Jedno sasvim novo i drugačije Presidency..

[kim_philby]

obama je ipak rodjen u US of A :o

[TBoneSteak]

tata mu je bio crnac iz afrike

[hazard]

valjda su ogromni R&D troskovi+reklame sto povecava cenu zdravstva

R&D? http://www.sciencedaily.com/releases/2008/01/080105140107.htm

Big Pharma Spends More On Advertising Than Research And Development, Study FindsScienceDaily (Jan. 7, 2008) — A new study by two York University researchers estimates the U.S. pharmaceutical industry spends almost twice as much on promotion as it does on research and development, contrary to the industry’s claim.The researchers’ estimate is based on the systematic collection of data directly from the industry and doctors during 2004, which shows the U.S. pharmaceutical industry spent 24.4% of the sales dollar on promotion, versus 13.4% for research and development, as a percentage of US domestic sales of US$235.4 billion.

I plus, da ne zaboravimo da masu istrazivanja finansira drzava (dakle trosi se vise od tih 13,4%, al iz drzavnog dzepa, dakle ne placaju farma kompanije, a profitiraju na kraju).i jos:http://www.pharmamyths.net/files/Biosocieties_2011_Myths_of_High_Drug_Research_Costs.pdf

ConclusionThe high prices of new medicines, the discounts offered to poorer countries and the newpolicy tools like the overpriced AMC are built on the mythic costs of R&D and their mythicpromise to save millions more lives than they can (see Light, 2009, pp. 14–17). The AMC isstructured as a surplus contract and does not even try to fulfil its original intent of rewardingthe discovery of new vaccines for the poor (Light, 2009). It prices extra doses well abovewhat low-income countries can afford, and also above the cost of manufacturing. GAVI, theGlobal Alliance for Vaccines and Immunization, has embraced the AMC, with hopes that itwill save 10 times more children than it realistically can (Light, 2009); and has created foritself a long-term financial burden that transfers donations into profits on blockbusterpneumococcal conjugate vaccines, throwing itself into a financial crisis (Butler, 2010). GAVIhas taken $1.3 billion from its core funding for much more cost-effective programmes tosupplement the $1.5 billion donated for the AMC, but this is not nearly enough to fund thepatent-preserving deep discount strategy of the AMC for purchasing vaccines. In themeantime, the heavily promoted AMC is poised to disrupt the delicate ecology in whichneglected disease research actually takes place (Moran, 2005; Pharmaceutical R&D PolicyProject, 2005). The self-perpetuating high-cost myth also produces wasteful and inefficientcorporate research structures (Fisher, 2009) because companies do not think lean, thoughthey talk of nothing but lean thinking. In fact, no one wants to believe that R&D costs mightbe much lower than claimed, or look more deeply into them with adequately funded studies,because so many people benefit from the high-cost myths and the generous budgetssupporting them. Nevertheless, this article provides reason for policy makers and developersto lower their estimates of how risky and expensive R&D must be to develop medicines forglobal health problems (Pharmaceutical R&D Policy Project, 2005; Moran et al, 2007).The deeper problem is that current incentives reward companies for developing mainlynew medicines of little advantage, and then competing for market share at high prices; ratherthan rewarding development of clinically superior medicines with public funding, so thatprices could be much lower (Light, 2010). One or two out of every 20 newly approvedmedicines offer real advances, and over time they have accumulated into a highly beneficialmedicine chest for humanity (see Table 3). Approving new medicines using non-inferiority orsuperiority trials against a placebo, and using substitute or surrogate end points, has resultedLight and Warburton14 r 2011 The London School of Economics and Political Science 1745-8552 BioSocieties 1–17for years in about 85 per cent of new drugs being little or no better than existing ones (Light,2010). These then become the medicines the rest of the world wants, because the rich havethem and presumably benefit from them. But in fact, they have spawned an epidemic ofserious adverse reactions that rank behind stroke as a leading cause of death and cause about4.4 million avoidable hospitalizations worldwide (Light, 2010). Thus the mythic costs ofR&D are but one part of a larger, dysfunctional system that supports a wealthy, high-techindustry, gives us mostly new medicines with few or no advantages (and serious adversereactions that have become a leading cause of hospitalization and death), and then persuadesdoctors that we need these new medicines. It compromises science in the process, andconsumes a growing proportion of our money. Many recent developments are addressingparts of the ways in which Western medicines are developed, tested and marketed, but in themeantime, a new generation of Indian and Chinese executives see how vulnerable thedysfunctional Western practices are (Frew et al, 2008).

