The Easy 80 Percent

Dr. McElhone was fond of many sayings, including "the easy 80%", meaning, of course, that success is non-linear in effort and/or effect. Happens all the time. The Reader may note the number of essays here on the capitalist's dilemma: often called The Tyranny of Fixed Cost. Pharma typically calls the cost of bringing a drug to market as $X billion. What they don't tell you: most drugs are modifications of existing drugs, most drugs are derived from government and academic and NGO research labs, and that $X billion number is reached by dividing total R&D spend by number of drug approvals in some time span. That last bit is key: pharma lumps all the costs wasted on worthless drugs into the numerator; they demand to be paid for failing.

So, here's another admission.

"This is very much the way that the industry argues that the pricing works," [Stacie Dusetzina] said. "In the rare disease space, for example, there's a strong argument that the price per person has to be really high because it's a smaller group of people using it."

The moral of the story? Pharma has tackled most of the diseases that affect most of the people most of the time, cancer being the obvious exception. We're left with the low sub-populations/diseases but still, there's that pesky $X billion bill for the drug. Like it or don't, but all you non-childbearing Pooh Bears will be paying for all those PPD sufferers. Who said Socialized Medicine was a bad thing? Or, to put it more bluntly: without Socialized Medicine (whether overt or covert), not even the rich could afford such drugs out of pocket.