Slashdot Mirror
Goldman Sachs Asks: 'Is Curing Patients a Sustainable Business Model?' (cnbc.com)
Goldman Sachs analysts attempted to address a touchy subject for biotech companies, especially those involved in the pioneering "gene therapy" treatment: cures could be bad for business in the long run. "Is curing patients a sustainable business model?" analysts ask in an April 10 report entitled "The Genome Revolution." From a report: "The potential to deliver 'one shot cures' is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies," analyst Salveen Richter wrote in the note to clients Tuesday. "While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow."
Richter cited Gilead Sciences' treatments for hepatitis C, which achieved cure rates of more than 90 percent. The company's U.S. sales for these hepatitis C treatments peaked at $12.5 billion in 2015, but have been falling ever since. Goldman estimates the U.S. sales for these treatments will be less than $4 billion this year, according to a table in the report. "GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients," the analyst wrote.
Richter cited Gilead Sciences' treatments for hepatitis C, which achieved cure rates of more than 90 percent. The company's U.S. sales for these hepatitis C treatments peaked at $12.5 billion in 2015, but have been falling ever since. Goldman estimates the U.S. sales for these treatments will be less than $4 billion this year, according to a table in the report. "GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients," the analyst wrote.
"Slashdot asks: Is posting fresh stories a sustainable business model?"
Ezekiel 23:20
Time to blacklist anyone working at goldman sachs from getting any sort of cure.
n/t
Curing something does not mean you won't sell the same cure to the same person again. Just because you cured HepC, hell, even curing AIDS in a person does not mean they can't get infected again and need your cure again.
The number of diseases that grant lifetime immunity to it after you survived it once is fairly low.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
If your competitors can't. If you develop a treatment and your competitor has a cure then your business is flushed down the toilet while your competitor gets rich. So unless the biotech companies collude with each other there is always the risk that a competitor will produce a cure killing your business, so you had better get there first and kill their business instead.
Nine meds for Mortal Men doomed to die,
One for the Dark Lord on his dark throne,
In the Land of Blankfein where the Shadows lie,
One med to rule them all, one med to find them,
One med to bring them all and in the darkness bind them
In the Land of Blankfein where the Shadows lie.
Yes, bloody idiots.
The longer the person lives the longer he might be a client of various medical/pharmaceutical companies because we're not getting younger and healthier with each passing day.
we could all break even at least?
For someone from GS to ask such a question, I'm surprised they're still employed there.
I anticipate that they sell the cure at a price that makes it sustainable, or change the model to one where it's like a license... shut it down, or somehow disable it if the income stream stops.
And people wonder why healthcare in the US is so fucking expensive. It's because we don't have any real competition, and one of the primary reasons Obamacare was never going to work. Stop allowing hospitals and pharma hide their costs. Stop the ambulance chasers from driving up the insurance. Get Wall Street out of our healthcare.
Just another day in Paradise
Nationalize cures, allow slow torture to stay privatized. Then advertise the hell out of it so your citizens know where to go so that they can continue to enjoy productive, meaningful, and satisfying lives.
Think of it as the opposite of the current big-business financial model, wherein they privatize gains and socialize the losses.
cures could be bad for business in the long run.
Large numbers of business analysts dangling from lamp posts could be worse.
Every well eventually runs dry.
Heck, with "Fracking" they usually run dry or nearly dry in 5-10 years.
BUT they are still cost-effective.
The main problem is looking at health care as a profit driven business in the first place. Take a look at Europe / Scandinavia for examples of much better models.
never fails
At digital age, I'm expecting a link to primary source. At least a screen cap of the paragraph where this quote is from.
Curing people once seems a valid business model for surgeons.
More people get sick.
Maybe not a business model for exploding profits over time, but a good steady business that helps people.
of course the sales of this drug would peak at the start and then slow down to a sustained level. This is a new drug. Everyone who has Hep C is going to line up to get it resulting in a spike. As the backlog of patients is exhausted, you will only be able to sell newly diagnosed patients for a mere 4 billion a year. I will happily settle for a mere 4 billion a year in sales.
At what point do we question if capitalism, as it is currently managed, has a ROI? When an investment company states that we need to keep people sick rather than cure them, it's certainly time to look at any other economic system which delivers higher value.
Many of us here probably know people who convinced that a cure for all cancers already exists, but somebody big (the government, pharma, maybe both) doesn't want it out because the revenue stream from current expensive treatments will dry up. This just feeds into their arguments that big business is against us all.
You have to keep paying off everyone that comes up with a cure? That doesnt seem sustainable.
Damnit Jim Iâ(TM)m a doctor not a poet!
Got to get mad about something!
shouldn't be a private enterprise. How does it profit a company to cure anyone?
...and that is the reason why we don't have a cure for cancer etc.
As long as we accept that the medication for keeping people alive is as expensive as it is there is no economical drive for curing.
btw. Scandinavia is better but is far from perfect, much of our medico has been sold so now we pay 500% more for medication than we would if we have kept them. Politicians have been cutting the health budget so we are now in a situation where we look at the "do this patient need to survive or would it be better if he/she died" problem.
I am actually from Scandinavia end I live in Scandinavia.
This question has been asked and answered by every pharama customer, if not every consumer, a long long time ago.
The answer is an unequivocal; NO! It is NOT a sustainable business model to eradicate aliments that generate billions of dollars annually to temporarily treat the symptoms of those ailments.
