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Citing 'Moral Requirement To Make Money', Pharma CEO Jacks Drug Price 400% (arstechnica.com)

The chief executive of a small pharmaceutical company defended hiking the price of an essential antibiotic by more than 400 percent and told the Financial Times that he thinks "it is a moral requirement to make money when you can." From a report: Nirmal Mulye, CEO of the small Missouri-based drug company Nostrum Laboratories, raised the price of bottle of nitrofurantoin from $474.75 to $2,392 last month. The drug is a decades-old antibiotic used to treat urinary-tract infections caused by Escherichia coli and certain other Gram-negative bacteria. The World Health Organization lists nitrofurantoin as an essential medicine. In an interview with the FT, Mulye went on to say it was also a "moral requirement" to "sell the product for the highest price," and he explained that he was in "this business to make money."

33 of 670 comments (clear)

  1. Making money is not a "moral requirement" by Anonymous Coward · · Score: 5, Insightful

    But maybe it's what they teach at MBA courses.

    Anyhow, time to decommercialise medicine. Yes, I know it sounds pinko commie socialist. Even so.

    1. Re:Making money is not a "moral requirement" by fishscene · · Score: 4, Insightful

      I reckon the same logic can be applied for taxes for this company too. It's a moral requirement for the federal government to make money.. by jacking up your corporate taxes by 400%.

    2. Re:Making money is not a "moral requirement" by ceoyoyo · · Score: 5, Informative

      There's fairly strong evidence against your primary assumption. Most drug discovery is done by academic, publicly funded researchers, who get paid fairly poorly considering their education, and the hazards of the field.

      The ones who rake in the big profits are business and investor types who mostly buy and sell existing IP.

    3. Re:Making money is not a "moral requirement" by layabout · · Score: 5, Insightful

      Markets can't correct this behavior because drugs are effectively a monopoly situation. Not just from the patent perspective but from the biological. When treating a condition, it's not uncommon to find that a patient can't tolerate one drug but can another. A classic example of this is statins. The protocol for using statin says if a patient can't tolerate the cheap ones, gradually try the increasingly more expensive ones until you find one that works. If the patient can only tolerate one particular drug to treat a condition, there is no market (i.e. only one supplier, the drug that works). The only power the patient has is to decide whether or not to treat the condition. There is no way the patient can put any pressure on the drug manufacturer to change pricing. If anything, the drug manufacturer is saying "you want to live? Don't ask about the price, just pay it."

    4. Re:Making money is not a "moral requirement" by Calydor · · Score: 5, Insightful

      No, this is just how a sociopath thinks. Quite literally, a sociopath thinks that anything that benefits him (regardless of what happens to the rest of the world) is morally right.

      --
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    5. Re:Making money is not a "moral requirement" by jellomizer · · Score: 4, Funny

      I try to avoid sarcasm online. Back in the mid-90's I made some sarcastic comments about a flat earth trying to point how how stupid it was to avoid Occam's Razor. Then a decade later I see this Flat Earth movement and I fear I may had helped cause that. I now avoid Sarcasm on the internet.

      --
      If something is so important that you feel the need to post it on the internet... It probably isn't that important.
    6. Re:Making money is not a "moral requirement" by Sperbels · · Score: 4, Funny

      Yay, the fuckers who charged me $50,000 to have my appendix removed will rescue us from the price gouging pharmas.

    7. Re:Making money is not a "moral requirement" by barc0001 · · Score: 4

      OP was making fun of idiots who cannot tell the difference between a socialist idea and a communist one. As a side effect he/she has also lured out those who have no sense of humor, like yourself.

    8. Re:Making money is not a "moral requirement" by ceoyoyo · · Score: 5, Informative

      Not really. You don't found a pharma startup unless you've got a promising candidate already. Basic discovery happens mostly in universities. The academic researchers find something interesting, use animal models to work out the mechanism and test efficacy, and occasionally even do some human studies. Startups are then either spun out of the university, started independently in conjunction with one of the university researchers, or in some cases just troll through the published literature looking for good ideas. The startup, or sometimes a bigger pharma company, then runs the basic human trials, and, if successful, sells the drug (or the company) to one of the major pharma corps for marketing and distribution.

      Basic discovery is still very much a publicly financed endeavour.

    9. Re: Making money is not a "moral requirement" by c6gunner · · Score: 4, Insightful

      You've got that exactly backwards, I'm afraid.

    10. Re:Making money is not a "moral requirement" by bondsbw · · Score: 5, Insightful

      However, you can't make it illegal for competition to exist ... without expecting the prices to be high.

      Yes we can. We regulate them.

      What we can't do is assume the free market will sort out a situation when we can't allow free market conditions.

      I love free market competition. It works in the vast majority of economic situations. But it cannot work for markets we must heavily regulate and we shouldn't try to force it.

