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Biohackers take aim at big pharma’s stranglehold on insulin

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Re: Biohackers take aim at big pharma’s stranglehold on insulin

#131

Post by kaesar14 »

oceanplexian wrote: post #129
a3n wrote: post #79

Earlier quoted context omitted.

> Call your congresscritter. Sorry, but regular people don't make "campaign contributions" of any noticable size, so all we get back is a form letter acknowledgement based on whatever box you checked for subject. Big Pharma, Big X and Big Y, on the other hand, "donate" enough "campaign contributions" that the campaigner can all but ensure (re) election based on recent name recognition to get the nomination, then coun…

Respectfully disagree. I live in a smaller US state and I’ve emailed my representatives and received a personal reply from both of them. One actually engaged and we politely discussed a public policy issue back and forth in an email thread. More often than not you can walk right into their office and meet them if you’d like.

And did meeting them shift their position on an issue where the opposition is a massively powerful and wealthy industry that spends millions on lobbying efforts?

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#132

Post by pimeys »

arwineap wrote: post #93
RHSeeger wrote: post #71

Earlier quoted context omitted.

> It’s fast acting, and varies in how it reacts in the body. I believe they offer R (short acting / 2-5h), N (medium), and L (long acting / 24h). The problem with the older insulins isn't so much that they're faster, it's that they're less "specific" (from my experience). A newer short acting insulin (Apidpra, etc) has a spike in the 15-30 minute range and the spike is steep and the tail (while up to 5 hours) is low.…

That's context I've never gotten before. Obviously there's a nice convenience benefit built into this product that a company has created, they should get to charge some markup for that. I wonder how different the production costs are though, my understanding is the costs to consumer are greater than 10x

The difference with the old insulin vs. the analogs is that with the old ones it's really easy to lose a toe, leg, kidney or get blind. With the new analogs it's possible to control your glucose levels so that you can stay healthy and get old.

Source: a T1 diabetic, used all possible insulins in my life. Very happy in Europe.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#133

Post by burkaman »

gruez wrote: post #110
burkaman wrote: post #95

Earlier quoted context omitted.

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…

>Do you think their business would collapse, 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?…

I am arguing that there are no marginal projects at current profit levels, and that's why they can spend billions on stock buybacks. There is a point that lessening patent protections would cause companies to cut back, but we are not at that point.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#134

Post by mkoubaa »

f6v wrote: post #17

As someone who had to create transgenic E.coli in a lab, I admire the effort. It’s hard to get it right, especially when trying to make bacteria produce stuff for you. However, it feels like a huge step backward. Imagine you couldn’t afford to buy a piece of bread. Instead, you need to grow your own grains and build a windmill first. Sounds ridiculous in 2021.

I agree with the sentiment but decentralizing and downscaling production is a win for resiliency. This is a good example but others include recycling and power generation have clearer benefits

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#135

Post by pimeys »

HideousKojima wrote: post #115
RHSeeger wrote: post #71

Earlier quoted context omitted.

> It’s fast acting, and varies in how it reacts in the body. I believe they offer R (short acting / 2-5h), N (medium), and L (long acting / 24h). The problem with the older insulins isn't so much that they're faster, it's that they're less "specific" (from my experience). A newer short acting insulin (Apidpra, etc) has a spike in the 15-30 minute range and the spike is steep and the tail (while up to 5 hours) is low.…

If that's actually the case that puts all the "You're literally killing us with expensive insulin prices" people in a very negative light. At best they're ill-informed, at worst they're being intentionally deceptive to achieve political aims.

I have to ask, are you suffering from a Type 1 diabetes? If not, at least for me, this answer kind of misses the point completely. Type 1 is a hell to manage. It is REALLY hard.

Like I actually use an open source pancreas to control my glucose levels so now I can sleep every night without having to worry about dying. This is in Europe where the insurance covers everything and prices are cheaper than in US.

Using the Walmart insulin makes everything much much more complex, and even for the smartest of us, even with the best possible insulins, managing T1 is a HUGE pain and can kill you quite fast.

I hope I misread your comment...

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#136

Post by icelancer »

HideousKojima wrote: post #115
RHSeeger wrote: post #71

Earlier quoted context omitted.

