EpiPen Price Rise Sparks Concern for Allergy Sufferers • Hacker News Board

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#121

Post by bobdole1234 » Tue, Aug 23, 2016, 2:15 AM UTC

toomuchtodo wrote: post #29

Cyph0n wrote: post #28

Earlier quoted context omitted.

That second discussion got heated quite fast. I agree with the downvoters though. 3D printing a medical device is not something to take lightly. Edit: Here's why I agree. You download this design from the internet, and 3D print the parts. You then assemble it. Awesome! Some time later, you get an allergic reaction. You use the pen, but it fails to work correctly. Who's responsible? The designer? You (if you're alive)…

Scarcity demands innovation. I don't think its being taken lightly; more like, "a private company is gouging medical users and the government won't step in". Not left with many options when your life depends on it. EDIT: Alternatively, a "better" temporary solution would be to arrange for the import of these from Canada, where the price is fixed by the government.

Not so much fixed as "Canada doesn't insist that everyone make separate deals so everyone can get fucked harder".

It turns out when you have millions of people dealing together as a block, they have much more bargaining power.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#122

Post by hackuser » Tue, Aug 23, 2016, 2:17 AM UTC

curiousgeorgio wrote: post #105

hackuser wrote: post #100

Earlier quoted context omitted.

> The government enforces some minimum safety standards I think this understates the safety regulations for automobiles by quite a bit. Maybe there's an example of an industry which makes lightly regulated, dangerous products, but I don't think cars are it.

True - the government's automobile safety standards are far from trivial, but there's no denying that the difference in safety between the cheapest smart car on the road and the safest car on the road is huge . In a head-on collision between the two, there's absolutely no contest. Asking why the government should allow an EpiPen competitor with a 0.1% higher failure rate is akin to asking why the government should al…

> there's no denying that the difference in safety between the cheapest smart car on the road and the safest car on the road is huge. In a head-on collision between the two, there's absolutely no contest.

I don't think that's true. Certainly expensive cars have new safety features, but ...

I read a study of empirical data on what, in practice, made cars more survivable in accidents. It was awhile ago but here is my vague memory:

The data was hard to analyze - they were trying to untangle cause and effect from wrecks - but the conclusion was that the most important factor was the relative location of hard points: If their hard point (e.g., bumper) lines up with your soft spot (e.g., driver-side door/window), it's bad for you. That's something that doesn't depend on cost.

Otherwise, I would assume safety depends heavily on weight and structural integrity, and certainly some cheaper vehicles, such as pickup trucks, would be much safer by those measures than much more expensive sedans.

It also might depend on center of gravity, roll-over potential, breaking ability, etc.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#123

Post by curiousgeorgio » Tue, Aug 23, 2016, 2:17 AM UTC

mikeash wrote: post #92

curiousgeorgio wrote: post #85

Earlier quoted context omitted.

The manufacturer is obligated to (1) obey the law, and (2) maximize profits for shareholders. If you have a problem with the current situation, blame the government/laws[1], not the company. [1] Blame is justifiably attributed to the government whether you believe the fix is a freer market (to reduce the costs associated with bringing suitable competitors to market) or you believe regulation should prevent this from…

(2) is a myth: http://www.nytimes.com/roomfordebate/2015/04/16/what-are-cor... (1) seems like a total cop-out to me. By that logic, you can blame everything on the government. Some guy murders his family in a fit of rage? Government should have done a better job preventing it. Also, part of the point of this kind of outrage is to punish these companies for their behavior so that the evil choice is not the most profit…

If corporations don't have an obligation to maximize profits for shareholders, then you'd better try and take that argument to shareholders rather than believe someone's opinion piece on the matter.

I didn't say corporations are legally required to seek profits, but they do have profit-seeking obligations in most cases. Without investors' expectations of future profits, those companies wouldn't exist in the first place.

And last I checked, murder is illegal, so no, I can't expect the government to do anything beyond that (as long as that law is enforced).

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#124

Post by helloworld » Tue, Aug 23, 2016, 2:19 AM UTC

refurb wrote: post #118

helloworld wrote: post #106

Earlier quoted context omitted.

In the study below, moms of kids with severe allergies were trained to use the EpiPen. Six weeks later in a simulated test, only about two out of five were able to successfully deliver a lifesaving dose of adrenaline. Shouldn't the FDA require that manufacturers provide evidence that consumer medical devices can be used reliably for their intended purpose? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4654245/ Patient…

Shouldn't the FDA require that manufacturers provide evidence that consumer medical devices can be used reliably for their intended purpose? What makes you think the FDA doesn't require this?

The fact that three out of five people trained to use this lifesaving product weren't able to.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#125

Post by rdtsc » Tue, Aug 23, 2016, 2:20 AM UTC

gozur88 wrote: post #94

rdtsc wrote: post #67

Earlier quoted context omitted.

Nah because it would upset the free market. I mentioned in another comment when someone from Europe or Canada asked something to the effect of "how come everything has to be free market in US even healthcare and such". And I think the answer is we treat free market as a religion. We don't evaluate what is better, healthier, more rational answer for a problem. Like say, "How do we keep people from dying from anaphylax…

I'm pretty sure you could put together epinephrine and a syringe for a few bucks. And sell it for twenty or so with a healthy profit. But you can't, can you? Is that because of free market worship, or worship of the regulatory state?

> But you can't, can you?

Yes you can! Believe it or not this completely unregulated free market utopia exists. It is not just a fantasy. Now don't get excited, I imagine after I tell you about you it, you probably won't be headed to the airport to go there -- that's because it is actually horrible.

Unregulated market is what was (and is) happening in any of the post-Soviet republics, Russia, probably China, probably many other countries.

