World’s Most EXPENSIVE Medicines: Greedy or Fair? What Makes them Special? (Gene Therapy, Chemistry)

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  • Опубліковано 27 вер 2024

КОМЕНТАРІ • 90

  • @totalsynthesis
    @totalsynthesis  Рік тому +7

    ▶ To try everything Brilliant has to offer-free-for a full 30 days, visit brilliant.org/TotalSynthesis/. The first 200 of you will get 20% off Brilliant’s annual premium subscription.
    The answer to the chemistry question from Brilliant:
    Assumptions - The added iridium is the same temperature as the steam/methane mixture, and the volume of the reactor tank is kept constant.
    Answer - Adding Ir while keeping the reactor size and the added gases constant will lead to an increase in pressure in the reactor (because by adding a solid, we've effectively decreased the volume of the reactor). An increase in pressure will push the equilibrium point of the steam reformation reaction towards methane and steam, since that would reduce the number of gas molecules in the reactor, partially counteracting the increase in pressure. Adding Ir will therefore decrease the total amount of HX2 produced, even though it doesn't react with any of the other chemicals present.

    • @levtrot3041
      @levtrot3041 Рік тому

      No effect whatsoever, the Iridium would get stolen way before it ever reaches the reactor

  • @interstellarsurfer
    @interstellarsurfer 11 місяців тому +16

    Is it morally acceptable to make everyone pay $10M so someone else's kid can live to the ripe old age of 15, rather than 13?

    • @totalsynthesis
      @totalsynthesis  11 місяців тому +3

      In short, not really

    • @stoneneils
      @stoneneils 6 місяців тому +1

      @@totalsynthesisNot in the USA where your citizens pay. But here our corps pay all our taxes. You might wann try it so you stop whining about macroeconomics.

  • @WarlordEnthusiast
    @WarlordEnthusiast Рік тому +20

    For some drugs I 100% understand the price, like if you're going to spend millions to develop a drug to cure a disease only 1 in 20 million people has, the price has to be high enough to justify its cost.
    The only real solution in this situation would be the government covering part or all of the cost as I doubt an insurance company would ever pay for it.

    • @asadburden1621
      @asadburden1621 Рік тому +12

      Well having the government cover the cost is risky and could end up increasing the price of the drug. It's the same idea as colleges increasing tuition because of federally backed loans.

    • @lead_sommelier
      @lead_sommelier Рік тому

      Governments are already pouring billions into medical research but the results still get privatized🤔

    • @W333L
      @W333L Рік тому +3

      ⁠@@asadburden1621yes, but much like with university, congress has the power to price cap as either the funder or buyer and could easily do so

    • @stoneneils
      @stoneneils 6 місяців тому

      @@asadburden1621 What nonsense are you blabbling. this drug is free to citizens around the world. You Ametricans are subsidizing us because of fools like you who buy the Fox news propoganda. Thank you for that. Very much.

    • @stoneneils
      @stoneneils 6 місяців тому

      @@W333L Don't bother. Where I live nobody complains about the economy cuz none of us pay 1 cent for healthcare, your right-wingers just like to be victims to they can complain. They know literally nothing about anything first-hand, its all from their talking heads.

  • @AnthonyBolognese710
    @AnthonyBolognese710 Рік тому +12

    You got yourself a new sub. Damn I missed organic chemistry. I can’t believe I’m saying that, but as someone who majored in biochem and then went into another field, it takes me back. It’s still difficult for me to follow along but I enjoy the challenge.

  • @science_and_anonymous
    @science_and_anonymous Рік тому +12

    It is always a pleasure to watch your videos. You bring an incredible amount of insight and brilliance to a topic that has so much controversy.

