iamnumerate Posted February 19, 2018 Share Posted February 19, 2018 10 hours ago, macca13 said: When you work out how much money they are wasting on buying drugs that are out of patent and could be manufactured for pennies, combined with agency staff cost and Pfi hospital contracts.. it’s a joke how much of the money is wasted.. Although a drug could be manufactured for pennies, starting the process is quite expensive. It is not that easy particularly if we want and we do, pharmaceutical grade. Quote Link to comment Share on other sites More sharing options...
Dorkins Posted February 19, 2018 Share Posted February 19, 2018 5 minutes ago, iamnumerate said: Although a drug could be manufactured for pennies, starting the process is quite expensive. It is not that easy particularly if we want and we do, pharmaceutical grade. Fixed costs are high in drug manufacturing - you need a government-approved manufacturing facility, a government-approved manufacturing process, government-approved testing to release batches of drug for use in patients etc. Ibuprofen can be made for pennies because the fixed costs are shared across enormous batch sizes. For lower throughput drugs the economies of scale are not so readily available so it may not be worth it for generics manufacturers to compete. Quote Link to comment Share on other sites More sharing options...
iamnumerate Posted February 19, 2018 Share Posted February 19, 2018 Just now, Dorkins said: Fixed costs are high in drug manufacturing - you need a government-approved manufacturing facility, a government-approved manufacturing process, government-approved testing to release batches of drug for use in patients etc. Ibuprofen can be made for pennies because the fixed costs are shared across enormous batch sizes. For lower throughput drugs the economies of scale are not so readily available so it may not be worth it for generics manufacturers to compete. Yep that is what I meant, but thanks for clarifying it. Quote Link to comment Share on other sites More sharing options...
winkie Posted February 19, 2018 Share Posted February 19, 2018 .....fewer people would wish to accumulate property if the capital inflation of it was not so high, far higher than working wages increases......so policies that do not encourage HPI would stunt property growth.....new policies to encourage viable business borrowing and other investment such as training and infrastructure would encourage growth in the areas that would benefit the country as a whole..... instead of discouraging people from living and working here when work no longer pays for a place to live, a family, bills and taxes.......nobody will spend into the economy when most of their income goes into paying debt interest and high rents..... ......high HPI also means many working people no longer have families....it takes so long to feel secure in both work and securing a safe affordable home they skip having children altogether (some with no hope, living hand to mouth continue to have children, their children are their future security)......no children mean nobody to inherit debt repayment vehicle or property asset deposit. Quote Link to comment Share on other sites More sharing options...
Dorkins Posted February 19, 2018 Share Posted February 19, 2018 The cost of healthcare could be reduced by lowering the standard of service. Lower the value of a NICE QALY (currently £20-30k per quality-adjusted life year) to exclude expensive treatments, abolish Cameron's NHS Cancer Drugs Fund which was specifically set up to pay for cancer medicines with a poor cost-benefit ratio, encourage doctors, patients and families to opt for palliative end-of-life care focused on quality of life rather than desperate attempts to extend life at any financial and human cost. Why are we doing major surgeries like removing most of the liver from somebody in their 80s who has metastatic cancer? Recovery time will be very long in somebody that old. Just give them painkillers (if they need them) and let them enjoy their final weeks/months with their friends and family. Quote Link to comment Share on other sites More sharing options...
iamnumerate Posted February 19, 2018 Share Posted February 19, 2018 2 minutes ago, winkie said: .....fewer people would wish to accumulate property if the capital inflation of it was not so high, far higher than working wages increases......so policies that do not encourage HPI would stunt property growth.....new policies to encourage viable business borrowing and other investment such as training and infrastructure would encourage growth in the areas that would benefit the country as a whole..... instead of discouraging people from living and working here when work no longer pays for a place to live, a family, bills and taxes.......nobody will spend into the economy when most of their income goes into paying debt interest and high rents..... ......high HPI also means many working people no longer have families....it takes so long to feel secure in both work and securing a safe affordable home they skip having children altogether (some with no hope, living hand to mouth continue to have children, their children are their future security)......no children mean nobody to inherit debt repayment vehicle or property asset deposit. I think it is for 2 reasons 1) Taxation has been better for property than other investments until S24, stamp duty changes, capital tax changes better. Thanks George Osborne for changing this. 2) Property is physical and people like this compared to shares which seem to be not so real. (Of course it is very hard to diversify a £100K investment in property but easy in shares). Quote Link to comment Share on other sites More sharing options...
