Peter Kolchinsky

Great comments about why price controls are bad for innovation. And any patient watching this would ALSO want to hear the answer to the only question that matters to them, that Congress needs to lower out of pocket costs so their insurance makes valuable drugs affordable.https://twitter.com/JimGreenwood/status/1223312850736832517 …

Based in Cambridge, MA

...in healthcare goes generic. All the drugs we haven’t yet invented that will eventually go generic are our best hope & value when we consider the diseases that will otherwise keep us worried, pained, and spending a fortune on doctors & hospitals, which never go generic.

And lastly, this is not a rationale for unlimited drug prices. For all the rhetoric & even with clear examples of abuses, moderate profit margins show industry doesn’t systematically price gouge. Competition (lots of it) & drugs going generics keep costs in check. Nothing else...

So, Congress, I urge you to beware of those promising their formulas will define the “right and fair prices”. They will likely grossly undervalue what you know to be valuable. And when innovation is undervalued, it doesn’t get done. You know that.

... and to do it with treatments that will be inexpensive generics for the long run. So what’s that peace of mind worth? A lot. I won’t say priceless. But you will never find a formula that captures its value.

...allow us to say that we’ve collectively “vaccinated” ourselves of worrying that our child might suffer from them. It’s within our reach to say my child won’t die of breast cancer, lupus, heart disease, at least not before a ripe old age...

And one more thing... if it seems that I’m making a narrow case for the value of vaccines against pandemics, I’m not. I’m hoping to inspire you with a bigger, beautiful idea that all the drugs and other technologies we are developing for many diseases might...

And making sure that all of those products go generic and remain expensive after they have gone generic (with new regulations in some cases, as I’ve proposed) is how we guarantee that America gets great value from its investment, like paying off a mortgage.

It would be like making the family whose house is burning pay out of pocket to fund the fire department that helps all of us sleep better. Insurance premiums and taxes spread across a mostly healthy, working population is how we can afford the fruits of biotechnology.

It’s wrong to ask the few vulnerable among us to pay, as insurance plans do when they impose high out of pocket costs, for the biotechnology vaccine infrastructure that brings peace of mind to all of us.

Yet we mustn’t ask vulnerable, sick, and poor patients to pay out of pocket what they can’t afford, as our broken insurance system increasingly has (a practice Congress can outlaw just as it eliminated denials based on pre-existing conditions).

As a society, it’s all our money... we can collectively afford to fund a vibrant biotechnology sector to develop new medicines that patients currently need as well as vaccines that we hope we’ll never use. Health economists don’t value our peace of mind, but YOU know it’s value.

Just as spending on iPhones supports the development of technologies that make their way into national defense, healthcare, and education, similarly spending on national defense makes its way into iPhones, medicine, and kitchen appliances. (Eg NASA/Apollo tech helps burn victims)

3) and that same insurance premiums, out of pocket spending, and healthcare taxes are spent on many other, seemingly unrelated, medicines, such as for rare genetic disorders and cancer, but which are based on technologies that can be applied to combat emergent viruses.

2) insurance premiums and out of pocket spending and healthcare related taxes (Medicare/caid) go to pay for commercially sold vaccines (eg flu), keeping the giant companies with massive vaccine production facilities in business and well practiced in making vaccines...

We pay for the security of having vaccine and antiviral infrastructure in three ways: 1) the US Government broadly taxes Americans and provides research grants for certain programs to biotech companies...

...or do we recognize that ideally the cost per patient would be infinite because we would spend hundreds of millions to develop the vaccine, maybe more, but prefer to never have to use it?