  • @sadface7457
    @sadface7457 Рік тому +7

    Martin skreli be like: write that down 😂

  • @alexandraschneider5651
    @alexandraschneider5651 Рік тому +5

    He‘s back 🔥🔥🔥 Always getting excited when I see a new video of you popping up in my feed! Keep it up please :D

  • @davidfetter
    @davidfetter Рік тому +13

    When you start with the assumption that there must be rent-seekers paid off at every stage of this process, of course these numbers can sometimes seem reasonable. Maybe re-examine that assumption instead of rimming plutes.

    • @nicov6383
      @nicov6383 Рік тому +8

      Exactly, the idea that healthcare should always drive a profit is the main thing wrong with this video

    • @totalsynthesis
      @totalsynthesis  Рік тому +4

      @@nicov6383 I know where you are coming from - that's how the capital-based world runs (not saying that this is my personal view/ preference, I'm just explaining status quo). I hope I could at least show why - even in the ideal scenario - it's impossible to sell some medicines below hundreds of thousands of dollars.

    • @nicov6383
      @nicov6383 Рік тому +3

      @@totalsynthesis I totally understand don’t worry, it just makes me incredibly sad that this is the case

  • @mythics791
    @mythics791 Рік тому +9

    my treatment is 120k a treatment that is 8 times a year plus nursing. Unfortunately especially in the USA drugs are not price regulated. But it is disgusting that health has a price tag.

    • @zorintoto1167
      @zorintoto1167 Рік тому +1

      Depending on what drug you are using there are labs in china that don't care about patents that will make you a life time supply of said substance . Ofc if it's a complex molecule then you can buy them from India for probably 25% the price

    • @joalsoal1645
      @joalsoal1645 Рік тому +1

      If you don’t mind me asking, what’s your condition and what treatments/drugs do you use?

    • @WarlordEnthusiast
      @WarlordEnthusiast Рік тому

      @@zorintoto1167 You'd likely need to send off whatever they send you to a lab to have it tested to make sure its exactly what you ordered but that would still be cheaper than 120k a treatment for a lifetime supply.

    • @mythics791
      @mythics791 Рік тому

      @@zorintoto1167 I take specialized chemotherapy and the drugs used have to be certified by the FDA or the Infusion people would not and legally unable to administer, I will agree other country's can and will sell different drugs at a much cheaper price.

  • @la7era1u54
    @la7era1u54 Рік тому +3

    My cousin has hemophilia, but I'm not sure if it is the B variant. He is not technically a blood relative, as my uncle adopted him when he married his mother, so the gene isn't in my family tree. I know he had to be hospitalized several times as a child. However, he is 44 now and seems to be fairly healthy

  • @justinkim9986
    @justinkim9986 Рік тому +6

    Glad to see you posting again, I really missed these :)

    • @totalsynthesis
      @totalsynthesis  Рік тому +2

      Thanks! At least monthly vids coming again :)

  • @Mr.Cucumba
    @Mr.Cucumba Рік тому +6

    Thanks again for this well researched, informative and interesting video. It is always a pleasure, to get my brain massaged by life science und chenistry terms non-stop. I'd like to watch a video from you, investigating the revenues from other high selling small molecules (e.g. pregabalin), which are actually low in production cost. ❤

    • @totalsynthesis
      @totalsynthesis  Рік тому +1

      Thank you for your kind comment! I will keep some related videos coming.

  • @gotnopee
    @gotnopee 3 місяці тому

    so i know this isnt exactly what this episode is about, but it reminded me of my amazing cousin mikey he had hemophilia a and i just was going to ask if you would do a video that involves it in anyway whether its about it or something else... thanks man i appreciate you . rest in peace mikey i love u bubba

    • @totalsynthesis
      @totalsynthesis  3 місяці тому

      Thanks for your comment - may Mikey rest in peace

  • @yes3858
    @yes3858 Рік тому +40

    Meanwhile the drug to cure phobias is illegal and cheap

    • @zorintoto1167
      @zorintoto1167 Рік тому +19

      It's a treatment not a cure , the only cure to phobias that exist today that I know of is an amygdalotomy which is a bit extreme

    • @Huey_Freeman357
      @Huey_Freeman357 Рік тому

      What's that?

