101–110 of 392 posts
I really wish this would be a higher priority for the current class of billionaire philanthropists: open source science. Medical research guided by the idea of preventing disease rather than creating expensive life-long treatments, and prioritizing the diseases that cause the most amount of suffering rather than present the best opportunity for profit. And not just medicine, but just about any industry could benefit.
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What's the actual situation there? I have read that cheap insulin for example is available at WallMart, but for some reason the price of insulin seems to be a huge issue.
The situation is that Type 2 Diabetes has raised the demand for insulin. More demand raises prices. The thing we can't talk about without risking cancellation is that nearly all Type 2 Diabetes is preventable. In other words, the choices of the many have a significant negative impact on those (i.e., Type 1'ers) who don't really have a choice.
Insulin is made in massive facilities in large batch runs. Making 5X to 10X is basically cost of materials, which haven't really increased enough to justify the price increase.
This is (mostly likely) a rent-seeking situation where a few providers who are allowed in the market are milking it for all the profit they can.
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Eli Lilly's profit margin is double digit, usually around 20%. Managed care organizations (insurance companies), which own the PBMs, have profit margins of ~5% or less.
That doesn't seem too strange when you consider that those two types of companies have different operating models. A drug company is in the business of taking relatively cheap goods and converting them to very expensive goods, in other words adding a lot of value. A insurance company/PBM is mostly in the business of skimming a percentage off transactions.
Insulin is a solved problem, in first-world countries the sale price is fixed and there's public healthcare. But in America you are supposed to take "personal responsibility" for your own health and biohack your way ouf of type 1 diabetes?! Srsly? This s a political, not a scientific problem. Call your congresscritter.
The US health care system combines everything bad about government-run health care (slow progress due to heavy regulation, layers of bureaucracy, government-enforced drug monopolies) with everything bad about free-enterprise health care (inequality, market price fixing, uneven quality, lots of quackery at the edges of regulation). We need to pick something. If we're going the free enterprise way we need competition,…
There are no free market health systems in leading economic nations (unless maybe you take a very small niche corner of the systems)
I really wish this would be a higher priority for the current class of billionaire philanthropists: open source science. Medical research guided by the idea of preventing disease rather than creating expensive life-long treatments, and prioritizing the diseases that cause the most amount of suffering rather than present the best opportunity for profit. And not just medicine, but just about any industry could benefit.
Wall Street Smart Genius types have long held that curing disease is bad business, managing symptoms over the entire lifetime allows them to extract more capital out of the cattle. So, if you're looking to cure something you're going to struggle to find funding. Don't worry though, the economy will survive.
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Would it be possible to get a limited amount of the fast acting stuff for unpredictable situations and then normally use the "cheap" stuff? I don't know how this works so I would like some info from someone who seems to know.
Not likely, also lets not forget - as a Type 1 diabetic, you also take long acting insuling (unless you are on a pump). So, for example, a pump uses only fast acting insulin - and it gives a small amount (known as "basil") every 5 minutes (+/- depending on pump). Whereas, if you use pens (or from a vial) with direct injection, you also take a long acting insulin (levemir, Lantus, etc) once or twice a day (they are su…
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Eli Lilly's profit margin is double digit, usually around 20%. Managed care organizations (insurance companies), which own the PBMs, have profit margins of ~5% or less.
That is a nonsense talking point from the industry. They use passthrough revenue to distort their profit margin. Express scripts is closer to 15% and CVS is closer to 10%. See https://www.fiercehealthcare.com/payer/facing-criticism-pbms... .
https://www.macrotrends.net/stocks/charts/CVS/cvs-health/pro...
Cigna purchased Express Scripts in Mar 2018, and has profit margins of 3% to 5% over the last couple years.
https://www.macrotrends.net/stocks/charts/CI/cigna/profit-ma...
If these PBMs are making lots of profits, then they are simply subsidizing losses elsewhere in the MCO. The total costs paid for insurance premium plus out of pocket costs by the end user in the US would not be affected.
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Do you doubt it was developed in 1996? Do you have evidence that the cost of production has significantly risen? Otherwise, you seem to be repeating the old economics joke: "The young economist looks down and sees a $20 bill on the street and says, “Hey, look a twenty-dollar bill!” Without even looking, his older and wiser colleague replies, “Nonsense. If there had been a twenty-dollar lying on the street, someone wo…
When there is a claim that there exists an arbitrage opportunity worth billions of dollars, I would consider it common sense to consider why has no one claimed the arbitrage opportunity yet. The world has many very smart people spending many hours working very hard to find these opportunities, so the likelihood of it just sitting there like a $20 bill on the street, and not being picked up, seems quite small. I do no…
The insulin in question is Lyumjev from Eli Lilly.
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> Call your congresscritter. unfortunately not likely to do anything as long as the big pharma lobby remains as powerful as it is
What else is one to do?
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> Can you think of any medical treatments that were developed without the promise of 20 years of limitless profits? I can. This sounds like it's responding to a strawman. Proponents of the patent system aren't claiming that zero innovation would happen without patents, just that it would be much less. In other words: No patent system: only inventions from altruistic inventors Patent system: inventions from altruistic…
Let's say corporations were only promised a 10 year monopoly instead of 20. Do you think their business would collapse, or would they keep trying? If profit-focused inventors could still be motivated by a 10 year horizon, then that extra 10 years only benefits corporate executives and kills patients. So, is the patent system as limited as possible while still encouraging innovation? Obviously not, because pharma comp…
It would depend on the project's margins and/or sunk costs. A project that had very little invested in it or is a breakout success might we able to weather a 50% cut in exclusivity period, but a marginal product might not. Most of the already developed drugs are probably going to be fine, assuming that the financing for them was already secured.
>or would they keep trying?
For the projects at the margins? most certainly. That is not to say all private drug development would, stop. If some sort of unpatented-but-super-cheap-to-perfect-but-still-not-patented drug showed up it might still be developed, but in aggregate I'd expect drug development to drop significantly.