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EpiPen Maker Quietly Steers Effort That Could Protect Its Price

nytimes.com

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Re: EpiPen Maker Quietly Steers Effort That Could Protect Its Price

#91
post #6

It's not a "quietly effort", Martin even said that this would be the best course of action on live TV[0]. The government will spend more money, but the public will get it for free. Of course there's two side to every story, but I think I choose to believe Shkreli on this. [0] - https://www.youtube.com/watch?v=RoMlxVimwiU

> The government will spend more money, but the public will get it for free.

You know where the government gets its money, right?

Re: EpiPen Maker Quietly Steers Effort That Could Protect Its Price

#92

Earlier quoted context omitted.

FDA's genesis was bound pretty close to marketing. If you wanted to sell "Aunt Eliza's Magic Elixir" and claim that it "cures all ails: backaches, headaches, etc", you are required to show evidence that validates those claims. See Pure Food and Drug Act. FDA's responsibility is mutually exclusive with USPTO which would approve/deny patents based on "novelty".

I'm not suggesting that the FDA could deny a patent. I'm suggesting that the FDA could simply refuse to approve the new version of a product. In the case where there are generics and the improvement is small, it doesn't matter if the company decides to take their ball and go home. It might be a fine line to walk, but the improvements to the Epipen don't seem to be very substantial (it's kind of hard to figure out wha…

As someone who has worked with EpiPens for seven years now, administering them to patients weekly, if not more, it's very hard for me to find any claim of "improving the product" to be more than lip service. Certainly I don't consider the drug beyond active ingredient, but in the delivery mechanism (where they've also claimed "significant improvements and refinements", very little has changed. The shape of the container is a bit different, the 'window' to see the drug (to look for cloudiness or discoloration) is a little bigger (mind you, such a window is more akin to "empty space in product coloring and branding").

Certainly, I know some things might happen "behind the scenes". Maybe they found a more durable spring for the needle (not that was ever a problem), or such. But yes, I struggle to see it as anything more than patent extension.

Which is why, after our relatively small county, which THROWS OUT $100,000 of EpiPens a year in the Medic One system (which we are mandated to carry by state law) is moving to train EMTs to draw up epi from $2.80 vials, themselves.

Re: EpiPen Maker Quietly Steers Effort That Could Protect Its Price

#93

This is why we need alternatives. Vote with your money: https://www.indiegogo.com/projects/allergystop-affordable-ep...

I see little indication that that doctor has any experience getting a medical device through the FDA and manufacturing. Couple that with the flexible funding goal and that looks pretty damned scammy.

Re: EpiPen Maker Quietly Steers Effort That Could Protect Its Price

#94
post #59

One thing that really annoys me is the fact that drug makers can refund the co-pay to customers. In the auto repair industry, I believe this has a name: insurance fraud.

That's a very specific thing.

The co-pay is a part of the price of the product that your insurer doesn't cover, so technically it's not theirs to begin with. Which is also why it's not a refund of the deductible paid, because that -is- considered part of the insurance contribution, i.e:

(deductible paid by customer + insurance payment) = your insurance contribution co-pay = your personal contribution to the cost of the treatment.

Re: EpiPen Maker Quietly Steers Effort That Could Protect Its Price

#95

Earlier quoted context omitted.

>> Does the FDA have the authority to deny marketing approval for minor improvements? They certainly don't. Look at Nexium, it is something close to a blatant scam but the FDA approved it and between Medicare and Medicaid alone the federal government has rewarded the scammers (AstraZeneca) with billions of dollars never mind private insurance companies.

Honest question, how is Nexium a scam?

https://en.wikipedia.org/wiki/AstraZeneca#Nexium

Nexium is just pre-broken-down Prilosec, which had just run out of patent protection. They then manipulated the results to make it look more effective so they could market it as such:

> AstraZeneca's scientists had misrepresented their research on the drug's efficiency, saying "Instead of using presumably comparable doses [of each drug], the company's scientists used Nexium in higher dosages. They compared 20 and 40 mg Nexium with 20 mg Prilosec. With the cards having been marked in that way, Nexium looked like an improvement – which however was only small and shown in only two of the three studies."

