The same pill that costs $1,000 in the U.S. sells for $4 in India

[Napa]

Indian pharma firms offer hope to billions around the world that they can afford life-saving medicines.

The companies sponsor screening drives, hand out free test kits to hospitals and offer bulk discounts to entire villages. Sofosbuvir was cheap by most any standard when it hit the market in Punjab at $10 in March. Then the cost kept dropping, to as low as $4.29, and doctors predict it will continue to fall.

That's in contrast to the situation in the U.S., where Gilead set off a firestorm in December 2013 by listing Sovaldi at $84,000 for a 12-week course regimen. It's a game-changing drug, often wiping out an infection in three months, and without the debilitating side effects of earlier treatments that took longer. Still, the cost started the latest backlash over high medicine prices. Dozens of state Medicaid plans limited access to the drug, and a U.S. Senate report chastised the company. Gilead, which has said it priced Sovaldi responsibly and thoughtfully, is giving insurers and bulk purchasers discounts.

Like others in the industry, the company arranges to make life-saving cures available in some parts of the world for far less; laws and pressure introduced so-called tiered pricing after expensive anti-HIV treatments became available in the '90s and reduced deaths in rich countries and not poor ones. In exchange for a 7 percent cut of sales, Gilead gave companies including Mylan NV, Cipla Ltd. and Natco Pharma Ltd. rights to make generics for distribution in 101 developing nations where hepatitis C is often untreated and $1,000 is more than people might earn in a year. The company wants to "foster competition in the marketplace" in low-income areas, according to spokesman Nathan Kaiser.

http://www.chicagotribune.com/business/ct-drug-price-sofosbuvir-sovaldi-india-us-20160104-story.html

 

[JaDed]

For one thing it's an old article,not taking anything away from the pharmacy industry , yes they are doing well but the amount these foreign pharma companies have they would buy the Indian ones and shut em down or increase the price,they need to expand into African and Asian countries,if not there wouldn't be growth,and more R&D!

Just today a friend of mine was having the same discussion and I was telling him meds are so expensive now and he was like he wishes it was this cheaper in Canada.

 

[Yossarian]

That's assuming they're what they claim to be.

The World Health Organization (WHO) estimates that one in five drugs made in India are fake and that fake pharmaceuticals are a $75 billion dollar global industry. A recent New York Times article points to India as one of the countries at the forefront of the problem, selling fake drugs locally and online to unsuspecting consumers worldwide


https://safemedsonline.org/2014/02/fake-drugs-india-present-public-health-threat/
.

 

[Syed1]

There was an article on this a while back in Canada in which a person complained that he got the same pill from the same company at the fraction of cost in India or Malaysia (I forget). Then the article was rebutted by an official of that pharma company who listed how much it went into doing the R&D for the drug, regulatory costs and other operational costs. Then he compared the average income of residents of both countries and said that companies push higher costs to areas where people can spend more otherwise their drug won't even sell in the third world. Also had a good point that most residents have medical coverage and hardly have to pay for drugs themselves meanwhile there is no such health insurance in third world countries.


So before chest thumping make sure you are completely knowledgable about the issue at hand.

 

[cricketjoshila]

That's assuming they're what they claim to be.

There are a number of billion dollar pharma companies in India.They are not fake.

 

[cricketjoshila]

There was an article on this a while back in Canada in which a person complained that he got the same pill from the same company at the fraction of cost in India or Malaysia (I forget). Then the article was rebutted by an official of that pharma company who listed how much it went into doing the R&D for the drug, regulatory costs and other operational costs. Then he compared the average income of residents of both countries and said that companies push higher costs to areas where people can spend more otherwise their drug won't even sell in the third world. Also had a good point that most residents have medical coverage and hardly have to pay for drugs themselves meanwhile there is no such health insurance in third world countries.


So before chest thumping make sure you are completely knowledgable about the issue at hand.

This is a totally different thing you are talking about.

Indian pharma companies produce generic drugs which are cheaper than what is produced by the original molecule inventing company.

 

[Proactive_]

Wish we could also provide oxygen to dying children, prevent people from dying due to starvation and help protect the dignity of at least the dead by not letting dogs feast on their bodies.. all three news coming from our own government hospitals just this week. What a time to chest thump about Indian health care!

 

[jusarrived]

That's assuming they're what they claim to be.

The article is about genuine products which are produced by likes of Cipla ,Sun , Dr reddys which they are able to sell for a lot cheaper than the likes of Novartis or a Pfizer . The fake can be off an Indian company as well as an American .

