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EpiPen Price Rise Sparks Concern for Allergy Sufferers

well.blogs.nytimes.com

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Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#71

Post by robryk »

ucaetano wrote: post #52
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.

Alas, there are significant differences between the Swiss and US one. Most importantly, law in Switzerland specifies exact coverage criteria for basic health insurance and prohibits excluding pre-existing conditions from it. I'm not sure how financing of hospitals works exactly (I was under the impression that they are at least partially publicly owned). Minor things: there are phone-a-doctor public services that are free of charge for residents in some areas.

Edit: also, every company that provides basic insurance can vary the price based on a limited set of factors and must accept any person.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#72

Post by Terr_ »

xnor wrote: post #42

If people don't want to buy two epipen there's always that neat trick for multiple doses in precarious locations far from hospitals. It is a well known hack taught in wilderness medicine training. https://www.youtube.com/watch?v=luultUD0eK0

So a "used" epi-pen's internal syringe might contain 4-5x more epinephrine than actually goes into a standard dose? I assume this means most of the expense of making it comes from the housing/mechanics. (And recouping whatever cost of QA/approvals.)

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#74

Post by nilved »

infinite8s wrote: post #73
nilved wrote: post #69

This seems less damming to me considering the medicine naturally occurs inside your body. What reason is there that nobody else can make a competing product for cheaper?

Regulatory hurdles to get a new device approved.

Maybe regulation is not so good after all

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#75

Post by etherealmachine »

toomuchtodo wrote: post #25
eliben wrote: post #23

Earlier quoted context omitted.

Thanks, so this is the missing information. The article misleadingly says the medication is decades-old, where actually the pen itself is patented.

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

Other posts have pointed out that companies have tried and failed to produce generics. Seems like a really broken patent system if the patent isn't descriptive enough to allow competitors to actually produce the product. Isn't the point of filing the patent to allow things to progress once the inventor has had their monopoly?

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#76

Post by Mandatum »

shanacarp wrote: post #46
Mandatum wrote: post #11

They don't produce EpiPen's as a generic in India because the Indian medical community does not recommend self-administration of epinephrine. If you're that much in need though, you can buy pre-filled epinephrine syringes for intramuscular injection - just keep in mind the ease-of-use of an EpiPen won't be available. You have to take the time to take off the cap, insert and inject the medicine.

what happens if someone goes into anaphylaxis?

I assume they intramuscularly inject epinephrine just as you would with an EpiPen. I doubt it'd be hard for patients to get hold of an epinephrine kit.

You'll also find developing countries have far less allergic population. It's said this is partly due to urban environments having more vitamin D deficiency as well as people being more exposed to more pathogens/etc during childhood outside of developed countries.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#77

Post by harryh »

sevenless wrote: post #30

How many people will this price hike kill? I'm sure that's estimable. What would be morally justified, to stop it?

I dunno. I bet it's a pretty small number. Fewer than 100 people die per year in the US from anaphylaxis and it's hard to find evidence that this number has risen along with the price of the EpiPen.

At the top end maybe the answer to your question is a dozen or so. About the same order of magnitude as the number of people that die due to dog bites.

It's really small.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#78

Post by kabdib »

If your kid is allergic and needs an EpiPen (or something like it), most school districts will not allow the child to attend class unless they have one at the school. Maybe two.

And of course you have to carry them. There's another two.

So that's $2400. Out of pocket if you don't have insurance, or if your insurance doesn't pay.

The EpiPen manufacturers are abusing their monopoly.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#79

Post by bottled_poe »

ccleve wrote: post #47
dfsegoat wrote: post #26

Earlier quoted context omitted.

So, The FDA, because they require drug and device makers to demonstrate efficacy and safety by going through a rigorous clinical trial process, are evil? Really? I also find your comment pretty uninformed considering that the FDA just paved the way for generic drug makers to basically "knock-off" super expensive biologic drugs like Humira and Enbrel which were previously covered by similar patents. The FDA has it's p…

> So, The FDA, because they require drug and device makers to demonstrate efficacy and safety by going through a rigorous clinical trial process, are evil? Really? Yes, if the process is so rigorous and expensive that it drives the cost of drugs beyond the reach of people who need them, and it hampers the effective functioning of the free market. And I think it's widely accepted that's far more expensive to bring a d…

> it should undertake a rational risk/benefit approach. Rather than saying that no drug gets through the filter unless it's safe (as demonstrated through reams of evidence), it should ask, how much risk should we tolerate in exchange for how much benefit?

Do you really believe the FDA isn't doing this? The price of these drugs is directly linked with the risk*cost of being sued. In order to reduce the cost of the drugs, we need to reduce the benefits of suing, but this will undoubtably upset libertarians. Can't please everyone.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#80

Post by tjl »

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?

As others have said it's the drug company itself, not an insurance company. The patent they had on the injector has expired so others have tried and failed to bring alternatives to market. Unlike drugs, each medical device has to be vetted by the FDA. Generic drugs can get quicker to market just by showing that they're equivalent to the already approved drug. Devices can't do that.

One of the alternatives was potentially better as they had additional features, but there were problems with the injector itself and it was recalled. That's what other companies have to contend with. It's bad if the injector fails to deliver the dosage and a person dies.

So, people making a 3D printed alternative can't really ensure that the injector works reliably without a lot of work.

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