An anarchist takes on Big Pharma by teaching patients to make their own meds • Hacker News Board

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#231

Post by alexanderstears » Sat, Oct 14, 2017, 5:41 AM UTC

Sangermaine wrote: post #172

alexanderstears wrote: post #109

Earlier quoted context omitted.

the US has an entire political party angrily decrying any effort to regulate healthcare as socialist slavery. Argubly regulation is the problem we're in this mess. Do you think an epipen would cost $600 if there weren't a Government granted monopoly? We have two parties who love the current amount of regulations on competition - you need to go to an AMA approved medical school to become a doctor, there aren't H1Bs fo…

>Argubly regulation is the problem we're in this mess. No, that's not even arguable. Other countries with even more highly regulated healthcare manage to provide it for much, much less. You're just regurgitating mindless libertarian talking points that have no relation to the real world. The particular form of regulation in the US may be a problem, but regulation in general is demonstrably not.

Let me clarify - the US's regulations are the reason the US has expensive healthcare.

IF we regulated single payer health care into existence, we'd have cheaper care. The problem isn't regulation per se, it's our current regulations.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#232

Post by vqc » Sat, Oct 14, 2017, 5:51 AM UTC

drvdevd wrote: post #116

sigstoat wrote: post #66

Earlier quoted context omitted.

as vonmoltke suggests, even if you've got some chemical synthesis procedure laid out in a peer reviewed journal, you are, in the best case, expert man hours away from successfully duplicating it. and you'll only know you've successfully duplicated it if you can run the result through really expensive analytical equipment to confirm that 1) you made the stuff you wanted to make and 2) it doesn't have impurities that a…

Obviously this is true. There’s much that goes into industrial synthesis that someone with a setup like his at home just can’t currently reproduce, and safely. What I find most dubious about the article is the lack of attention to synthetic biology. Because QA in that sense can become say, “this modified organism can produce the drug in question under most conditions and all future populations will carry the new gene…

But only kind of. Even if you could get a strain of yeast to produce a specific antibody 100% of the time, how reliably could you get the yeast to grow? If you can get it to grow, how reliably can you extract a enough of the antibody to form just one dose? If you can extract, can you get it into a formulation that is pharmaceutically viable? Its not just about synthesis.

There's so much tooling and expertise that goes into front end, back end, deployment, db, QA, etc ,etc, etc just to get one app going. Why would would drug deployment be any different?

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#233

Post by alexanderstears » Sat, Oct 14, 2017, 6:02 AM UTC

hacking_again wrote: post #196

Banthum wrote: post #192

Earlier quoted context omitted.

You seem very strongly invested in this point, which is strange considering how easily refuted it is: Property existed long before third-party regulation. Rather than ownership being enforced by a third party with monopoly on violence, it was enforced by the threat of escalating violence from the property owners themselves. Eg. You take one goat from my herd and refuse to give it back, and we are now at war. Result:…

This doesn't mean property exists in the same way that objects exist. A piece of property is just a protected object.

Go try to wrestle a caveman for his fur pelt and see if he considers it to be a protected object.

Force protects the object, sometimes the government exerts the force sometimes not.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#234

Post by PeterStuer » Sat, Oct 14, 2017, 6:19 AM UTC

dv_dt wrote: post #48

octaveguin wrote: post #40

Earlier quoted context omitted.

Enbrel? They just received another patent extension, too. This is what government granted monopolies look like.

This is what the breakdown of working competitive markets look like, and in this case it takes both government monopolies, as well as well as overwhelming short-term greed on the part of the private companies. Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort... or maybe they think they should extract profits now because of a cha…

No, this is exactly what a 'working competitive market' looks like. If you somehow still believe the simplistic fantasies of economics 101 with a clean partition between 'the market' and the meta-market game, then you urgently need to wake-up.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#235

Post by AnthonyMouse » Sat, Oct 14, 2017, 6:48 AM UTC

dv_dt wrote: post #230

AnthonyMouse wrote: post #225

Earlier quoted context omitted.

> Isn't that exactly what's happening in slower motion with the incredible price hikes in many drugs such as insulin? Again, the market for medicine suffers from regulatory capture. The regulations make it prohibitively expensive (literally millions of dollars) for new competitors to enter the market, which allows the incumbents to conspire to fix prices. If we had the same standards for manufacturing medicine as we…

Did you read the linked article? A generic maker of generic drugs in dramatically increasing prices with no sign of the entrance of competitors. Competition can enter but the barriers are too high - even without any government protection remaining on the generics in question. The competition doesn't pay the cost of duplicating production - not after the competition has lowered the price. At least the chance of that i…

> Competition can enter but the barriers are too high - even without any government protection remaining on the generics in question.

But that's the whole point -- what is causing the barriers to be so high? Regulatory capture isn't just patents. Drug companies like the fact that a would-be competitor has to pay millions of dollars in regulatory compliance costs to enter the market. Because it should cost them $1 to make drugs they sell for $1.25, but apply enough red tape and it costs them $100 to make drugs they can sell for $300. They still can't charge $10,000 because that would invite competitors, but the $99 in overhead is what allows them to charge $300 for something that should cost $1.25. The overhead raises the barrier to competition, resulting in less competition.

And the fact that most of the drugs are paid for by insurance companies or the government only exacerbates the situation, because they're deep pocketed bureaucracies under orders to pay whatever price the seller sets. No surprise the sellers take advantage of that.

> (well and lack of price regulation by our healthcare system)

The problem with price regulation is that it only solves a small part of the problem. If you're wasting $99 in overhead, you might shave off some of the profit margins but you're still spending $100 to produce something that should cost $1 and sell for <$2. You have to actually address the regulatory costs -- and if you did that then you would have competition.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#236

Post by drvdevd » Sat, Oct 14, 2017, 7:03 AM UTC

vqc wrote: post #232

drvdevd wrote: post #116

Earlier quoted context omitted.

Obviously this is true. There’s much that goes into industrial synthesis that someone with a setup like his at home just can’t currently reproduce, and safely. What I find most dubious about the article is the lack of attention to synthetic biology. Because QA in that sense can become say, “this modified organism can produce the drug in question under most conditions and all future populations will carry the new gene…

But only kind of. Even if you could get a strain of yeast to produce a specific antibody 100% of the time, how reliably could you get the yeast to grow? If you can get it to grow, how reliably can you extract a enough of the antibody to form just one dose? If you can extract, can you get it into a formulation that is pharmaceutically viable? Its not just about synthesis. There's so much tooling and expertise that goe…

Well, yes you’re correct, there are associated complexities I’ve glossed over. My point however is simply that all of these complexities only really need to be solved once by an expert or team of experts such that non-experts can then utilize such a biotechnology (“yeast strain”) to produce some medicinal compound or other useful engineered metabolite. A yeast strain that can’t be reliably cultivated by a non-expert with relative ease and safety (in a non-laboratory) wouldn’t make the cut, in theory.

Also the same semi-synthetic organism could be applied in traditional pharmaceutical process settings as well, if for no reason other than cost reduction (and probably workforce reduction as well). So even “big pharma” has some incentive to contribute to this sort of technology.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#237

Post by jaggederest » Sat, Oct 14, 2017, 7:20 AM UTC

Sangermaine wrote: post #61

dv_dt wrote: post #48

Earlier quoted context omitted.

This is what the breakdown of working competitive markets look like, and in this case it takes both government monopolies, as well as well as overwhelming short-term greed on the part of the private companies. Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort... or maybe they think they should extract profits now because of a cha…

>Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort No, because it demonstrably won't. People say they're angry and then do nothing about it. The US has an entire political party angrily decrying any effort to regulate healthcare as socialist slavery. The drug companies know they'll be just fine. Maybe some token slaps on the wris…

I suspect that at some point there will be a backlash in the form of someone or some people with nothing to lose becoming violent in the face of an effective death sentence in the form of unaffordable healthcare.

"Ultima ratio regum" is an appalling way to enforce fairness, but it doesn't seem to me that greed in general will stop short of a true class war or an external threat ala a World War.

Also to be clear I am definitely not advocating this route, I'm trying to figure out what anyone can do to prevent it and thus far I am at a loss.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#238

Post by tehlike » Sat, Oct 14, 2017, 7:22 AM UTC

Skunkleton wrote: post #136

pcnonpc wrote: post #135

Earlier quoted context omitted.

Is it not possible to order a generic from India or another country? The drug should be out of patent a long while already? If no competitor is available, why doesn't anyone set it up? It looks like a great startup opportunity.

Import laws exist to prevent this specific scenario.

travel might still be cheaper, no?

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#239

Post by Mz » Sat, Oct 14, 2017, 7:26 AM UTC

jaggederest wrote: post #237

Sangermaine wrote: post #61

Earlier quoted context omitted.

>Long term don't these companies think that charging outrageous prices for drugs will cause a future voter/government backlash of some sort No, because it demonstrably won't. People say they're angry and then do nothing about it. The US has an entire political party angrily decrying any effort to regulate healthcare as socialist slavery. The drug companies know they'll be just fine. Maybe some token slaps on the wris…

I suspect that at some point there will be a backlash in the form of someone or some people with nothing to lose becoming violent in the face of an effective death sentence in the form of unaffordable healthcare. "Ultima ratio regum" is an appalling way to enforce fairness, but it doesn't seem to me that greed in general will stop short of a true class war or an external threat ala a World War. Also to be clear I am…

I'm trying to figure out what anyone can do to prevent it and thus far I am at a loss.

You quietly find another path and make these insanely expensive drugs vastly less relevant. The real challenge is effectively spreading the word. Something truly disruptive in this area seems to be about the most offensive thing a human being can do.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#240

Post by hacking_again » Sat, Oct 14, 2017, 7:30 AM UTC

alexanderstears wrote: post #233

hacking_again wrote: post #196

Earlier quoted context omitted.

This doesn't mean property exists in the same way that objects exist. A piece of property is just a protected object.

Go try to wrestle a caveman for his fur pelt and see if he considers it to be a protected object. Force protects the object, sometimes the government exerts the force sometimes not.

Eh, I don't disagree, I was just trying to distinguish between property existing and objects existing. But maybe force defines existence all the way down.