TOPIC: Trump’s Plan to Cut Drug Imports Could Raise Prices, Not Lower

I believe he meant that if we were allowed to import and prescribe foreign-priced drugs into the USA, then the tariff on them would force US prices down. They would only be able to mark them up only 20-35% that way.

Tariffs and deregulation are sole and separate items.

Deregulation opens up the market to competitive pricing. Tariffs simply level the US domestic playing field for US companies to compete with offshore manufacturers who have the advantages of lower labor costs, less environmental regulation and the associated costs, and currency manipulation (e.g. Yuan/US$ Exchange rate).

So, if Irish manufactured Sofosbuvir (with tariffs) beat U.S., Indian, Bangladesh, etc. Sofosbuvir pricing, then insurance companies and health care providers would be free to buy Irish Sofosbuvir. US pharma manufacturers who have become fat and lazy though a captive market guaranteed by their bedfellows in congress and previous administrations would necessarily have to become more efficient to compete with the lowest cost suppliers, domestically and offshore - with a little home court advantage (within the US) to ensure they tend to stay home and don't head to Ireland or Bangladesh to manufacture.

Additionally - what is being contemplated are selective tariffs which specifically target US companies who move production and jobs abroad in order to sell their products back to the US at a higher profit. In a 'carrot and stick' scenario, selective tariffs, and selective is the key word, are the 'stick'.

The 'carrot' is a lowering of US corporate tax rates (currently among the very highest in the world) to among the lowest in the world to attract new capital, repatriate capital currently held offshore, fuel domestic economic growth and allow US companies to be more globally competitive.

Regardless of tariffs (unless they turn out to be ridiculously high) competition will drive prices downward - everywhere.

<flame-proof-jacket-on>

Suppose that Blue Cross or Kaiser ask Gilead Sciences (Ireland) for a price for Sofosbuvir?

Gilead Sciences (Ireland) will give a polite answer: "we can supply for price X + Import Tariff (where X = about $50,000 after discount on our regular List Price, and USA Import Tariff is usually Zero for most pharmaceutical products, but it might rise if the New President changes it)."

Gilead Sciences (Ireland) will then kindly propose: "If you are importing to the USA, it would be faster and easier for you if you contact our US distributor, who will offer you a price of X (same X as above) with no delays and no Tariff."

Bottom Line:

Even if the new US Administration increases Import Tariffs on Medications, Gilead will still have it all Stitched Up because Gilead Ireland UC is a subsidiary of Gilead Inc., and Gilead Inc still hold a world patent (almost) on Sofosbuvir.

<flame-proof-jacket-off>

Just For Info:

www.bloomberg.com/research/stocks/privat...p?privcapId=22613423

www.gilead.com/about/worldwide-operations/europe/ireland

www.dutycalculator.com/dc/285931/health-...india-to-spain-is-0/

Keeping it Non-Political:

This post is not about America-Bashing or Trump-Bashing or Clinton-bashing. It is about Bastard-Corporation-Bashing. There is a Bastard-USA-Corporation called Gilead Sciences that is still Literally Killing People and Holding The World to Ransom through its pricing strategy.

But It IS A Political Problem:

And that Bastard-USA-Corporation will Keep On Getting Away With It until the USA Government (or new USA President) will stop them.

Mr Trump, Mr President-Elect, if by any chance you are reading this, please don't just threaten tariffs. Please Stop Big Pharma companies like Gilead from Getting Away with Murder!

Hi Vororo,

I find the whole patent thing a bit strange now and it must be hard to work in companies like big pharma where the focus on developing something great, new and worthwhile, is suddenly changed to fart arseing around with mods to the drugs and using patents to get profits when you do.

I am typing this post on my 13 inch MacPro for which I understand Apple holds a patent for a rectangular aluminium case with round corners. My 27 inch iMac is with Apple Care as the bloody hinge is broken - a design fault probably made when Apple was looking after their patents rather then considering their cheap silly hinge was not strong enough to support the computer.

Another question is about charging what the market will bear - big pharma did this here in Aust and basically no one could afford it until eventually it was on the PBS. I suspect that over time this will be for a much reduced price anyway; not considering the year or so of lost sales because no one was buying.