It has long been the very reasonable suspicion of the average consumer that the pharmaceutical industry conspires to specifically not cure the major ailments that are their bread and butter.
How could it possibly be sustainable to cure cancer when treating the symptoms of cancer make these companies trillions of dollars in recurring revenue?
How does it satisfy their fiduciary responsibility, as a public company, to turn a $1,000 per pill medicine into a $1 per pill or even completely redundant and unused medicine?
It is contrary to the company’s survival to cure the common cold, rather than to continue selling pain relievers and cough suppressants to treat the symptoms for perpetuity!
FUCKING DUH!!!!
Seriously, what more should these guys do so you'll understand you how rotten they are, drink the blood of a child on live TV?
Avantgarde Hebrew science fiction
This is the inevitable logical conclusion of for-profit health care. I'm not at all surprised.
The US health care system is fucking awful (unless you're in the 1%). We need single payer now.
I don't respond to AC's.
The drug companies already avoid cures, as that would eliminate their customers.
They just make drugs that temporarily suppress symptoms (and often introduce others) just so they have a repeat customer base.
There are two choices, and they have their detractors:
1. Socialism: We all pay for this and enjoy the benefits of a healthy society.
2. Ferengi: Mortgage. Because the treatment works so well, it is also expensive, and the only way to finance it is by taking a lifetime loan. If you need a second treatment, better take a second mortgage then.
"Everybody's naked underneath" -- The Doctor
They're looking at new advances in medicine the wrong way. These fantastic new cures rely on a model of customizing the cure for the patient. So, rather than selling a particular drug, these investors/manufacturers should look at it as selling Cure-O-Matic machines which when loaded with the patient's DNA and some parameters then produce customized drugs. Such machines will need consumables, reagents, spare parts, and programming. That's the new source of revenue.
No matter what your product, planning to sell the same thing forever doesn't work, you'll run out of customers or competitors will paste you. The key is to keep developing new products and always keeping a step ahead of competition.
Here's the deal -- making a buck on the suffering of others is morally and ethically wrong. Health care is a service best provided by a single payer (the government) and paid for through taxes.
The insurance system in the US values profit over reducing suffering; insurance companies make money by denying care to their customers. It is a first class example of how for-profit capitalism is not the best way to do some things, like health care. A single payer system provides better care at a lower cost. We know this is true because we have numerous real world examples -- the Nordic countries, most of Europe, etc.
If we start to ask that kind of question I think as a society we have a good lot of thinking to do....
And mostly a good lots of changes to make...
This is the same issue that any Dr has who treats chronic disease patients as a specialist. Their livelihood is based entirely on their patients not getting better.
If every insta cure had a target market, the companies could price in a TAM size and still profit. Just differently than they did for chronic treatment drugs.
Drugs are patented for 20 years, it means that in the ideal case where your competitor didn't find something better your "recurring revenue" is going to be severely cut down by cheap generics after your patent expire.
If you develop a cure however, you are going to completely destroy your competition, and get a good backlog of already ill patients to treat. Sure, it won't last, but neither will your patent. So the ones who aren't getting rich are the ones who make generics, you get to keep all the profits.
Require that patients sell the drug maker an... uh... let's call it a reverse annuity, yeah, I like that. Want to live? Well, for an actuarially like 480 easy payments of $99.95...
...we now have Health as a Service. Brought to you, no surprise, by Goldman Sachs.
-This signature is strictly to prevent comments ending with questions or propositions.-
Shit like this is why healthcare needs to be run by governments.
Goldman Sachs doesn't seem to understand that wealth is not a privilege but a responsibility. They clearly don't deserve their position.
In a competitive market, consider what happens if a drug company chooses to make a chronic addict when a cure is a reasonable alternative.
A competitor makes the cure and the first company has no business.
The necessary but distasteful question in medicine is how to choose who lives and dies when allocating resources.
Asking the best way to take more money off the table in profits is a sad sign.
As opposed to socialism where the empty hospital was free for all ? And I mean empty as in literally, as you could not find drugs or help. Don't blame the free market for human greed. You ask what more they can do? Well they could send a few million to the gulags for added evilness, how about that ? Would that qualify sir ? These fuckers just profit, instead of creating evil on purpose.
I'm not sure if this guy has just lost perspective, or has Sociopathic tendencies.
Either way, scary.
Because there are a host of medical conditions out there that will ALWAYS require preventative/palliative care.
Blowing out as much in the way of disease/etc as possible with actual CURES stops the medical apparatus from being overwhelmed. Especially by serious conditions that require extensive (and expensive), ongoing medical support.
It allows us to "right size" our medical industry. Rather than building out this huge industry that has to stretch to cover ongoing care for every conceivable medical issue Homo Sapiens is capable of manifesting.
Chas - The one, the only.
THANK GOD!!!
Proving that the guys in GS do not work in the medical business. YES! Curing people has ALWAYS been a sustainable business model. I promise you as a family doctor, if I cure every issue you have for 100 years, I'll get more money out of you than "managing your condition" for 10.
I've seen this crop up before in some philosophizing about why Socialized medicine is inferior to the US model: the incentive to keep coming up with cures and treatments to keep people alive is because the longer they live the more the pay. In countries with Socialized medicine, that incentive isn't there and people bleakly conjecture there's *less* incentive to keep people alive.