      --
      All my liberal friends think I'm a conservative, all my conservative friends think I'm a liberal.
    11. Re:Making money is not a "moral requirement" by Zmobie · · Score: 4, Insightful

      Can the law of supply (his lab's production) and demand (price people are willing to pay) make this self-regulating?

      This is the inherent flaw in that type of argument and the main reason that healthcare needs to be single-payer and pharma companies (and other medical type companies) need to be heavily regulated. Demand is not, "price people are willing to pay", demand in the healthcare world is how healthy do people want to be. Incidentally this is always as healthy as they can be (and fun fact, in many cases if a person decides they don't want to be healthy we consider that to be a disease, potentially even criminal!). This is why healthcare costs go up every year and don't actually ever go down.

      Building on this, basic macro-ecnomoics tells us that the supply and demand of a free market is supposed to rise and fall against each other until a general state of price equilibrium is attained. Want to know what happens when demand literally will not (possibly cannot if we want the species to survive) fall? The price can be raised ad infinitum. The execs and many of their politician buddies know this, but they don't ever acknowledge it. Healthcare is literally a money pit if left in the current system and will far out pace wage earnings in all industries eventually. If you don't believe me look at the wage growth over the past several years vs healthcare costs for yourself.

      Based on these simple facts (and yes I do mean facts), to me, there is really only one way to fix this appropriately. By changing the system and acknowledging that you cannot apply a free market model to healthcare in any sustainable way. Pricing and costs would be regulated and made equal across socio-economic areas/demographics and then we take all of that excess money that was a result of price gouging and reinvest that into medical research, hospitals, etc. Seriously if we switch to a single-payer system tomorrow we would actually SAVE money as a country.

      Most sane people are not asking the business to operate for free or at a loss. They are allowed to make a profit, but not to gouge it simply because they recognized the flaw in the current system. The numbers have been stated over and over, we pay by far the most money per person into healthcare of any 1st world country. If we used that money to improve healthcare availability we would have an affordable system for everyone that you don't have to wait forever for anything to happen. Everyone loves citing Canada having long waits, but that is only for more difficult procedures or tests and even then they are not the only country with universal healthcare (and gasp! there are countries that don't have that same issue).

      For me, the solution is sitting right in front of us, but because of the fervor like devotion many people have to "free-market" everything we can't actually implement it yet. This, just like with everything else, is a perfect example of there is no one-size fits all solution for all problems and we as a country need to stop acting like that.

    12. Re:Making money is not a "moral requirement" by Immerman · · Score: 4, Insightful

      > but the regulations could be modernized and improved.

      They certainly could - patents could be made perpetual, and it could be made illegal to make a drug that competes in any way with any competitor's drug.

      Oh, you meant better for patients and the public good? First we'd need to hire politicians that are more interested in serving the public good than lining their pockets. Good luck with that.

      --
      --- Most topics have many sides worth arguing, allow me to take one opposite you.
  2. sad by fluffernutter · · Score: 4, Insightful

    The sad part is, if making money can be called a "moral requirement", apparently it is more important than the truly moral cause of healing as many people as possible.

    --
    Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
  3. He's not wrong by rsilvergun · · Score: 4, Insightful

    if you accept the premise of private, for profit insurance as a means to access medicine and healthcare and that these companies will be privately traded companies with shareholders then yes, that's where the moral imperative lies. This is one of the consequences of such a system.

    We already know the solution is single payer healthcare. We can see it working in a dozen countries. The question is will we swallow our pride long enough to vote the sorts of people in that'll give it to us?

    --
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    1. Re:He's not wrong by fluffernutter · · Score: 4, Interesting

      Canadian here. Most people love our health care system and will fight to keep it. Yes there are some downsides, like some longer waits. Yet people who really need it do get care immediately. It's not really as bad as the vocal minority make it sound. Don't just take my word for it.

      --
      Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
    2. Re:He's not wrong by Pulzar · · Score: 5, Interesting

      Canadian here. Most people love our health care system and will fight to keep it. Yes there are some downsides, like some longer waits. Yet people who really need it do get care immediately. It's not really as bad as the vocal minority make it sound.

      As someone who's lived in both places, I can tell you that the biggest downside of Canadian system over US is all the times where you'd really like to get care right away, but you're not going to die if you don't. *That's* the stuff that really sucks in Canada.

      Emergency room visits where you're not bleeding out on the floor, or finding an obstetrician when you get pregnant that's not an hour away, finding a specialist to listen to your baby's heart when it sounds a little off, father needing a hip replacement... With all of those, I've had bad experiences in Canada.

      In US, if I need a doctor, I can almost always find one the next day, or next week if it's a really unique case. It absolutely sucks having to deal with insurance, costs, and so on, don't get me wrong.... but it is nice to know that I can see someone quickly when I need help.