Simple view I suppose.

Having used generics and the alleged real deal, I cannot fid the difference between them - aside from that Riba stuff being added in with retreatment. Using the PBS is obviously cheaper for me, but part of me still would prefer the government save themselves a quid, and give me (receipts have to be provided) a few thousand bucks and let me do my own thing with my doctor.

Just some thought from the again recently brain fogged and hopefully defogged.


Yours


Jeff

The world is not fair; nor will it ever be. Imagine, a doctor who goes to 10 years of medical school and bears the debt of instruction making $160,000 a year, and someone who throws a football but can't stay out of jail or spell correctly makes millions.

I doubt the powers that be will ever relinquish their stronghold over drug pricing. We may win a few small battles, but don't look for Hep C cures selling for $800 in the USA.

* see 'Rothchilds'-- 'Federal Reserve' for further study.

Realistically, prices will not change from Gileads side unless the intellectual property is literally taken from them, either by changing pharmaceutical patent laws to a much shorter expiration (this will also force innovation), or simply 'commandeering the patents in the public interest through Eminent Domain.

What has happened in the US, and throughout the world is that taxpayer, and citizen bank accounts have been hijacked by Big Pharma via the public health mandate. The fundamental problem is not the insurance companies, or exchanges, or what ever you call it where you live. It is what the insurance company and ultimately the consumer is forced to pay for.

Any answer to more affordable public/private health insurance must come fundamentally from pharmaceutical price reform, or more to the point - by bringing Big Pharma patent and price abuse to a drop dead halt.

Let me be the one to put the controversy here to rest....

Gilead has a patent on Sofusbuvir, Harvoni and Epclusa in the USA and some other countries. That means that the insurance companies and whatever government agencies that must abide by the patents can only purchase from Gilead.

Generics are available for importation to many countries. Only the individual, with his own money in hand, has the opportunity to buy these meds and save his life. So if Trump bans Generics, that means everyone has just one option.

If Trump imposes a tariff on generics, that only affects drugs not under patent. Sofusbuvir, Harvoni and Epclusa have 20 year patents in USA.

Let me just add that I don't believe that Trump will do anything to affect drug pricing. But it would be easier to get changes to generic importation laws than to patent laws, which would affect many other industries and products. They are not going to change the patent laws, trust me. Because that would mean knockoffs of Microsoft Windows, Boeing Airliners, Intel chips, etc. is all okay.

So under this scenario, a change to the ability to import generics means you must buy from Gilead.

Therefore, for any Hep C patient not being treated, the Fat lady is singing, time to saddle up and ride.

You can contact This email address is being protected from spambots. You need JavaScript enabled to view it. for generic Epclusa or Harvoni

Yes, GreedFighter, I believe you describe the sad but realistic truth of it.

If only there was a way to combine professional medical consultations with guaranteed supply-chain integrity (as demonstrated by FixHepC) and make that available on-line everywhere in the world ... ?

We must be very careful about altering patent law. It is the cornerstone of all creativity and innovation. And freedom. It is a form of property rights, which is what the United States of America is founded upon first and foremost.
Maybe form a commission to decide what a fair price pharma can charge is? But then everyone will demand equality, and they will have to eventually determine a 'fair price' for all trades. Not an America I want to live in. This is a very complex, and complicated problem that I don't see getting resolved completely anytime soon. I do believe something must be done though, as no one deserves to die because they can't afford medicine.

The problem is - for obvious reasons - Big Pharma would like us to believe that all intellectual property is equal. Nothing could be further from the truth.

No one ever died for lack of a licensed copy of a Led Zeppelin CD, or because they couldn't afford the latest version of Microsoft Windows 10. People are dying every day because insurers, health care providers, and individual patients simply can't afford to pay the extortionate pricing required for lifesaving medications.

There are now round the clock public service ads from the US Centers for Disease Control urging baby boomers to get tested for Hep C (paraphrasing here) 'before it is too late'. The irony is, that once tested most won't qualify for treatment.