Re: EpiPen Maker Quietly Steers Effort That Could Protect Its Price

#96
post #6

It's not a "quietly effort", Martin even said that this would be the best course of action on live TV[0]. The government will spend more money, but the public will get it for free. Of course there's two side to every story, but I think I choose to believe Shkreli on this. [0] - https://www.youtube.com/watch?v=RoMlxVimwiU

> The government will spend more money, but the public will get it for free. You know where the government gets its money, right?

So what if taxpayers are paying for it? Companies need to make a profit.

Is there a specific reason why the price is unreasonable? (don't anchor the previous price)

Re: EpiPen Maker Quietly Steers Effort That Could Protect Its Price

#97
post #78

Earlier quoted context omitted.

Humanitarian missions and charity are notoriously ineffective at achieving real change. See, for example, the utter failure of aid organizations to achieve any fundamental changes in Africa. Meanwhile, big drug companies and their anti-retro viral cocktails changed the course of the AIDS epidemic there almost overnight.

And yet I continue to go untreated thanks to the profit motive...

So? Money is a representation of human effort. Nobody wants to work for free or invest for 0% gain.

Is there a reason you think the price should be lower? (remember people working need money too)

Re: EpiPen Maker Quietly Steers Effort That Could Protect Its Price

#98
post #65

Earlier quoted context omitted.

Maybe they should fold the R&D department into the marketing department. That's where all the drug company money is spent.

The fact that companies often spend more on marketing than R&D is irrelevant. The fact is that they spend billions on R&D. They have to recoup that. Presumably they don't spend money on marketing for shits and giggles--they spend how much they need to maximize revenue.

It's very relevant. With the incentives in place now, the most profitable thing a drug company can do is alter an existing drug enough to extend patent protection for as long as possible. It's sleazy.

Are you not bothered at all about the EpiPen situation? Martin Shkreli doesn't make you angry?

A pharmacologist friend once told me that the best way for a drug company to get a customer for life is to make sure they don't cure or kill them. She was joking, but I think it's true.

Re: EpiPen Maker Quietly Steers Effort That Could Protect Its Price

#99
post #64

Earlier quoted context omitted.

This. Exactly This. I am sick of hearing "oh you just pay $20 co-pay". No we don't. The real cost is much more and these pharmas and insurance companies know it. I know because I paid it for a family of 4. It costs $1500/Month for a decent plan that does not have high "out of pocket" costs (Read capped at $5000). So you pay $1500 per month and in worst case scenario, you can still pay $5000 out of pocket for a year I…

Transparent medical pricing is not possible so long as hospitals have an obligation to treat sick people whether or not they can pay. Hospitals heavily cross subsidize between insured, uninsured, and Medicare/Medicaid patients. As long as we put expectations on doctors and hospitals that compel them to do that, they cannot provide transparent pricing.

The work done by David Belk MD shows that these costs are an extremely small cost of hospitals, and that you're basically promoting a myth. [1][2]

He directly addresses the inaccuracy of that claim in the following 10 minute video, "The $55,000 Appendectomy: What Everyone Should Know About Hospital Bills". [3]

[1] https://www.reddit.com/r/IAmA/comments/4lgnif/i_am_david_bel...

[2] http://truecostofhealthcare.net/conclusion/

[3] https://www.youtube.com/watch?v=jkAY15p2DN4

Re: EpiPen Maker Quietly Steers Effort That Could Protect Its Price

#100

Earlier quoted context omitted.

>> Does the FDA have the authority to deny marketing approval for minor improvements? They certainly don't. Look at Nexium, it is something close to a blatant scam but the FDA approved it and between Medicare and Medicaid alone the federal government has rewarded the scammers (AstraZeneca) with billions of dollars never mind private insurance companies.

Honest question, how is Nexium a scam?

Omeprazole is a mixture of two mirror image molecules. One of the two versions is the active and the other isn't (for 97% of the population). When the patent was running out on omeprazole AstraZeneca patented esomeprazole, which is just the active isomer. In order to show improvement over omeprazole they did clinical trials that used a higher effective dose of esomeprazole than omeprazole. The FDA, for reasons unknown, let them get away with this fraud and approved the drug.

The government has spent literally billions of dollars buying esomeprazole when a double dose of omeprazole is the same damn thing for 97% of the population. I caveated my original statement ("something close to") because there might be some role for esomeprazole as a second line drug for the 3% of the population that is sensitive to the other isomer, but even there a perfectly fine alternative would just be a lower dose of omeprazole.

Nexium is 18th on the list of drugs by global sales in 2014. These are not small potatoes.

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