EpiPen Maker Quietly Steers Effort That Could Protect Its Price • Hacker News Board

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

#151

Post by harryh » Fri, Sep 16, 2016, 10:29 PM UTC

gizmo wrote: post #141

harryh wrote: post #122

Earlier quoted context omitted.

why is the United States the only country in the world where advertising prescription medicine to consumers is allowed? Because the US has the strongest freedom of speech protections in the world.

Freedom of speech is for humans, not for corporations. Otherwise you also have to accept the bizarre citizens united decision that permits companies to spend an unlimited amount of money to campaign on behalf of political candidates. Extending personhood rights to corporations is a really bad idea.

Corporations are people, my friend.[1]

Which is to say, they are made up of people. My right to free speech is not diminished by the fact that I choose to work with other people for a common goal.

1. https://www.youtube.com/watch?v=KlPQkd_AA6c My second favorite republican quote that was mistakenly maligned by the left. In first place is, of course, Rumsfeld's rumination on the nature of unknown unknowns.

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

#152

Post by SilasX » Fri, Sep 16, 2016, 10:36 PM UTC

mikeyouse wrote: post #150

SilasX wrote: post #145

Earlier quoted context omitted.

You're seriously claiming that no doctor has ever modified a treatment plan due to research provided by a patient?

I'm seriously claiming that no patient committed to modifying their treatment plan has ever started that process due to a TV commercial and that the societal loss from doctors acquiescing to patient demands for treatment for Restless Leg Syndrome or whatever other made-up disease far outweighs the benefits from airing said commercials. Any patient engaged enough and knowledgeable enough to participate in improving th…

>I'm seriously claiming that no patient committed to modifying their treatment plan has ever started that process due to a TV commercial and that the societal loss from doctors acquiescing to patient demands for treatment for Restless Leg Syndrome or whatever other made-up disease far outweighs the benefits from airing said commercials.

Well, originally you said that no doctor could ever learn about anything that they didn't already aggressively seek out due to their diligent efforts to stay in compliance with the continuing education requirements.

Now you're recognizing that it happens but the costs outweigh the benefits.

Could you update your original post and be a bit clearer about your actual claim in the future? I wouldn't want people to be misled.

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

#153

Post by mikeyouse » Fri, Sep 16, 2016, 10:43 PM UTC

SilasX wrote: post #152

mikeyouse wrote: post #150

Earlier quoted context omitted.

I'm seriously claiming that no patient committed to modifying their treatment plan has ever started that process due to a TV commercial and that the societal loss from doctors acquiescing to patient demands for treatment for Restless Leg Syndrome or whatever other made-up disease far outweighs the benefits from airing said commercials. Any patient engaged enough and knowledgeable enough to participate in improving th…

>I'm seriously claiming that no patient committed to modifying their treatment plan has ever started that process due to a TV commercial and that the societal loss from doctors acquiescing to patient demands for treatment for Restless Leg Syndrome or whatever other made-up disease far outweighs the benefits from airing said commercials. Well, originally you said that no doctor could ever learn about anything that the…

> Well, originally you said that no doctor could ever learn about anything that they didn't already aggressively seek out due to their diligent efforts to stay in compliance with the continuing education requirements.

Hmm.. maybe you misread the original comment?

I specifically said no patient will learn something from a TV commercial that their doctor/nurse/pharmacist aren't aware of. It wasn't a comment on the infallibility of medical education but the uselessness of pharma advertising.

Of course knowledgeable patients can improve their own care by aggressively researching whatever condition they might have.

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

#154

Post by vonmoltke » Fri, Sep 16, 2016, 10:46 PM UTC

shanacarp wrote: post #148

vonmoltke wrote: post #102

Earlier quoted context omitted.

They were, if I understand the background correctly, trying to make a workalike competitor, which King/Mylan asserts they cannot do without violating a patent on the current EpiPen injector. The only thing stopping them from making a non-workalike is getting doctors to prescribe it instead of EpiPen, since pharmacies can't autosubstitute in that case.

Why does workalike matter?

The various auto injectors work slightly differently. Rightly or wrongly the FDA expects doctors to instruct their patients in the specific auto injector they prescribe. This prevents pharmacies from subbing out other brands unless they are functionally identical.

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

#155

Post by sleight42 » Fri, Sep 16, 2016, 10:58 PM UTC

As a pharmacy company, wanting to charge a higher price for my products, doesn't it sound like an excellent strategy to outrage my customers, get them actively protesting, only to present a solution that many of those outraged customers will support while continuing to allow me to charge my higher price?

This feels like a House of Cards-like strategy: take up an unpopular selfish position only to later use its most vociferous opponents as leverage in maintaining that strategy.

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

#156

Post by mindslight » Fri, Sep 16, 2016, 11:05 PM UTC

harryh wrote: post #127

mindslight wrote: post #103

Earlier quoted context omitted.