In this case, the lack of incentive comes from the fact that people *won't* be paying as much as they would if they stay sick/get sick on a regular basis.
That this question is asked lays bare the fundamental question of health care. The fact is, care costs money so how does it get paid for? Either healthcare is a business or it is supported by the people for the people (taxes thru government).
This question, as revolting as it is, simply puts in stark relief the reality of the choices.
"Consensus" in science is _always_ a political construct.
The problem is fucking. It all starts, with people fucking all the fucking time! Stop fucking doing it!
In the US, the government should start a series of medical schools and allow "free" attendance with the caveat that you serve the government as a doctor for 10 years. The current medical schools could stay open and charge what they do. After 10 years of service, you are free to pursue the private sector.
I would also like to see children under 18 get free medical care. Don't get me wrong, I'm a huge proponent of a single-payer system. I grew up in Europe and I know they work. America is a weird animal. It's the only country in the developed world with the horrible system it has. It's sad when a country like Cuba has better medical care than the US. In fact, Cuba exports doctors. Not long ago, there was a large neurological conference on brain surgery down in South America, where among the participants, some American doctors were in attendance. They were amazed at the techniques the Cuban doctors were using because they were more advanced than their own.
Until we get a single-payer system, we will suffer and go broke. I would gladly pay an additional 10% in taxes in America to achieve this, and I'm sure the average person who has thought this through would as well. If you're making, say $35k a year, and you're paying $10k for "health insurance", what's an extra 10% in comparison? Nowhere near $10k, that's for certain. People cry "Socialism!" "Not in America!", but they have not thought it through. Then, when something befalls them, they're suddenly 1M or more in medical debt, and that debt grows very quickly. My late wife died of cancer, and during that few years of surgeries and treatments, the total for all treatments was about 2M. I was almost 100K in medical debt. I had to sell my house and was pursued for over a year by the hospitals and doctors. A surviving spouse should never have to pay for medical debt. Only two states that I'm aware of practice no medical debt for surviving spouses: Alaska and Florida. We live in a sad world where money is more important than people. God help us all.
I wonder the same thing about bureaucrats. It's interesting to me that with all the money and effort poured into solving e.g. poverty, drug addiction, etc. that not much seems to have improved since the Great Society.
Perhaps that's because doing well at your job could potentially put you out of a job.
I feel like this will force medical innovation, continued revenue will rely on it.
You can be great to, you just need to apply yourself harder. Those guys are the one that 'made' it, only the weak and the feeble like you are complain. Work harder, maybe one day you will come close to their greatness.
Whats so great about them you ask? Why the ability to suck the life force out off everyone (while they themselves do nothing) around them is amazing, and not only this, they can convince others to suck the life force out of others and transfer it all to them. Even more, everyone around them is hypnotized because of their skills and hard work. So do you 'understand people' now? Yes, the top of the human food chain is not the scientist/creator/..., it is the elite parasite, feeding off everyone else.
But don't try to say something bad about them specially if you have a proof - its the worst kind of attack you can do. They will rally their army of loyal followers and its nap time for you. So you see, talking about how rotten they are - you are not doing yourself any service are you? Luckily for you you don't have any 'concrete proof' like a photo/video of them doing bad things or a witness ready to testify.
Maybe not. But then it shouldn't be a business, maybe ? Get it off the business and let the state handle it. It will save a huge amount of money for everyone in the long run. To say nothing of saving lives.
Non-Linux Penguins ?
Did they just make an argument for socialized medicine?
The problem is that when you're talking about publicly traded corporations, they have a fiduciary responsibility to shareholders to produce as much profit, quarter to quarter, as is legally possible, by the letter of the law, with no regard to whether it is moral or not.
So when considering possible avenues of treatment, if they have one option that might produce a cure but another option that might produce an effective long term maintenance treatment, they are LEGALLY required to run the numbers, figure out which would produce the most profit and then go with whatever option does.
Remember that coworker that tries to keep everything secretive about their work to protect their job? Then the world comes along and changes without them, forcing them on the street because they were so focused on protecting what they have that they didn't invest time in learning anything new. This is literally how that sounds.
The problem is that regardless of automation, there will always be something else pushing us forward, new skills to learn, more problems to solve. Curing illnesses would be great in that perhaps we could learn how to cure them better or focus on curing other things, or prolonging life. One of the single impactful innovations at the end of the twentieth century was a boner pill.
If you build your business model around prolonging a problem instead of fixing it, the hope is that capitalism would suggest otherwise. Yet this is where one of the inherent evils of capitalism pops up its ugly head and says, "No, we need more money, keep things broken just a bit longer."
To conclude, you can say that curing something is less profitable, but that's a busted business model that's designed to fail unless you can ensure that no one will come up with a cure on the cheap.
Place something witty here
.. just like in numerous other sectors if the business world.
Get government out of the way, and let free market competition take its course.
When there is competition out there, providers don't contemplate whether giving the customer what he wants is "bad for business in the long run." Instead they are contemplating whether the custoner's perceived quality of the product will drive their customers to their competitiors.
If Government is to be involved at all, it should be in the area of encouraging competition, rather than arcane regulation.
you need to do it smart. Best way is to have a 'cure' but it causes all sorts of side effects which can only be cured with another cure, ideally lifetime long.
