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EpiPen Price Rise Sparks Concern for Allergy Sufferers

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Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#51

Post by leereeves »

Animats wrote: post #13
helloworld wrote: post #2

Why haven't competitors entered the market with cheaper products?

They did. Windgap[1] took venture capital, took state funding from Massachusetts back in 2012, and didn't ship the product. Cool web site, though. Sanofi tried, but their product misfired at least 26 times and was recalled.[2] Teva tried, and their product was rejected by the FDA because of problems; they're going to try again with a new model in 2017.[3] [1] http://www.windgapmedical.com/ [2] https://www.auvi-q.com/…

Three companies tried and failed?

It sounds like it's harder than we might think to make this work.

Given that, and the low volumes, it might not be that profitable even at $600 per sale.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#52

Post by ucaetano »

gkanai wrote: post #40

This is a simple example of how health care systems should be nationalized. Or that the profit motive in health care is corrosive to health.

No it doesn't. Switzerland has one of the best healthcare systems in the world, which is completely private (although there are some public hospitals), but heavily regulated.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#53

Post by serge2k »

jonahx wrote: post #36
ceejayoz wrote: post #21

Earlier quoted context omitted.

That's about what it cost in the US until recently. It's a decades-old generic med, the patent on the delivery device is long expired ( https://www.google.com/patents/US4031893 ), and the original research was even done by the US military.

so how is this insurance company getting away with what they're doing? you'd think someone else would produce it, sell it for <$100, and people would just buy them out of pocket. what stops that?

Other companies don't sell them. They bailed for various reasons, and the expense of getting in just isn't worth it.

If you develop an EpiPen and it costs you a bunch of money then in theory you can make it up by selling more volume. Except your competitor can just cut the price because they are already selling for an absurd amount of money, so how do you win now?

Maybe we should have a non-profit that does generic versions, and we can subsidize it by preferring them to companies like this (e.g. all medicare provided drugs now go through this company which sells generics). Unless the companies are willing to match prices.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#54

Post by JunkDNA »

serge2k wrote: post #8
helloworld wrote: post #2

Why haven't competitors entered the market with cheaper products?

> Last year, the drug maker Sanofi recalled a competing product, Auvi-Q, because it may not have been delivering the correct amount of epinephrine, leaving the EpiPen as the primary emergency treatment for severe allergic reactions.

To all the folks in this thread suggesting 3D printing and all sorts of other ideas, keep in mind that Sanofi is not some fly-by-night or scrappy startup. They are a major pharmaceutical company with decades of experience manufacturing pharmaceuticals and the quality control that is required and even they couldn't get it right.

They actually had a very innovative product. It was much smaller than the EpiPen and used voice prompts to tell you how to administer the drug (people in the heat of the moment sometimes don't remember to leave the EpiPen in long enough for a proper dose to be fully administered). I'm frankly mystified how they botched things so badly that they had to pull the product.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#55

Post by cortesoft »

hkmurakami wrote: post #50
mikeash wrote: post #35

Earlier quoted context omitted.

Dying because you can't afford a device you need is also not something to take lightly. It may not be a good idea, but blame should lie with the manufacturer for raising the price to such ridiculous levels.

Not condoning this behavior at all, but don't we see this with the lack of equal access to drugs all the time? :(

Yes; this is why using the free market to set prices in health care is always such a troubling thing. People don't like the idea of putting a price on their health.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#56

Post by alecdbrooks »

ccleve wrote: post #16
helloworld wrote: post #2

Why haven't competitors entered the market with cheaper products?

There are really two villains here, Mylan, of course, but more importantly, the FDA. FDA regulations make the cost of bringing a new medical device to the market absurd. There are no competitors because the time and effort to bring a competing device is so ridiculously high that it doesn't pay to do so. I have a child with a peanut allergy. I am worried every damn day of my life. I see articles about people who die e…

I'm sure the FDA could be more efficient, but isn't a large part of the difficulty intrinsic to bringing a safe and effective device to the market? The flip side of people dying from not having an Epipen is people dying because their generic Epipen didn't work.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#57

Post by ceejayoz »

jonahx wrote: post #36
ceejayoz wrote: post #21

Earlier quoted context omitted.

That's about what it cost in the US until recently. It's a decades-old generic med, the patent on the delivery device is long expired ( https://www.google.com/patents/US4031893 ), and the original research was even done by the US military.

so how is this insurance company getting away with what they're doing? you'd think someone else would produce it, sell it for <$100, and people would just buy them out of pocket. what stops that?

> so how is this insurance company getting away with what they're doing?

It's not the insurance company, it's the drug company. The insurance companies are probably livid about the extra costs they're having to cover.

The answer to "how" is a variety of different techniques, including changing the formulation slightly (http://www.nytimes.com/2014/09/16/business/new-york-files-an...) and outright bribery of competitors (https://www.washingtonpost.com/opinions/pay-to-delay-pharmac...).

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#58

Post by mikeash »

hkmurakami wrote: post #50
mikeash wrote: post #35

Earlier quoted context omitted.

Dying because you can't afford a device you need is also not something to take lightly. It may not be a good idea, but blame should lie with the manufacturer for raising the price to such ridiculous levels.

Not condoning this behavior at all, but don't we see this with the lack of equal access to drugs all the time? :(

Of course. This case is particularly interesting because the device/drug combo is so commonly needed. But you'll find many other stories of manufacturers hiking the price of drugs people need to live, and the resulting backlash. Look up Martin Shkreli for a couple of recent examples that got attention.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#59

Post by tw04 »

Cyph0n wrote: post #28
gmisra wrote: post #18

One of the early on-line responses was "maybe we can figure out how to 3D print these cases". It turns out that an Epi-pen is just a plastic safety housing around a normal syringe. Some discussions: https://www.reddit.com/r/news/comments/4y5481/cost_of_epipen... https://www.reddit.com/r/3Dprinting/comments/4y7f26/epipen_f...

That second discussion got heated quite fast. I agree with the downvoters though. 3D printing a medical device is not something to take lightly. Edit: Here's why I agree. You download this design from the internet, and 3D print the parts. You then assemble it. Awesome! Some time later, you get an allergic reaction. You use the pen, but it fails to work correctly. Who's responsible? The designer? You (if you're alive)…

Well, if I can print 3 of them for 1/100th the price of a single one from said manufacturer, if the design is even adequate I'm probably still better off.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#60

Post by Sanddancer »

shanacarp wrote: post #43
toomuchtodo wrote: post #25

Earlier quoted context omitted.

The patent is expired: https://www.google.com/patents/US4031893 Courtesy ceejayoz below: https://news.ycombinator.com/item?id=12340464

so why aren't there more case manufactures

Because there's no equivalent of the bioequivalence study that generic drugs go through. Even if it's an exact copy, making a generic medical device means you have to go through the same entire approval process that the original went through.
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