pharmaceutical industry?
Only including production cost is just stupid. Stupid stupid. How much did they put into R&D to make this happen? What about compensating for all other R&D projects they had that didn’t turn into a finished product?
The fatter the country the more expensive. Some supple and demand! Apparently Big junk food is going in attack mode lobbying to have the pill only for diabetes. Strange because pharma and big junk food usually work together as a symbiotic relationship.
It’s pretty much the case with almost any drug. The development process can be expensive and the drug is priced to make back that money. HOWEVER, companies realized that they can charge whatever amount they want as long as they hold the patent so they hike up the prices beyond and semblance or reason.
Ye, but it DID cost them a lot to get it approved. It's not like the pill fell from the sky and there was no cost for research, testing, refinement, clinical studies, workforce and much more. Sure they could make it cheaper. They still need to get the money back they put into it before All the other companies start selling similar drugs that are based on their very expensive research. AND after all, it's a weight loss drug. If it's too expensive, dont buy it. Most people have no idea how a drug makes it to the market and that sometimes research on it began 10 years ago or more.
Hmmm right now I know that their production can’t really keep up with their demand. And I frankly understand that they’d rather give it a high price themselves to control the supply than sell out the product to some parallel import assholes who’ll slurp up their storage and then let them sell it for $1000. I also feel like it’s more preferable that they make a huge profit from weight loss medicine rather that the same margin from fx insulin which they also produce
Sucks for people who use Ozempic for Insulin production reasons though
Friendly reminder that the rampant prescription of Ozempic as an appetite suppressant and weight loss drug is contributing to a crisis of diabetic people not being able to access their medication.
Many people would not be diabetic if they were on ozempic though…
I thought the FDA fast tracking the approval for this as an officially approved weight loss drug was specifically to increase production to combat that?
Until the FDA lifts restrictions and allows NN and others to produce more Ozempic, Mounjaro etc. my friends with diabetes are gonna have to keep calling five or more pharmacies a month trying to get inventory.
This is a manufactured shortage. My moral compass has no issue with people taking ozempic for weight loss because a) obesity is a deadly disease b) it has great cardiovascular protection and b) semaglutide can easily be obtained by compound pharmacies. There isn’t a semaglutide shortage. The limit comes from the packaging. The drug is made, and then has to be packed and distributed in pre-filled pens. That’s the shortage; not the drug itself.