Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Illinois governor signs law capping insulin costs at $100 per month

nbc15.com

Post reply on HN
Print view View original

181–190 of 422 posts

Re: Illinois governor signs law capping insulin costs at $100 per month

#181

Post by monadic2 »

refurb wrote: post #169
Ididntdothis wrote: post #148

Earlier quoted context omitted.

But medical advertising doesn’t inform the patient. Often it misleads. It has no value. Having medical information in public would be good so people can learn themselves but advertising provides no value.

FDA has done research into it and it clearly provides some value. Other highlights of the surveys include: Most physicians agreed that because their patient saw a DTC ad, he or she asked thoughtful questions during the visit. About the same percentage of physicians thought the ad made their patients more aware of possible treatments. Many physicians thought that DTC ads made their patients more involved in their heal…

I would imagine you’d need to draw a correlation between advertisements and quality of care and successful treatment rate; awareness and involvement aren’t positive or negative per se.

Secondly, I see too many damn branded pens in my doctor’s office to be under the illusion that the marketing is only directed at the patients. I can’t count the number of times I’ve been prescribed medication just to have it swapped out at the pharmacy for a generic variety. Doctors are just as susceptible to advertising than the rest of us, except exclusively at harm to the patient.

The demonstrated “value” being provided seems to be mostly in the form of cash in the pockets of providers and pharmaceuticals, not in material benefit to the patients.

Re: Illinois governor signs law capping insulin costs at $100 per month

#182

Post by UnFleshedOne »

ikeboy wrote: post #104
mumblemumble wrote: post #99

Earlier quoted context omitted.

Given that closer research is finding that a lot of popular drugs and treatments actually do more harm than good, I don't think it's so easy to characterize the current testing regulations as onerous. The current regime in the USA didn't happen for nothing. It's well-known now that pharma companies had long been exploiting the file drawer effect and p-hacking to inflate the apparent safety and efficacy of their drugs…

https://www.fdareview.org/issues/theory-evidence-and-example... This provides what to me is compelling evidence that the efficacy requirement by the FDA is wasteful.

> Thus, he concluded, “(the) penalties imposed by the marketplace on sellers of ineffective drugs prior to 1962 seem to have been enough of a deterrent to have left little room for improvement by a regulatory agency”

Amount of homeotherapy currently on the shelves bring "penalties imposed by the marketplace on sellers of ineffective drugs" into a sharp contrast... People will take pure water if you tell them it works.

EDIT: But I suppose a complex measure of: removing efficacy requirements AND banning advertising to both consumers and doctors AND mandating pre-regisration of trials might lead to more drugs on the market with companies using efficacy trials to compete with each other and doctors selecting best drugs based on cost/benefit/harm analysis.

I'm sure there are loopholes that would be promptly exploited in this scheme given enough incentive though.

Re: Illinois governor signs law capping insulin costs at $100 per month

#184

Post by vertex-four »

zentiggr wrote: post #86
cjfd wrote: post #39

It may very well be quite true that the price of insulin is too high but price controls really are not that great. If the price now is to high, $100 probably still is too high. Also, in the more general case (not for insulin, obviously) pharma does need to recover its research costs and who is going to say what is a good price and what not. You know, capitalism actually kind of works and price controls just don't. Th…

You're way overthinking this. What needs to happen is, again and again with health care issues, transparency. Manufacturers should be required to declare and with audits prove how much they're spending to manufacture everything. Then everyone can see the price they're being charged and figure in their head what sort of markup they are being charged. Then we can start to push back on the companies need to recoup prima…

Exactly what does the accountability process look like? Angry newspaper articles? We've got plenty of those. Boycotting their products? You realise we're talking about insulin, right?

Re: Illinois governor signs law capping insulin costs at $100 per month

#185

Post by vasilipupkin »

save_ferris wrote: post #139
mdasen wrote: post #74

Earlier quoted context omitted.

Let's say that you write a bill "you can't sell insulin for over $100". If insulin sellers refuse to sell for less than $100, there's no insulin available. However, the bill might also say that insurance companies must keep the out-of-pocket costs under $100 or that the state will make up any amount over $100. In reality, it seems unlikely to harm insulin availability since most jurisdictions have cheap insulin and t…

> Theoretically, price caps can be set low enough that no one will produce and sell an item. But studies show that the US currently pays as much as 7x what the UK does for insulin[0]. How can insulin be so cheap in some places but so expensive in others to the point that manufacturers stop making it? 0: https://insulinnation.com/treatment/u-s-pays-much-uk-insulin...

because UK subsidizes it. But UK residents pay 33% of GDP in taxes vs US pays only 27%, according to this https://www.oecd.org/tax/tax-policy/global-revenue-statistic...

so it comes out of the higher taxes.

Re: Illinois governor signs law capping insulin costs at $100 per month

#186

Post by balfirevic »

throwlaplace wrote: post #88
stochastician wrote: post #37

Earlier quoted context omitted.