So you could perhaps 'tweak' some gene stealthily causing diabetes or something, they you can enjoy all the profits you want. Or if you want to be even more stealthy, just increase the risk of other diseases and enjoy the increased money inflow from selling 'solutions'.
Good example could be perhaps 'increase stress' in society by acting like an asocial douchebags and then sell solutions in form of various magic ulcer prevention drugs. Hmmmmmmmmmmm.....
This way nobody can pin anything on you cause we know how hard it is to 'prove' something is bad right? What do you care, its all just business, nothing personal right?
Isn't science great? It can solve all kinds of problems :D
Now what are you going to do about it?
This is, in one quote, exactly the reason why it should be illegal for medicine to be for profit. Prioritizing profit over life is the very definition of evil.
You say that it's capitalism that's the problem: I would argue that it is socialism and entrenched bureaucracy that is the problem. Things stagnate, and then capitalism (some hot-shot startup) comes along and "disrupts" the status quo.
This is precisely why patents are granted. Duh.
Actually, it is not worth the while for lowlifes like those at Goldman Sachs.
"GREED IS GOOD!!!" said GS!!!
I bet they would change their tune, if/when they became such patients!!! (& GS would fire them next!)
This sounds like the exact plot for the movie Johnny Mnemonic. The "black shakes" was affecting much of the population, due to excessive exposire to technology, and the "big pharma" / pharmacorp were keeping the cure a secret because "it was more profitable to treat the symptoms than to cure the patient"
As I recall, it didn't end well for PharmaCorp.
I work for the Department of Redundancy Department.
This statement of what should be obvious is a great service. They are saying what we have suspected for quite some time. That the for profit biotech business model is very likely against the best interests of individuals and society in circumstances where there could be a cure for disease.
Society and individuals have great interests in curing people at least cost. Biotechs clearly have the contrary interest of creating treatments that create dependency and not cures. Having this stated succinctly is the kind of frank discussion we need.
The answer isn't immediately clear, since there is nothing wrong in finding treatments that make people's lives better. And if there is "no cure" then a treatment is better than nothing.
If cures are being ignored because resources are all going toward predatory dependency inducing treatments (like the opiods), then government regulation that encourages more free market competition to push the business interest further towards making cheap cures and better treatments should be on the table. In a free market would you rather pay a doctor to cure you or to just treat your symptoms? If there is only one doctor in town, then good luck. If there is only one doctor in town because government makes it so onerous to become a doctor or stay in private practice... then shame on the government. Likewise many government regulations appear to benefit big pharma and big biotech. Yes quality is of great importance when lives are on the line, but innovation is also of great importance when lives are on the line and we see areas of stagnation in medical advancement with only expensive treatments making it to market.
Also on the table should be treating the discovery of cures as a critical public interest to be funded with more government dollars instead of private. Government funded research has a mixed track record also. But here too there should be a big enough pool of money that it allows for sustained competition between the Universities and non-profit, or even for-profits getting grants.
The government should be in the business of making sure we have a healthy and efficient free market and stepping in with regulation, policing, and even some money when we don't.
If the problem gets solved, there is no need for the politician whose support depends on the problem existing.
"why on earth would you cure someone when you can just milk them for everything theyve got & leave their widow destitute?"
Basic human compassion is a completely alien concept. Making the world a better place is a useless distraction from the pursuit of record profits.
I cant believe that the management couldnt anticipate that their product was like a movie, initial sales peaked, followed by a sharp decline. Now just like movie productions they should be satisfied with royalties and the prestige that comes with it.
The real question is why these ancient bankers should be allowed to exist in a society that they keep destroying without repercussions.
The main problem is looking at health care as a profit driven business in the first place. Take a look at Europe / Scandinavia for examples of much better models.
If it were true that that alone makes it more likely to find cures then Europe/Scandinavia would be coming up with cures that Americans could then just benefit from.
Whether it be a "non-profit" or for profit company there seems to be a problem in the economics and incentives of cures versus treatments. There is just going to be more money in treatments than there will be in cures. I think there is something more fundamental that needs to be recognized there that affects either type of business model. And something that the government should recognize so we can find ways to get to more cures.
In the case of a non-profit business model that doesn't mean people aren't making a living doing some sort of work... that means more money for them or more people getting more money.
The for-profit aspect just layers additional mouths to feed (investors) on top of the people that work there and the interests on any loans. Think of "for-profit" just as loans with interest rates that depend on how good the revenue is compared with expenses. Depending on the terms of the shares and how much money is taken out of the business then it can be onerous, but so too can terms on loans.
In an unregulated market, competitors could compete directly on price and quality of care.
please kill G-S.
The discussion is still a fresh one. Whether medical assistance is privatized or government run, discussion whether it's economically viable to maintain life will always come up. If you look at the majority of reasons we commit abortion is because the mother did not think it was an economic best interest they have a child. Regardless of which side of the aisle you stand on
I think so.
There is a reason that the big pharma companies are spending all their research money to develop drugs that relieve symptoms temporarily, but don't actually cure anything. Think statins, impotence pills for men, and various skin nostrums to improve your complexion. These are all big money-makers and none of them cure anything. Rather, they alleviate symptoms temporarily, and require the patient to continue buying them for the rest of his or her life to enjoy their benefits. Now, this is a good business model. Just ask Pfizer how much they have made from their impotence pills. Conversely, there is relatively little money being spent on research to cure viral infections or to produce vaccines for various deadly infectious diseases. The reason is simple: these drugs are taken once or twice, the disease is cured, and the patient walks away without being required to continue dropping money on the pharma company.