    • @Taygetea
      @Taygetea Рік тому +16

      @@Huey_Freeman357 presumably MDMA

    • @davidfetter
      @davidfetter Рік тому +15

      Given the wide array of phobias and their etiologies, it's just irresponsible to assert this. Some things work under some circumstances for some people.
      Oh, and whichever one you had in mind should be legal, not on this flimsy and dishonest pretext, but because humans have bodily autonomy, and should not be forced to go to a potentially poisoned supply in order to exercise it.

    • @Huey_Freeman357
      @Huey_Freeman357 Рік тому +1

      @@Taygetea awesome

  • @stonerman15
    @stonerman15 Рік тому +3

    Greed 100%
    cant even get adhd medicine since 6/22 of last year.

  • @mikescholz6429
    @mikescholz6429 5 місяців тому

    Yea of course its a good idea to name our pharmaceutical company something that sounds suspiciously close to eugenics.

  • @samueldeschwanden3065
    @samueldeschwanden3065 Рік тому +1

    🎉🔥🔥 I love your videos

  • @socksincrocks4421
    @socksincrocks4421 4 місяці тому

    So there is a niche pharma market for only the most wealthy of people. Shocking huh, the rest of us a expendable while Billionaire can buy life.

  • @stevengill1736
    @stevengill1736 Рік тому

    Thank goodness that hepatitis c medications didn't end up in that high cost profile...

    • @totalsynthesis
      @totalsynthesis  Рік тому

      Especially looking at cumulative revenues those are some real heavy hitters as well

  • @nexigent
    @nexigent 2 місяці тому +1

    I love you

  • @waltgodsoe9111
    @waltgodsoe9111 Місяць тому

    I believe it is called extortion

  • @AnthonyBolognese710
    @AnthonyBolognese710 Рік тому +8

    They really should’ve chosen a different name. It sounds a bit too close to “eugenics”

    • @warrior7038
      @warrior7038 Рік тому +2

      There's nothing wrong with eugenics

    • @AnthonyBolognese710
      @AnthonyBolognese710 Рік тому +2

      @@warrior7038 women do this literally every time they reject a guy

    • @warrior7038
      @warrior7038 Рік тому

      what does any of what you just said have to do with eugenics?@@AnthonyBolognese710

  • @thetaintpainter5443
    @thetaintpainter5443 Рік тому +6

    “Small molecule.” It’s weird how drugs are considered small up to 1500 daltons cuz that molecule looks pretty damn big to me

    • @totalsynthesis
      @totalsynthesis  Рік тому +2

      _smol_

    • @ZakBellinger
      @ZakBellinger Рік тому +1

      Get smol hahaha. Great reply.

    • @DaveDave-e4t
      @DaveDave-e4t Місяць тому

      @@thetaintpainter5443 "Small" usually maxes-out at a molecular weight of about 350 to 500, although admittedly the size of some of those non-peptide natural products can be amazing.

  • @takeopariu
    @takeopariu Рік тому +3

    Congratulations on the excellent video. It must have taken a lot of work to create and edit it. If I may have a suggestion, I would like you to comment on Tamiflu (Oseltamivir phosphate). It seems that his effectiveness is not what it seems, could you clarify that? The synthesis routes are interesting, especially Corey's and Hayashi's. There are many other aspects around Tamiflu that can provide a good context, such as shikimic acid, the lack of the drug during flu epidemics, and so on...

    • @totalsynthesis
      @totalsynthesis  Рік тому +4

      Thank you very much!!
      Tamiflu is indeed quite the interesting story - I will put it on my list of potential videos!!

