Coronavirus: Better Call Sol - CORONAMANIA (7 Viewers)

magicbastarder

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Far as I can see the letter is basically making a false equivalency between generic drugs and vaccine manufacturing.
The generic drugs necessarily have slightly different formula/makeup for the very reason that big pharma won't let go of the IP rights, so 'generic' manufacturers are forced to make something that might have a different level of effectiveness but doesn't involve just giving all the money that buys them to one pharma giant.
i had understood that what enabled generics to be made was that IP rights had expired? 15 years IIRC.
 

Cormcolash

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i had understood that what enabled generics to be made was that IP rights had expired? 15 years IIRC.
My understanding is that any drug can be manufactured in a generic version if the people that want to do so can figure out how to make a drug that achieves the same basic effect using a slightly different formula/process/manufacturing chain whatever.
Perhaps your suggestion is also correct though, these interpretations are not mutually exclusive.
 

rettucs

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Wrong, for all I know it is much more likely that he is incorrect.

As for you telling me what it is that I think, incorrect again, I don't think these companies are immoral, I think they are amoral. These companies exist to make money, they have shareholder meetings where they say this constantly.

You can do whatever you want. I already spelled out my position multiple times, you don't have to believe me.

"Do I need to print out the "controversies""

was part of the quoted text in your post. I didn't write that.
 

egg_

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Wrong, for all I know it is much more likely that he is incorrect.

As for you telling me what it is that I think, incorrect again, I don't think these companies are immoral, I think they are amoral.
Aargh you infuriating prick! Stop doing rhetoric on me! I've read the articles you posted, and maybe I've missed stuff, but I'm not getting why IP laws are the problem. There's price-gouging in the insulin market according to that article above with no IP issues at all. Why do you think it's much likely that he is incorrect? Just fucking explain, and I'll listen.
 

Cormcolash

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Aargh you infuriating prick! Stop doing rhetoric on me! I've read the articles you posted, and maybe I've missed stuff, but I'm not getting why IP laws are the problem. There's price-gouging in the insulin market according to that article above with no IP issues at all. Why do you think it's much likely that he is incorrect? Just fucking explain, and I'll listen.
Na the point of that article was more that the price-gouging has been drastically drastically reduced by the development of generic insulin drugs so that the previous main insulin manufacturers no longer have a monopoly on it.
It's like the car insurance racket over here, everybody knows that the insurance companies here are taking the absolute piss, but as long as there's nothing to stop them, they'll keep taking the absolute piss.
 

Lili Marlene

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"Do I need to print out the "controversies""

was part of the quoted text in your post. I didn't write that.
Sorry rettucs, that was just me getting frustrated

Aargh you infuriating prick! Stop doing rhetoric on me! I've read the articles you posted, and maybe I've missed stuff, but I'm not getting why IP laws are the problem. There's price-gouging in the insulin market according to that article above with no IP issues at all. Why do you think it's much likely that he is incorrect? Just fucking explain, and I'll listen.
hold on i'll try and compile something coherent
 

egg_

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Na the point of that article was more that the price-gouging has been drastically drastically reduced by the development of generic insulin drugs so that the previous main insulin manufacturers no longer have a monopoly on it.
That's not what I'm getting out of the article at all
Ms Marston was diagnosed with T1 diabetes when she was 14. She laughs when recalling how the price of insulin in 1996 - $25 for one vial - was a shock to her.

Two decades later, Ms Marston still uses the same formula of insulin - Eli Lilly's Humalog. Even the packaging is the same.

"Nothing about it has changed, except the price has gone up from $21 a vial to $275 a vial."

It's the same story for Sanofi's Apidra and Novo Nordisk's Novolog.
The price has gone up by a factor of >10 without them developing new patents. There's nothing about generic insulin bringing prices down at all
 

egg_

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I've thought about this more now and my lukewarm take on it is ... you can't make pharmaceuticals at scale without big and very hi-tech factories, expensive staff, reliable supply lines, stringent quality controls, etc etc. Only large corporations and nation states have the resources to gather that shit together. It's unfashionable these days for this stuff to be done by nation states, so it's left to corporations. Corporations exist to maximise profits, so they'll charge what the market will bear within the bounds of what nation states demand of them.