macca13 Posted February 19, 2018 Share Posted February 19, 2018 52 minutes ago, Dorkins said: If nobody is manufacturing a cheap generic version of a drug where are the NHS supposed to buy it from? Is it really wasted spending if there's no cheaper alternative? American hospitals are looking at building their own manufacturing facility, they can then make whatever un patented drugs they want.. such is the greed of the drugs companies they are looking to do it themselves.. it’s that sort of thinking that will make or break our public services.. not a CEO on 300k a year.. that’s just jobs for the boys.. i would manufacture our own drugs, build a facility to produce patented drugs, they can then also be sold abroad to make us a profit.. so it’s a business opertunity as well.. open an NHS agency and ban private agencies! use this to cut agency costs massively.. removing the profit side and cutting the cost side through wage reduction in the agency sector.. people gotta work, you can’t hold the nhs to ransom.. just these 2 things would save billions.. just for starters.. I wish I was in charge of the NHS.. they don’t fix it because their is a big pile of our tax money and they all get rich off it.. greed and corruption Quote Link to comment Share on other sites More sharing options...
winkie Posted February 19, 2018 Share Posted February 19, 2018 4 minutes ago, iamnumerate said: I think it is for 2 reasons 1) Taxation has been better for property than other investments until S24, stamp duty changes, capital tax changes better. Thanks George Osborne for changing this. 2) Property is physical and people like this compared to shares which seem to be not so real. (Of course it is very hard to diversify a £100K investment in property but easy in shares). Yes, you are right about low taxation in property has pushed people who can into putting own and borrowed money into property/flooding the property market with new money, also social collective funds have been subsidising the property speculators, low interest rates and tax efficient policies for the BTL brigade......all this even without recent foreign money buying up land and buildings for in the main speculation and security purposes. Why does property do well in certain areas? it is because of past investments and infrastructure that created the growth in population in well invested areas.......previous generations have created this.....all the new investors do is plug into what history has already created, our ancestors, previous generations have worked for and invested in..... Shares are volatile and with algorithms and automatic nano second bid offer trading will become more so......every thing is financialised, speculative,......true value has become obscured....big problem being you don't need stocks, shares, coins or gold to live, but we all require a home so housing speculation affects everyone, more so when fewer people can secure one. Quote Link to comment Share on other sites More sharing options...
iamnumerate Posted February 19, 2018 Share Posted February 19, 2018 4 minutes ago, macca13 said: American hospitals are looking at building their own manufacturing facility, they can then make whatever un patented drugs they want.. such is the greed of the drugs companies they are looking to do it themselves.. it’s that sort of thinking that will make or break our public services.. not a CEO on 300k a year.. that’s just jobs for the boys.. i would manufacture our own drugs, build a facility to produce patented drugs, they can then also be sold abroad to make us a profit.. so it’s a business opertunity as well.. open an NHS agency and ban private agencies! use this to cut agency costs massively.. removing the profit side and cutting the cost side through wage reduction in the agency sector.. people gotta work, you can’t hold the nhs to ransom.. just these 2 things would save billions.. just for starters.. I wish I was in charge of the NHS.. they don’t fix it because their is a big pile of our tax money and they all get rich off it.. greed and corruption Generic drugs often cost more in the US IIRC also as Dorkins said this not as easy as it sounds. If you ban private agencies then someone has to do their work in the NHS (looking for staff etc). Quote Link to comment Share on other sites More sharing options...
winkie Posted February 19, 2018 Share Posted February 19, 2018 If you want to know what the NHS could turn out to be like if we let it?......it will be just like the veterinary service we have today......if they know that insurance is held all number of procedures are undertaken, overnight stays etc to find problem no expense spared, some things of use other things inappropriate and wasteful......no insurance, basic and sometimes the best more direct common sense route found....sometimes can find vets that will do operations and provide drugs for very little something the animal owner can afford or even for free.....two tiered society, those with v those without and unlikely ever to get, reliant on charity. Quote Link to comment Share on other sites More sharing options...
