I succeeded at this. My academic physics career petered out, then I stumbled into an industry role with almost as much physics as I was doing in my quantum mechanics postdoc.
The jobs you're looking for are rare, but they do exist. There must be a bunch of them in this project, for example:
In my case, the unicorn factor worked both ways. The job was advertised for a year before my hiking partner encouraged me to apply, and it took a few months more before I did. From that point, the job was easy to get.
In this job market, supply and demand are reasonably well matched; the problem is that the market is very illiquid. Science jobs are rare to begin with, and people stay in them for decades, so vacancies are even rarer.
On the one hand, a programmer at my company who was interested and capable of switching to optics could have had my role by asking for it. On the other hand, if you joined the company as a programmer, you would have had to wait 5 years for an optics role to come up.
So my advice is to stay in touch with your friends from the earth science days, and expect this to take a long time. Good luck!
Thank! I actually worked with people in that article :) Now I'm based in Europe so my grad school friends work at companies in a different continent, so so far, no luck there.
There was literal starvation in the US in the Great Depression too (which was 1929 all the way to the late 30s, pretty close to WWII). The US got over it after a couple of decades.
Similarly the EU of 2025, has nothing to do with WW2-era starvation, that has been over half a century in the past.
And of course there was literal starvation in China as well after WWII, and much more poverty there than in the EU 30 years ago (even including Eastern Europe).
And you think China, which had started for a very poor place after their civil wars, and had been ravaged by the Japanese invasion and occupation (including the only mass scale biological warfare in modern times), weathered WWII better than Europe?
EU taxes exorbitantly and does not reinvest in people. Instead wastes money on expanding bureaucracy and making the Government fatter. Passes asinine laws that stifle companies from innovating. If a company is wasting more time trying to be compliant with crazy regulations and avoiding ridiculous fines, it won't have time to focus on innovation.
First, the EU (well, governments of EU member countries, not the EU itself, which anyway doesn't tax citizens) invests far more into people than China does; civil services, from sanitation to healthcare to schools to social security, are all much better in the EU countries than in China.
Secondly, China also has extremely high bureaucracy, and extreme levels of government regulation - a classic problem for dictatorial regimes, especially ones spanning huge spaces (where direct control is physically impossible, even in the information age).
The big difference is that EU governments have drunk the coolaid on modern economical theories, and don't generally pick winners and losers in the market (beyond few key companies with deep ties to the ruling elites, mostly in banking), don't invest massive amounts to prop up companies doing price dumping, and generally play within the rules of world trade.
Of course, those rules are made up specifically to prevent any state from using its power to out-compete incumbent companies, many of which are US owned, but also German, French, Spanish etc owned.
Also, there is little appetite for EU level strategic decisions, EU member countries are far too divided. For example, Finland probably didn't have the power to prop up Nokia's phone division when Apple and Samsung started eating its lunch with smartphones, and France or Germany wouldn't have wanted to invest EU resources into doing it either. France is likely not going to be ok with propping up a German rival to BYD using massive funds, or vice versa for a French company.
So, while collectively the EU easily rivals China on money antld the USA on population, it is far too divided to pool those powers together, and the EU population mirrors this sentiment - there is not a strong EU identity that would see a Belgian person deeply proud of a major tech company based in Slovenia, or a Czech person cheering for a massive new investment in Portugal.
Microsoft is using IoT in a loose sense. The "thing" could be an industrial PC at the train station that plays a recorded message saying the 8:15 will run late today.
I wonder how much this will cost? A drug you take 2 times a year could be much cheaper than one you take 365 times a year, and that's a big deal.
The existing daily pill is really expensive. Australia knew that PrEP would practically eliminate HIV transmission. Even so, the decision to pay for it took years and was fiercely contested. That was before COVID, and people are more willing to pay for public health today. But cheap PReP would make a big difference in the poor countries where HIV prevention really matters.
The shot will likely be exorbitant in the USA. Gilead charged almost $2k/month for Truvada (list price, of course) and Descovy is the same. Generic Truvada is like $30/month now, so the price was never about the cost to manufacture. Obviously Gilead is developing these new drugs/shots for when Descovy's patent expires.
They rely on the government mandating that health insurance companies cover the shots. This drives up the price.
The price is rarely ever about the manufacturing cost.
"A new study in 2020 estimated that the median cost of getting a new drug into the market was $985 million, and the average cost was $1.3 billion, which was much lower compared to previous studies, which have placed the average cost of drug development as $2.8 billion.[4]"
It should be pointed out that looking at the average cost of developing a drug is misleading, since one has to include the cost of all the drugs that failed to make it to market. One also has to include the money spent by small companies that failed and were not bought out, not just the money the big companies spend buying the successful ones.
This is critical, and exactly the sort of thing someone will gloss over, intentionally or not. The numerator is the total cost of developing ALL the drugs, even (especially) the failed ones, but the denominator is only those drugs that are successful.