I can't see that dicking around with patent law is really going to change any of that - I have no objection to dicking around with patent law, let me be clear, but (shrugs).
 

Cormcolash

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I've thought about this more now and my lukewarm take on it is ... you can't make pharmaceuticals at scale without big and very hi-tech factories, expensive staff, reliable supply lines, stringent quality controls, etc etc. Only large corporations and nation states have the resources to gather that shit together. It's unfashionable these days for this stuff to be done by nation states, so it's left to corporations. Corporations exist to maximise profits, so they'll charge what the market will bear within the bounds of what nation states demand of them.
They won't though, because what they'll actually do is pay the various people in charge of nation states to look the other way whilst they charge what they want, such as with the insulin example in the US.
The 'market' cannot regulate pharmaceutical prices when all the regulation apparatus is controlled by the pharmaceutical companies.
When Martin Shkreli took control of the drug Daraprim, and immediately raised the price of it from $13.50 to $750 per pill, the 'market' did nothing. There was widespread outcry, including from many of the leading democrats at the time, and still nothing was done. There was literally no legal action they could take against it.
Daraprim was a drug that had no generic version available, because it wasn't seen as particularly profitable to develop one whilst Daraprim was $13.50 per pill, even though it's patent had actually lapsed so anybody could have made a generic one at that point.
It was only after the price hike, outcry, uproar, and subsequent broken pledges by the company to reverse the price-hike, that a different company developed a new generic drug that could be used in its place.
As far as I know, Daraprim is still priced up at $750 per pill. There's nothing anybody can do to change the price of it, presumably people just use the generic version instead now. The market has done absolutely nothing about the price, even though a generic version has been developed and is available.
$13.50 per pill to $750 per pill is a 5456% increase.

The idea that 'the market' will somehow regulate this kind of exploitation is nothing more than wishful thinking, and it's exactly what the likes of big pharma want you to believe.
 

egg_

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"Charge what the market will bear" is, I thought, a common phrase that's usually understood to mean "grab as much money as possible". Do I have its meaning wrong? You sound like you're disputing a point with me, but you're not saying anything different to what I said
 

Lili Marlene

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Right so this is what he says at the start:

It has become clear that there is a shortage of Covid-19 vaccines, not just in Europe but also across much of the world, leading to the proposal to suspend intellectual property protection on vaccines to allow other companies manufacture them. However, not only will this not resolve the issue it could even make things worse.

So, to be clear, he says it could make things worse, not will. I am assuming he is writing in good faith, meaning that I'm going to take him at face value when he says things. If he is leaving out important context or oversimplifying to make a narrative it's fair game to point that out. We can pretty much all agree that there is a shortage or we'd all be vaccinated by now.

Next bit:

Making a generic version of a small-molecule drug is relatively simple. The patent describes the structure and synthesis of the drug and the generic company simply has to show that their molecule is identical and confirm that their version delivers the same amount of drug in a small number of healthy volunteers, ie bioequivalence. However, bioequivalence does not work for large molecules such as proteins, as trying to prove that they are identical is extremely difficult.

Furthermore, because of their size, they could differ but still be equally as effective. This led to the concept of biosimilars, which requires generic manufacturers to show that their product has no significant differences in structure and also demonstrate the same clinical benefit.


I'll take his word on this, he's the expert in the School of Pharmacy. So, it's hard to do. Not impossible, but hard. Generics are not the same as IP protected vaccines stripped of their IP though (at least I don't think they are? Maybe these concepts are interchangable, it doesn't make a lot of difference but I probably could have saved a load of words if that is the case.)

Next Bit:

Generic manufacturing of vaccines is challenging – 15 million doses of the Johnson & Johnson (J&J) vaccine were destroyed because of errors in manufacturing in one of their sub-contracting facilities and this would have been under the supervision of J&J engineers.