Dorkins Posted February 19, 2018 Share Posted February 19, 2018 (edited) 5 hours ago, macca13 said: American hospitals are looking at building their own manufacturing facility, they can then make whatever un patented drugs they want.. such is the greed of the drugs companies they are looking to do it themselves.. it’s that sort of thinking that will make or break our public services.. not a CEO on 300k a year.. that’s just jobs for the boys.. i would manufacture our own drugs, build a facility to produce patented drugs, they can then also be sold abroad to make us a profit.. so it’s a business opertunity as well.. open an NHS agency and ban private agencies! use this to cut agency costs massively.. removing the profit side and cutting the cost side through wage reduction in the agency sector.. people gotta work, you can’t hold the nhs to ransom.. just these 2 things would save billions.. just for starters.. I wish I was in charge of the NHS.. they don’t fix it because their is a big pile of our tax money and they all get rich off it.. greed and corruption A hospital-owned drug manufacturing facility will still need to be built, staffed, kitted out, approved by the government's medicines regulator, receive regulatory approval for the manufacturing and testing process for every drug they intend to produce etc. Laws governing how medicinal products are controlled by regulators still apply to them, they can't just pump out whatever chemicals they want and (legally) put them into people's bodies. The fixed costs will be just as high as if a generics manufacturer did it, the main difference is generics manufacturers know what they're doing while hospitals don't. Here's a question for you: if generics manufacturers are charging far more than the manufacturing cost, why isn't anybody in the private sector trying to undercut them? Edited February 19, 2018 by Dorkins Quote Link to comment Share on other sites More sharing options...
macca13 Posted February 19, 2018 Share Posted February 19, 2018 8 minutes ago, Dorkins said: Here's a question for you: if generics manufacturers are charging far more than the manufacturing cost, why isn't anybody in the private sector trying to undercut them? That’s quite a simple answer, because they all have agreements to rig the market.. have a read http://www.dailymail.co.uk/news/article-3246093/Drugs-boss-hiked-price-life-saving-AIDS-treatment-5-000-cent-tried-kidney-pills-vows-reduce-price-refuses-say-much.html https://www.google.co.uk/amp/uk.mobile.reuters.com/article/amp/idUKKBN1D0201 too much greed and evil in the world.. Quote Link to comment Share on other sites More sharing options...
Arpeggio Posted February 19, 2018 Share Posted February 19, 2018 18 minutes ago, macca13 said: That’s quite a simple answer, because they all have agreements to rig the market My theory is that because the "terrorists" (so to speak) are under peoples skin (illness & disease), being betrayed is inconceivable so people don't conceive it. http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020138 Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies Quote Link to comment Share on other sites More sharing options...
Dorkins Posted February 19, 2018 Share Posted February 19, 2018 32 minutes ago, macca13 said: That’s quite a simple answer, because they all have agreements to rig the market.. have a read http://www.dailymail.co.uk/news/article-3246093/Drugs-boss-hiked-price-life-saving-AIDS-treatment-5-000-cent-tried-kidney-pills-vows-reduce-price-refuses-say-much.html https://www.google.co.uk/amp/uk.mobile.reuters.com/article/amp/idUKKBN1D0201 too much greed and evil in the world.. The UK is a very different market from the US though. We effectively have a monopsony in which the NHS is virtually the only buyer of drugs so it has huge market power. Whereas in the US members of a cartel can divvy the market up between themselves, in the UK you either get the NHS contract to supply a drug or you don't. Quote Link to comment Share on other sites More sharing options...
macca13 Posted February 20, 2018 Share Posted February 20, 2018 5 hours ago, Dorkins said: The UK is a very different market from the US though. We effectively have a monopsony in which the NHS is virtually the only buyer of drugs so it has huge market power. Whereas in the US members of a cartel can divvy the market up between themselves, in the UK you either get the NHS contract to supply a drug or you don't. All drugs are not produced by a single manufacturer, if you need a drug what choice do you have if only one manufacture produces it? The point is out of patent drugs could be produced by the Government directly.. that’s what the American health providers are saying.. why pay £700 for 1 tablet that the ingredients costs 0.01p.. They are going to produce them themselves and drastically reduce costs.. it takes the p!ss when allot of the research into drugs/cures is done by charities paid for by donations anyway.. Quote Link to comment Share on other sites More sharing options...