On the contrary, often pharma proponents will gloss over the fact that most “failures” are discovered and canned at a small fraction of the investment of getting a drug to market (when it’s obvious it won’t do what you need or has other challenges).
Actually not in the contrary - you are right. It’s just that the failures often cost a small fraction. They don’t get to 95% testing and approval before “nope, not even close”.
No, that's not quite accurate - the phases are effectively additive.
37% fail in Phase 1. Of those that make it through, 69% of those fail in Phase 2, and of those, 42% fail in Phase 3.
So, of 1,000 possibles, you have 630 make it through Phase 1, and 195 that make it through phase 2, i.e. 80.5% of your drug candidates didn't even make it to Phase 3, that "most expensive phase".
A more accurate phrasing would be that 42% of the drugs that made it through Phase 2 fail to make it through Phase 3.
Supposing the cost ramps up exponentially at each phase, e.g. it costs $10 million to get to Phase 1, $100 million to get to Phase 2, and $1 billion to get to Phase 3, then we see the total expenditure for 1000 possible drugs as:
$ 3.7 billion for Phase 1 failures (370 drugs)
$ 43.5 billion for Phase 2 failures (435 drugs)
$ 82 billion for Phase 3 failures ( 82 drugs)
$113 billion for Phase 3 successes (113 drugs)
This sums to a little over $242 billion spent against 113 successful drugs, or about $2.14 billion per successful drug, or more generally, accounting for failed drugs, the full cost of a successful drug is a little more than twice what was directly spent on its development.
Certainly I do not mean to imply that Phase 1 and Phase 2 failures are cost-free. But it is challenging to measure. As seen elsewhere in this thread, Gilead essentially included the acquisition of another company who had a whole retinue of drugs and product lines as "R&D" for Truvada, I believe. That is creative accounting that would not pass an audit or SEC filing, which is why Gilead only counts it as an R&D cost in their press releases...
It certainly should count; that company didn't get delivered for nothing by the Drug Discovery Fairy. And even more: the companies that didn't get bought by Gilead should also count, since the funders of all those small companies could not tell ahead of time which would succeed enough to be bought out.
No, it really shouldn't. If I acquire a drug company that has, say, 100 patents on a suite of drugs for $1B (just using nice round numbers), I don't get to say "I spent $1B on "R&D" for 1 drug" as a sunk cost.
R&D is a sunk cost. Presumably acquiring an active company with a portfolio is an investment.
Published estimates of trial costs from a 2011 systematic review ranged over an OOM.[1]
A 2017 report focused on 7 top-20 companies and 726 studies from 2010-2015 found " median cost of conducting a study from protocol approval to final clinical trial report was US$3.4 million for phase I trials involving patients, $8.6 million for phase II trials and $21.4 million for phase III trials". [2] These are not all that far off from another 2016 study on cost drivers of pharma clinical trials in the US using means and breaking down costs by therapeutic area. [3]
Plugging the first study's numbers into your 1000-drug profile, we'd have:
$ 1.3 billion for Phase 1 failures (370 drugs)
$ 3.7 billion for Phase 2 failures (435 drugs)
$ 1.8 billion for Phase 3 failures ( 82 drugs)
$ 2.4 billion for Phase 3 successes (113 drugs)
That sums to $9.2 billion spent against 113 successful drugs, or about $80 million per successful drug. This implies the full cost of a successful drug is almost 4x what was spend on its development.
One limit here is we're working with medians, not means, and I wouldn't be surprised if this is an underestimate of clinical trial costs.
Roche has had pretty stable net income (profit) of $9.2-$15.2B/year from 2011-2023 against revenue from $49.9-$72B/year in the same time period. Using this estimate, ignoring inflation, if they ran 1,000 clinical trials per year it would account for a maximum of about 18% of their costs and they'd get 113 new drugs out of it annually.
Obviously that is not what's happening: there are an average of 53 FDA new drug approvals per year across the entire industry. If Roche was the only pharma company running clinical trials, the total cost of those trials would be more like $4B, so a max of about 10% of their annual costs. In reality this estimate makes it seem like it must be substantially lower.
The Congressional Budget Office[4] says total pharma R&D spending in 2019 was $83 billion. With 53 new drug approvals per year on average, that implies about an average cost of about $600 million per drug in R&D spending, compared with the $80 million estimate obtained above.
So this makes it sound like running clinical trials account for only about 10% of total R&D spending. Given that Roche's costs alone look to be in the tens of billions per year, as compared to $83B or so annually for R&D across the industry, it also looks like R&D is only a part of the story on cost drivers for pharma companies. Google is not being helpful on this question (almost all the conversation is on R&D cost, it seems), but my guess is it's costs of manufacture, legal, sales, etc.
> it also looks like R&D is only a part of the story on cost drivers for pharma companies ... but my guess is it's costs of manufacture, legal, sales, etc.
