Your reasons for the high cost of Tysabri sound as though they have come directly from the Biogen Marketing and Sales department.
I have never been near a drugs company annual report and accounts or have seen anything from Biogen. This is basic accounting stuff - and could be applied to car manufacturing, hamburgers or defence equipment. Some time ago I posted the UK MS Society's Research Matters - in this publication is a figure of £350 million for bringing a new drug to market. We cannot possibly look at the price of a drug and claim it is expensive or cheap. As commercial companies, drugs companies have to make a profit so they can pay dividends to their shareholders - I don't think any of us could claim to know what a fair profit is - 5% return on investment, 10% return on investment. But at the very least, we need these companies to break-even, otherwise they might not invest in research for the future.
In layman's terms, Tysabri is twice as good as the CRABs at reducing relapses (67% v 30%), so one could argue that the price should be twice as much as the CRABs- who knows? Biogen / Elan are likely to have a fairly short run with this drug - given that by 2010 there will be oral treatments on the market. So they have got four years to recoup the £350 million investment and their on-going costs. They know they are under pressure which is why they are buying up several promising drugs. If, for example, Rituximab is shown to be effective (in terms of reducing relapse rates and disease progression), this will be a direct competitor to Tysabri (and part owned by Biogen). Sufferers might switch to Rituximab given the lower number of infusions required each year and the unknown risks with Tysabri (Rituximab brings risks, but has a known safety profile). So it might be that Tysabri never recoups the investment made by Elan and Biogen.
Of couse the real value of these drugs is to the sufferer. If the companies could come up with a drug to stop / reverse this condition - how much should the price be? $64,000? $150,000? I suspect that sufferers and / or their partners would sell their homes to get their lives back and no-one would be questioning price / profit / marketing tactics. Unfortunately, we are not yet in this position.
I think we need to move on from the 'drugs companies bad' standpoint. Many are producing drugs which are saving lives. It's unfortunate that the drugs for MS have to date been pretty ineffective (probably due to the fact that this is a much more complex disease than originally thought), but as other drugs companies move into the market this should improve.
Government's could set up and fund their own drugs companies, but I fear they would not pay the rates required to attract the best researchers or take the risk of funding drugs which may never make it to amrket.
Your obedient servant