I hate socialism, but this is a case where we need the government to step in and start making these drugs, and selling them at cost.
Now the company has to find somewhere else to make their blood money.
True, the government has to respect their patent, but wanna bet that the $1 drug made with the formula that the patent has expired on works almost as well as the new $1,000 drug does, but cost way less?
Problem solved, and people get to pay a reasonable price to get their meds.
Why does the wealthiest nation in the entire world have one of the least effectual healthcare systems in the developed world? Because it can afford it!
As long as companies have a vested interest in treating a chronic condition without curing it, we in the US are doomed to live with them. The longer term they are as chrnic illnesses, the better.
I can't help wondering how much money and pain Jonas Salk saved the world. There were 20,000 to 57,000 cases of polio in the US each year until the vaccine was introduced. There were 22 cases of polio reported in 2017, in the WORLD.
Sounds to me the problem isn't capitalism so much as it's lazy people (e.g. Bankers) who believe after they produce something they are entitled to sit idle and keep getting paid for doing nothing in return.
No, it's actually about high time somebody asked this question.
I've recently been thinking about this a little in terms of game theory: Insurance companies see medical care as an expense and premiums as income. Patients see medical care as a benefit and insurance premiums as an expense. This has led to a system with a whole lot of problems, but the fundamental flaw is that the two sides have fundamentally conflicting goals.
How can we rework this into a better system?
The first thing we need to do is define the goal of the system, and "longer average lifespan" seems like the right goal. We can also add a quality of life rider by saying that anyone can check out if their life becomes unbearable, with lots of safeguards against coercion and suicidal depression and such. (I imagine a process similar to sex-change operations - the patient has to really want it over an extended time, and have psychiatrist buy-in.)
With "longer average lifespan" as the goal, now how do we pay the doctors?
One answer might be to assign to the *doctor* (primary care physician) a monthly fee per patient, regardless of that patient needing medical service. If patients could switch to a new doctor at any time and for any reason, doctors would then have incentive to a) provide the best medical care, b) compete with each other for quality of service, and c) keep their patients healthy, happy, and long-lived.
This seems to work at the "primary care physician" level, but it isn't a good fit for specialist and above, hospital care and ER. The PCP should feel free to refer a patient to a specialist without incurring a drop in salary, and an ER doc should have incentive to save a patient's life without regard to payment.
Also, medical research should be included, so that there's incentive to cure diseases instead of masking symptoms.
Anyone good at game theory like to add to this model?
The real issue is how long can we bear Goldman Sachs?
Sent as ripples into the electromagnetic field. No single photon has been harmed in the process.
Drillem, Billum, Killem and Chillum. Seriously, there is a whole class of human endeavor that is not made better by the profit motive. Healthcare certainly belongs in it. It is something that should be pursued by practitioners and institutions to improve the public good not to get filthy rich. Charging large sums of money to prolong life is essentially extortion. Most developed societies recognize this by having long ago instituted single-payer systems. It is expensive, but demonstrably such a system vastly improves the society's productivity and quality of life from the bottom up -- a measurable plus economically. And, besides, it is just the decent way to run things.
"No fear. No envy. No meanness." Liam Clancy
There was an article in Science about a cure, *cure* for Type 1 diabetes. It involved the BCG vaccine, the worldwide vaccine for tuberculosis, applied in small doses for 30 days with tight blood sugar control. It permits the change of adult stem cells to insulin producing cells that cured Type 1 diabetes in lab animals.
The human study was invalid because they kept the dose of BCG so very low "for safety", so it proved ineffective in the second round of human testing. The market for insulin in the USA is $43 billion annually. The market for glucose test strips, which has even greater profit, is similar size. Guess which markets drop by at least 50% if a cure for Type 1 hits the market? Especially such a cheap cure?
I'm as angry as when they replaced "animal" insulin, with genetically engineered, e.coli produced "human" insulin which is 10 times the price and is, in fact, medically inferior to beef or pork insulin. Human insulin contributes to hypoglycemic unawareness and doesn't last as long, so you need more human insulin which can *kill* you if you miss a low blood sugar while driving. But hey, if you also want to spend $10/day on continuous glucose sensors that don't stay calibrated and still require $3/day pricking your finger, sure, you can get a mechanism to unreliably detect low blood sugar for you! It's technology, to always be pursued rather than the simpler and safer solution!
Look at the common cold: Billions each year to treat the symptoms, but if it was cured, Big Pharma might suffer horribly.
Ditto for Caner, Diabetes, the Flu and Allergies.
This then becomes a shining (sci-fi based) example of Cures for the Rich, and the rest for everyone else.
Have gnu, will travel.
Why do you think the pharmacy industry gives you all the sob stories wanting more money for "research into a cure" because they know if they CURE something, they are OUT of business.
how much money is enough?
The principals in a biotech company made a couple billion $ and then ran out of patients? Boo-hoo.
If you develop a cure for one disease, you may run out of patients who need that cure, but there are always other diseases that need to be cured. If you don't want to risk your money on the development of another cure, retire to your private island and let someone else do the work.
So people have to pay for two doses to get better? There's a lot of money we're leaving on the table here /s
Start public killings of investment bankers. Watch how fast the rest of them start to behave.
