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Originally Posted by justplugit
Spence, I would love to see Canada's national formulary. Guarantee it is limited to one drug per class which means you won't have a choice when it comes to efficacy or side effect profile. For instance there are many statin drugs on the market for lowering cholesterol. They are all variations of statins
but each works a little differently. When there is only one,that will be based on the cheapest, and you can't tolerate it or it's not efficacious for you, too bad. That is One of the biggest problems with government health care, no choice AND mediocore medicine.
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Well, Canadians would beg to differ...they love their health care. I think polls are usually 85-90% in favor.
As for prescription drugs, you can still get private insurance to cover prescriptions there...though as was mentioned above, the governments will negotiate costs which Medicare/Medicaid here isn't allowed to do by law.
I'm not sure the claim that only one drug per class is allowed is accurate. For instance, I found one report that listed % market share of the various statin drugs there.
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Rationing drugs based on age becomes another problem as expensive chemo drugs etc. will be too costly to add another 5 years to say maybe a 75 yr old.
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No different than in the USA.
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Good point on killing the Golden Goose. It is already happening. Companies will not go out on a limb in R+D if they find a compound that has a limited use. For instance, Amphotericin B was developed years ago to treat fatal San Juakien (sp?) Valley ,a disease limited to the valley. They won't be willing to spend millions and years of development when there will be no return on investment. They will stay with the large markets for cardiovasculars and anti effectives.
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I think a bigger issue is simply that the big companies are making more profit based decisions than just counting how much money is going into R&D. R&D spending is going down as they focus on better returns.
For a large organization it's probably just not practical to go after niche drugs unless you have a business model built around it. This should encourage growth in small companies to meet low volume needs.
There are a TON of companies like this in the Boston area alone.
-spence