Marketing. At least 7 of the top 10 pharma companies globally have marketing as a multiple of R&D for their spending (sometimes up to 7x). IIRC, at the other 3, it still exceeds R&D, less egregiously.
The big issue with "Marketing" spend is that though these numbers are global, there are only two countries in the world where you can advertise prescription medicines to consumers: the US, and New Zealand (and the latter, if I recall, is trying to phase it out, and only allowed it after being bullied by the US on a Trade Agreement).
So you end up with "US Marketing spend at many pharmaceutical companies grossly outpaces their global R&D spend" (and while a not insignificant portion of R&D happens in the US, most of those companies also have a notable R&D investment in Europe).
Marketing wouldn't go to zero without that, of course, but it'd be a huge sea change.
> One also has to include the money spent by small companies that failed and were not bought out, not just the money the big companies spend buying the successful ones.
If you're looking at the total amount spent by "the economy" (drug development costs X% of GDP), sure. If you're looking at "why are drug prices so high", it probably doesn't make sense to to include costs funded from other places (which in this example I assume would be research grants ie taxes, and venture capital funds).
For the private parts of development, the costs are absolutely priced in. A large drug company needs to amortize the cost of all development attempts, not just the successful ones. Private investments into smaller firms price in a very large chance of failure, so the cost of capital is quite high.
That's not quite right. A drug company with a new product will charge whatever the market will bear. What the costs do is control the scope of the industry: if profits are high, the industry expands to try more kinds of drugs, stopping when the attempts on the margin are just profitable enough (on average). If profits are not expected to be adequate, the industry contracts.
Perhaps you prefer: A company must think it's likely that they'll have a good return on all development costs, not just the costs of drugs that happen to be successful, to continue to invest.
> if profits are high, the industry expands to try more kinds of drugs, stopping when the attempts on the margin are just profitable enough (on average).
Of course, something like pharmaceutical products, with exclusive sales of specific products, few sellers, strategic conduct relative to other industries (insurers), and heavy regulatory influence is not guaranteed to converge to normal profit.
The problem with this argument is it assumes the cost of a failure is the same as the cost of success, which it cannot be: the successful drug has to go through more rounds of testing and approvals than a failure.
In reality many failures are early or first round failures. Not free but a small fraction of the price of getting to market.
So to you example a 90% failure rate may only require a 2x or 3x return on your successes to “break even”.
"They found that the probability of success was 63% in Phase I trials, 31% in Phase II trials, 58% in Phase III trials and 85% during the regulatory review process"
42% failure rates in phase 3 is enormously high. By then you've pretty much spent 90%+ of all the cost of getting a drug approved.
But it's 42% of 19%. So out of 1,000 drugs, you're looking at 805 being ruled out before you even get to that "most expensive phase", which is my point. At Phase 3, you're looking at 113 succeeding, so you're "only" eating the really expensive[1] costs of Phase 3 for 82[2] of 1,000 attempts.
[1] Which isn't to say there's zero cost for Phase 1 or Phase 2, but it's a lot lot less than Phase 3 trials.
[2] 1,000 drugs, 63%, 630 of which make it through Phase 1. In Phase 2, 195 drugs, 31% of 630 succeed and make it through to Phase 3, and then 82 drugs (58% of 195) make it to regulatory approval.
> "A new study in 2020 estimated that the median cost of getting a new drug into the market was $985 million, and the average cost was $1.3 billion, which was much lower compared to previous studies, which have placed the average cost of drug development as $2.8 billion.[4]"
PrEP repurposed Truvada, an existing blockbuster drug that had already reaped immense profit for Gilead for use in HIV treatment by the time the trials for PrEP began. The trials for PrEP were funded by the government, not Gilead. Gilead, however, got to retain all profits earned from PrEP.
Did Gilead fund the R&D? There's a lot more to developing a new drug than just trials (though I think Gilead should have foot the bill for the trials too).
I don’t know if it’s the case here, but very, very, very often in biotech you’ve got the primary foundational research happening at university labs funded by grants, and it’s the productionization of the research (and then clinical trials, etc) that are what the biotech companies are doing. I’m not sure where that shifts the “who deserves what” conversation, but without university research labs, there’s no pharma industry.
If the university owned the IP, then its value should have been reflected in what was bid for it.
If the knowledge was not restricted by IP law, then any drug company could use it, and compete for new drugs based on it. As such, it would not provide any of them with a competitive advantage, and so would not be reflected in what they could charge.
What universities typically produce is not a chemical that can serve as an actual drug, but is only a starting point for a long and expensive process of producing such a chemical. And then, it's often found that the target of the class of potential drugs isn't actually a good one. One can't determine that until drug candidates are available to test on real patients.
> What universities typically produce is not a chemical that can serve as an actual drug, but is only a starting point for a long and expensive process of producing such a chemical
Remember you need to include all the failed attempts at finding useful things at university labs to see how much governments spend on research (just like you did failed pharma attempts), and if you add that up you see governments actually contribute a massive part of the cost to bring medicines to market.
