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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

#81

Post by schmidty »

rdtsc wrote: post #67
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?

Nah because it would upset the free market. I mentioned in another comment when someone from Europe or Canada asked something to the effect of "how come everything has to be free market in US even healthcare and such". And I think the answer is we treat free market as a religion. We don't evaluate what is better, healthier, more rational answer for a problem. Like say, "How do we keep people from dying from anaphylax…

How is government protecting a monopoly free market exactly?

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#82

Post by rtkwe »

nilved wrote: post #74
infinite8s wrote: post #73

Earlier quoted context omitted.

Regulatory hurdles to get a new device approved.

Maybe regulation is not so good after all

There was a competitor but it wasn't able to reliably inject the correct amount of medicine so it was recalled. [0]

[0] http://www.fiercepharma.com/marketing/sanofi-s-auvi-q-recall...

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#83

Post by jdpedrie »

rdtsc wrote: post #67
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?

Nah because it would upset the free market. I mentioned in another comment when someone from Europe or Canada asked something to the effect of "how come everything has to be free market in US even healthcare and such". And I think the answer is we treat free market as a religion. We don't evaluate what is better, healthier, more rational answer for a problem. Like say, "How do we keep people from dying from anaphylax…

That's silly. How do you propose to "evaluate what is better, healthier, more rational"? I suppose some panel of experts could give you their best approximation, but it will always be sub-optimal. Markets exist in order to answer these questions, and they answer them by delegating the decision to every person involved in the decision, not by hoping a designated person can make a guess that's close enough.

It appears that the problem in this case is that there is a single producer who is able to engage in monopolistic pricing, which is certainly not something a market-oriented person would condone.

And the market for healthcare is not a free market. Not anything resembling a free market.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#84

Post by cloudjacker »

etherealmachine wrote: post #75
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

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?

its to build upon it too

it is primarily to avoid redundancies

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#85

Post by curiousgeorgio »

mikeash wrote: post #35
Cyph0n wrote: post #28

Earlier quoted context omitted.

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)…

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.

The manufacturer is obligated to (1) obey the law, and (2) maximize profits for shareholders. If you have a problem with the current situation, blame the government/laws[1], not the company.

[1] Blame is justifiably attributed to the government whether you believe the fix is a freer market (to reduce the costs associated with bringing suitable competitors to market) or you believe regulation should prevent this from happening. Apart from the requirements codified into law, we should have no expectation of altruism by companies, especially when their existence is intrinsically related to profit-seeking motives.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#86

Post by actuallyalys »

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? :(

Yep. :(

We also see drug shortages because the lone manufacturer temporarily or permanently stops manufacturing. For example, there's an ongoing injectable estrogen shortage because the manufacturer has an issue sourcing a key ingredient [0] [1]. (Thankfully, other forms and dosages are not impacted.)

[0]: https://www.theguardian.com/commentisfree/2016/aug/13/estrog...

[1]: http://www.out.com/out-exclusives/2016/8/04/exclusive-theres...

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#87

Post by DSMan195276 »

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…

I don't really think you know all the history here. There are other companies who have/are attempting to create competitors to EpiPen. A few of them weren't able to get passed by the FDA, and one of them passed the FDA in 2012 but was recalled because of the product misfiring. The EpiPen problem seems to be much less an FDA problem then it is a problem with manufacturing, other companies don't seem to be able to make products that work nearly as well as EpiPen. If the FDA wasn't in the picture, you would still have the problem that there aren't any other reliable replacements for EpiPen even though companies have tried.

IMO, I also don't see how your solution would solve any real problems. People shouldn't have to ask themselves "Do I buy the one that is 600$ with a 100% success rate, or the one that's 100$ with a 95% success rate?". That sounds like a pretty bleak state of affairs, and could easily encourage cutting corners to cut costs. "How much does a death cost us?"

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#88

Post by noonespecial »

tw04 wrote: post #70
shanacarp wrote: post #43

Earlier quoted context omitted.

so why aren't there more case manufactures

For the same reason there were no competitors to daraprim before Martin Shkreli decided to be a complete ja. When the price is low enough that there's little profit to be had, nobody bothers competing because it's not worth the time, money, and effort to get FDA approval. When the price gets jacked up like that, you will find generics pop up quickly. The problem is the window between the price hike and when generics…

If EVERYTHING were deregulated, the time, money, and effort to get FDA approval would also vanish along with this particular problem. Would other worse problems appear in its place? Maybe. But calling foul on free-market capitalism in the very most regulated market in the US is a bit disingenuous.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#89

Post by Mandatum »

kabdib wrote: post #78

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.

Given the proper age, teaching kids to use syringe/vials or having a school nurse that can administer epinephrine would be a much cheaper alternative.

EpiPens are purely about the delivery mechanism. Stabbing a syringe into your thigh and injecting a predetermined amount of epinephrine into your leg isn't majorly complicated.

Maybe having a single pen on the kid and vials/syringes at the school would be a cheaper option.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#90

Post by rtkwe »

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…

> a $10 bottle of epinephrine and a $1 syringe can save a life

You're not prevented from using that method and some people and a lot of emergency services (that have relevant training) do. There are problems with that too though, epinephrine isn't completely stable and properly injecting when you or someone you know needs the shot isn't an easy task.

What the FDA is and should prevent are devices like the Auvi-Q that couldn't inject the proper amount reliably.

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