Comment by s1artibartfast

I dont think you have an accurate model of how US prescribers and patients operate.

They want the best, and are willing to sepnd 10x the price or switch treatment to secure that 1% survival, extra week of dosing interval, or the ability to inject at home via mail instead of some sweaty infusion clinic.

I used to think like you before transitioning from medical devices to pharmaceutical development.

The USA is the only real Market that matters for drug development. Unlike the with marginal benefit pricing and National negotiation, the US market is consumer Centric, with patients and their providers wanting the best, even if it is marginal. That 1% means that you can either take the market share or 10x the price.

> I guess these VEGF agents you list feel like a very straightforward engineering question

Each of those straightforward engineering questions takes about 100,000 labor-years and a billion dollars to get approval.