What they produce is necessary to even begin the work pharma does, currently it is basically a gift from the people to the pharma industry.
"without university research labs, there’s no pharma industry." - I think you have it exactly backwards: Without the pharma industry, there's no medicine. Good research goes nowhere if you can't bring it to market.
The pharma industry COULD do their own foundational research, but the university system cannot bring a drug to market.
> The pharma industry COULD do their own foundational research
Citation neeeded - have they ever done so? Would the shareholders accept it? Would they be able to manage borderline autistic PHD types detached from reality, and would these scientists want to work there?
PhD types doesn't mean they make foundational research.
> They are numerous, smart, very cheap, and work very hard.
Yeah, this is a good reason to hire such people, but they generally don't do foundational research work at companies, and if they do it is extremely narrow.
Just like government work the problem is the environment, Governments hires management and planning types just like companies do, but that doesn't mean they can scale up like a company can. Same with foundational research, private companies aren't a good place to do that.
It's difficult to overstate just how menial, fiddly, difficult, risky, time consuming and unclearly profitable foundational biomedical research is. A research project could easily take 4-5 years, have a 5% likelihood of success, and have no clear monetizability, yet end up being a groundbreaking foundational result and necessary to investigate.
In other fields, either there's some tangible hope of profit down the road, or at least you can attract talent and prestige. Not so much here.
The direct role that university research plays in drug development is overstated. The majority of cost and difficulty in pharma is _drug development_ not _drug discovery_. Pharma can do the discovery and the development, academics can only do the development. Absent academia, we'd have less drugs. Absent pharma we'd have no drugs.
Academics focus on drug discovery because it's better aligned with academic incentives and timelines (see this commentary for a brief description [0]). Drug development costs (including clinical trials, extensive and repeated med chem, etc) are borne mostly by drug companies.
Fair data on this is hard to come by because the two main sources have clear conflicts of interest (academics and pharma industry publications). One study Derek covered before (data from 1995-2007) shows only 24% of drug scaffolds were first found at a university and transferred to a biotech or pharma for development [1]. You can break this down further to highlight any story you want to support ('university ID'd drugs more innovative' vs. 'pharma ID'd drugs help more people') but they key point is that combining all the US research leads to only 24% of drug scaffolds that make it to market.
I think everyone acknowledges that outside of finding the scaffolds and the basic biology, pharma is paying the vast majority of clinical trial costs. [2] gives a figure of total NIH funding of clinical trials at 10% of overall (e.g. pharma covers 90%).
I think an argument could be made that the NIH training grants (which pay grad students in the biomedical sciences) subsidize the work force substantially, and might have a higher impact than direct research grants. I couldn't find quantitative data on this with a quick search, but I think this is often overlooked in the discussion.
Finally, a less quantitative pieces make me think the impact of the NIH/government funding is overstated even given the above numbers. In my own field (microbiome), academic research has been almost inimical to the production of quality drugs. For every disease there exists a paper suggesting that a certain gut microbe changes the likelihood/severity/X about that disease. Academic labs have incentives to publish significant results fast, and in the microbiome this has led to a) abysmal signal to noise ratio with very high likelihood of failure to replicate, and b) an epistemic closure about what types of microbiome data matter and how they should be pursued as drugs that is totally divorced from the reality of how drugs are developed. Much of the knowledge base is polluted by low-quality research that has been done for the purpose of publishing. While the NIH spends ~40 billion a year on external research grants [3], I think you have to heavily discount this for the amount of just pure "grad student needs to graduate gotta publish" material that gets produced.
i've always viewed big pharma as like pre-internet record labels. they pick up talent (that often comes from bohemia aka government funded research), vet it, run the trials and put up the money, do the engineering to deliver it at scale and then market it.
A significant portion of the cost is the drug trials. Excedrin Extra Strength and Excedrin Migraine have identical formulations, but IIRC Bayer spent $300m on FDA approval for migraine treatment, which is why the migraine variant continues to be more expensive.
>
A significant portion of the cost is the drug trials. Excedrin Extra Strength and Excedrin Migraine have identical formulations, but IIRC Bayer spent $300m on FDA approval for migraine treatment, which is why the migraine variant continues to be more expensive.
Your analogy would only be relevant if the US government paid $300M for the FDA approval and Bayer got to pocket 100% of the markup.
A 2022 study invalidated the common argument as is for high medication costs that research and development investments are reflected in and necessitate the treatment costs, finding no correlation for investments in drugs (for cases where transparency was sufficient) and their costs.[20][21]
The Wikipedia editor was a bit naive to think such a basic study could invalidate that whole claim. They measured the correlation between the list price, adjusted for use amount, and development cost. As far as I can tell they didn't take into account number of customers each drug would have, how long the drug would stay on the market before profits are cannibalized by competitors (see e.g. Wegovy), and definitely not the cost of failed drug development.