> It’s fast acting, and varies in how it reacts in the body. I believe they offer R (short acting / 2-5h), N (medium), and L (long acting / 24h). The problem with the older insulins isn't so much that they're faster, it's that they're less "specific" (from my experience). A newer short acting insulin (Apidpra, etc) has a spike in the 15-30 minute range and the spike is steep and the tail (while up to 5 hours) is low.…

If that's actually the case that puts all the "You're literally killing us with expensive insulin prices" people in a very negative light. At best they're ill-informed, at worst they're being intentionally deceptive to achieve political aims.

It's the same with basically every other campaign that wants to grab headlines. It literally makes no sense that insulin prices are killing people and it's unavailable, and a basic amount of research shows that yeah indeed, it's clickbait intended to hook you into a more complex discussion.

I pay zero attention to people and news sources that repeat that behavior more than once. Lead with the truth.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#137

Post by HarryHirsch »

RHSeeger wrote: post #125
HideousKojima wrote: post #115

Earlier quoted context omitted.

If that's actually the case that puts all the "You're literally killing us with expensive insulin prices" people in a very negative light. At best they're ill-informed, at worst they're being intentionally deceptive to achieve political aims.

What you've said is true. Refusing to use the older insulins is what is killing people. Having to use the older insulins is shitty, and it shouldn't be happening, but it's not the thing that's killing people. However, actually _saying_ that tends to get people up in arms, harassing you about how it how it shouldn't be necessary for people to use the older insulins, and how the newer insulins shouldn't cost what they…

Having to use the older insulins is shitty, and it shouldn't be happening, but it's not the thing that's killing people.

In a way it is killing people, blood sugar control is much easier with a mix of the newer insulins, and patience compliance is much higher. This directly translates into better quality of life and lower disease burden from diabetes complications.

No one can argue that pharmcos shouldn't be paid for R & D that increases quality of life, in civilized countries the taxpayer should and will pay for your medication if it's an improvement over what's already at market.

But here people seem to be arguing that if you can't afford anything else there's still Walmart short-acting Humalog, and you get to bear all the risk, and that's just fine.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#138

Post by ravitation »

HPsquared wrote: post #119
mgarfias wrote: post #53

Earlier quoted context omitted.

There’s different kinds. IIRC the cheap stuff and Walmart is just that, cheap. It’s fast acting, and varies in how it reacts in the body. Our real issue here is that there is absolutely no incentives to control costs. You’d think our ins companies would do it, but I’m practice, they end up negotiating sweet deals with the drug manufacturers. say med X @ $1000/mo msrp, but the ins companies negotiate it down to $400/m…

I guess the question is, do countries with socialized healthcare provide the cheap version or the expensive one?

Not actually the question since countries with modern healthcare systems provide all types of insulin at an average cost per unit that is roughly 1/10th to 1/20th the cost in the United States (cheap vs. expensive is an over simplification).

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#139

Post by lotsofpulp »

nceqs3 wrote: post #117
lotsofpulp wrote: post #107

Earlier quoted context omitted.

CVS net profit margin is in the 2% to 3% range: 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 insuran…

You are not addressing my main point which is that these MCO's distort their "net margin" stat using accounting tricks. And yes PBM's are INCREDIBLY profitable. Express scripts made 4.5 billion in net income in 2017. They have never produced a drug that has saved a life. PBMs are important but they should not be able to put a gun to these pharma companies heads because they control the formulary. CVS net margin inclu…

I am not addressing it, because I do not see any further evidence of distortion of an MCO's net profit margin other than what this article claims. Nor would it matter to me unless some MCO executives are smuggling cash out of the country or something.

As a customer, it does not affect me.

In the healthcare business, the flow of money is:

Individual -> MCO (insurance company) -> healthcare providers and drug manufacturers

What does it matter to the individual what portion of an MCO is earning what profit if the net profit margin of the whole MCO is 5% or less? They are obviously not left with a lot of money, their employees are not known to be lavishly compensated.

Re: Biohackers take aim at big pharma’s stranglehold on insulin

#140

Post by sneak »

api wrote: post #46
HarryHirsch wrote: post #9

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,…

You're absolutely right that either would be better than the current situation.

The issue, though, is not that it's half-assed and fucked up. It's working by design, to use legislative schemes to funnel money to incumbents and friends/donors, while still supporting the "free market" ideology, when really it's just regulatory capture.

The system is designed for graft, and it's working as intended. Those with the power to "fix" it won't, because to them it's not broken at all.

The US has the same problem in telecommunications, war/defense, and medicine. The largest vendors become integrated with the budget- and policy-makers, and the whole system exists to extract maximum value from the consumer class.

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