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How a Cabal Keeps Generics Scarce

43 点作者 dopkew超过 11 年前

7 条评论

refurb超过 11 年前
No offense, but this is a very weird article.<p>A little background on group purchasing organizations: GPOs represent their member hospitals. They &quot;buy in bulk&quot; and extract discounts from manufacturers and take &quot;administration fees&quot; to cover theirs costs.<p>Who owns the GPOs? The hospitals do! The largest GPO, Novation, is <i>owned</i> by VHA and UHC, two of the largest healthcare alliances that is comprised of US hospitals.<p>Margaret Clapp, the first author of this article used to work for Mass General who is a member of VHA, who thus owns the GPO Novation.<p>These GPOs <i>exist</i> because the hospitals themselves created them.<p>And it&#x27;s ridiculous to say that GPO discounts are responsibly for drug shortages. GPOs don&#x27;t want drug shortages because (1) their member hospitals don&#x27;t get the drugs they want (2) because the GPO loses money every time a hospital can&#x27;t order a drug.<p>The current drug shortages are actually due to a number of different factors:<p>(1) Margins on generic drugs are razor thin, they are basically commodities. The purchasers of these drugs don&#x27;t care who makes them, since they are all deemed equivalent by the FDA; the result is that whoever has the lowest price gets to sell their drug<p>(2) The generic drug market looks like a commodity marketplace, but in fact it isn&#x27;t. There are a number of costs associated with manufacturing a drug to FDA standards. If the FDA comes in and says &quot;you can&#x27;t ship that drug&quot;, you&#x27;ve probably just lost all of your profits for an entire year.<p>(3) Drug prices are &quot;sticky&quot; due to the way that Medicare and Medicaid pays for drugs. If you suddenly have a manufacturing problem and need to raise the price of your drug to cover costs, you&#x27;re out of luck since it means the purchasers of your drug will lose money.<p>(4) Because of the low profit margins, companies are simply getting out of the business. There are other products they could sell that are lower-risk and higher margin.
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Symmetry超过 11 年前
<i>How could this happen in a free-market economy?</i><p>I don&#x27;t think you can reasonably call our system of medical drug production &quot;free-market&quot;. Heck, I&#x27;m not even convinced that our drug production system is freer than the Soviet Union&#x27;s was, though it&#x27;s clearly still quite capitalist.
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mschuster91超过 11 年前
Well, for all those who say &quot;a free market does exist&quot;: I don&#x27;t consider a market as strictly regulated in terms of manufacturing (FDA) as well as in pricing (at least in Germany, and IIRC in the US anywhere Medicare&#x2F;Medicaid is involved) as a truly free market.<p>That being said, the medical sector needs extreme regulation for obvious purposes (eg. to give <i>all</i> people access to adequate health care, not only the rich, and to make sure that the products do what advertised and do not kill the patients). What has been missing in the US is a compulsory insurance scheme...
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jotm超过 11 年前
Opening a drug manufacturing business nowadays is ridiculously hard - the regulations are insane, the costs for getting everything <i>right</i> are insane, and the clients are also insane (you think a hospital with shortages will gladly buy your stuff? Ha, dream on, they&#x27;ve already got their arrangements).<p>And so there are shortages. Or you get stuff from China, where manufacturers can ship you 1 or 1000 KGs of stuff with a month&#x27;s notice.
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codygman超过 11 年前
Did anyone else think this was about Haskell and get disappointed?<p>When I saw nytimes.com I thought of the Haskell project they did with the supermodels.
efnx超过 11 年前
I actually thought this article would be about Haskell, lol.
zhemao超过 11 年前
It took me a few seconds to realize that this was about the pharmaceutical industry and not the Haskell programming language.
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