Comments like this always make me sad. Not just because I disagree with them (I do!) or that I think they are claiming certainty about facts in dispute (I think they are ! [1, 2] ) but because they make no mention of trade-offs. We can vehemently disagree about these things, get our information from different sources, and advocate for different policies, but hopefully we can all agree that there _would_ be tradeoffs?…

whenever anyone casts doubt on the idea that healthcare (or pharma) could be cheaper (and implicitly that the tradeoffs would be worth it) my simple response is: then please tell me how does every other western nation accomplish it? overall healthcare goals are met and for less money (in aggregate and individually) all around the world. in which way is america exceptional except insofar as exactly that here business…

> in which way is america exceptional except insofar as exactly that here business tries to extract as much as value as physically possible

Apparently, it's exceptionality comes from high levels of obesity, homicide, car accidents and drug abuse, of which only the last one has any link to businessy nature of healthcare.

https://randomcriticalanalysis.com/2019/11/07/a-tale-of-two-...

Re: Illinois governor signs law capping insulin costs at $100 per month

#187

Post by jahaja »

tptacek wrote: post #136
jahaja wrote: post #111

Earlier quoted context omitted.

So your solution to drug companies jacking up the prices as much as they can is to reward them by removing regulations?

No, his solution is to dial competition back up by reducing regulatory barriers to new entrants, competition being the thing that tends to actually produce durable price decreases in markets, and is, for instance, the reason virtually everyone in the country has a phone in their pocket that only rich people had just 12 years ago. You can't coherently and simultaneously believe that markets are inefficiently pricing i…

This is the classical "tricke down economy" type of solution. Give companies, who are additionally acting unethically, a guaranteed and direct profit increase and _hope_ that it solves itself in the long-term.

Surely it depends on the barriers and how much of a cut those actually are in practice.

Furthermore, private corps aren't the only way drugs can be invented.

Re: Illinois governor signs law capping insulin costs at $100 per month

#188

Post by ars »

throwaway_tech wrote: post #149
ivolimmen wrote: post #106

Earlier quoted context omitted.

That's why we (the Dutch) have pharmacies that take the prescription of the doctor and then determine, based on your current medicine and medical history, alter your new prescription to fit your need (and he will confer with the GP if needed)

In the US, we have something similar (but evil) that people don't know or refuse to acknowledge. A Doctor writes a script, and then a pharmacist (not on their own, but at the direction of an insurance company) suggests a change typically to benefit the insurer (for example changing a name brand to a generic or changing 30 days to 90 days so the patient doesn't get seen by the doctor again for 90 days for additional t…

That's not something similar, and has nothing whatsoever to do with what you replied to.

And there's nothing wrong with switching from brand name to generic, and most patients don't need to see their doctor every 30 days, and if they do, they can still make an appointment.

The length of the drug prescription does not control the appointment - and anyway you can just call and they'll extend the prescription on the phone.

Re: Illinois governor signs law capping insulin costs at $100 per month

#189

Post by alamortsubite »

rayiner wrote: post #54
Someone1234 wrote: post #8

I'm really past the whole "pharma need to charge high prices to fund research" line of argument. Aside from being factually untrue (research funding is dwarfed by marketing for example[0]), it is also arguing for a continued unhealthy relationship with pharmaceutical care. A large amount of research is currently publicly funded. Either via public academic research or directly. When that research bears fruit it is oft…

Ironically, insulin is a great example of why your premise is false: Insulin replacement was developed a century ago, being first discovered by a government entity (U of Toronto). Private companies commercialized the treatments in the 1940s and 1950s, developing long acting forms that could be administered in a single injection per day. Since then, pharmaceutical companies have made continuous improvements with fewer…

> Drug development is high tech work. If the government could do it well, while squeezing out the profit margins, there would be no reason for the government not to run Google or Netflix.

I agree we don't need a state-run version of Google or Netflix, but how does their being "high-tech" in any way preclude that? NASA seems like a great counter-example.

Re: Illinois governor signs law capping insulin costs at $100 per month

#190

Post by [deleted] »

rayiner wrote: post #54
Someone1234 wrote: post #8

I'm really past the whole "pharma need to charge high prices to fund research" line of argument. Aside from being factually untrue (research funding is dwarfed by marketing for example[0]), it is also arguing for a continued unhealthy relationship with pharmaceutical care. A large amount of research is currently publicly funded. Either via public academic research or directly. When that research bears fruit it is oft…

Ironically, insulin is a great example of why your premise is false: Insulin replacement was developed a century ago, being first discovered by a government entity (U of Toronto). Private companies commercialized the treatments in the 1940s and 1950s, developing long acting forms that could be administered in a single injection per day. Since then, pharmaceutical companies have made continuous improvements with fewer…

[deleted]
Post reply on HN