Friday, March 16, 2012

IPR and Medicines 23: Profitability of Innovator Pharma Companies

After I posted IPR and Medicines 22: CL on Anti-Cancer Drug Nexavar on Chito Gascon's wall where the discussion started, another friend or relative of him came in and we extended the exchanges. Here they go, I inserted the images in their larger size.

March 16-19, 2012

  • Peter  Great piece! Cuz..thanks for posting. Interesting thread here on the paradox of capitalism. I thought the sole purpose of a business is to create customers not kill them off? Don’t get me wrong I’m all for capitalism (and borrowing from Churchill’s quip about democracy, I’d say the same of capitalism, it’s undeniably the worst economic system except for all others) and I respect, honor and defend the tenets of private property with some exceptions for sure, but I also don’t delude myself that capitalism is a moral system (amoral in fact at best). However, I can’t understand the rabid attacks against advocating a more balanced approach in cases where the product plays a critical role to the immediacy of such a critical thing like sustaining life…I mean to me it’s just principle isn’t it? For such critical circumstances, there’s just no arguing in my book that unfettered capitalist model should take a back seat to a more equitable and balanced solution for all, otherwise what’s the point of providing the service/product when the most needy of it (the target customer) are essentially forcibly blocked from receiving it all in the name of profit..a denial of service resulting in a loss of life all because profit margins are threatened?..c'mon!! Anyway, all in, I’m fascinated by my own tug-of-war between the intrinsic empathic response and the equally intrinsic libertarian convictions…like the proverbial angle and demon sitting on my shoulders whispering to my ear. Problem is neither the angel nor the demon is entirely good or bad, and there’s the rub ;)

  • Nonoy Oplas ‎" I can’t understand the rabid attacks against advocating a more balanced approach in cases where the product plays a critical role to the immediacy of such a critical thing like sustaining life"
    The rabid attack started from the government and the various groups that prod govt to issue CL, to confiscate private property rights (in this case, a drug molecule used to fight liver cancer) and give such right to some other capitalists (usually cronies of those in government). If such attack and coercion was not initiated in the first place, then people do their own things. More innovator companies will challenge existing innovator firms with their new products and services, like a new cell phone, a new flat tv, a new medicine or vaccine. Generic producers wait their turn, all patents expire, they are not forever. Once a product or a molecule is off patent, generics come in, they compete among each other along with the original innovator company, in producing a different product using the same molecule, have their own marketing schemes.

  • Peter  Sorry Mr. Oplas, I just can't see it that way..lives are at stake..nuff said.

  • Nonoy Oplas Yes, lives are at stake. So many killer diseases, some are old, some are new, some are mutants of old, and not too many vaccines or treatment to kill these killer diseases. People would rather be in telecom, in transpo, in energy, in real estate, etc., never in medicine innovation. The few innovators are evil because they want to make money and profit out of their investments.

  • Peter  Ok will dabble a bit here. Would you agree that most of the innovation in pharma research and production is done not by private enterprise but through govt and public money (i.e. taxes)?

  • Nonoy Oplas No. public spending on medicine R&D is small compared to private spending, at least in the US,
    Total biopharmaceutical company R&D, PhRMA member R&D, and NIH operating budget: 1995-2009

  • Peter
     Of course..that's a study paid for by Pharma lobby. Try this on for size.

  • the fist link..not sure what the 2nd one is about.

  • Peter  Anyhow..this is like politics and's a stale mate. I'll respect your personal opinions and would just hope that you find a way to seeing things from desperate destitute dying patients view some day. Cheers!

  • Nonoy Oplas There's no chart or table to the link you gave. Meanwhile, stick to issues, not on emotion. My brother died of prostate cancer, my sis in law died of colon cancer. My mother and father are now sick with variious diseases due to their old age. But I won't throw those scenes in a discussion on health policy.

  • Peter  It's ok Mr. Oplas, data abounds on either side of the argument. In the end to me there's more than enough space in the profit margins of the single most profitable industry in the developed world (where most meds are created and produced) to give up a bit for those who most need their products...that's not accounting for emotions.

  • Nonoy Oplas Again, no data shown or wrong data. In the US for instance:

    Top 10 Industries Producing U.S. Billionaires, 2012:

    1. Investments: 100 billionaires
    2. Technology: 51 billionaires
    3. Media: 37
    4. Energy: 35
    5. Food and Beverage*: 31
    5. Service*: 31
    7. Fashion and Retail: 28
    8. Real Estate: 27
    9. Manufacturing: 18
    10. Sports: 15

    Seems no billionaires came from the pharma sector? What happened?
    What's the best route to becoming a billionaire? B-school professors weigh in.

  • Peter the list of billionaires dictates that the source industry ranks in the same position with respect to profitability? Can you give me some insight then on what Industry does "investments" fall into? and "manufacturing" for that matter? profitability is not measured that way good sir. Anyhow, believe what you wish and I wish you good luck in hoping and fighting for this industry to keep forcing the kind of profit margins they insist for critical care drugs. I will in turn pray for the opposite and hope that the aging demographics of many countries (Russia, China, US, Japan, etc.) will squeeze this industry from usury heights to something more ethical.