You are welcome on my lawn.
This seems obvious and it's probably in the comments, but how do we incentivize companies to research and release these cures to the public? Shouldn't these companies be massively rewarded if they permanently fix one of society's problems? We should obviously tax treatments much more than cures, the latter should probably be fully subsidized too, no? Shouldn't this be pushed to the extreme, if a company is found to be suppressing technology that could save lives yet they're focusing on therapies that simply treat the disease, doesn't that warrant some sort of punishment? This is the one of the best examples of how capitalism can be detrimental to society and should be an area that is fully explored. People are dying because there is more money to be made off of treating a disease than curing it and the amount of death and suffering caused by this is simply inexcusable.
Follow theYellowBitRoad.com
Is it a good idea, to sell a product, that every human being on the planet, from now into the foreseeable future, will likely be intersted in buying? (That's assuming we ignore the moral reasons.)
Awk! Pieces of eight. Pieces of eight. Pieces of seven... ERROR: General Protection Fault. [Paroty Error.]
I don't see the difference. Given time their good intentions equally end up corrupt.
Much medical research is already publicly financed in the United States. Just do more of it and repeal the Bob Dole law allowing universities to get together with pharma to profit from public research.
Your answer may vary depending on age, health, and other factors. Think carefully, your life may depend on that answer.
perfect example while all but one of the major economies are working on removing the profit motive from health services.
.
The fact is that pharmaceuticals are a tough business; you have to keep moving and developing new products; you can't just sit on your hands and milk the profits, or someone else will eat your lunch.
Isn't Goldman Sachs making the argument that research for cures should be done by the gov, "free health care"?
That is one of the better arguments for state control of health care. The state is interested in minimizing costs, not maximizing profits.
its really very simple
healthcare is too important to be allowed to be capitalist
the government should set and mandate a FIXED price for the 80% of most common procedures
no health care provider should be allowed to provide the service except at that known fixed price
this one change would disrupt and destroy the corrupt INSURANCE industry
focus on healthcare not insurance - mandate that the 80% of most common procedures can only
be provided at a known fixed price.
Someone please slap that finical analyst.
There are things more important than sucking the life savings out of people that are suffering.
We need to make sure society provides sufficient compensation for developing permanent cures.
Or rather... part of it may be that we may allow temporary treatments to be rewarded too much ---- I would suggest the government Alter the Patent System for drugs such that each patient pays a One Time Royalty for the use of drugs which treat symptoms but are not Permanent cures... Profits derived from a drug's failure to cure --- or due to ongoing dependence on the drug NOT allowed to be guaranteed to the original maker/inventor of the drug. They can charge a premium, but competitors will ALWAYS be allowed to make generics --- Instead of providing a number of years during which only the primary drug can exist
After a patient pays the One Time Bounty: the patent holders' rights are exhausted, and ANY company with the manufacturing capability is allowed to produce and sell the drug to them without paying any license fees - the government approval process for such generics should be streamlined as much as possible ----- Only condition on generics is that drugs can only be administered to a patient on whose behalf a One Time Bounty has been received (For the X years during which the invention is protected to compensate the inventor/creator), OR whose One-Time-Bounty was waived in writing by the patent holder.
By inviting the generics competition ---- the price of all drugs will approach the marginal cost of production, just like the cost of non-patentable foods, etc. The BOUNTY Term then provides comparable compensation to companies that innovate new drugs; regardless of whether or not the drug is a permanent cure.
Intentionally allowing people to remain ill? THE SPECIAL HELL for you!
EVIL. Plain and simple, this is EVIL INCARNATE.
The purpose of medicine is to cure people, not make profit! Ethically speaking passing up the opportunity to cure a disease because it's 'less profitable' is WRONG in the extreme.
I've thought for quite some time now that certain industries should, by law, be not-for-profit, and healthcare and the pharmaceutical industries should be on that list -- or at least a legal limit of some sort to limit profits and discourage profiteering, or ethically wrong decisions like not curing something you could develop a cure for, to keep 'stringing people along' with 'management' of a disease or condition, just because it makes you more money.
Shit.. the very mention of something like this severely pisses me off.
Some industries should be not-for-profit, to discourage profiteering, unethical business practices, and outright criminal activity.
IN MY OPINION, the healthcare and pharmaceutical industries should be at the top of that list.
If the issue is long term recurring revenue, simply extend gene therapy patents to something like 35 years. By developing the cure, you become the exclusive seller to fix an entire generation of genetic disorders.
This is why Hilter killed the juice
But you have to make damn sure you don't let campaign "contributions" cause congress to pull funding for a cure that competes with the lifelong treatment some private company previously devised!
Because you know damn well that's what they'd try to do - some senator would get up on his soapbox and say "We need to make sure the funding bill for FY 2021 drops funding for research into a cure for AIDS, since there are already treatments available that prolong life indefinitely. We need to put those funds towards things that don't have a treatment!"
See how reasonable he made that sound? So reasonable you can't know for certain if he means what he says, or that his campaign got $5 million in dark money contributions from a company that makes AIDS drugs that cost $10,000 a month. The only way to be sure would be to completely ban ANY political contributions or lobbying of any sort by companies doing private medical research.
Lloyd Blankfein, the CEO of Goldman Sucks, has lymphoma, which is currently in remission. I hope that it comes back, and that a potential cure was suppressed due to Goldman not investing in the technology.