This is where he starts to lose me. The J&J vaccine is not a generic vaccine, they had to destroy loads of this vaccine because people made mistakes while making it. Ok, but what does this have to do with generic vaccines? Is the implication that generic vaccines go through less safety tests? The next paragraph seems to imply that although I can find no data saying this is the case. I googled a little and found this AP news piece which says as follows

One thing all vaccines have in common: They must be made under strict rules that require specially inspected facilities and frequent testing of each step, a time-consuming necessity to be confident in the quality of each batch.

I'm not saying this is a silver bullet against his argument, but generic vaccines are still vaccines. There's also this piece which concludes that "for the most part, generics appear to be just as good at treating conditions as the brand-name formulations."

Furthermore, what does generics have to do with anything? The argument he opened with was about "the proposal to suspend intellectual property protection," which would not make these drugs generic but specific. I.e. The Johnson&Johnson one is still the Johnson&Johnson one.

Next Bit:

India-based Ranbaxy was one of the biggest manufacturers of generic medicines in the wold and in 2014 was fined $500 million by the US government for selling adulterated medicines and banned from selling in the US.

This appears to be true. I'm not going to look into the full details of the case but I had a quick look and it looks like a pretty bad company that was caught. It only takes 5 minutes to look up a few other pharmaceutical companies to see that they are all being fined all the time for all sorts of malpractice. My conclusion would be that "India-based" Ranbaxy (actually owned by a Japanese company at the time) wasn't behaving that different to how Pfizer or Johnson & Johnson or whoever behave. Things are probably a little more lax in India, true, but then again we use drugs made in India all the time. Being a "manufacture of generic medicine" is in no way indicative that you cannot be trusted. Once again though, this is not necessarily about generic medicines anyway.

Next Bit:

Would we be happy that the developing world was to be supplied with sub-standard vaccines that are not as effective or with a higher rate of adverse effects?


I mean, my answer to this is yes. Obviously it depends how less effective they are, are we talking 90% down to 5% or 90% down to 65%? A higher rate of adverse effects? Such as? This is incredibly vague. He has presented no evidence that companies in India (or anywhere else) couldn't make these drugs, generics or not. We do have evidence I posted above that, in general, generics do well.

We also have plenty of evidence that drug companies will protect their profits at the expense of human life, e.g. with AIDS and HIV drugs,

At the mercy of drug giants

We also know that drug companies will do whatever it takes to protect their profits by, e.g. paying generic makers to not make the generic drugs.


All of this which is to say that there is no evidence to suggest that brand-name drug companies care that much about anything but their bottom line so why should we believe this letter when he says no one but the brand-name drug companies can make their own drugs?

Next bit

Rather than generic manufacturing, it is more effective for pharma companies to license out manufacturing to other facilities.

Once again we're talking about generics again. Is this about generics or stripping IP? As for more effective, in what way? It's certainly more profitable. These companies exist to make a profit, they have shareholders who expect such, and based on the large number of controversies/lawsuits surrounding each one, they don't let morality get in the way of making a profit.

To use an analogy, ask an ice-cream salesman whether to have ice cream or something else for dessert and he's going to say ice cream. Ask a for-profit drug company whether to use the drug that makes them money or some one else's and they'll say their drug .

Next bit:

However, there is a shortage of such facilities and those that exist are already producing important drugs.

For instance, Pfizer’s facility in Grange Castle in Dublin makes Enbrel, an important drug for rheumatoid arthritis. Do we stop providing Enbrel for these patients?


Assuming he is correct that there is a shortage we have no more info as to why for what reason is there a shortage. And who is calling for anyone to stop making drugs? This is ludicrous.

In reality, any company with a bio-pharma manufacturing facility that is fully equipped and staffed can easily get a contract to manufacture a Covid-19 vaccine, it is just that there are very few of them.

We have no idea what is needed to manufacture any of these vaccines because he has not told us. We have no idea who is capable of creating them to the standard required because he has not told us.

India is already making Covid19 vaccines. The India manufacturing sector already makes a huge amount of drugs, it's either insulting or racist to suddenly say "oh, this is a bit difficult for you," especially since it's so clear that the only reason this is being said is to do with IP protection (opening sentence of this letter).

Here's a map of the countries who want to remove the patents vs those who want to keep them.