Same with software. I saw IntelliJ costs $250/year but it costs almost nothing to send that file (it's like maybe 1 GB max, cents). You can get it from generics manufacturer on TPB but updates are not as frequent.
1. Pharmaceuticals actually don't do all their own research. Universities find the drugs and what they can treat, pharmaceuticals research the product viability. They make medicinal products, they're not research labs
2. The research is often majority funded by the government, i.e. your taxpayer dollars. So the costs are often socialized, but of course the revenue is not.
IntelliJ actually develops they're stuff, they don't just take existing code, test it a bit, and then make a product. And IntelliJ is a truly private company, pharmaceuticals are not because they get huge sums of money from the gov.
I'm no fan of pharma industry but there's an unfounded and troubling assumption embedded in this comment: that any drug price over cost-to-manufacture can only be extortion. How do people recoup R&D costs (which are the vast majority of costs in getting a new drug onto the market)?
The government funds a lot of early stage preclinical research. These are the inexpensive stages of the pipeline.
As soon as you move into humans you can add another 2 or 3 zeros to your burn rate.
It is not politically feasible for the public sector to fund later stages. The numbers are just too big. Just think of the campaign ads that would run around $200M late stage failure funded by the government.
The reason why mega giant pharma companies exist is because they make enough money and are capitalized enough to withstand multiple $100M failures without going belly up.
The public gets access to a life-saving drug that otherwise would not exist, which is exactly what the government is paying for. You can reasonably argue they they should get more, but arguing that they should get some ROI is moot; they're already getting a tremendous ROI
The public gets the privilege to be price gouged for stuff their taxes paid for. Doesn't sound like a good deal. Many will not have access at higher costs. Price gouging restricts access.
Are you saying the public would prefer that the drug not exist over the drug being expensive? If not, the public is getting a return. Like I said, it is reasonable to argue that the public deserves more return, ie. that it's a bad deal. But the argument that it's paid for by taxes and therefore should provide value to the public falls short of disagreeing with the status quo.
I'm saying it may as well not exist for people who can't afford it. You might say it's worse than not existing when it does exist but they can't have it because you would rather people die than receive treatment, due to your weird ideas about people making money and how justified that is.
Your bend over backwards justification of greed over human life is rather insane.
It clearly seems not to be the case that this treatment "might as well not exist" for people who can't afford it, in that it has been administered to many people in Sub-Saharan Africa, and likely will continue to be.
Further: omit things like your last sentence from your comments; they hurt your case.
> Further: omit things like your last sentence from your comments; they hurt your case.
It hurts people more to deny them medical care, and that is what makes it so enraging, I would say reasonably so. Becoming angry at such absurdity is a reasonable response. I toned it down from something much harsher. It is a truly deranged position to advocate for denying access to health care breakthroughs, and then act like that's doing people favors, calling it expanding access when you want to deny it.
It makes little sense to me to advocate an explicitly inhumane action, then say I'm doing an ad hominem when I call it what it is. What do you call an opposing view which happens to be ad hominem to humanity in general? Misanthropic, I guess. Your sibling comment says hey now, I didn't say any of that, after having said all of that.
That's why people here argue in a passive aggressive fashion and advocate violence indirectly, like violence through economics or violence by withholding medical care or necessary services to undesirables. It doesn't read on the surface as uncivil, while still wanting others to suffer.
I agree about that phenomenon and it doesn't change anything about you shooting yourself in the foot by personally attacking people when making your case. Please stop.
I don't understand the point of lying about me when all of the evidence is directly above, six sentences in total length, and abundantly clear. That leaves me with the conclusion that, no, indeed, three times was not enough.
>You can reasonably argue they they should get more
>Like I said, it is reasonable to argue that the public deserves more return
>it is reasonable to argue that people should receive more benefit for their tax money
That brings us to six. Can I just add that I think a reasonable argument might be made that the public is entitled to a greater benefit from their contribution to drug research? Or is it supposed to be 77 times 7 times?
The word was used in the construction 'I don't think it makes sense that you would be lying, therefore I must conclude that I haven't gotten through to you', to justify my repetition.
It certainly has gone off the rails, but I am entitled to defend myself at least as much as you are entitled to tell me to stop. I haven't done anything wrong. I am finished now though
I'm not sure how many times I'm expected to say that it is reasonable to argue that people should receive more benefit for their tax money before you stop accusing me of disagreeing with that. Is it three?
Pardon the snark, but come on. Before you get to the point of throwing insults, take a moment and determine whether I've actually argued for the positions that you believe would make me weird and/or insane. And then don't do it regardless, but definitely don't do it if I've only ever said a very specific thing very precisely and very explicitly.
If the R&D cost (including amortised failures and whatever) for some hypothetical drug is $1B and the manufacturing cost is $100M for 100M doses. The drug should cost about $11 + a reasonable markup in a fully private system.