The Chinese can still claim it costs a fraction to make an iPhone in China compared to EU/US , even though there are 100s of companies making fake iPhones in china ?

 

[jusarrived]

Wish we could also provide oxygen to dying children, prevent people from dying due to starvation and help protect the dignity of at least the dead by not letting dogs feast on their bodies.. all three news coming from our own government hospitals just this week. What a time to chest thump about Indian health care!

you wished ? wow !! am sure all the kids got their oxygen supply that instant .

 

[Yossarian]

There are a number of billion dollar pharma companies in India.They are not fake.

I'm sure there are many billion dollar pharma companies in India. But that doesn't preclude the fact that counterfeit, or even completely fake, brand name medication manufacturers also operate in India on a very large scale. At least the counterfeit brands probably contain real (but unlicensed from the patent holders) medications. Whereas the fake ones can contain anything from harmless flour, to industrial chemicals or veterinary drugs. Besides, you don't believe the WHO stats as regards the extent of India's problem with fake medications?

 

[Yossarian]

The article is about genuine products which are produced by likes of Cipla ,Sun , Dr reddys which they are able to sell for a lot cheaper than the likes of Novartis or a Pfizer . The fake can be off an Indian company as well as an American .

The Chinese can still claim it costs a fraction to make an iPhone in China compared to EU/US , even though there are 100s of companies making fake iPhones in china ?

Chinese are now using fake iPhones in lieu of medications to cure themselves? Do they swallow them with a glass of water or stick them up their .....?

Reminds one of the case of the patient going to the doctor and saying he's finding it difficult to swallow the (suppository) pill prescribed to him for his constipation.

 

[maxamax]

Forget medicines, even stem-cell therapy is much afforable in India.

 

[Napa]

Ah, the critics are here. As they have no positive alternative to offer, they spend their time criticizing. Let's take a look...

For one thing it's an old article

It's from 2016, quite relevant I would say.

Also had a good point that most residents have medical coverage and hardly have to pay for drugs themselves meanwhile there is no such health insurance in third world countries.
So before chest thumping make sure you are completely knowledgable about the issue at hand.

Yes, the point was that most patients in poor countries do not have insurance, hence the importance of Indian pharma firms. Their AIDS cocktails have had a dramatic effect in sub-Saharan Africa, saving millions of lives and preventing new infections to millions more (a HIV positive patient with a lower viral load is less likely to infect).

Wish we could also provide oxygen to dying children, prevent people from dying due to starvation and help protect the dignity of at least the dead by not letting dogs feast on their bodies.. all three news coming from our own government hospitals just this week. What a time to chest thump about Indian health care!

You argument seems to be that because there are problems in some places, so the good work being done is irrelevant. Yes, let's shut down the pharma firms till there are zero baby deaths.

I'm sure there are many billion dollar pharma companies in India. But that doesn't preclude the fact that counterfeit, or even completely fake, brand name medication manufacturers also operate in India on a very large scale.

I would say that even if 1 out of 5 drugs are fake, the patient has a 4/5 chance of getting the proper drug, as opposed to a 0/5 chance if these pharma firms were not there. The reality also is that the drugs of the pharma giants Cipla, Ranbaxy, Dr Reddys etc. are 100% genuine.

 

[Specialisttailender]

This is a totally different thing you are talking about.

Indian pharma companies produce generic drugs which are cheaper than what is produced by the original molecule inventing company.

Are they 100% same ? Or do they exclude certain ingredients ?

 

[akki]

even if 1 out of 5 pharma is fake. but this article is talking about branded indian pharmas like cipla and all , and tge price difference between 1000 dollars and 4 dollars is huge. Indian IT , Pharma and space program are second to none in the world.

 

[Napa]

Are they 100% same ? Or do they exclude certain ingredients ?

The active ingredient is the same. Sometimes the "binding" agent is different, but that shouldn't affect the effectiveness of the drug.

 

[Yossarian]

The active ingredient is the same. Sometimes the "binding" agent is different, but that shouldn't affect the effectiveness of the drug.

Strictly speaking, not 100% true. I know of friends and relatives who have sometimes had negative side effects of various drugs, and these have disappeared after a change of brands. Or vice versa, if the pharmacy had simply issued a different generic brand upon the next repeat prescription because the local pharmacy had changed suppliers. This is in the UK where the standards are strict, and adherence to the standards is strictly enforced. In a 3rd world country like India, I very much doubt that the adherence to the standards is at the same level.

