• America's drug problem

  • Dec 18 2024
  • Length: 1 hr and 34 mins
  • Podcast

America's drug problem

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  • Summary

  • We dive into the pharmaceutical industry, so buckle up! As a side note, we reference Karendia (finerinone) as an expensive drug (around $800 a month list price) with minimal benefits. It provides 3-4% reduction in people having decreases in their GFR (a measure of kidney function) over 4 years, but no benefits in death, kidney failure, hospitalizations, heart attacks, strokes or any of the other things they measured. This is one of the medications that is being pushed on everyone with kidney disease but really is far too expensive to make sense with that little benefit. It would cost over $1,000,000 over 4 years for 1 person in 30 to not have a 40% reduction in the GFR with no other appreciable benefits. Here's the trial - https://www.nejm.org/doi/full/10.1056/NEJMoa2025845 References: https://repository.si.edu/bitstream/handle/10088/97768/Daemmrich%20PharmaMfg%20PharmHist%202017.pdf?sequence=1 - history of pharmaceutical manufacturing https://pharmaphorum.com/r-d/a_history_of_the_pharmaceutical_industry - more history https://jamanetwork.com/journals/jama-health-forum/fullarticle/2811344 - PBMs https://www.help.senate.gov/imo/media/doc/big_pharmas_business_model_report.pdf - profits in Pharma https://www.fda.gov/drugs/special-features/manufacturers-mouth-your-ears-direct-consumer-advertising - DTC advertising https://www.propublica.org/article/doctors-prescribe-more-of-a-drug-if-they-receive-money-from-a-pharma-company-tied-to-it - Doctors’ prescribing patterns https://lowninstitute.org/more-than-half-of-doctors-receive-industry-payments-with-some-making-millions/ - industry payments https://jamanetwork.com/journals/jama-health-forum/fullarticle/2804378 - drug research money source https://www.raps.org/news-and-articles/news-articles/2019/4/how-biopharma-companies-use-nih-and-vice-versa - NIH royalties https://www.gao.gov/prescription-drug-spending - Govt prescription spending https://oig.hhs.gov/reports-and-publications/featured-topics/drug-spending/ - Govt drug spending https://www.aafp.org/pubs/afp/afp-community-blog/entry/will-the-high-price-of-gene-therapy-for-sickle-cell-disease-put-this-cure-out-of-reach.html#:~:text=The%20approval%20of%20Casgevy%2C%20which,distributional%20cost%2Deffectiveness%20analysis%20standards. - sickle cell example https://www.fiercepharma.com/pharma/top-20-pharma-companies-2023-revenue - Pharma Revenue https://www.npr.org/2024/04/12/1244509038/u-s-drug-makers-see-big-profits-but-many-pay-taxes-far-below-the-corporate-rate - drug company taxes https://www.gao.gov/products/gao-18-40 - drug company profit margins https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690298/ - History of drug advertising https://www.pharmacytimes.com/view/are-pbms-downplaying-their-profits - PBM profits https://www.nbcnews.com/health/health-news/gaming-us-patent-system-keeping-drug-prices-sky-high-report-says-rcna47507 - “Evergreening” and patent thickets
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