Hacker News new | past | comments | ask | show | jobs | submit login

Why on earth should the patient choose whichever drug put money into advertising, rather than the one their doctor deems the most suitable? How could that possibly be beneficial?

edit: reading further down the article, there is an advert for an antipsychotic medication which offers a $15 discount on your copay. This particular medication has serious discontinuation effects, it's not something you can just stop taking and it's not something that is prescribed lightly in the first place. Offering a discount for the first few doses is plainly exploitative.




There are some aspects to the supply and demand of drugs, particularly psych drugs, that I'm not sure are described in econ 101 or popularly known.

Let's say the most common, first prescribed drug for your condition is available in a generic, for $0.30/month. That's not entirely hypothetical, that really happens.

A naive person would say "ok, if the generic is so cheap, then the brand name can't be much more, can it?" - free market competition, the FDA ensures they're all equivalent, blah blah blah.

However, I noticed that in recent years, the alternatives to the dirt cheap first-line option are way more expensive and going up. So I thought about why.

It occurred to me, that a simplistic view of competition ignores the fact that the different options are not exactly in competition at all. Because everyone tries the cheap one first, and then if they have problems or it's ineffective, they try another.

This means that fundamentally the drugs which are supposed to be in competition are not in competition practically speaking. If you have a drug that is not the first option, then you might as well charge $1000/month because everyone who is a possible customer already by definition has given up on the cheap one.

And even worse, in order to justify (for example) $1000/month, you don't have to have something better, just different enough to give people a little hope. They proliferate, but it's not progress.




Consider applying for YC's Spring batch! Applications are open till Feb 11.

Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: