As opioid overdoses exact a higher price, communities ponder who should be saved • Hacker News Board

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#21

Post by extra88 » Sun, Jul 16, 2017, 3:36 PM UTC

tcj_phx wrote: post #9

Clubber wrote: post #3

Earlier quoted context omitted.

I don't know how long this country can survive with this rampant corruption and profiteering. When do we hit a breaking point, and what does that look like? I mean I read your response and think, "wow, that's horrible." Then realize absolutely nothing is going to be done about it.

100 years ago, politicians were tricked into trusting organized crime to tend to the health of people who are drawn to opiates. Those politicians are dead & gone, but we're still stuck with their mistake. My mother broke her wrist 6 months ago, and was given opiates to deal with the pain of having a plate put in her wrist. She did not become an opiate addict. I presume she managed to avoid becoming a junky because sh…

By "organized crime," I assume you mean something other what's traditionally thought of as organized crime, e.g. the Mafia, but I can't tell what.

> I presume she managed to avoid becoming a junky because she has a pretty stable day-to-day life.

While circumstance and upbringing are factors for addition, I think it's accepted that there is also a biological component; your mom may be inherently less prone to becoming addicted to opiates.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#22

Post by tcj_phx » Sun, Jul 16, 2017, 3:40 PM UTC

dwelch wrote: post #7

tcj_phx wrote: post #2

(this article can be read by searching for the title on http://twitter.com/ , then opening the link in a private window) > Two doses of an injectable form of naloxone, Evzio, cost $4,500, up from $690 in 2014. The price of other forms of the drug, including the nasally administered Narcan, typically range from $70 to $150 per dose, officials say. The cost of naloxone [1] is an insignificant part of the cost of revivi…

Furthermore, I'd imagine the cost of the naloxone alone is a small percentage of the total cost of the emergency responders + acute care given in life-threatening overdose. The article doesn't discuss a recurring theme in medicine: acute care is really, really expensive. It'd be far more cost-effective to reduce the need for acute care by providing access to addiction treatment before things get to this point. Easier…

> It'd be far more cost-effective to reduce the need for acute care by providing access to addiction treatment before things get to this point. Easier said than done I suppose.

Johann Hari has pointed out that it's very effective to just give heroin addicts pure heroin and a safe place to inject it. Switzerland has 'essentially' [edit] eliminated opiate deaths with this strategy:

[edit: added 'essentially' in response to tptacek's comment below because the swiss probably haven't gotten rid of 100% of their opiate deaths]

https://www.irishtimes.com/news/health/johann-hari-heroin-in...

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#23

Post by extra88 » Sun, Jul 16, 2017, 3:40 PM UTC

TomMarius wrote: post #13

robk wrote: post #6

Why is the price increasing as volume has gone up? Is it FDA-type regulation that's preventing new market entrants or patents? Or something else artificially preventing new market entry like legal risk?

Not sure why you differentiate, patents are regulations too.

Patents are intellectual property rights established by law. Congress passes laws giving the executive branch the right and responsibility to create regulations but much of the content of those regulations are not dictated by law.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#24

Post by ivanbakel » Sun, Jul 16, 2017, 3:41 PM UTC

maxerickson wrote: post #17

ivanbakel wrote: post #4

How can it be acceptable that you would declare people too expensive to save, rather than challenge the prices of a profit-making company that is bringing those costs in the first place? Shouldn't you be able to detect the sheer amount of corporate worship in such a statement before it leaves your mouth? It breaks my heart to keep reading about this epidemic, with such a consistent reaction of hatred from so many peo…

Resources are finite. For a less dire example, when people stop making progress in physical therapy, insurance stops paying for it. Not because there is no chance they will benefit from further therapy, but to control costs.

>Resources are finite.

But the important point is what exactly is making this drug scarce for local authorities. Opiod addicts are not rapidly consuming all the reserves of the drug on earth; companies have just set high prices and left the people to take the burden.

Accepthing that this resource is scarce for governments means inherently agreeing with the price set by the pharmaceutical company - and I don't think that's what we should do at all.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#25

Post by traviscj » Sun, Jul 16, 2017, 3:41 PM UTC

Alex3917 wrote: post #18

ivanbakel wrote: post #4

How can it be acceptable that you would declare people too expensive to save, rather than challenge the prices of a profit-making company that is bringing those costs in the first place? Shouldn't you be able to detect the sheer amount of corporate worship in such a statement before it leaves your mouth? It breaks my heart to keep reading about this epidemic, with such a consistent reaction of hatred from so many peo…

Naloxone is already generic and basically free, government officials just like buying the branded version so they can get kickbacks while complaining about the cost.

Ugh. That is sickening. Since it seems like you have some expertise in the area, is this antipattern actually codified In regulations, or more of a de-facto/status quo thing?

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#26

Post by norikki » Sun, Jul 16, 2017, 3:41 PM UTC

creaghpatr wrote: post #12

ivanbakel wrote: post #4

How can it be acceptable that you would declare people too expensive to save, rather than challenge the prices of a profit-making company that is bringing those costs in the first place? Shouldn't you be able to detect the sheer amount of corporate worship in such a statement before it leaves your mouth? It breaks my heart to keep reading about this epidemic, with such a consistent reaction of hatred from so many peo…

This is what happens in the UK right now. The government decides when the life support machine gets turned off- they pay for it so it's their choice. Not a common or planned outcome, but an unfortunate byproduct of nationalized healthcare. http://www.bbc.com/news/uk-england-40423371

>Not a planned outcome.

Sure, but the people responsible clearly don't care, as evidenced by the tone of the article.

Drug addiction is the result of the weak border [1], and a depressing job market [2], which is also the result of the weak border [3].

[1] http://www.businessinsider.com/us-heroin-coming-from-mexican...

[2] http://www.gallup.com/opinion/chairman/181469/big-lie-unempl...

[3] https://www.judiciary.senate.gov/imo/media/doc/03-16-16%20Bo...

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#27

Post by DanBC » Sun, Jul 16, 2017, 3:42 PM UTC

creaghpatr wrote: post #12

ivanbakel wrote: post #4

How can it be acceptable that you would declare people too expensive to save, rather than challenge the prices of a profit-making company that is bringing those costs in the first place? Shouldn't you be able to detect the sheer amount of corporate worship in such a statement before it leaves your mouth? It breaks my heart to keep reading about this epidemic, with such a consistent reaction of hatred from so many peo…

This is what happens in the UK right now. The government decides when the life support machine gets turned off- they pay for it so it's their choice. Not a common or planned outcome, but an unfortunate byproduct of nationalized healthcare. http://www.bbc.com/news/uk-england-40423371

This is completely untrue.

"The government" has no say in life support. The government has given Charlie Gard world class medical treatment. The government has also paid for Charlie Gard to have his own legal representation - independent of his parents - to protect his legal rights.

You might want to learn more about the case because nothing in your comment is true.

Here's the GOSH statement which lays out the facts:

http://www.gosh.nhs.uk/news/latest-press-releases/latest-sta...

> 7. Charlie’s parents fundamentally believe that they alone have the right to decide what treatment Charlie has and does not have. They do not believe that Great Ormond Street should have had the right to apply to the Court for an independent, objective decision to be made. They do not believe that there is any role for a Judge or a court. They believe that only they can and should speak for Charlie and they have said many times that they feel they have been stripped of their rights as parents.

> 8. GOSH holds and is bound by different principles. A world where only parents speak and decide for children and where children have no separate identity or rights and no court to hear and protect them is far from the world in which GOSH treats its child patients.

> 9. Throughout this court process, Charlie has been represented by his Cafcass Guardian who has visited him in hospital, spoken to Charlie’s parents, nurses and doctors and written reports that ensure that as much as is possible for a desperately unwell baby, Charlies own viewpoint is articulated and given weight. When asked what happens to the role of the Guardian if their belief that only they have the right to decide on Charlie’s treatment is correct, Charlie’s parents answer that he does not need a Guardian because they will speak for him.

> 10. GOSH believes in its core that every patient is his or her own, unique and special person and that it owes a duty of care to each. The hospital’s mission statement is “The child first and always” and the hospital does not treat any child differently or as less of an individual because of the severity of illness or disability or because of infancy. If anything, special care is given to discover and work out with parents what is best for very vulnerable patients who cannot speak for themselves

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#28

Post by maxerickson » Sun, Jul 16, 2017, 3:45 PM UTC

Alex3917 wrote: post #18

ivanbakel wrote: post #4

How can it be acceptable that you would declare people too expensive to save, rather than challenge the prices of a profit-making company that is bringing those costs in the first place? Shouldn't you be able to detect the sheer amount of corporate worship in such a statement before it leaves your mouth? It breaks my heart to keep reading about this epidemic, with such a consistent reaction of hatred from so many peo…

Naloxone is already generic and basically free, government officials just like buying the branded version so they can get kickbacks while complaining about the cost.

GoodRX shows the cash price for generic Naloxone for the general public shopping at retail pharmacies as ~$20 a dose ($13 at one pharmacy).

So yes, it is quite inexpensive.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#29

Post by Melanie343 » Sun, Jul 16, 2017, 3:45 PM UTC

joshlemer wrote: post #8

Clubber wrote: post #3

Earlier quoted context omitted.

I don't know how long this country can survive with this rampant corruption and profiteering. When do we hit a breaking point, and what does that look like? I mean I read your response and think, "wow, that's horrible." Then realize absolutely nothing is going to be done about it.

I guess one way it could play out is that as the corruption becomes more and more obvious, together with increasing differences in political ideology between red and blue states, an appetite for seceding from the United States could develop in some states, and if that sentiment becomes common enough, it could become a reality?

I get paid over $95 per hour working from home with 2 kids at home. I never thought I'd be able to do it but my best friend earns over 10k a month doing this and she convinced me to try. The potential with this is endless. Heres what I've been doing, •••••••••>>http://www.joinmate2.com

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#30

Post by matthewaveryusa » Sun, Jul 16, 2017, 3:46 PM UTC

nimish wrote: post #11

tcj_phx wrote: post #2

(this article can be read by searching for the title on http://twitter.com/ , then opening the link in a private window) > Two doses of an injectable form of naloxone, Evzio, cost $4,500, up from $690 in 2014. The price of other forms of the drug, including the nasally administered Narcan, typically range from $70 to $150 per dose, officials say. The cost of naloxone [1] is an insignificant part of the cost of revivi…

If you totally discount the good manufacturing practices and traceability that pharmaceuticals have to follow, sure you can hack together a cheap substitute that might not work when the chips are down Except for biologics, many drugs are not that expensive to manufacture. The cost is in proving they will do what they say they do on the package.

Do you really believe that it costs upwards of 4000 dollars to track a little box with medication in it? For that money I hope each box comes with a solar rechargeable smartphone that sends a gps beacon every half hour.