At what point does abusing one's intellectual property rights to extort the public become outright murder? Even genocide? The answer I believe is clear. It happens on a massive scale, every day - and no one so much as lifts a finger, or bats an eye.

The rare exceptions are right here. We - at FixHepC - as group have refused to accept decline, illness and eventually death in mindless deference to insatiable corporate greed.

The nature of pharmaceutical patents can be redefined - at any time. Any country which collectively chooses to do so can define the way it treats pharmaceutical patents. Take China for example... or now Moldova, or Bangladesh, or Egypt. Or the US after January 20th 2017 (that is only a hope at this point).

There is also precedence for Eminent Domain in the public interest. To my knowledge it has never been applied with regard to intellectual property, but what better case than a drug like Sofosbuvir which one could easily compare to Penicillin, or Polio Vaccine.

Maybe come up with a sliding scale where any life-saving medicine, or device would be priced at say, ~15-25% above cost, based on units sold. But then what is cost? You have to factor in office space, equipment, materials, wages, real estate,even the electric bill, etc. Nothing will be easy.

'Intellectual Property' isn't about innovation or creativity. It is the second word in the phrase which clearly defines what it is about. Ownership.

I don't have a problem with patents. In most cases they work reasonably well in protecting someone's hard work from exploitation. So Frootle get to protect their round edged iThings and we get the choice of those or Samtel's sharp edged Spamdroid devices. There is choice of brand and because these are toys/tools rather than essential lifesavers we want them rather than need them so the prices are constrained by competition which circumvents exploitation by excessively greedy bastards.

Medicine is different, it is necessary to our health and wellbeing and in many cases a medication is specific or 'breakthrough' for the disease and/or patient. (e.g. GT3s are not well served by Harvoni and/or Sofosbuvir is the backbone of HCV tx). This has allowed a situation where the patent goes beyond protecting IP and allows the excessively greedy bastards to exploit society as a whole while justifying their prices with bullshit spin about R&D costs and rewarding themselves with $400 million per year for doing so.

I'm not certain what the full answer is here? Perhaps some sort of process where medicines that are deemed "Lifesaving" by the WHO or other designated body can be manufactured by any suitable Quality & GMP compliant company as a generic with some form of regulated licensing fees payable to the Patent holder? This may provide the necessary competition to control pricing and still provide adequate reward to the patent holder by the sheer volume of sales.

We not only need to look at how we in the US treat and regulate pharmaceutical patents, but also how we define fiduciary duty for a publicly (or even privately held) corporation which actions and policies, and intellectual property holdings have such a grave bearing on public health and well being.

The concept of fiduciary duty for a company that makes cogs and sprockets, and for a company that trades in lifesaving cures which may directly affect the survival of hundreds of millions of people should be very different.

The sprocket and cog company should be free to charge whatever the market will bear to maximize profits for shareholders. Free enterprise! I'm all for it.

However, a company which trades in building and maintaining the very foundations public health has (or should have) a very different duty, and that is to deliver a product which provides maximum benefit to the greatest number of health care consumers possible in exchange for a healthy margin proportionate to larger the market it serves.

What is missing in the current predatory Big Pharma pricing strategy is any sense of stewardship or public responsibility.

No one has ever published the numbers - but if one has half a brain, the Big Pharma formula for creating and maintaining absolute maximum profits is simple. "Keep the price of the product as high as possible, and the profits (they call them 'pipelines') flowing at full capacity by ensuring through prohibitive pricing that the rate of infection outstrips the rate of cure - ad infinitum.

If I were a betting man, I'd be shorting Big Pharma about now, and Gilead would be first on the list.

This sums the problem up. And it seems to be an international problem that isn't just restricted to the pharmaceutical industry. It is represented at its best (worst) by those members of boards of listed companies who feel it appropriate to reward themselves with packages of >$400 million per year as I commented earlier. Justified to shareholders by the improved performance they achieve (which is often illusory juggling) and often retained when things slump because that was "outside their control".

Moderator post:

I have just gone through the thread and removed several off topic posts. This is something that rarely happens on this site but flame wars will not be tolerated. Please remain on topic.

Thanks
Gaj