Biotech Values

[iwfal]

You probably think I’m overdoing this, but I consider #msg-80935662 (the message I’m replying to) one of the seminal posts in the iHub archive.

Not at all. If nothing else it is clearly important for the effect it has on the biotech stock prices as it keeps coming up in the news.

But it is a hard problem to solve without a central negotiator capable of just saying some drugs won't be on formulary. Period. Especially hard without even a squishy benchmark (like QALY) that allows comparison across diseases (a little like competition even in diseases where there is no competition).

To solve it without those tools (which seem to be largely impossible in the US) you need to either piggy back on countries that can solve it (e.g. David Millers suggestion) or fix all the things that enable shadow pricing (a kind of collusion but via signals like those in the card game bridge).

BTW - the even more interesting problem is solving the larger medical cost problem since drugs are just a small part of the increase in medical care costs that have increased faster than inflation for decades. E.g. MD salaries for instance (especially specialist) - apologies to all the MDs reading this but the party can't go on forever (interestingly I know several MDs who left private practice for Kaiser even though they make less money - because is just plain more enjoyable).