Dorkins Posted February 20, 2018 Share Posted February 20, 2018 (edited) 4 hours ago, macca13 said: The point is out of patent drugs could be produced by the Government directly.. that’s what the American health providers are saying.. why pay £700 for 1 tablet that the ingredients costs 0.01p.. They are going to produce them themselves and drastically reduce costs.. The ingredients might cost 0.01p, it's the manufacturing and testing process that costs a lot more. Anyway, I think it's a good thing the US hospitals are trying to do this, I'm just sceptical as to whether it will really reduce costs much. I've seen government attempts to get involved in drug manufacture and it ended up bloated and expensive. You seem very excited about Shkreli hiking the price of Daraprim to $750 a tablet in the US. While this was going on, outside of the US this drug was supplied by other manufacturers for a few pennies a tablet e.g. GSK supplies it in the UK for about 50p a tablet. https://en.wikipedia.org/wiki/Pyrimethamine#Availability_and_price Even in the US you can now get the drug for 99c a tablet now that another generic manufacturer decided to compete in this market after Shkreli's price hike. I get the feeling you read a lot of stuff about the US healthcare market but things really are different in the rest of the world in terms of healthcare costs. Edited February 20, 2018 by Dorkins Quote Link to comment Share on other sites More sharing options...
iamnumerate Posted February 20, 2018 Share Posted February 20, 2018 3 hours ago, Dorkins said: The ingredients might cost 0.01p, it's the manufacturing and testing process that costs a lot more. Anyway, I think it's a good thing the US hospitals are trying to do this, I'm just sceptical as to whether it will really reduce costs much. I've seen government attempts to get involved in drug manufacture and it ended up bloated and expensive. You seem very excited about Shkreli hiking the price of Daraprim to $750 a tablet in the US. While this was going on, outside of the US this drug was supplied by other manufacturers for a few pennies a tablet e.g. GSK supplies it in the UK for about 50p a tablet. https://en.wikipedia.org/wiki/Pyrimethamine#Availability_and_price Even in the US you can now get the drug for 99c a tablet now that another generic manufacturer decided to compete in this market after Shkreli's price hike. I get the feeling you read a lot of stuff about the US healthcare market but things really are different in the rest of the world in terms of healthcare costs. The US is not the same as the UK, prices in Canada etc can be much cheaper than the US. I once read about someone who went to Colombia for 2 week to buy a years medicine and made a profit - despite having insurance etc. Another way of explaining what Dorkins said is it only costs 30 p in petrol to drive 5 miles,so why pay for a taxi? However if you do not have a car or a driving license, insurance etc, it is much cheaper to pay for a taxi than learn to drive, buy a car etc and then drive 5 miles, if you are only going to do so twice a year. Does that make sense? Quote Link to comment Share on other sites More sharing options...
LittlePig Posted February 20, 2018 Share Posted February 20, 2018 (edited) 1 hour ago, iamnumerate said: The US is not the same as the UK, prices in Canada etc can be much cheaper than the US. I once read about someone who went to Colombia for 2 week to buy a years medicine and made a profit - despite having insurance etc. Another way of explaining what Dorkins said is it only costs 30 p in petrol to drive 5 miles,so why pay for a taxi? However if you do not have a car or a driving license, insurance etc, it is much cheaper to pay for a taxi than learn to drive, buy a car etc and then drive 5 miles, if you are only going to do so twice a year. Does that make sense? Bush legislation fubar in the US. http://www.courant.com/business/hc-drug-cost-enablers-20160929-story.html Edited February 20, 2018 by LittlePig Quote Link to comment Share on other sites More sharing options...
iamnumerate Posted February 20, 2018 Share Posted February 20, 2018 17 minutes ago, LittlePig said: Bush legislation fubar in the US. http://www.courant.com/business/hc-drug-cost-enablers-20160929-story.html Your link blames Obama as well Quote Obama's health care law provided makers of cutting-edge biologic drugs 12 years of protection from generic competitors, not a shorter period sought by consumer advocates. Quote Link to comment Share on other sites More sharing options...
LittlePig Posted February 20, 2018 Share Posted February 20, 2018 1 minute ago, iamnumerate said: Your link blames Obama as well Same difference. Bad legislation. Quote Link to comment Share on other sites More sharing options...
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