Those countries are better at free market than America. Yes on paper they have their EPAs, FCCs, FDA and other nuisances, but in practice nobody cares.

So you can buy some pills from the street corner shop that sells cigarettes. But chances are they are expired at best, made in a basement from chalk and sugar, or harmful at worst. Of course the claim is, "ah but market takes care of it, next time you won't buy from there and they'll go out of business". Nope, you might be dead next time and no they won't go out of business.

You can go and buy unregulated vegetables from the market. And they look fresh and plump and nice, but they are chock full of horrible chemicals in them. How do I know? My relatives there grow and sell them. They have a separate plot of land for such things and wouldn't let their kids or themselves eat from there.

Gun ownership there is restricted. Unless you are friends with the police. Then you can have a special permit for a gun. Oh but you have to pass a psych exam to make sure you are not crazy. But it so happens you are crazy. But, no worries, such regulations are bypassed with a quick $50 gift. And yes, I have seen them shoot their Dragunov sniper rifle, in a village, with houses right next to each other, and nobody cares.

The list goes on. Now maybe I assumed too much that you won't like it. Who knows, maybe you would. Well you are welcome to visit and try it out.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#126

Post by maxerickson » Tue, Aug 23, 2016, 2:22 AM UTC

kasey_junk wrote: post #120

maxerickson wrote: post #104

Earlier quoted context omitted.

Apparently they'll cover your copay. https://www.epipen.com/en/copay-offer (I didn't read it closely, but the eligibility criteria seem to be 'private insurance')

I don't have a copay on epipens, but I do have a deductible. This actually can help me but the max is $100 off of full price (a few years ago I got $75 off with a similar card).

Oh, I didn't think you would be terribly concerned about the savings, I thought the company helping patients use their insurance was a nice addendum to your comment about the agency problem.

Edit: The way I read it, if you give the card to the pharmacy, the company will pay the $25 on your wife's plan.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#127

Post by hackuser » Tue, Aug 23, 2016, 2:23 AM UTC

curiousgeorgio wrote: post #85

mikeash wrote: post #35

Earlier quoted context omitted.

Dying because you can't afford a device you need is also not something to take lightly. It may not be a good idea, but blame should lie with the manufacturer for raising the price to such ridiculous levels.

The manufacturer is obligated to (1) obey the law, and (2) maximize profits for shareholders. If you have a problem with the current situation, blame the government/laws[1], not the company. [1] Blame is justifiably attributed to the government whether you believe the fix is a freer market (to reduce the costs associated with bringing suitable competitors to market) or you believe regulation should prevent this from…

Companies have those obligations, and others too. We all have many obligations, including to our communities/society. If most businesses didn't meet those other obligations for the last several hundred years, there would be no community, no market, no technology, and nobody rich enough to buy epipens. You'll notice that most companies are responsible members of their communities to some extent, but there are a few leaches of course who live off everyone else's contributions.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#128

Post by gwright » Tue, Aug 23, 2016, 2:23 AM UTC

Ironchefpython wrote: post #110

gwright wrote: post #99

Earlier quoted context omitted.

Please don't blame the free market for these high prices. This is a highly regulated medical device market with patent protections and insurance market complications. The price hikes would immediately attract lower-cost competitors if this were truly a free market.

> The price hikes would immediately attract lower-cost competitors if this were truly a free market. Any participants in a free market for a product with inelastic demand (e.g. something you need to stay alive) and non-trivial entry costs immediately implements price fixing in the absence of regulation. When life-saving devices that require a significant supply chain to manufacture capture the bulk of consumer surplu…

The non-trivial entry costs are there because of regulations and the legal environment regarding liability.

You can view the high price as the free-market finding the intersection of supply and demand given the regulatory and legal constraints but that seems like a less than useful way of understanding 'free-market'.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#129

Post by niels_olson » Tue, Aug 23, 2016, 2:23 AM UTC

toomuchtodo wrote: post #29

Cyph0n wrote: post #28

Earlier quoted context omitted.

That second discussion got heated quite fast. I agree with the downvoters though. 3D printing a medical device is not something to take lightly. Edit: Here's why I agree. You download this design from the internet, and 3D print the parts. You then assemble it. Awesome! Some time later, you get an allergic reaction. You use the pen, but it fails to work correctly. Who's responsible? The designer? You (if you're alive)…

Scarcity demands innovation. I don't think its being taken lightly; more like, "a private company is gouging medical users and the government won't step in". Not left with many options when your life depends on it. EDIT: Alternatively, a "better" temporary solution would be to arrange for the import of these from Canada, where the price is fixed by the government.

Surely design files can be signed...

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#130

Post by tibbon » Tue, Aug 23, 2016, 2:24 AM UTC

Cyph0n wrote: post #28

gmisra wrote: post #18

One of the early on-line responses was "maybe we can figure out how to 3D print these cases". It turns out that an Epi-pen is just a plastic safety housing around a normal syringe. Some discussions: https://www.reddit.com/r/news/comments/4y5481/cost_of_epipen... https://www.reddit.com/r/3Dprinting/comments/4y7f26/epipen_f...

That second discussion got heated quite fast. I agree with the downvoters though. 3D printing a medical device is not something to take lightly. Edit: Here's why I agree. You download this design from the internet, and 3D print the parts. You then assemble it. Awesome! Some time later, you get an allergic reaction. You use the pen, but it fails to work correctly. Who's responsible? The designer? You (if you're alive)…

I rather dislike the (frequently American) immediate viewpoint of assigning blame/responsibility in the case of a failure, and thus who can someone sue. This isn't an uncommon viewpoint at all, rather it seems to be the first that many go to.