EzuinrMX0Ak0Ae3


Anyway, one hopes India just do what Brazil did, ignore IP laws and save their people:

 
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Cornu Ammonis

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i had understood that what enabled generics to be made was that IP rights had expired? 15 years IIRC.

My understanding is that any drug can be manufactured in a generic version if the people that want to do so can figure out how to make a drug that achieves the same basic effect using a slightly different formula/process/manufacturing chain whatever.
Perhaps your suggestion is also correct though, these interpretations are not mutually exclusive.
@magicbastarder is right but I think it’s “only” 10 years. Once that 10 years is up, anyone can make that compound and sell it at any price. However, there are arguments sometimes made that generic versions of drugs have different potencies because the manufacturing process is slightly different (as rival companies only know the end product, not necessarily the full synthesis process so will backwards engineer that) but I don’t think that has ever really held up.

The situation @Cormcolash mentions sounds more like a new molecule than a generic version of a specific molecular, which would be immediately licensed by the company who found it and then sold at a high price for 10 years. And the amount of luck, work and money that goes into even finding a small change in a molecule that not only hasn’t been already covered by the first company or that actually still works means very few companies could afford to put it on the market at a goodwill price, let alone make a profit (which is their aim).
 

Cormcolash

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"Charge what the market will bear" is, I thought, a common phrase that's usually understood to mean "grab as much money as possible". Do I have its meaning wrong? You sound like you're disputing a point with me, but you're not saying anything different to what I said
I'm not familiar with the phrase, but it doesn't really feel like a great description of how the market supposedly works, is all
 

therealjohnny

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The local charity shop has closed down, no don't as a result if the lockdowns. It was very sad watching the owner take the sign down and put it in her van.
 

Lili Marlene

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Probably should point out that all these IP vs generic rules come from the global north, benefit the global north, and were implemented on the global south via the WTO pretty much down the barrel of a gun.



Simple fact is, you want people to get vaccines, you remove IP protections. Everything else is a drug company selling you something (their drugs) and you're a sucker for falling for it.

But hey, sorry to be "unfashionable" about this.
 
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Cornu Ammonis

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Probably should point out that all these IP vs generic rules come from the global north, benefit the global north, and were implemented on the global south via the WTO pretty much down the barrel of a gun.



Simple fact is, you want people to get vaccines, you remove IP protections. Everything else is a drug company selling you something (their drugs) and you're a sucker for falling for it.

But hey, sorry to be "unfashionable" about this.
Well, yeah, obviously. Big Pharma is looking out for Big Pharma and has the world over a barrel at the best of times.

That said, they are actually producing medicines and have pushed R&D in medicine way further than academia/government-led research because they are motivated by profits. It’s hard to stay working as a noble postdoc for buttons and little progress when a pharmaceutical company will pay you 2-3 times the salary, give you a pension, and you’ll make a medicine that will actually make it into patients. They will also screw you over at the first sign of failure but universities will too.

Does any of this help the most vulnerable in the world? Nope. Is it a system that we can break? I don’t think so.
 

Lili Marlene

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Well, yeah, obviously. Big Pharma is looking out for Big Pharma and has the world over a barrel at the best of times.

That said, they are actually producing medicines and have pushed R&D in medicine way further than academia/government-led research because they are motivated by profits. It’s hard to stay working as a noble postdoc for buttons and little progress when a pharmaceutical company will pay you 2-3 times the salary, give you a pension, and you’ll make a medicine that will actually make it into patients. They will also screw you over at the first sign of failure but universities will too.

Does any of this help the most vulnerable in the world? Nope. Is it a system that we can break? I don’t think so.
I'm not sure the bit about them being the best is true, billions upon billions of dollars public money was spent developing these vaccines, operation warp speed etc, and suddenly the vaccines we were told normally take 5 years were ready in a few months.

There's a book called The Entrepeneurial state that argues (very politely with a fair amount of deference to the private sector) that most of the R&D stories we hear coming from the private sector are myths and PR, and that most private R&D ultimately comes from governments, in ever increasing amounts from the 1960s onwards.


The basic takeaway isn't to stay "noble" and work for peanuts btw, it's that governments should get a stake in the profits.
 

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