So we CAN afford these drugs to begin with, because employer sponsored health plans with minimal coverage cost around $14000 and have $6500++ copays (I don't remember today's limits for copays, but you have to pay those copays out of pocket before an insurance company covers drugs typically.) The actual drugs cost pennies to make but sell for hundreds to thousands to hundreds of thousands. The prices that are listed for these drugs at retail are not actually what the insurance pays for these drugs, we're never going to see those figures, but they're aligned to maximize profits from the industry. Pharmacy benefit managers also collude by using a third party service to recommend pricing.
Last year they had about ~63600 million in revenue.
~38691 million last year was in the US alone.
~16057 for "developed markets" aka europe and wealthy nations
~8879 for "developing nations" e.g. africa, latin america, poor asian countries.
So 38 billion in the us vs 63.6 billion total revenue.
If you have to choose between keeping US revenue or keeping non-us global revenue, you're gonna choose the US. It's not even close.
I'm guessing they can license their drug to some other business to sell internationally and get out of first party sales, but it's possible they may have a legal mechanism to skirt this already since it's typical for the US business to be a separate company than the holding company, and all the international businesses are separate companies under said holding company, it's hard to say. I don't have any inside information for today's strategy.
Just to tack onto this... it's possible that we will see different branded drugs, and perhaps even slightly modified drugs to contain effectively a placebo to go through clinical trials concurrently with the primary drug. From there they just release one drug in the US and the other drug exclusively everywhere else.
That's just one creative way to keep prices exorbitantly high. They can also target medical devices aka the delivery mechanism (think pre-packaged syringes) to try and keep profits high. Just release a US only delivery mechanism and suddenly it's different than the rest of the world. I've worked at companies that slightly altered the injector of their drugs to keep their monopoly going, as doctors preferred the improved injector that had no generic due to being in copyright, even after the drug patent expired.
The pharma lobby is so wealthy and powerful though I sincerely doubt even dumpy can fight them. There's a reason why biden started with just a handful of drugs, it built a foundation to slowly drain their profits while their current patents run out and they adapt to the new dynamic.
There's also all those health insurance companies that legally can only profit a % of overall revenue that will face severe profit cuts if treatment costs actually dive, drugs are a key component to building a sizable margin today.___
The gravy train of giant margin drugs is coming to an end.
Medicaid is gonna get gutted and drugs won't be very profitable in the US overall. I suspect the pharma answer to this may be suspending sales in all other nations so long as the US patents are live, the profits here are so above and beyond all other places in the world that there's little reason to focus on global markets if the restriction is lowest common denominator pricing in the US.
I worked in pharma for a while at a level that interacted with C level executives and the executive leadership of said companies. I've seen where the money is and seen internal numbers. US oncology sales are almost all profits.
Now, it seems like your point of view is that all the knowledge and experience of a university education is useless anyway.
I think standardized testing is not a good way to measure if someone has achieved the learning objective of a lesson. I'm hardly the only one to think this way. It's great for testing how good someone is at rote memorization of facts for a single test for topics that are never brought up again so immediately forgotten. If you do it in person with pens and paper the kiddos can just read their neighbors shit, or sneak in a cheat sheet. Did this not happen in every single class you've ever taken from K-12 and then 4 years in a uni? Did for me!!!!! I promise. I never needed to cheat, but there was always someone within eyeshot doing it. I'm not a snitch.
why the fuck arent you filthy rich yet?
Lack of motivation, lack of a million dollar loan from mommy and daddy. You can't teach motivation really. My upbringing was free room and board until I was 18.
Tell me when you make your first million
Already there man... 300k in 401ks, 350k in non-retirement fund investments, 500k townhouse with 50k mortgage left on it as a rental. 600k condo too.
Lol, english classes have always been the biggest joke of college for me. All you do is write an outline, pull some bullshit quotes to back up your argument from the source to satisfy MLA, and write enough to satisfy the word requirement. It's all bullshit. it's all opinion. Easy A for me, except when i'm forced to write by hand.
If you really want to make people learn how to write professionally without computer assistance like spellcheck or LLMs, give them a fucking typewriter. It's how I learned to type as a kid in the 90s. At least the typing skill is transferable and you get a great understanding of why applications like Word function the way they function.
I would argue that in person exams with no resources to do research goes against how the world works for most white collar workers.
Few are unable to research on the internet to verify information, or at least look at say a man page for coding or look up past stuff on stackoverflow, if they are working through a problem.
Standardized testing is just not as useful as-is. I do great at it and can typically pass exams without really studying the material, but others are not so lucky.
I've met people who can flunk exams but talk about the problems, go into how they would fix it, and work through a problem to implementation and testing in the real world.
Oh, and LLMs are the new typewriter, for better or worse. It's unlikely we are going to have a future where they are not readily available. We already have models that run locally and do not transmit data anywhere, and AI customized to your own data that is not shared is already a service provided by Microsoft.
Education needs to evolve with technology. It's always been 5-10 years behind the curve.
Maybe we should be using LLMs to proctor tests and generate interactive testing. Grading can be verified by a professor reading a transcript to verify hallucinations didn't occur or influence the results. We can even have LLMs monitor the working process of people to help determine what are the most efficient ways to work custom tailored to individuals. This is just one idea of many potential options.
Umass boston was largely a joke. I do agree with that.
It's mostly a time and money sink for a piece of paper unless you're going into a profession that requires it... though you don't usually need a degree, instead you need to pass various certifications. There's even wacky exceptions like not needing a degree at all to take the BAR exam in Vermont.
Then there's the hyper conservative colleges out there.... I couldn't tell you at all how those go but I wouldn't assume very well.
Preach. I can do nothing but agree, and I have insider info in the insurance industry, pharma and healthcare. It's all a game to make the rich even richer and the politicians are colluding in such a bipartisan fashion you'd think the parties were fully unified.
They have to learn the hard way. People can't think that hard by and large.
Time and time again the crooks win because they are the best liars and they don't have any scruples. Until people feel the impact of poverty or supply chain disruption they are just gonna keep believing whatever they hear from the source their buddies at work tell them is legit.
Wow, look at that! The price of strollers just went up 5k!
Replace strollers with basically anything related to birth or infants. 5k more to spend? 5k more to earn by big business selling wares.
This assumes the hospital doesn't determine that you seem to owe 5k more for that one out of network service provider they slipped in while you were distracted during birthing.