 

[cricketjoshila]

Are they 100% same ? Or do they exclude certain ingredients ?

Same.

 

[JoniInsafian]

Well obviously cost of drugs is not producing it it's developing it....Companies in the west spend billions developing drugs then India, a country with no concept of intellectual property just produces them... So obviously they will be cheaper....

The question is if pharma companies go bankrupt then how will India produce the new drugs??? They won't because they're not the ones doing the research, west is....

Just being parasites off the back of the west and then claiming they're better.....

 

[JoniInsafian]

It's like saying Hollywood spends 100 millions to produce a film.... But I can rip it on my DVD and sell it for 5$.... So obviously I make great movies for cheap...

 

[cricketjoshila]

Well obviously cost of drugs is not producing it it's developing it....Companies in the west spend billions developing drugs then India, a country with no concept of intellectual property just produces them... So obviously they will be cheaper....

The question is if pharma companies go bankrupt then how will India produce the new drugs??? They won't because they're not the ones doing the research, west is....

Just being parasites off the back of the west and then claiming they're better.....

Sir you have no idea of generic drugs.A huge part of the revenue of these indian companies come from exporting these drugs to west.These are legal exports.Go first read before you spew your vitriol.

 

[SandyB]

Isn't this one of the reason why the US want us to sign up to all those Trade Agreements, so they can kill the low prices of drugs in India and give the US firms access to our huge market ?

I'd rather have our country manufacture drugs for cheap and make them accessible to poorer Indians than trying to export them and face litigations/closure threats from western firms.

Let them but drugs for 1000$ , who cares! Human life costs far too less in the subcontinent, so the cost of maintaining it must cost proportionally less too .

 

[Napa]

Strictly speaking, not 100% true. I know of friends and relatives who have sometimes had negative side effects of various drugs, and these have disappeared after a change of brands. Or vice versa, if the pharmacy had simply issued a different generic brand upon the next repeat prescription because the local pharmacy had changed suppliers. This is in the UK where the standards are strict, and adherence to the standards is strictly enforced. In a 3rd world country like India, I very much doubt that the adherence to the standards is at the same level.

True, it is not 100% certain. However, a drug is supposed to be a particular molecule, or possibly a group of molecules. A proper generic drug has to have the same molecules. However the human body is rather complicated and your relatives' experience may show that all drugs purporting to be the same are not so.

 

[last_knight]

In situations when it's a new drug and has risks associated with it, FDA doesn't approve it for usage in USA.

That's where Third World Countries come into plan. For Phase IV trials of new but risky drugs, they distribute it in marketable countries at low prices (In case of Sofosbuvir, it was for Egypt, Indo-Pak for brand name SOVALDI).

USA Price is apx $1000. That's the catch point.

You have to convince market countries that FDA has approved the drug. And at the same time you have to restrict it's usage in USA. Hence a very high price that is one way to restrict usage in USA.

If Phase IV trials see minimal and insignificant side effects, the price comes down to say $50. Otherwise it remains very high.

I had explained it in another thread few months ago.

 

[Napa]

Isn't this one of the reason why the US want us to sign up to all those Trade Agreements, so they can kill the low prices of drugs in India and give the US firms access to our huge market ?

The last US Trade Representative Forman said on taking office that his biggest priority was to get India "respect intellectual property". His attempt to create create a block with the Trans Pacific Pact was also directed towards India and China.

I'd rather have our country manufacture drugs for cheap and make them accessible to poorer Indians than trying to export them and face litigations/closure threats from western firms.

Let them but drugs for 1000$ , who cares! Human life costs far too less in the subcontinent, so the cost of maintaining it must cost proportionally less too .

Quite right

 

[Yossarian]

Well obviously cost of drugs is not producing it it's developing it....Companies in the west spend billions developing drugs then India, a country with no concept of intellectual property just produces them... So obviously they will be cheaper....

The question is if pharma companies go bankrupt then how will India produce the new drugs??? They won't because they're not the ones doing the research, west is....

Just being parasites off the back of the west and then claiming they're better.....

Sir you have no idea of generic drugs.A huge part of the revenue of these indian companies come from exporting these drugs to west.These are legal exports.Go first read before you spew your vitriol.

There will be no generic drugs if someone first didn't do the R&D, which, as [MENTION=137723]JoniInsafian[/MENTION] has pointed out, is a very large cost that needs to be recouped.