Let the piece of filth get a taste of his own medicine!
I'd pay $10,000 for that!
I was in my twenties, I think, before I realized there were for-profit hospitals.
Capitalism, to be blunt, has no business model for health care. You want to argue? So, you've never had US medical insurance, and had something denied, even though your doctor said you needed it? Ever had your insurance co-pays and payroll deductions go up, EVERY SINGLE YEAR, because the CEO and "investors" demand increases in ROI?
No? Then you're either 20 years old, or you're a liar.
We need a national healthcare system, like EVERY OTHER industrialized nation. And while we're at it, we need to nationalize big pharma. "Oh, but all their research?" Bull. 60% 80%? of ALL US MEDICAL RESEARCH, in hospitals and colleges, is funded by... grants from the US NIH, yeah, our tax dollars.
Callous indifference to human suffering ... I'm so proud to be an American right now
Prior to Nixon's gift to a major donor, healthcare was non-profit, from what I've read. After that, once healthcare was allowed to make a profit, the emphasis has been on "treatments", not "cures". Why fix something and get paid once when you can cash in on suffering forever by "treating" it?
The question should be this: When other countries generate cures for their citizens and American Medicine is left behind, can a no profit business model be sustained when Americans will opt to be treated in other countries?
That is basically the ancient Chinese model. Everyone living in the same lock with the doctor payed a monthly fee.
Got he sick, he stopped paying and visited the doctor. As soon as he was cured, he payed again.
I'm not sure this would work under game theory, because people would have an incentive to get out of paying by claiming to be sick when they're not, or get out of paying by going to the doctor for trivial reasons.
For the system to work, there can't be any monetary incentive to "game" the system. The system has to be viewed from all angles, and cheating and other abuses have to be eliminated from the point of view of incentive.
Curing patients is very bad for Capitalism. It is much more efficient to just keep manufacturing drugs and "controlling" an ilness instead of curing it. Phuckers.
And they admit cancer is not cured because it is simply not profitable.
Fun fact - all the execs and insiders at Goldman use the cure for cancer all the time on themselves, while letting millions die. Fun huh? :)
Itâ(TM)s as sustainable as anything else that lots of people need just one of. There are countless examples: a home, a piece of sturdy furniture, a tool, etc. These are all sustainable for as long as we keep making new people.
https://www.eff.org/https-everywhere
Just because you use gene therapy to wipe put a disease from a person, or a group of people at any given time, doesn't mean you cured anything.
We still get vaccinations don't we? Because new people are born. And because you can't control mutations in your eggs or sperm, disease won't disappear. So, you need that neat gene therapy that works.
Not surprise they didn't see the 2010 crack coming. How much do they charge for their services? Clearly too much got the qualityof their work.
So if the analysis is done properly:
And obviously there's more money to be made from the latter. GS is committing the same incorrect comparison to a zero base state I've mentioned before. Where the person leaves out indirect consequences of their actions from the comparison (in this case, the person dying from a different disease some time in the future).
When a person or company refuses to cure a disease because of profits it is the same as war profiteering and they should be shot for crimes against humanity
Of course curing patients is a serious problem from I want to make unlimited money prospective. More beneficial for the government, so why not buy the cure, for a fair price then cure population at cost? Just a thought.
what we're asking is, in a society where all or most decisions are made by investors what is the optimal decision?
Good ROI is _never_ enough. Great ROI is never enough. It has to be extraordinary. That's why you've got so many venture capitalists buying up life saving medicines and raising the price 4000%. That's why my dad just paid $800 for his insulin... on Medicare (thanks Bush Jr and Medicare part D, and thanks for the right wing Clinton style Dems who voted for it, I'm looking at you Corey Booker. ).
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in one of the animated superman movies, Lex Luther was told by his scientists they found the cure for cancer. Lex said to see if they can spread the cure into a lifetime of treatments (or something similar). as greedy as the pharmaceutical companies are, who is to say it is not being done now with some diseases.
Couldn't they sell cures on the subscription model. You keep paying 30 dollar a month for as long as you live. For every cure you use your monthly subscription goes up. if you ever stop paying you will be barred forever from signing up again till you pay all your back dues. So if you get the cure and then stop paying next time you get sick and need a cure you need to pay all your backdues. 40 years of subscription is surely more than what they could charge for a one time cure.
**Life is too short to be serious**
The Jews in India came to India when the early Christians were massacring them for being complicit in the death of Christ. Hindu kings gave them sanctuary. Hindu kings also gave sanctuary to early Christians when the Romans were oppressing them. They gave sanctuary to Zoroastrians from iran when the Iranians were being forced to convert to Islam. India has a long tradition of sanctuary and allowing people to continue to practice their religion. This is a function of the Hindu religion which is Polytheistic with many gods. For a typical Hindu there is no contradiction in someone believing in a different god - for all they care it's just one more God in the Hindu Pantheon whether the god is called Jehovah, Jesus Dad or Allah.
**Life is too short to be serious**
The cure can be sold with a lifetime Warranty where if they get infected again the company will cure them and in return for the warranty they pay a monthly warranty fee. This also acts as quality control so the companies are motivated to find permanent cure so that they dont have to actually honor the warranty.
**Life is too short to be serious**
Charge the person 10% of their net worth
And there's no cure for stupidity.
Sure there is! The "B" ark!