If the R&D costs are fully funded by taxpayers, it should cost $1 + a reasonable markup.
The public doesn't "get" anything if it still costs $11 (+markup) and a company is allowed to take a 1000% profit margin because they're only risking the $100M for the manufacturing.
There is a limited amount of money we can spend on medicine. Every overpriced life-saving treatment kills someone who is in turn denied resources for another life saving treatment.
The outcome for taxpayer ROI should be about the benefit to the public at large regardless of who commercialized it. Commercialization should eventually lead to better and cheaper version of the technology, which increases benefit to the public.
Of course, the people who worked to commercialize it deserve pay for their work, so the question is exactly how much.
I think it's perfectly fine to assume that it's a form of extortion to profit from life-saving products, which is why some people agree that pharmaceuticals shouldn't be a for-profit industry at all.
> the vast majority of costs in getting a new drug onto the market
Debatable.
> according to these firms' annual reports, 16 percent of revenues was taken as profit, and • 31 percent went for marketing and administration. That's nearly three times as much as their R&D spending.
Maybe, but even people with chronic conditions might not go to doctors often. They see an ad for a new medicine for their disease, they go to the doctor, it works better, and hooray.
Maybe doctors should be able to send out email blasts to people, but I'm guessing that's not HIPAA friendly. Also, I've had online ads aimed at oncologists served to me for different medications.
I think the fact that there are both TV ads for cancer medications and online ads aimed at oncologists says a lot about the fact that a ton of doctor's aren't keeping up with what's new, even in something as critical and limited in scope as specific cancers are.
Gilead's R&D costs for Truvada as PrEP were literally almost zero. They paid none of the costs for actually conducting the trials.
Their only contribution was that they donated the actual pills used in the trials - in other words, the unit price of 30 pills per person for the duration of the trial.
You are quoting a corporate press release that was written in response to an editorial criticizing Gilead, which was based on my colleagues' work.
This is a great example of how easy it is to fall for propaganda, because not a single thing in your link refutes what I said! They spent money developing Truvada as a treatment for HIV, then made that money back in record profits for nearly a decade. Only then did clinical trials for PrEP begin, and for those, Gilead donated only the production costs of Truvada (which are minimal). They did not spend any money in actually conducting the trials - which, as pharmaceutical companies are generally very quick to point out - is where most of the costs of bringing a drug to market are.
Gilead is claiming that, when it spent half a billion dollars to acquire a biotech company that went bankrupt, 100% of the money in that transaction should as "R&D related to Truvada". This is preposterous. Neither the SEC nor the IRS would endorse that accounting, which is why you're seeing it in a press release and not their 10-K.
That's a ridiculous claim even when you're talking about the development of Truvada, but that's not even the question at hand. The actual topic is how much was paid for the development of PrEP, which came nearly a decade later, and for which Gilead paid nothing but the per-unit costs of production.
The $1.1 billion figure is for Truvada total, not for PrEP specifically. It’s perhaps notable that Gilead chose not to break that down, given that the original claim they were responding to was about PrEP specifically.
> The $1.1 billion figure is for Truvada total, not for PrEP specifically. It’s perhaps notable that Gilead chose not to break that down, given that the original claim they were responding to was about PrEP specifically.
And even then it's a dishonest claim. Half of that $1.1 billion is the amount of money they paid to acquire another biotech company in a firesale. It's beyond disingenuous for them to claim all of that towards the amount they spent developing Truvada, since they received way more assets in that sale than just the patent for one drug.
I just want to point out that the government has assumed the role of telling everyone how to take risks for its economy, and literally all you have to do is do that, successfully, and it will privilege your rewards by reducing risk on profits or reducing taxes
This is not controversial when you look at the state’s role in these outcomes
It’s life-saving medication. It should be freely available to everyone, period.
If we’re not willing to question the degree to which big pharma ought to profit off of controlling access to scientific miracles, the least we could do is use taxes to subsidize the cost - “I can’t afford it” should not be a reason to not be on PrEP.
Anyone should be able to walk into a CVS and walk out with 2-1-1 dose, as easily as they’d pick up the morning after pill, or a bottle of aspirin.
To find the correct pricing you just check how much shareholders make. If they get unreasonably high return on their investment that means the company is overcharging.
Tax shareholders on their gains and rebate customers if the company doesn't adjust the price.
The patent system literally grants monopolies, on purpose. I don't know why people are surprised when patented things are priced like there's a monopoly exploiting their customers, because that's exactly what's happening and everyone knows it. But somehow people never seem to come to the conclusion that granting monopolies is not the ideal way to incentivize things.
Maybe it is if the alternative is those things you granted monopoly on wouldn't exist. With drugs especially it's a difficult proposition to spend time researching if the day after you make your pill and sell the first one the next guy can just sell it too. So we need a larger change than just modifying the patent system for medicines, we'd also need to change the way we fund pharma research and after having thought about it a lot I don't have a solution. I agree with the problem you mention, but the solution isn't simple.