To give a similar (but perfectly legal) example to the one [MENTION=137723]JoniInsafian[/MENTION] gave:

It's like saying Hollywood spends 100's millions to produce a film... but a free-to-air tv broadcaster pays a relatively small amount for transmission rights to show it to millions of viewers once the cinemas have finished showing it and the subsequent DVD sales have also declined.

 

[JoniInsafian]

There will be no generic drugs if someone first didn't do the R&D, which, as [MENTION=137723]JoniInsafian[/MENTION] has pointed out, is a very large cost that needs to be recouped.

To give a similar (but perfectly legal) example to the one [MENTION=137723]JoniInsafian[/MENTION] gave:

It's like saying Hollywood spends 100's millions to produce a film... but a free-to-air tv broadcaster pays a relatively small amount for transmission rights to show it to millions of viewers once the cinemas have finished showing it and the subsequent DVD sales have also declined.

Exactly... Basically the 1000$ US drug is subsidizing the subsequent production of a 3$ pill by India.... The day they stop paying the 1000$, there will be no new drugs...

 

[cricketjoshila]

Exactly... Basically the 1000$ US drug is subsidizing the subsequent production of a 3$ pill by India.... The day they stop paying the 1000$, there will be no new drugs...

As i said.You have no idea what a generic drug is.

 

[cricketjoshila]

There will be no generic drugs if someone first didn't do the R&D, which, as [MENTION=137723]JoniInsafian[/MENTION] has pointed out, is a very large cost that needs to be recouped.

To give a similar (but perfectly legal) example to the one [MENTION=137723]JoniInsafian[/MENTION] gave:

It's like saying Hollywood spends 100's millions to produce a film... but a free-to-air tv broadcaster pays a relatively small amount for transmission rights to show it to millions of viewers once the cinemas have finished showing it and the subsequent DVD sales have also declined.

That example is invalid.Generic drug producers are not license copy producers of the original drug manufacturer.

 

[JoniInsafian]

As i said.You have no idea what a generic drug is.

https://www.forbes.com/sites/johnla...ces-except-for-home-grown-drugs/#2d034b2f2cba

 

[JoniInsafian]

''Drug pricing is a major issue in India. The Indian government believes that the prices of lifesaving drugs shouldn’t be set by market forces. In a country where very few people have health insurance, 70% of Indians pay for healthcare expenses out of their own pockets. When it comes to cancer drugs, the problem is even more acute. There is no way that people in India can pay even a fraction of the cost for drugs that can be priced at $50,000/year in the West.

This issue was again in the news last week when the Indian Supreme Court denied a patent application for Glivec (also known as Gleevec), an important treatment for leukemia made by Novartis. (Derek Lowe has done a great job in explaining the nuances of this patent decision, which won’t be repeated here.) Given that there is no patent for Glivec in India, any generic drug manufacturer in India can now make and sell this drug, which will be priced at a fraction of what Novartis charges in the rest of the world. This is good for the company that will profit from usurping all of the R&D that Novartis put into the discovery and development of Glivec. It is also good for patients who couldn’t afford Glivec. However, it must be noted that Novartis provides Glivec free of charge to 16,000 patients in India, roughly 95% of those who need it via the Novartis “Glivec International Patient Assistance Program”. The remaining 5% are either reimbursed, insured, or participate in a very generous co-pay program. Thus, not granting a patent for Glivec really hasn’t prevented patients from getting this life-saving medication.''

 

[JoniInsafian]

That example is invalid.Generic drug producers are not license copy producers of the original drug manufacturer.

India forces drugs into becoming generics... By refusing patents of pharma companies.... As mentionned in the article above... This works for now because 80% of revenues come from west:

''The real issue is the R&D costs inherent in drugs creation. The Novartis spokesperson argues, "only one out of 10,000 experimental compounds in development will reach the marketplace – at a cost, according to one recent analysis, of $1bn (£642m) for each medicine approved. Thus each successful molecule that makes it as a drug needs to pay for the thousands of molecules that fail ... Without patents, investment in R&D will plummet and people suffering from diseases without effective options will be left without hope. Simply put, without patents there will be no new medicines for untreated diseases and no new generics."

All of which is true. However, "you don't base your investment in R&D on one country's market, you base it on the whole global market", says Dr Mohga Kamal-Yanni, senior health and HIV policy advisor at Oxfam. "In the EU or America or Japan … the law is not going to change. They are safe in these countries, that's where their profits come from, and that profit is protected."

