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

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

#111

Post by jahaja »

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…

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

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

#112

Post by aaomidi »

This sounds great but I would've liked to see them:

- Protect people without insurance. Usually they're the most vulnerable.

- Don't just force someone to pay for the Insulin. These companies making them don't need to become richer. Take it from them forcefully.

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

#113

Post by EpicEng »

jerf wrote: post #14
save_ferris wrote: post #5

Earlier quoted context omitted.

How will people lose their insulin over this?

If you can only charge $100, but it costs $110, what happens isn't that it gets sold at $100 anyhow. What happens is that it doesn't get sold. Nobody has an obligation to manufacture insulin. I'm not saying the costs are $110. I don't know. I'm just explaining why this can result in lost insulin.

You're making a hypothetical argument when you don't need to. Since we're specifically talking about insulin, and not placing an arbitrary cap on any drug, there's no need.

We know what it costs to manufacture insulin, and it's literally a few bucks per vial [1]. You're framing this as if it represents the larger debate between fixing medical costs and the free market, but it's not that at all, and no one is going to lose their insulin.

[1]: https://www.businessinsider.com/insulin-prices-could-be-much...

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

#114

Post by fortran77 »

ptah wrote: post #42
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…

> research funding is dwarfed by marketing for example i really believe pharma advertising should be banned

When television cigarette advertising was banned (in the US) profits and stock prices went up! [1] Since all the cigarette companies were in an even playing field, they saved a lot of money by not having to advertise.

I think it may be a win-win if the U.S. prohibited television medical advertising.

[1] https://economicdynamics.org/meetpapers/2011/paper_868.pdf

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

#115

Post by petschge »

nodesocket wrote: post #84
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…

My mother has diabetes and pays quite a bit for her insulin in California. I however am not sure government enforced price caps are the way to go. Today, people neglect to factor in the law of unintended consequences, and instead stand on a pedestal of moral superiority argument. What happens if price caps do reduce research. It’s no coincidence that the US has the best pharma companies and develops some of the most…

Ah, yes. The famous American pharma companies Roche, Novartis, Bayer, GlaxoSmithKline and Sanofil come to mind...

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

#116

Post by EpicEng »

UnpossibleJim wrote: post #103
lightbyte wrote: post #29

Earlier quoted context omitted.

That's not really a relevant argument here as insulin costs <$5 to manufacture.

Which insulins? Not all insulins are equal or cost the same to produce.

https://www.businessinsider.com/insulin-prices-could-be-much...

If you can find any variant that even approaches $100, please link a source.

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

#117

Post by jldugger »

ceejayoz wrote: post #41
JumpCrisscross wrote: post #35

Earlier quoted context omitted.

> It doesn't cost anywhere near $100 to produce a month's supply Is the $100 indexed to inflation? Separately, this is a supply-side problem. Why can’t I start a business that manufactures insulin while selling it at a reduced—but profitable—margin? Those barriers to entry are a fundamental issue.

"Is the $100 indexed to inflation?" > In 2009, the list price for a 10-milliliter vial of Humalog, a fast-acting insulin made by Eli Lilly, was about $93. Today it costs closer to $275. Similarly, Novo Nordisk's fast-acting insulin Novolog cost almost $93 for a 10-milliliter vial in 2009. Today, it costs about $290. - https://www.businessinsider.com/insulin-price-increased-last... If you've got any evidence that the…

I seem to recall from an Economist podcast a few years ago (and a brief glance at wikipedia confirm) that humalog was a human biologic, instead of the more common insulin extracted from pig pancreas. The option to take animal or human insulin is likely welcome to folks with adverse reactions or maybe a religious prohibition.

As you can imagine, we don't just extract humalog from human pancreases. They instead modify plants to generate the exact molecule humans would. This is somewhat common these days, but it does take some effort and innovation to cultivate, versus the naturally occurring substances previously used.

I don't know if human insulin is any more effective (wikipedia citations suggest no but...), but the impression I got from the podcast was not really, and that the drug was considered a net loss for its developers.

What I did learn today is that in 2006, we restricted the supply of products competing with Humalog (https://en.wikipedia.org/wiki/Insulin_(medication)#Principle...):

> Since January 2006, all insulins distributed in the U.S. and some other countries are synthetic "human" insulins or their analogues.

If we truly cared about affordability, why ban additional supply? Even if not everyone can use it, forcing people who need the human insulin to compete with those who could choose seems likely to drive up prices.

tl;dr: Humalog was an alternative to an already existing treatment, and by 2009 it already was enjoying 3 years of import protections from the treatment it intended to replace.

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

#118

Post by jogjayr »

ikeboy wrote: post #57
toomuchtodo wrote: post #50

Earlier quoted context omitted.

How much is spent on marketing in comparison? Only in the US and New Zealand can you market drugs directly to the public. I sense an opportunity to destroy an unnecessary cost.

If you believe the market is choosing to waste money on ineffective marketing, sure. Do you have any particular reason to think that? Why would you expect return on capital to go up without marketing?

You only need one participant in the market to start advertising and seeing profits, and then everyone else has to follow suit. Collectively the money may still be wasted because no one's relative market position changes very much.

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

#119

Post by mc32 »

ollie87 wrote: post #76
ptah wrote: post #42

Earlier quoted context omitted.

> research funding is dwarfed by marketing for example i really believe pharma advertising should be banned

It is where I live, so weird visiting the US and seeing "ask your doctor for" adverts. If I asked my GP for a specific medication they'd look at me like an alien.

I know a couple of doctors overseas and while there isn’t direct to consumer advertising for Rx drugs, the doctors get invited by the pharmas to conferences in the Greek islands or the Adriatic, sometimes they are invited to “talk”. They can bring their spouses too... in addition I think they get kickbacks for Rxs -but I’m not sure.

Not sure which one is better or worse.

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

#120

Post by mmhsieh »

rayiner wrote: post #78
toomuchtodo wrote: post #38

Earlier quoted context omitted.

I don’t demand my roads, libraries, or other public goods turn a profit. I wouldn’t demand the same of public pharma research (NIH, DARPA). Perhaps the market is not designed for this sort of endeavor (drug research). Let government stand in where the market has failed.

Except the market has succeeded fantastically. In my lifetime alone, AIDS and HepC went from death sentences to chronic conditions. Many forms of leukemia went from fatal to highly treatable. Meanwhile, what has the government done? The trip from DC to New York on Amtrak is slower today than it was in 1960. In 1980, DC’s Metro had self driving trains. They had to shut that down in 2009 due to lack of maintenance and…

there is a distribution of talent in the government as there is in a private enterprise. the talent is distributed as much across functions as within them. where government "chooses" to be excellent, it is. such pockets of excellence are nurtured by funding, top cover and insulation from the inefficient and less competent parts of government. if policymakers wanted to create an enclave of excellence in public pharma, it could. if.
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