      Both sides need improvement, and Canadian system is a much better starting point... but it's not all roses up there either :(.

      --
      Never underestimate the bandwidth of a 747 filled with CD-ROMs.
  4. This man gives off by fredrated · · Score: 4, Insightful

    the stench of evil.

  5. Another one of these by Kohath · · Score: 4, Insightful

    There are no patents on this. It's an old medication. What keeps other companies from selling exactly the same substance? Answer: Government regulation.

    Government needs to do more to help more companies make these medicines at reasonable prices.

    1. Re:Another one of these by ceoyoyo · · Score: 4, Informative

      Other companies do sell exactly the same substance. This appears to be an example of a company taking advantage of either (a) consumer gullibility where brand names are concerned or (b) corrupt physicians.

      Although from the article it sounds like the competition might be cranking the price up as well, so perhaps it's (c) collusion.

      In the rest of the world, apparently actual government regulation successfully keeps the price between $0.10 and $10.

  6. Let’s allow the free market to work by Applehu+Akbar · · Score: 5, Informative

    Actually it was I, not Ms Mash, who posted this story.

    I’m always amoused when these low-budget shkrelis claim to be defenders of the free market when they make insane price moves. If we actually did have a free market in pharma, we would be able to fill our prescriptions for this compound at the world market price of $18, as per the closing line that was oddly edited out of my post.

    The only way price increases like this can be made to stick is to have the FDA on your side, preventing us from being able to compete. Time to rip out the FDA’s ability to keep competition out of the market. Let it manage testing, not price manipulation.

  7. Yep by American+AC+in+Paris · · Score: 5, Insightful

    This is exactly how for-profit industries work.

    Maybe instead of trying to find ways to make for-profit healthcare marginally less of a roiling tire fire for Americans, we should instead nationalize healthcare, like the rest of the civilized world.

    :|

    --

    Obliteracy: Words with explosions

  8. We're we told drug prices would be lowered? by smooth+wombat · · Score: 5, Funny

    I seem to recall some orange-faced liberal from New York City telling us he'd force drug companies to lower the price of their drugs. You know, use the power of big government to dictate to private companies how they should run things.

    He wasn't lying when he said that, was he?

    --
    We will bankrupt ourselves in the vain search for absolute security. -- Dwight D. Eisenhower
  9. Re:Decades old by avandesande · · Score: 5, Interesting

    a better solution would be to let the US citizens freely engage in commerce and give them a choice to purchase drugs from overseas

    --
    love is just extroverted narcissism
  10. Re:What do you know the man is a comitted lefty by fred6666 · · Score: 5, Informative

    On a world scale, the US democratic party is on the right of the center of the political spectrum. Despite being in power for years, they still didn't implement basic social net such as free health care that are considered standard everywhere else in the developed world. Even right-wing political parties support the idea in most places.

  11. Moral requirement not to support patents by FeelGood314 · · Score: 4, Interesting

    Patents have never been to spur innovation. Their purpose is to preserve knowledge. We as society decided we would trade a limited monopoly on an invention for the complete description of that invention. The invention was supposed to be innovative such that any other person knowledgeable in the craft would say "hey, that's a really good idea, I can use that". I should want to read patents because they would teach me, they should be a resource when I want to solve a problem. Journalists should publish them in trade journals because of the innovation in them.

    Inventors will invent because we want to solve problems, because there is profit in providing solutions to our customers. We don't need patents to do that. (and we don't need drug patents either - our way of developing drugs is wasteful and broken)

    Today when someone actually comes up with something innovative they often don't patent it. Manufacturing methods, if they are truly useful are rarely patented. Small companies can't defend a patent and any inventor who is altruistic will publish their idea almost anywhere other than the patent office. Not only are patents now unreadable (I can't make any sense of any of the patents my name is on) but we are told not to read them because it might increase our companies liability.

    When companies spend more money on patent lawyers than on new product development (Apple, google, Oracle) or get screwed when they don't (RIM/Black Berry) we have a problem.

    It is now your moral duty to shun East Texas and actively fight patent laws.

  12. Re:Same Thing by Anonymous Coward · · Score: 5, Insightful

    Europeans and Canadians aren't starving.

    In fact, they are far better off than the average american.

    Americans are just too uneducated and unenlightened to see the benefits of proper socialised medicine.

  13. Re:The reason you can buy the drug for $18 by ooloorie · · Score: 4, Interesting

    internationally is that you're buying from countries that have single payer healthcare and therefore can negotiate much, much better drug prices than private insurance companies can/do. The free market doesn't solve drug prices.

    You can buy generic Nitrofurantoin in the US for $15 for 14 capsules. That's what the free market provides.

    The reason American insurance companies pay $2800 for the same treatment is because under the ACA, they can get away with this crap and maximize their profits.