Indeed, more than 80% of pharmaceutical, pharmachemical, and biotechnological patent applications recorded between 1995–2006 were in just six countries (US, Japan, Germany, France, UK and Switzerland), says Shalden: "If they didn't have protection in [those six countries], that's when they would have a point to make." But there is little chance of that happening soon, if ever, given it is those countries that house the Big Pharma firms, and those national governments that argue on their behalf on the global stage.

Some view the recent fights in the Indian courts as a sign of Big Pharma's growing desperation; stubborn attempts to cling to old business models rather than face the truth of spiralling R&D costs. The inability to find new blockbusters has nothing to do with the sales of a couple of drugs in the Indian market.''

But if west stops granting patents and producing drugs for 4$ like India (and they could if they wanted) then there will be no new drugs...

Basically India is parasiting off the west and nobody cares because you are not a big enough market...

 

[Napa]

There will be no generic drugs if someone first didn't do the R&D, which, as [MENTION=137723]JoniInsafian[/MENTION] has pointed out, is a very large cost that needs to be recouped.

To give a similar (but perfectly legal) example to the one [MENTION=137723]JoniInsafian[/MENTION] gave:

It's like saying Hollywood spends 100's millions to produce a film... but a free-to-air tv broadcaster pays a relatively small amount for transmission rights to show it to millions of viewers once the cinemas have finished showing it and the subsequent DVD sales have also declined.

Exactly... Basically the 1000$ US drug is subsidizing the subsequent production of a 3$ pill by India.... The day they stop paying the 1000$, there will be no new drugs...

The market capitalization of J&J is $330 billion dollars. What does this figure represent? As J&J has minor physical assets, say $30 billion, the remaining $300 billion is the discounted value of their profits, that is revenues minus costs. So J&J could sell its drugs for a much lower price and still remain profitable.

 

[Yossarian]

The market capitalization of J&J is $330 billion dollars. What does this figure represent? As J&J has minor physical assets, say $30 billion, the remaining $300 billion is the discounted value of their profits, that is revenues minus costs. So J&J could sell its drugs for a much lower price and still remain profitable.

For shareholders/investors not to bolt, the profit levels not only need to be maintained, but increased on a year-upon-year basis, or at least give better returns than if they invested their money elsewhere. Even profitable companies can go bankrupt if the investors flee, which they will if the profits start going down and the value of their investments/shares start to nosedive.

 

[jusarrived]

Chinese are now using fake iPhones in lieu of medications to cure themselves? Do they swallow them with a glass of water or stick them up their .....?

Reminds one of the case of the patient going to the doctor and saying he's finding it difficult to swallow the (suppository) pill prescribed to him for his constipation.

That was an example , next time will remember put a note when I talk to you .
God forbid if you try to stick it up your .. for my fault of not being clear !!

 

[Yossarian]

That was an example , next time will remember put a note when I talk to you .
God forbid if you try to stick it up your .. for my fault of not being clear !!

You're the only implying that the Chinese use fake iPhones for that purpose. I'll just have to take your word for it as it's something you might be speaking about from personal experience.
As for "next time will remember put a note when I talk to you", here's a suggestion, don't 'talk' to me or reply to my posts. Will obviate the need for any extra notes. .

 

[Napa]

You're the only implying that the Chinese use fake iPhones for that purpose. I'll just have to take your word for it as it's something you might be speaking about from personal experience.
As for "next time will remember put a note when I talk to you", here's a suggestion, don't 'talk' to me or reply to my posts. Will obviate the need for any extra notes. .

That is not how the markets work. Shareholders "fleeing" may be correlated with a firm experiencing financial troubles, because financial troubles lead to a fall in stock prices.

However, say that J&J saw a cut in profits that led to its market cap dropping to $100B from $330B. It is still a long way away from bankruptcy as the market estimates it has physical assets and will make profits in the future that add up to $100B. Some shareholders may "flee" that is sell their shares, but they are replaced by new shareholders who believe J&J is a good buy.

Bottom line is that with a market cap of $330B, J&J's expected future expenses (with includes R&D) is far less than future revenues, so a drop in price leading to a drop in revenues should not make their future investments in R&D unprofitable.

 

[jusarrived]

You're the only implying that the Chinese use fake iPhones for that purpose. I'll just have to take your word for it as it's something you might be speaking about from personal experience.
As for "next time will remember put a note when I talk to you", here's a suggestion, don't 'talk' to me or reply to my posts. Will obviate the need for any extra notes. .

I dint , but if you say so ..!!