Those hospitals' standard rates should be paid by direct reimbursement from the government at their set rate. In the event they're out of line with the expected market (no idea what that distribution looks like, but obviously there would be one), then the hospital would be investigated for price gouging all their customers (as customers of this industry are less able to shop around). The problem we have here is the e…

I wonder if it might be possible to start some kind of group buying organization to negotiate insurance like rates without the actual insurance. I would seriously consider going without insurance except for the highest cost goods & services (say over 100k) except for the fact that it will cost me more to go to the doctor for a check then my insurance company currently pays. The group discount without the risk sharing…

This would be pretty great, but so would real healthcare reform where businesses were simply required to publicly post uniform prices.

I think a fundamental problem of trying to privately implement this idea is that medical businesses have an extreme amount of overhead simply to deal with insurance companies, but they don't precisely ascribe it to insurance as payment. From a doctors' office's perspective, the "actual cost" of providing you cash service still includes paying all their back office rather than just actual services rendered.

Coming from the other direction, you have high-deductible plans that effectively do this in many more words. Plus that whole tax subsidy that fueled the growth of this institutional cancer in the first place.

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

#157

Post by FireBeyond » Fri, Sep 16, 2016, 11:09 PM UTC

GordonS wrote: post #106

FireBeyond wrote: post #90

Earlier quoted context omitted.

Ask yourself, why is the United States the only country in the world where advertising prescription medicine to consumers is allowed? Why is it even needed? I know some people say "education", but that's backward. You have a problem. You go to your physician. He works out a treatment plan for you. For drugs advertised for specific conditions? To enlighten you to alternatives? You can oftentimes assume that alternativ…

> why is the United States the only country in the world where advertising prescription medicine to consumers is allowed? I believe it's also allowed in New Zealand. But I totally agree with you, it's a ridiculous practise

I knew it had been and appears to still be, but I believe it's been already decided to end, if not already.

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

#158

Post by kasey_junk » Fri, Sep 16, 2016, 11:54 PM UTC

harryh wrote: post #151

gizmo wrote: post #141

Earlier quoted context omitted.

Freedom of speech is for humans, not for corporations. Otherwise you also have to accept the bizarre citizens united decision that permits companies to spend an unlimited amount of money to campaign on behalf of political candidates. Extending personhood rights to corporations is a really bad idea.

Corporations are people, my friend.[1] Which is to say, they are made up of people. My right to free speech is not diminished by the fact that I choose to work with other people for a common goal. 1. https://www.youtube.com/watch?v=KlPQkd_AA6c My second favorite republican quote that was mistakenly maligned by the left. In first place is, of course, Rumsfeld's rumination on the nature of unknown unknowns.

The known unknowns speech ought to be engraved on every engineering school in America

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

#159

Post by kasey_junk » Fri, Sep 16, 2016, 11:59 PM UTC

harryh wrote: post #127

mindslight wrote: post #103

Earlier quoted context omitted.

Those hospitals' standard rates should be paid by direct reimbursement from the government at their set rate. In the event they're out of line with the expected market (no idea what that distribution looks like, but obviously there would be one), then the hospital would be investigated for price gouging all their customers (as customers of this industry are less able to shop around). The problem we have here is the e…

I wonder if it might be possible to start some kind of group buying organization to negotiate insurance like rates without the actual insurance. I would seriously consider going without insurance except for the highest cost goods & services (say over 100k) except for the fact that it will cost me more to go to the doctor for a check then my insurance company currently pays. The group discount without the risk sharing…

Isn't the risk sharing a component in the discount? That is, aren't the providers more likely to collect from people participating in a risk sharing arrangement?

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

#160

Post by riahi » Sat, Sep 17, 2016, 3:47 AM UTC

phkahler wrote: post #118

gizmodo59 wrote: post #56

Earlier quoted context omitted.

Adding to this, if you have insurance most of the hospitals will jack up the prices. One of my friend did not have the insurance card, so the hospital billed X$ and told him that if he later gives the insurance id they will charge them. He later called the hospital and gave the insurance details and he is charged (X+Y)$. Being the first time he got sick this year, he had to pay his entire deductible meaning he paid m…

IMHO providers should be required to charge the same price to all patients. That's not to say hospital X should pay the same as hospital Y, just that X needs to charge the same to all it's patients for a given service/procedure and Y needs to charge their own price for the same to all their patients. If you have insurance, then they need to be charged the same too. This would go a long way to promoting competition an…

We are legally required to charge the same price to all patients. Specifically, we cannot charge less than we charge Medicare/Medicaid. Insurance companies are charged the same amount too; except, they negotiate a set reimbursement for a given service. Medicare/Medicaid does the same. Individuals are totally able to call up the financial services department of $LocalHospital and negotiate.

In fact, if we accept insurance/Medicare/Medicaid and OFFER a cash discount to an uninsured patient, we are one whistleblower away from a Medicare Fraud investigation.