  • Nonoy Oplas It's obvious you did not read that short article, it says
    "...Number one is the hodge-podge category of investments, which includes hedge fund tycoons but also a wide assortment of others like Warren Buffett..."
    Yes, to each his own, but when it comes to public policy on health and use of government coercion, the stated goal should be placed in contrast with the unintended and often negative consequences.

  • Peter  Yes I did Mr. Oplas, and that's precisely why I asked the question. Take a look at the market cap of the top 10 pharma ..better yet ask the question of what portion of said investments are parked in stocks of pharmaceutical companies?..I’ll give you a hint. Just one (yes 1!) of Buffet’s funds has over $100 million allocated in two pharmaceutical firms (other investment houses are even more heavily weighted in this sector for many! funds)..why? because it is extremely profitable. So in short, the underlying facts of that list which will take a lot of investigation to uncover is likely involving the pharmaceutical industry and simply because it is one of the (and on occasion it is THE ) most profitable industries anywhere. Now, I’m not and never have in this thread, arguing that Pharmaceutical firms should not be profitable, on the contrary, without profit they would seize to exist to the detriment of all, but the argument is how profitable they should be. With a product that is integral to sustaining life (in many instances) excessive profit margins are a barrier to achieving its end goal – providing better health care. It’s a captured market, so the natural free market competitive models don’t apply and its as simple as that. Apologies for being argumentative Mr. Oplas, I do understand your position and agree to some just struck a nerve :)...but in any case I hope you’d reconsider. I'll send you some links that may help persuade you that striking the right balance is the key. Btw, Chito..sorry for hijacking your wall cuz...but you know me naman I can get carried away :) Oh sya! God Bless and good health to one and all. Cheers!

  • Nonoy Oplas Am wondering who should determine what is the socially or economically "acceptable" or "tolerable" profit rate that an innovator pharma, a generic pharma, a drugstore chain, a hospital, a drug wholesaler and importer, a health insurance firm, etc. -- should make? The UN, WHO, DOH, Bill Gates, Mang Pandoy,... who? On what ground that such person or office can determine what is that socially acceptable profit rate? I can only think of a central planning and near-socialist economy to be able to do that.

Free riding attitude is everywhere. People want some subsidies from somewhere else, whether public or private. In healthcare in particular, they want government to provide affordable if not free healthcare (medicines, hospitalization, physician visit, etc.) to people even if would mean large-scale borrowings and perennial budget deficit every year. They want private enterprises in the health sector to be heavily regulated -- their products and services, their pricing and promos. That is how drug price control, issuance of compulsory licensing (CL), special CL and related government policies,  are created and expanded.

Meanwhile, here's another chart from,  
where the above chart of R&D spending was lifted.

  • Peter Casimiro Good question Mr. Oplas, let me ask a counter question to that then. Would you agree that the current Pharma industry sets it's own price NOT to what the market can bare as a free market model would dictate for critical care drugs? In short the current market isn't a free market anyhow, so for now yes that pseudo central planned market needs intervention to break the barrier...without it people's as simple as that. Critical care drugs is not like any other product; tv, house, shoes, jewelry, car, etc. which people can forego without. A cancer patient (even with average means) can't afford these drugs, and are literally forced to dream foolish dreams like "oh $50,000 a year? ok thank's Doc maybe next year I'll buy me that Avastin to help rid me of my cancer, just give me tylenol for now". I hear you loud and clear, I don't like market interventions like price controls either but it's the lesser of two evils at this point (the other being price gouging)

  • Chito Gascon hey guys!!! loved the thread... a lively and engaging debate indeed... interestingly enough between two persons i value and respect who crossed the path of libertarian thinking at different stages of their lives... democracy and the dialogue it engenders is great! cheers to veryone

  • Nonoy Oplas Chito, thanks for your original posting, I was able to write a long post out of it, hehehe. cheers.

  • Rolex Suplico I wrote the Cheaper Meds Act when I was a first term congressman. In fact, I also coined its short title -Cheaper Meds Act. I based it in the Indian law. It was for a mandatory price regulation. But a senator deliberately castrated and weakened it. It became optional. Sayang...

  • Peter Casimiro Thanks! Chito..yeah enjoyed my lively exchange with Mr. Oplas..aha! so we're more alike pala! Mr. Oplas :) Cheers! Cuz..thanks for allowing us to make a mess of your wall :)

  • Peter Casimiro Interesting Mr. Suplico, would like to read the Act you wrote, is it available in a public domain site? As for it being castrated..not unusual..that happens all the time here (US) since Pharma is one of the top lobbying groups in the beltway (energy/oil, and finance are the other two..the rest pale in comparison to these 3 musketeers :) As you can see on the thread above I'm open to both sides of the argument, but wary and watchful of either one overreaching their in all things..striking a balance is key to a sustainable and equitable model for all.

  • Nonoy Oplas Hi Rolex, I wrote a book, "Health Choices and Responsibilities", published in January 2011, 233 pages long, mainly a critique of the drug price control policy and other provisions of the Cheaper Medicines Law RA 9502),, thanks.

See also:
IPR and Medicines 10: Innovator Drugs and Generics Complementation, July 13, 2011
IPR and medicines 11: When blockbusters' patent expires, September 07, 2011
IPR and Medicines 17: Why are Drugs Still Expensive After Patents have Expired? November 17, 2011

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