Biohackers take aim at big pharma’s stranglehold on insulin • Hacker News Board

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

#241

Post by tomaszs » Mon, Jun 28, 2021, 9:33 PM UTC

nknealk wrote: post #30

Some considerations on manufacturing — there’s a variety of product quality steps necessary to release batches of medicine. The FDA mandates this as part of GMP regulations. These steps help ensure things like: * How do I know that every vial has the same concentration of insulin each time? That is to say 1 unit from a vial today and 1 unit from another vial is going to have the same dosing. * How do I know the insul…

It makes sense. On the other hand pharmaceutical companies make mistakes also, just on a bigger scale. Also I imagine that when it will be easier to set up insulin small scale production, than more scientists will be able to do innovate and improve the process.

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

#242

Post by bfrink » Mon, Jun 28, 2021, 9:34 PM UTC

deeviant wrote: post #6

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.

You mean like this billionaire philanthropist? https://chanzuckerberg.com/science/programs-resources/open-s...

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

#243

Post by KaiserPro » Mon, Jun 28, 2021, 9:34 PM UTC

I simply don't understand the healthcare system in the US. Its meant to be a free market, yet insulin costs a ridiculous amount. However Opioids and synthetic opioids are cheap as chips.

To put it into context, In the UK the NHS buy Insulin at you can see the prices here: https://bnf.nice.org.uk/medicinal-forms/insulin.html They come from the same companies and are produced to the same standard. How can a bureaucratic "socialist" care system get better price, and a much better availability than a "free market" system. (thats rhetorical, I know why)

Given the number of non and under insured, I just don't understand why its not swinging elections.

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

#244

Post by ska » Mon, Jun 28, 2021, 9:38 PM UTC

RHSeeger wrote: post #237

ska wrote: post #211

Earlier quoted context omitted.

I guess my mistake was thinking 20 plus years was old enough, that would be out of patent.

My understanding it that they are out of patent, but regulations make it hard for new players to enter the market. Since the number of companies making them are so limited, even the generics cost a lot. For example, Basaglar is a "generic" of Lantus, but it's still expensive. Here’s How to Save on Basaglar, the Expensive Lantus “Generic” https://www.goodrx.com/blog/basaglar-expensive-lantus-generi... > Basaglar conta…

I understand that argument.I hadn't thought of the issue of insulin being a biologic, so true generics aren't likely, hence biosimilars. None of this justifies a 10x+ price increase on the same product over 20 years of course.

By the way that same site had an interesting article breaking down costs normalized by insulin unit

https://www.goodrx.com/blog/how-much-does-insulin-cost-compa...

By that table and some assumptions about approx 40 IU/day it looks like the cheapest you could get away with at full retail would be about $120/mo, assuming optimal usage etc. The most expensive version would be at least 5x that.

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

#245

Post by RHSeeger » Mon, Jun 28, 2021, 9:42 PM UTC

burkaman wrote: post #210

RHSeeger wrote: post #199

Earlier quoted context omitted.

They are two different, but related, things. There are people who die early because they eat extremely poorly; lots of fats and sugars. 1. If the fatty and sugary foods were too expensive for them to buy, they would not have died from those things. 2. They did not die because fatty/sugary foods weren't expensive. They died because they chose to eat fatty/sugary foods. [1] Just because X (good insulin being cheaper) w…

Ok, I guess that's the core of our disagreement. I do believe that "X prevents Y" means " causes Y". Thanks for the discussion.

To me, it's the difference between "is a requirement for" and "is the cause of".

- People drive cars.

- Cars are car jacked.

- If people did not drive cars, carjackings could not happen.

- People driving cars is a requirement for carjackings.

- People driving cars is not a cause of carjackings.

I understand that it is possible and truthful to argue that people driving cars is a cause of carjackings; it's just not my view of the meaning of those words.

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

#246

Post by shkkmo » Mon, Jun 28, 2021, 9:47 PM UTC

f6v wrote: post #230

mkoubaa wrote: post #134

Earlier quoted context omitted.

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

Yes, but what about economies or scale? And the the production is already decentralized. I guess there’s more than one plant in the US.

Those econmies of scale are simply driving up profits for an oligopoly that uses IP laws and acquisitions to extract maximum value from sick people.

We could revoke the IP and thus force these companies to compete on price... but that hasn't happened. Thus the only solution that is making any progress is circumventing the IP and developing an open process.

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

#247

Post by maxerickson » Mon, Jun 28, 2021, 9:53 PM UTC

KaiserPro wrote: post #243

I simply don't understand the healthcare system in the US. Its meant to be a free market, yet insulin costs a ridiculous amount. However Opioids and synthetic opioids are cheap as chips. To put it into context, In the UK the NHS buy Insulin at you can see the prices here: https://bnf.nice.org.uk/medicinal-forms/insulin.html They come from the same companies and are produced to the same standard. How can a bureaucrati…

Generic Insulin Lispro is currently ~$50-60 per vial in the US, without any insurance or assistance from the manufacturer (though you do have to understand the system and go to specific pharmacies to get that price).

The reason it's not a big issue in elections is because lots of people don't vote.

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

#248

Post by Natsu » Mon, Jun 28, 2021, 9:55 PM UTC

Benjamin_Dobell wrote: post #213

My 3 year old daughter was recently diagnosed Type 1. Soon after her diagnosis I discovered a heap of articles about the Open Insulin Foundation. I was even on their website 24 hours ago. However, for the life of me I can't find anything "open" about the Open Insulin Foundation. Could someone please point me in the right direction where I can read anything with more substance than a news article quoting an interview?…

I don't know about this place mentioned in the article, but there's a similar orginazation at https://cheapinsulin.org/ that you can look into.

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

#249

Post by slt2021 » Mon, Jun 28, 2021, 9:55 PM UTC

Why not allow patients to buy generic insulin from overseas (from India for example) ?

If I could just you know, ask a friend of mine to fly to India and bring a monthly supply of cheap India made generic of Humalog, that would be great, right?

and if insurance company kicks in a few bucks for me, that would drive down the cost of care for insurance company as well

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

#250

Post by maxerickson » Mon, Jun 28, 2021, 9:57 PM UTC

myelin wrote: post #40

sparrish wrote: post #8

This is bogus. Wal-mart sells insulin for $24.88 a vial without prescription currently. It's only the newer 'guchi' insulin brands that are crazy expensive. Stuff from 1996 that is compared to in this article is actually cheaper than it was in 1996 (adjusted for inflation).

Type 1 diabetic here. Managing T1D even with the "Gucci" insulins (I use Novolog and have tried Fiasp) is still a huge pain in the butt; you have to give yourself a dose of insulin a fairly precise amount of time before eating, and accurately judge how much you're going to need, which is half science and half wild guesswork. My per-meal dosage requirements vary randomly from month to month -- a dose that would be fin…

The no-direct-cost PBMs price generic Humalog at $50-$60 now.

Generic Novolog is also ~$55 at Walgreens (more at other places).