I know of a one shot cure that will have dramatic effects.
Take all those Goldman Sachs Analysts that would rather not have effective cures especially the ones that don't have reoccurring treatments, and line then up in a row.
Now go to the end of the row, and use a very powerful and high caliber gun, possibly an anti-tank weapon, and one shot should cure the entire issue of that kind of evil greed for at least an entire generation.
Nope, it's my house too. The best you'll get is a compromise. If you can't compromise then the only other way to fix the issue is forcebly remove one of us. I'm not going quietly, either.
Is bailing out GS from toxic assets worth it for the rest of society who are not shareholders? Isn't it better to let it fail and start over with new companies?
Weird: this story and the comments are simultaneously from 21 hours ago and from April â18. But itâ(TM)s February â19.
Primary care physicians - General Practitioners - are paid an annual fee for each patient they have on their books. They are free to refer them to specialists at hospitals or elsewhere. The taxpayer pays for all health care.
There are, of course, many problems. One is that people over consume health care to the point where it's rationed by waiting times. Which is probably better than by ability to pay except that you can still buy additional coverage.
The second is that some GPs have realised that because young adults make little demand on the service, providing a service focused on these consumers generates higher income for less work. Tweakable by the rules changing to reflect useage levels, but the point is significant.
The UK's NHS operates a mixed market. Primary care physicians are actually independent contracts, paid a fixed amount per patient on their books. Most hospital services are provided by government owned services, but not all, However the core point - that it's ultimately paid for by taxes - apart from a few people who choose to go privately or have private insurance - is correct.
Whilst that sounds impressive in theory, in reality somebody has to pay for the research that leads to new drugs. Unless the taxpayer is willing to fund this - and that will mean a significant tax hike - your morality will end up killing people. And even if the taxpayer does fund it, how does that relate to other countries' health care system. If Australia develops a drug, does it have to allow everyone to prescribe it? If so, how do you stop freeloading by countries unwilling to do research? NATO has this problem in defence...
The problem with medicine in America is that it's being run as a for profit business.
That's why they don't cure anyone of anything. They just like the find old people to fill with meds and tell them they have to come back every 30days
Endless supply of greedy people and lots of cash to be extracted on false promises.
what kind of psychopath do you have to be to think like that?
On a long enough timeline, the survival rate for everyone drops to zero.
Instead of asking if one-shot cures are a good business model, they should be asking if there should be a shift to a business model that's better for people...
At some point a new form of socialism + capitalism + something else.
Look, humans have to progress, markets will change and old ones will die as new ones are created. Humans need to prepare of the age of cureable wellness. Where cancer, organ transplant, diseases, viruses, even dysphoria are all cured or prevented. Health markets will change, people will want more control over their bodies and yes, things like elf ears and shit all have a market, if you could have elf ears at 16 then go back to normal ears at 17 when the fad is over, lots of people would pay to do it, a lot.
Regardless if you like this or not, believe the magic people in the sky allows it or not, whatever, Science is coming and it's coming fast. So these old industrial markets need to get with it, or the Musks of tomorrow will pass you up and all that old money will be just that. Old money.
... our P&L needs curing more than you do.
One answer might be to assign to the *doctor* (primary care physician) a monthly fee per patient, regardless of that patient needing medical service. If patients could switch to a new doctor at any time and for any reason, doctors would then have incentive to a) provide the best medical care, b) compete with each other for quality of service, and c) keep their patients healthy, happy, and long-lived.
We do something like that in several provinces in Canada - it's called "capitation". Payments are pro-rated (old people with diabetes are more work to take care of than 20-somethings with no health problems, and you don't want to incentivize avoiding certain patients), and it takes a certain amount of active management to catch & correct imbalances, but it works better than fee for service. Your family doc usually works as part of a group practice; payments are dinged every time you show up at the ER or drop-in at someone else's clinic that's open late, which incentivizes out of hours options for semi-urgent issues.
A big plus is that it incentivizes preventative medicine. Spend a lot of time firefighting vs the effects of obesity, smoking, mental health issues etc, or work with your patients to lose weight, quit smoking, resolve mental health issues and then use the extra time to take on more patients, go golfing, whatever.
In the US you'd probably have to worry a bit more about regulatory capture fossilizing opportunities for arbitrage into the payment structure (people seem a bit more vigilant when it comes to keeping lobbyists away from health care decisions in Canada), but I bet you could come up with a market-based approach by looking at who can & can't find a doc and adjusting rates automatically based on a simple formula (e.g. if this year no-one wants to deal with retired firefighters but 25 year old office workers all get docs instantly, rebalance the payments until the rates are consistent across the board).
The other big concern of course is that in Canada the insurer is the government, and their fundamental incentives are to a) keep costs down; and b) not get voted out of office because people are angry about themselves or their neighbours not getting adequate health care. You guys don't have b. Yes, you can change providers if you're healthy, but once someone actually starts to really need healthcare, no insurer wants them as a customer, so your market value correlates inversely with experience of the system and rapidly becomes negative.
Yes, because:
mutation
of course, no one said it had to be a large business.
Lodragan Draoidh
The more you explain it, the more I don't understand it. - Mark Twain
What's to keep rich established company A from buying new company B's cure - then letting the recipe for the cure rot in a vault?
Goldman Sachs is uniquely positioned to ask that question, given its impeccable moral reputation.