Edited April 27, 2011 by hazard

[расејан]

drug companies izgleda mogu da prodaju droge samo 8-10 godina profitabilno, posle toga svi mogu da ih prave; valjda su ogromni R&D troskovi+reklame sto povecava cenu zdravstva

Негде сам нашао обрачун цене за лекове (збирно, ваљда, за целу фирму), и испада да зарачунавају чак и неку фантазмагоричну категорију, не сећам се тачно како се зове, али је то проценат који губе зато што производе уместо да играју на берзи. И то улази као трошак производње .пјаф: аха, ево га и у тексту што је Хазард окачио - трошак капитала. Муфљуска посла.А онда те исте фирме продају те исте лекове у, рецимо, Канади по упола мањој цени и не жале се да су притом на губитку.Трошкови истраживања, развоја и тестирања су углавном надувани, сви се као раде по не знам којим америчким тарифама и стандардима, а после кад пукне брука око непримећених нуспојава, испадне да су тестирани на студентима у Данској или Пољској, у режији тамошњих института и по тамошњим тарифама, а резултати мало прилагођени, мало тумачени...Когод млати толике паре, има за адвокате, посланике и медије. Edited April 27, 2011 by расејан

[WTF]

obama je ipak rodjen u US of A :o

tata mu je bio crnac iz afrike

Grdno se varate ako mislite da je ovom objavom cela ova prica zavrsena i da ce birthers retardi da jednom konacno poveruju da je covek rodjen na Havajima i da zacute za sva vremena. Sad ce tek da pocne prica o verodostojnosti™ ovog novog certificata, a raznorazni eksperti™ ce da krenu da analiziraju kvalitet papira, stamparske greske, fontove, rukopis, svracije noge i ovcije glave, etc...

[Shan Jan]

Da li u ameriku postoji ogranicenje koliko godisnje doktora moze dobiti licencu? Meni sve ovo izgleda kao jedan dobar nedostatak konkurencije.

[Indy]

Sad ce da kazu, "pa ja isti takav Birth Certificate mogu da kupim za 20 dolara iza coska". Niko jos nije pobedio teoreticare zavera, niti ce.

[hazard]

Da li u ameriku postoji ogranicenje koliko godisnje doktora moze dobiti licencu? Meni sve ovo izgleda kao jedan dobar nedostatak konkurencije.

Ne znam, al moras da studiras 10ak godina a prodje ciglo 15 dok ne stignes na stalan posao lekara, tako da je to samo po sebi sto bi rekli ameri "barrier to entry".

[Shan Jan]

Mislio sam na strane lekare. Zasto ne bi neki indus il srbin dosao i otvorio svoju kliniku u kojoj bi se radilo dobro, koristili jeftiniji a kvalitetni lekovi i opet ostajalo dovoljno para i ako ne oderes musteriji kozu s ledja?I ovde u Bocvani deru lekari. Doso zapad i u Afriku <_<

[Indy]

Dosli i lekari u Afriku, mislis.

[WTF]

Da li u ameriku postoji ogranicenje koliko godisnje doktora moze dobiti licencu? Meni sve ovo izgleda kao jedan dobar nedostatak konkurencije.

Nema pisanog/zakonskog ogranicenja, ali nije lako ovde postati doktor. Treba minimum 8 godina skolovanja + 2 staza, a to sve papreno kosta i mnogi doktori zapocinju svoju karijeru sa $100-200K duga za troskove skolovanja. Najveci tekuci trosak im je to osiguranje za slucaj da budu tuzeni za malpractice. Tako da ih nema mnogo, pogotovu ovih opste prakse. Ja kad hocu da odem kod mog doktora zbog neke bolesti, tesko je zakazati istog dana, a i ako dobijem termin, ja ne vidim doktora nego medicinsku sestru ili visu medicnisku sestru (to se ovde zove nurse practitioner) i oni mi daju dijagnozu a doktor samo uzme to zdravo za gotovo i prepise lek, ako treba. Ako se pitas zasto vise doktora ne dolazi iz inostranstva gde je lakse i jeftinije steci obrazovanje i diplomu, odgovor je to da treba da polozis masu nimalo lakih ispita da bi dobio certificat da mozes da radis ovde.

[Indy]

Najveci tekuci trosak im je to osiguranje za slucaj da budu tuzeni za malpractice.

Pa, kazem ja... a TBone kaze "5-10%". Izgledalo mi malo cudno, u najmanju ruku.

[hazard]

Mislio sam na strane lekare. Zasto ne bi neki indus il srbin dosao i otvorio svoju kliniku u kojoj bi se radilo dobro, koristili jeftiniji a kvalitetni lekovi i opet ostajalo dovoljno para i ako ne oderes musteriji kozu s ledja?I ovde u Bocvani deru lekari. Doso zapad i u Afriku <_<

Prvo kao sto rece WTF ne mozes da dodjes kao stranac lekar i otvoris praksu tek tako. Nostrifikacija je dug i tezak proces.Drugo ne mozes ti da prodajes lekove koje ti se cefnu, nego koji su FDA approved.Sve je to jedna velika mafija da se tako izrazim.

[WTF]

Pa, kazem ja... a TBone kaze "5-10%". Izgledalo mi malo cudno, u najmanju ruku.

Ja ne znam sta je on tacno mislio sa tih "5-10%" i "troskovima sudjenja". Ono o cemu ja pricam je osiguranje, a to je koliko doktori placaju osiguravajucim kompanijama da budu pokriveni u slucaju da budu tuzeni i da im sud odrapi da plate neku basnoslovnu odstetu. Naravno, sad se u celu tu jednacinu ubacuju i osiguravajuce kompanije koje su jos jedan zajeban igrac sa ogromnim uticajem u Washingtonu i masom politicara na svom platnom spisku. Tako da nije cudno da cena jos vise raste. Svako ima neku svoju racunicu, i svako ko je ugradjen™ u ovaj sistem debelo profitira, tako da je svaka reforma u startu osudjena na propast.

[Indy]

Pa da, i ja bas tako mislim.