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Peter Kolchinsky Profile picture
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26 Aug, 4 tweets, 3 min read
Wow. Reporting by @jeffreybillman on medical debt collectors, why they hate their work & who they blame, may make you cry or vomit. Thank you @NPLB_org for covering. Many gutting quotes. 115,000 do this work, few love it. More attention: @NPR @nytimes nopatientleftbehind.org/publications/a…
What if it worked like this for all appropriately prescribed treatments?
And you don’t have to accept the injustices of medical debt collection. Defend yourselves by knowing your options. Read more here. Again, thank you for great coverage by @NPLB_org nopatientleftbehind.org/publications/w…
Actionable advice: “If your debt has been sold, the buyer bought it cheap—probably 3 percent of its face value. Even if you settle for an 85 percent discount, the buyer profits handsomely.”. Definitely read whole article. It might keep you from ruin.

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More from @PeterKolchinsky

Peter Kolchinsky Profile picture
10 Sep
Dear Lawmakers @POTUS @RonWyden @SpeakerPelosi Hundreds of us biotech investors, innovators, patient advocates, & NIH academics representing >40k US jobs, >600 drugs in trials, & >$200B invested propose solutions to affordability that preserve R&D. 1/
nopatientleftbehind.docsend.com/view/a6bxibzxy…
This is grassroots, not PhRMA. We offer solutions! We support real negotiation: play products off one another to get better prices. Help patients by lowering what insurance can demand OOP for medicines they need. And save by ensuring all drugs go generic w/o undue delay. 2/
But you must not redefine the word “negotiation” to mean that government can just dictate the price of a new drug & force a company to accept it under threat of a ruinous tax. That’s not negotiation, even if you like calling it that. That’s a repudiation of basic economics. 3/
Read 14 tweets
Peter Kolchinsky Profile picture
22 Aug
Focusing on EpiPen, academics suggest patents on device improvements are problem. They acknowledge patents may be essential to incentivizing valuable improvements yet lament poor patient access. Yet never mention “INSURANCE” (except one footnote). How did peer review miss it?
Must we reinvent innovation incentives to fix what are clearly failings of insurance design in America? How about proper insurance w/ low out of pocket costs. To then save $ for society AS A WHOLE, enforce genericization w/o undue delay. This is for you: nopatientleftbehind.org/about/our-vide…
But whenever patients can’t afford a drug, first thought should be whether insurance is doing what it’s supposed to. If not, propose fixing it. If you think society as a whole is overpaying for something, present evidence for why & then let’s talk about solving market failures.
Read 4 tweets
Peter Kolchinsky Profile picture
15 Aug
Turns out that COVID vaccination would ideally have been a 3-dose course (day 0, Day 21-28, & one more shot at 6 months), akin to what we do when vaccinating kids & even adults against many pathogens. But ideals are going to be compromised… here’s why…cdc.gov/vaccines/paren…
Data from all major vaccine trials now show that immunity wanes gradually after first two shots… AND the virus mutates to build its resistance (ie delta variant). 2/
Vaccines still protect at 6m, but while their efficacy was 95% against original strain shortly after the peak of immunity after the 2nd dose, it drops down to being 40-80% protective against delta infection by 6m (still something!). 3/
Read 26 tweets
Peter Kolchinsky Profile picture
11 Aug
Consider controversy whether pharma sales & marketing is necessary. For COVID, gov’t distributes vax w/o companies doing marketing. Data are out there. People still unclear, say gov’t isn’t teaching right. New drugs w/o understanding of their utility are a wasted effort. 1/13
In some cases, it seems marketing can be harder than R&D. The drug industry does spend more on R&D than on sales & marketing, but that’s arbitrary & shouldn’t be seen as inherently right. They aren’t relative expenses. They are each essential. 2/
We should spend what we must on R&D, and we should spend what we must to ensure all the right people are informed and suitably convinced of the utility of each new medicine. Only then will innovation have made a difference. 3/
Read 14 tweets
Peter Kolchinsky Profile picture
16 Jul
Math is precise, but doesn’t make it accurate. Formulas health economists use calculate a drug’s value rely on uncertain human inputs. @SpeakerPelosi, don’t import this math from Europe. Errors can brand a drug as “not worth it” even when it is. Help patients by fixing insurance.
I’m not saying that one can’t attempt to appreciate how much value a drug generates for society. I’m saying that one should be very careful about math that attempts to override the market to set prices. The math can and should be improved. Here’s how. global-uploads.webflow.com/606ac6e3ee6c27…
And if you are curious about why price controls based on bad math would kill innovation, here’s a step by step explainer of the murdering process. nopatientleftbehind.docsend.com/view/b65fjkcdi…
Read 5 tweets
Peter Kolchinsky Profile picture
13 Jul
Hmmm… Drug companies develop meds to keep people out of hospitals, go out of their way to offer patients copay assistance, & get vilified & sued for it. By contrast, hospitals hound patients mercilessly for last $. How will Congress prioritize? @NPLB_org axios.com/hospital-billi…
If you want some tips on how to deal with predatory hospital billing, check out articles on nopatientpeftbehind.org. There is advice on who to call, what to say, what not to sign, etc. And sadly lots of people who have been left behind. We’re working on solutions. @NPLB_org
And if that axios link didn’t work for you. Lots of related articles on hospital predatory billing. axios.com/hospitals-pati…
Read 4 tweets

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