There’s no reason pharma research should be for profit. The researchers aren’t doing it for profit, they would do it either way, the only thing private pharma brings to the table is price gouging.
Citation needed on "the researchers aren't doing it for profit". All drug companies have a bunch of them, more than wall street types running around. Most of them enrich themselves with biotech stock bets, insider trading, regulatory capture of national agencies etc. Why do you think somehow people that go into pharma research are different from people in any other industry?
If you speak to anyone in the field, their goal to get to a point where you having a patent or two giving you a passive income stream. You can't do it if you just public domain your work.
Maybe my understanding is wrong, you’re telling me researchers keep the rights to patents they develop under the employment of pharmaceutical companies, and profit off of licensing? If that’s the case I was wrong.
But as for your other point, yes, researchers are different from people in other industries because of the high barrier of entry into the field through years of schooling, and the uncertainty of the work. Anyone that’s motivated primarily by money wouldn’t go into pharma research, they’d go into CS or finance straight off university.
Of course, that doesn’t mean they don’t want money. If you can do a job you love and get rich off it that’s the dream. And there’s no reason the public sector can’t pay enough to motivate researchers.
> But as for your other point, yes, researchers are different from people in other industries because of the high barrier of entry into the field through years of schooling, and the uncertainty of the work. Anyone that’s motivated primarily by money wouldn’t go into pharma research, they’d go into CS or finance straight off university.
Careful with generalizations like this, you're not far from "all CS people are neckbeards" with this "all researchers are good people". My rule of thumb is "every large enough group of people is very similar to any other". This comes from the Central Limit Theorem.
Regarding you thinking researchers don't get paid from patents, here you go:
> “Recently, our organization at OpenTheBooks.com forced NIH to disclose over 22,100 royalty payments totaling nearly $134 million paid to the agency and nearly 1,700 NIH scientists,” Adam Andrzejewski, the group’s founder and CEO, wrote in a May 9 report. “These payments occurred during the most recently available period (September 2009 – September 2014).”
The article is mostly about a specific claim they made about Fauci but you can see even just at the NIH there's a lot of money being made personally by researchers or ex-researchers like this. Which is not inherently bad, but we should keep it in mind.
Stop putting words in my mouth. Engage with my argument, not with the straw man you constructed in your head.
Ok, I’m happy about your theorem, but there’s a reason only tall people play in the NBA.
And like, are you even reading what you’re posting, or are you just googling for articles that support your position? We’re talking about private pharmaceutical companies and you’re linking an article about a public research institution.
See, blaming private companies for the consequences of government-granted monopolies is exactly the kind of thing I don't understand. The government is handing out permission to price gouge. On purpose!
How did governments create pharmaceutical monopolies? And, if they did, why does that make the companies killing people by charging exorbitant amounts for drugs free of guilt?
Governments create pharmaceutical monopolies by granting parents that make competition illegal. They do this explicitly so that companies can raise prices, to incentivize and fund drug development (which other government regulations make more expensive). Companies are using the system as designed and intended by the government.
Nobody would develop drugs under today's ridiculously expensive process without some kind of very large incentive, so those life saving drugs wouldn't exist without those high prices. But obviously the system is terrible. Costs could be lower to reduce the need for the price gouging incentive, and there are other incentive structures that could be used instead of granting monopolies that wouldn't have as many terrible side effects. (Price gouging is far from the only issue with patents.)
I see what you mean, but it’s not that simple. Sure, the government of a country issues a patent, but that patent is enforced by the WTO, not by the individual country.
Sure, an individual country can decide to break that patent, but if they do that they’re punished by the WTO. And large pharmaceutical companies have a large influence on the WTO through lobbying, and the revolving door from public and private executive positions in rich countries in Europe and the US.
So it’s not like these companies aren’t culpable either.
One more thing, you say that no one would develop drugs without some kind of very large incentive.
The incentive to governments is making sure their citizens don’t die. Even ignoring the ethical side of it, you can’t tax a dead person, so it’s in the governments best interest to develop drugs, and charge as little as possible for them for its own citizens.
The WTO is a creation of governments and ultimately under their control. If the US wanted to change how medical patents work it could absolutely do so. These are government failings and blaming them mostly or exclusively on private companies is ridiculous.
Well yeah, but not all governments are equal. Sure, if the USA wanted to it could do whatever it wanted to, but that’s not the case for any other country in the world.
And the same people that wrote those legislation are also the ones running big pharma.
In the Netherlands until recently you could get it for ~$10/mo (now ~$20). We have a whole website naming prices in different pharmacies around the country.
Like the other commenters allude to, how would you like software mandated to cost just 10% margin over COGS? Do you think selling cloud services for 10% more than the cost of server parts is going to be a business when there's thousands of software engineers in R&D needed?