    There really is only one solution and it's single payer.

    The US has a large single payer system and it is horrendously inefficient. If you want to use single payer to lower drug prices, you need European-style nationalized healthcare.

  14. Re:Same Thing by PsychoSlashDot · · Score: 5, Informative

    I'm Canadian, and I can assure you that our "socialised" system is:

    • Damn expensive (50% of budget in Quebec)
    • Inefficient (people waiting 26 hours in an emergency room for a fractured arm)
    • Inefficient (people waiting 2 years for some basic surgeries)
    • Inefficient (people waiting 1 year for an MRI)

    So please, don't say our system is better than in the US. People are not dying in the streets up here, but when you have a condition, you better be patient. A patient patient.

    I'm a Canadian too, and the circumstances you've cited are worst-case and relatively uncommon. Non-critical illnesses are at a lower priority than critical ones, but people get the care they need, regardless of the depth of their pockets. So yes, our system is better, in most ways.

    --
    "Oh no... he found the .sig setting."
  15. Re:What do you know the man is a comitted lefty by Sperbels · · Score: 5, Funny

    That's one of the reasons there is so much joint animosity against the current President, he's actually trying is damnedest to keep his campaign promises and that is a threat to the permanent politician class.

    Indeed, when I think of Donald Trump I think of a man who keeps his promises. A paragon of virtue right there. Quite a catch.

  16. Re:Same Thing by Rob+Y. · · Score: 4, Insightful

    Obviously, your 'invisible hand of Supply vs Demand' isn't working in this particular Capitalist case. The problem is our perverted version of Capitalism. We grant monopolies on pharmaceuticals, and then act in total denial of the ways monopoly distorts supply and demand.

    So, I'll grant this guy his 'moral imperative' to charge as much as he can. As long as we recognize (and insist on) Government's moral imperative to fix the distortions of the market caused by, yes, important government interventions like patent protection. I.e., there needs to be a government enforced limit on how much as he can charge. And then let the market work its magic within that reasonable playing field. And if the market doesn't work in all cases - well, maybe those gaps need to be filled by the government too. That's not fascism or slavery or any of the hyperbolic anti-government names you want to use. It's just a simple acknowledgement of reality.

    --
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  17. Re:Same Thing by Kiuas · · Score: 5, Informative

    So please, don't say our system is better than in the US. People are not dying in the streets up here, but when you have a condition, you better be patient.

    Because these systems are always partially or entirely tax-funded this obviously means that wait times for some non-critical operations can be higher, because people in immediate risk take priority but this is true in the states as well. If you actually compare waiting times for a specialist for example, you'll note that US is pretty much on par with the UK, and that Canada is on the slower side of other universal model countries (which, is all advanced countries other than the US). I work for the largest health care district of the Finnish single payer health care system with about a million people under it, I can quote you some numbers (these are from 2015 because they're publicly available (Finnish only though), can't access the current stats from home). Of the 27 most common types of surgery, we had altogether 26 658 people in queue in 2015, of which 19,5 % waited for more than 6 months. The median wait time was 87 days. For the 2 heart-related surgery-types on the list (bypass and percutaneous coronary intervention the median was below 30 days). The question here is: would it be better for the uninsured in the US to wait a bit to get good health care from the existing system with public money, or wait til' they die or go bankrupt? Is it beneficial for the US economy as a whole to remain the only country where people have to go into debt due to medical problems?

    Thing to realize is that this is about availability, not quality. Quality-wise the US model is not significantly better nor is it worse. In fact, quality-wise the system is just fine for the people who're insured, the main difference is that the lack of universal public insurance leaves some people outside of the system driving up deaths. And the far more commercialised nature of the systems drives up margins and administrative costs (which is a large part of the huge spending difference (about twice the average spending of comparable countries) between the US and the rest of the world. In fact, medicare for example is already cheaper (per head covered) costs-wise than private options, largely cause it has better costs-management and lower administrative costs).

    The are plenty of universal models out there which aren't single payer like Canada or here. All the US would have to do to implement such would essentially be to allow medicare/medicaid like option for all , and it would likely bring total costs down in the long term and better care for everyone.

    But sure, keep posting anecdotal stuff about wait times instead of the larger picture., that's always constructive!

    --
    "It is the business of the future to be dangerous" -Alfred North Whitehead
  18. Re:Same Thing by j-beda · · Score: 5, Insightful

    LOL!

    Who decides what is "needed"?

    Who decides what is a, "priority"?

    Do they just give you a pill and send you home?

    Yeah! We don't want a faceless government bureaucracy ultimately beholden to elected officials to set health policy! We want all our healthcare decisions to be made by a faceless corporate bureaucracy ultimately beholden to shareholders! Clearly that is the one true path to success!