upvote

points

by sudopsuedo18 hours ago |
comments
upvoteby onraglanroad18 hours ago|
next
[-]
> the existence of America's prescription drug markets drives the new innovative drugs that the rest of the world picks up for cheap.

That's the ludicrous propaganda that you've been fed but you really should be intelligent enough to dismiss it.

The world would get along just fine without you overpaying for your drugs. You pay for marketing costs.

reply
upvoteby nine_k17 hours ago|
parent|
next
[-]
Mostly not marketing (still large), but the R&D costs and clinical trial costs. The latter are in hundreds of millions to billions range for the entire journey from a promising discovery to an FDA-approved medicine.
reply
upvoteby dv_dt13 hours ago|
parent|
next
[-]
Every time Ive looked into it marketing is more than half of the costs of US pharma companies - and I would suspect even more as don't know if there has much work to unmask even more of that spending via channels that can occur in ways not obviously marked as marketing or at least are really not core to research and manufacturing.

e.g. is all the "discount coupon" pharmacy rigamarole considered marketing or administration.

reply
upvoteby mdorazio9 hours ago|
parent|
[-]
This is not correct. Here's Pfizer's 2025 annual report [1]. Total expenses for the year were $55.1 billion. Advertising expenses were $2.7 billion of that, or just under 5%. R&D expenses were $12.1 billion, or just under 22%. They do have a lot of SG&A, but the large majority of that is not going to marketing.

[1] https://d18rn0p25nwr6d.cloudfront.net/CIK-0000078003/908eb6a...

reply
upvoteby dv_dt9 hours ago|
parent|
[-]
Advertising is only a subset of marketing. From that doc, look at operating costs: SGA was ~$11B and R&D ~$12B - basically 50/50. Pfizer is very international, so is pretty difficult to break out US operating costs and what marketing vs R&D is for just the US. But one can also assume US marketing is higher than any other nation as direct-to-consumer advertising is primarily only allowed in the US.
reply
upvoteby thrwaway5515 hours ago|
parent|
prev|
next
[-]
Why not just research it outside of the US if the problem is the FDA cost
reply
upvoteby phyzix576113 hours ago|
parent|
next
[-]
You still need the same FDA approval and process to sell it in the US
reply
upvoteby thrwaway5513 hours ago|
parent|
[-]
Cost cut them. You think the administration won't take a bribe at that point?
reply
upvoteby estearum6 hours ago|
parent|
prev|
[-]
Because the problem isn't the FDA cost

The problem is proving your drugs work

It's very hard and expensive to do

reply
upvoteby standardUser15 hours ago|
parent|
prev|
[-]
Right, but the idea that Americans specifically should pay higher prices is beyond propaganda. It's Stockholm Syndrome-level delusion. Big Pharm has thrived for generations on our research universities (for the time being anyway) and had a front row seat to expanding foreign markets under US-led globalization. In return, we get the world's most expensive healthcare system and the privilege of paying too much for meds because our leaders won't cut a deal. All they have to lose is the "hundreds of millions to billions range" in annual lobbying expenditures by Big Pharma.

In a sane world - or literally any other country - that $300-$500 million in annual lobbying would be the literal difference that makes medicine accessible for those who need it. Instead, it goes to expensive lunches.

reply
upvoteby mlmonkey3 hours ago|
parent|
prev|
[-]
Agreed. I mean, where did the COVID mRNA vaccine come from? Which company makes the GLP-1 inhibitors like Ozempic and Mounjaro? Are these American companies?
reply
upvoteby tptacek18 hours ago|
prev|
[-]
That's an interesting argument --- that massively increased access to pharmaceuticals would have knock-on impacts on other cost areas in the NHE.

I think if we dig into the numbers we're likely to find those effects, even if we maximize them, are marginal, unless we do other structural things to untangle the provider pricing system and do price transparency. Like: you could posit a material impact on CVD costs by making statins more widespread, and that should make a dent somewhere, but I don't know that CVD costs in non-Medicare-insured patients are really that big a line item, and non-Medicare is important here because people already Medicare-qualified generally have all the statins they want already. Meanwhile, providers are still ripping patients (and insurers) faces off for shoulder impingements, stents, and spinal fusions.

It's a super interesting comment. Thanks!

reply