Doc,
I completely agree with what you're saying, but know the FDA just won't work that way. I do believe the FDA is slowly changing, but clearly the right to try, which should make many products available, is still fraught with problems and companies aren't using it to make their products available.
I believe the rub with right to try is largely based on what can be charged, especially if drug developers have to show the actual cost of making the product without considering the developmental costs to date. I.E. if I already have the production facility for making a product, and don't consider the cost of development, my cost is probably few dollars worth of chemicals, and the cost of the time people spend making the drug, plus operational costs of running all associated equipment.
If instead of divulging costs, under right to try the drug producers could simply charge a reasonable percentage of what was agreed would be the list price for the approved product, I believe the drug makers would be much more willing to cooperate. That reasonable percentage might be as low as 10%, or as high as 50%, that would be negotiated. If at the negotiated price the insurance companies would have a lessened burden, they would participate in paying for the product. If the anticipated benefit would save the insurance company overall, even if treatment cost up front were higher, they should participate in the costs.
When it comes down to list price for drugs, few people with the exception multi millionaires can afford to pay unless they're covered by insurance, and the co-pay's are reasonable. Of course the general public never really knows what price insurance companies actually pay, but I believe it's often a small percentage of the list price.
There is a need to bring healthcare down to what should actually be paid, but that's fodder for our politicians. My personal physician now has a concierge add on that patients can pay for more personal service, to date we've avoided such payments. At least he's not demanding it to continue using him, I believe some Doctors are.
Gary