  • @knivesnico8775
    @knivesnico8775 Рік тому +3

    I LOVE YOU I LOVE THIS CHANNEL

  • @fmdj
    @fmdj 7 місяців тому +2

    4:00 wait what? sales cost more than twice as much as R&D? the marketing people must be geniuses or the researchers dumbasses lol

    • @totalsynthesis
      @totalsynthesis  7 місяців тому +2

      Yeah dude, most big pharma companies spend like $5-10bn in R&D - much more than that and they get pretty inefficient (large organizations, slow processes, no sense of prioritization). Employing people who sell the pharmaceuticals and managing the business is a bigger cost. The system sounds f'ed (and it kinda is) but medicines dont sell themselves - for bad and good reasons

  • @DeusExWolksvagen
    @DeusExWolksvagen Рік тому +3

    Why is that alkylation enantioselective?

    • @radeksuchy123
      @radeksuchy123 Рік тому +3

      due to the chiral promoter in the form of quinine. Quinine is the well known organocatalyst. Better are their thiourea or squaramide derivatives, but this depends highly on reaction.

    • @totalsynthesis
      @totalsynthesis  Рік тому +2

      Quinine reacts first and is thus a chiral alkyl transfer reagent

    • @radeksuchy123
      @radeksuchy123 Рік тому +1

      @@totalsynthesis it reacts (creats new bond with quinine) or just simply catalyze this reaction due to oxonium-ion catalysis?

    • @totalsynthesis
      @totalsynthesis  Рік тому +7

      @@radeksuchy123 Yes (most likely). As shared in their original paper, there were some funky observations though so the ultimate mechanism was not determined.
      "We first suspected that water was detrimental to the LDA reaction. Counter-intuitively, a consistently lower range of ee values was observed when moisture was vigorously excluded from the system. To follow up on this unexpected observation, we then spiked different amounts of water to the reaction mixture prior to the addition of a second equivalent of LDA. To our delight, water had a pronounced positive effect on the ee as shown in Table 2. The higher the water contents the better the ee with an optimum being 1.0 equiv. The same trend was also true for the yield. With added water, 95% ee was consistently achieved with either 6d or quinine. The added water was compensated by an equal equivalent of LDA. Interestingly, addition of solid LiOH, B(OH)3, MeOH, and AcOH had no effect on the ee. The mechanism is under further investigation."
      (From J. Org. Chem. 2003, 68, 984)

    • @radeksuchy123
      @radeksuchy123 Рік тому +1

      @@totalsynthesis yeah, I read about it just minutes ego before you have posted your respond :D You have right about all of this, this funky situation with water also surprised me, very good topic for investigation, but there is one key factor - they are using 1.2 eq of quinine so there must be mechanism based on creating some bond between reagents. If the quinine acted like organocatalyst, they would use only catalytic amound of it (like 10% mol). So i have mistakenly assumed that it must be some sort of oxonium-ion catalysis. Or maybe quinine reacts in both ways, because the slightly deeper knowledge of organic chemistry lead to assumptions that our reality isnt black or white, it is in fact grey... ;)

  • @DaveDave-e4t
    @DaveDave-e4t Місяць тому

    Cost to the patient should not result from a comparison between cost of therapies, but the cost to produce that therapy (including R&D and approvals) plus a reasonable margin for the company shareholders. The former is capitalism, the latter is socialism, which is why we need socialized medicine in the US.

    • @totalsynthesis
      @totalsynthesis  Місяць тому

      Problem with this is how do you finance the cost of failed drugs? (so 90% of all clinically tested drugs)

    • @DaveDave-e4t
      @DaveDave-e4t Місяць тому

      @@totalsynthesis That's easy. You factor that cost into your overhead, as with construction, maintenance, utilities, finance, insurance, etc. Pharma already does this, so that's not where the end-user cost originates. It originates from the principle of maximum exploitation, which is most fully realized in the U.S. In fact, that's a legally required corporate principle. Other countries regulate, so have much lower prices, yet these same companies still seem to manage a profit, just not as large. No danger of bankruptcy, in any case.

  • @brettmoore3194
    @brettmoore3194 Рік тому

    Just wtite off the research and equipment and adminastration as charity 🎉