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
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