I would love that, as long as the cost includes that R&D and those engineers, the actual bits might be immaterial but the engineer salaries are part of the cost of the goods.
The problem is that we're being told that the cost of insulin is $270 per vial, or that Daraprim used to estimate its cost per dose at 90% of $13.50 and then Shkreli decided to raise it to $750.
The Shkreli case has nothing to do with the rest. He was playing the insurance companies and there isn't a single person that went without the medicine due to the cost. Almost nobody takes this medicine.
It's true. Harvard education costs $300k, so that engineer's lifetime earnings can be $300k plus some small margin so that he does not price gouge. Community college engineer can be paid $2k+small margin.
I see. So all software engineers can charge what they want until the moment they join another software engineer. The moment the two of them work together on a shared enterprise, their margin must be capped.
As an employer, hiring single-person LLCs provides such a strong advantage in this universe over hiring employees. The former can't charge you more than a small percentage. The latter can charge as much as they want. I suppose we would all be like Uber drivers.
Honestly, 10% above costs would put a lot of people far more into the black than they currently are, because you are failing to account for ongoing expenses which raises said cap by a lot. To say nothing that most folks are struggling to make rent and buy food; I think they would like such a deal.
Software devs in the US are not struggling to make rent and buy food. More likely for them to have one or two airbnb side hustles than be starving. Yes, some have it rough but I'd wager the bell curve puts professional devs in the better-off-than-most boat
Oh no you misunderstood, it’s not 10% more than your costs, it’s 10% more than what the cost for a person to live a dignified life should be. So this would really only take money away from people that earn way more than needed.
If it's like every other IP-encumbered drug, the price will be approximately "the value the recipient places on HIV resistance," which is probably close to what's being charged now.
Why would they give up the profit? What's your rationale here?
Cure = $X
If the treatment is daily then it's $X/365 if it's monthly the price is $X/12 if it's twice a year it's $X/2
Imagine being an exec at that company and being like "let's give up 50/52 of our profit because it's more convenient for the patient"? How many hours would it take between giving that speech and getting fired, do you think?
I've finally gotten around to reading SICM, but I can't get MIT Scheme to install on the current OSX 14.2. Autoconf requires an old version of the OSX SDK. Has someone else already solved that problem?
I was surprised by how many ways Sussman and Wisdom found to modernise the Landau and Lipshitz treatment. There is the obvious change, where the first time they solve some equations of motion, it's done numerically, and the solution is chaotic.
There is also a more subtle change, where they keep sneaking in the concepts of differential geometry. The word "manifold" is reserved for a footnote, but if you know what tangent spaces and sprays are, it's straightforward to translate the "local tuples" and see what they're actually talking about.
I think this is a good idea. If physics undergraduates were exposed to manifolds and tangent spaces in their analytical mechanics course, then saw some exterior calculus in their first electromagnetism course, they might be ready for curvature and geodesics when they study general relativity.
I don't know if this is useful to you. I haven't tried to install MIT Scheme directly on macOS. Instead, I'm using the sample project at [1] to run a linux VM with Fedora on macOS x86-64. I was able to install MIT Scheme and scmutils on the VM by following the instructions at [2][3][4][5] for CentOS. It appears to have succeeded but I haven't really worked with the system yet.
I haven't tried the instructions for ARM-based macOS at [6] because I'm still on Intel.
It's less convenient to run a VM than to run on macOS directly. But I prefer to sandbox "random" software that way, and some things support linux better than macOS.
(You have to install texinfo for the online documentation part of [5]. Skip the 'install-pdf' documentation target if you don't want to depend on tex/latex.)
> in my experience aerospace is way better in most ways.
As an Amethyst user, I'm approaching this comparison from the other direction: is there one compelling reason to switch?
The improvement I'd most like to see in Amethyst is more stable window placement when I remove a monitor then add it again (I do that a lot with my laptop).
It would be fantastic to have integration between Amethyst-managed spaces, Firefox windows, and Proton Pass vaults. As in Space 1 knows that new windows should use the Google account in my Work vault, and Space 2 knows that new windows should log out from Google because there is no Google account in my Personal vault. I doubt that's an imminent prospect, though.
In general, I prefer the Amethyst approach of extending the builtin OSX window management to the Aerospace approach of replacing it. Clearly the Amethyst developers weren't convinced that it's impossible to move windows between spaces with hotkeys, because they went ahead and implemented that.
Overall, I'm really happy that these window managers are being written. I use a 42 inch monitor, which would be awkward without them.
I'm trying to figure out the name. Is it simply a play on Hypothesis, or am I missing something clever about this being the opposite of property-based testing?
Thanks for the pointer; another one for my "to read" list.
However i have read about the Economist Utsa Patnaik's works on the same subject where she makes the argument that Colonialism/Imperialism gave rise to and sustained today's Capitalism. There is a direct correlation which is well supported by available facts. Whether we want to face it or nor is another matter.
