Originally published at: The Price of Remission - TPM – Talking Points Memo
This article is part of TPM Cafe, TPM’s home for opinion and news analysis. It was originally published at ProPublica, a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox. The pain jolted me awake. It was barely dawn, a misty February morning in 2023. My…
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A half billion Dollars to board members of the company. For an idea that they did not even come up with, nor did they make substantial improvements to the pharmaceutical.
This is the future of our country. An all-you-can-steal buffet. My health insurance premiums go to paying these outlandish amounts for a drug that doesn’t cost that much.
I wonder how many times Celgene lauded themselves as heroes, and vilified Beth Wolmer as un-degreed in health sciences, thus unworthy to share in the profitability of the treatment she helped develop.
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I’ve dealt with cancer in me…twice. Different but treatable kinds. Been “cancer free” for 6 years. Next check is in September.
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I was diagnosed with MM Labor Day weekend 2011. I entered clinical trial at NIH October 2011 & completed the trial in May 2012. I began maintenance therapy in June and did not like the data on GI risk side effects, so I ended Revllimid maintenance therapy. The trial at NIH had an option for bone marrow transplant, I opted out as the theory behind the grueling treatment is not convincing. I go for annual follow up with Ola Langren who now heads up the Sylvester Cancer center in Miami. Dr Langren also ran the NIH trial& is considered global expert on MM. Langren believes a cure definition for MM will soon be announced based on MRD negativity which I’ve had since the end of the carfilzomib tria.
It is 2025 and thus far there has not been a relapse which I am grateful for especially as at time of MM diagnosis the prognosis was six months.
The cost of revilimid is inhumane. Hopefully, the generic formulation will put an end to the price-gouging.
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A tremendous financial hardship for those who need this drug especially when it costs 25 cents per tablet to produce. Greed must be in the DNA of big Pharma executives.
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The beauty of the pharmaceuticals racket is that in many cases, it can be a true “Your money or your life” kind of deal. How much will people pay to live? To live just a little longer?
The customer is at the mercy of the supplier. Only a third party, responsible to the public at large, could keep things fair. Which is why businessmen hate government.
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This is an outstanding long-form piece of writing and reporting and I hope it gets a lot of play! Great job to David Glassford and researcher Alec Glassford.
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Also the past, at least the last 40 years or so, that has led us to where we are. Gross, and grotesque, inequality–the wealthiest and most powerful stuffing their pockets from the suffering and desperate need of ordinary people. And now these same wealthy vampires are exploiting the very suffering and distress they’ve caused to remove the last barriers to the plundering of the most by the obscenely rich few.
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This drug was what’s now called a “unicorn.” A tiny investment that brings gargantuan returns. The people who own these are now our society’s epitome of the highest success.
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The greed and cruelty of expensive drug makers is reprehensible.
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We can beat up on the business people that make these decisions, and rightfully so.
That said, just to refocus the discussion, the US government has organized our drug development and deployment system this way. There are other ways, as the rest of the world demonstrates. And in particular, patent abuse is rampant in the US. This is a case in point.
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Just a quick comment that anyone who tries to play the “it’s just the free market playing out” game should be reminded that a key, underlying principle of truly free markets is that there is no requirement to make a deal—both buyers and sellers have the option simply to walk away from a transaction.
Toying with vulnerable people’s lives ISN’T a “free market”, it’s extortion. 
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But it hasn’t has it? $19,660/month for the original and $17,349/month for the generic. I don’t see this drug dropping below $5,000/month or even $10,000/month. I wonder how many people have opted for a dose of street corner fentanyl rather than bankrupt their family?
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Examples? My experience is the rest of the world lags behind when it comes to new & innovative drug therapy. The european countries seldom use new agents as 1st line therapy. They continue to use 30 year old agents that have lower overall survival & are far more toxic as first line therapy. The health system abroad is rigidly cost-effective.
Where have you found globally that to be different when it comes to cancer?
Is the generic on the market? I do know that without multiple generics it’s hard to get a price drop, as there are few options; so the original & generic mfgr collude to keep the price high. Competitive pricing is only effective when the generic mfgr decides to take all the market share with 25% cut price war.
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My main point is that it is different in other countries. So, there are other ways.
As to how to organize it and what might be better, well that is a long discussion. Shorter version, from the article, the main discovery here did not come from inside the pharmaceutical industry, but from medical research at a publicly funded medical research center.
This seems generally true. So, the more basic question is how to move new drugs from publicly funded medical research to patients. We depend on drug companies to do that and I have no issue that they make a profit doing so. Even this short stage of moving the drug to patients is risky for investors.
But, what the article documents is how Celgene still managed to leverage astronomical profits, probably better called gouging, in the face of potential competition by avoiding government oversight. Drug companies might say that the risk of drug “development” is so high that what they charge for drugs is reasonable.
If that is the case, may be we should fund more downstream drug “development” (bringing it to market) through the government. For example, that is what we do for basic research since it is too risky for businesses to fund such when payouts are so uncertain.
I am not saying we will get something different anytime soon. I am just saying reorganizing the market is possible, and avoiding that possibility stems from a lack of imagination.
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I’ve not seen a way to re-organize the costs to mass market agents. I suppose the government could say that federally funded research is limited to x % markup but that would not likely work. Typically, pharmaceutical industry pays the university for any patents discovered during medical research as they already have vested interest.
I would love to have price controls in terms of cost. I think a 1K% mark up on a drug that cost 25 cents to manufacture more than covers the ROI as well as marketing & distribution, plenty of profit.
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In my experience, this amounts, in itself, to reorganizing the pharmaceutical market as it exists in the US now. As it is presently organized, leveraging of market position and patents are allowed to the extreme. That is, the Celgene case is not a one-off circumstance, just one that is easy to recognize as such. Another relatively easy case to understand was the opioid crisis, which was a manipulation of market position which did identifiable harm.
What I am trying to say is that drug companies make the case that they need this extreme environment to make money and have a new drug pipeline. I am not taking some Marxist position to own everything, or even that chasing money is necessarily bad. I just do not think drug companies need a wild west patent and pricing environment where the fastest-gun-lawyers win. May be you have some agreement to this point.
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If you’re selling a generic against a drug that costs $18K a month, it makes no sense to price it any lower than you need to gain market share. The money is essentially there for the printing. Sure, someone could come in at $1000 a month and (maybe) take over the whole market, but the market wouldn’t get significantly bigger (how many uninsured people with MM as a fraction of total number with MM), so they’re all maximizing revenue.
I wonder what the story is outside the US. Are costs similarly high, because the generic companies have a price umbrella, or has a government established a production facility to sell at cost?
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Definitely have points of agreement. We have same goal. Masses should not bear the cost of their capitalistic greed. I don’t think your position is Marxist at all
You are 100% correct. They do not need extreme profits. Yet, there are no restraints on that* so greed prevails, as no one is willing to cap when their profits go beyond benefit of masses. No one will put limits on it. I think there should be cap when you, individual or corporation are profiting monetarily over 1K times more than masses. That is greed beyond measure.*
- The issue is American opportunity is built on capitalism. Everyone believes they can succeed as capitalists. Capitalists are successfully independent of their profits benefitting society. The lawyers support that via litigation, as that’s how they too make their money. They don’t make money defending the masses. Which is why I support labor unions & ACLU.*
IOWs I can love capitalism & support restraints when the profits do not benefit the masses. Unfortunately, we are a minority when it comes to American politics. The capitalists fund politicians. Until the masses collectively politically support their own interests, we lose.
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