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Insulin is way too expensive. California has a solution: Make its own

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Re: Insulin is way too expensive. California has a solution: Make its own

#121

Post by cuteboy19 »

cheaprentalyeti wrote: post #116
genderwhy wrote: post #60

This is great news. Honestly, I hope to see more nationalization of widely used services (or whatever the equivalent word for nationalization is at state or municipal levels.) Municipal broadband, power, roads, schools, post, housing, and healthcare? It's long overdue, and with an appropriate amount of funding has been shown to be effective at controlling costs and delivering moderately good quality in most cases. A…

You say that as if healthcare isn't extremely regulated already and as if the regulation weren't a big factor in allowing these companies to monopolize the production of insulin. (Or, my favorite example back when I needed the stuff, colchisine.)

Nationalization is different though. It's not possible for anyone to monopolize it

Re: Insulin is way too expensive. California has a solution: Make its own

#122

Post by jjk166 »

aqme28 wrote: post #62
rayiner wrote: post #36

Reflecting a common theme in our healthcare system, the problem of insulin costs is very unevenly distributed: https://www.healthsystemtracker.org/brief/out-of-pocket-spen... . About 3 in 4 enrollees in ACA plans that use insulin pay $35/month or less out of pocket. For people with private insurance, 4 in 5 pay $35/month or less. The biggest problem seems to be too many plans, too many choices, and too many ways to f…

Is the $35 the amount the patient pays, or is it the total amount paid for the insulin? It's still a despicable racket if the patient only pays $35, but the insurance company is paying $500.

Yeah, it's important to note that all the money the insurance company pays for medicine is still coming from you and other policy holders, it's just in the form of a predictable monthly policy plan instead of a possibly very large unexpected bill. If the drugs were cheaper, you could get a cheaper insurance plan that offered the same quality of coverage. So extremely high insulin prices hurt you even if you personally don't take insulin.

Re: Insulin is way too expensive. California has a solution: Make its own

#123

Post by cuteboy19 »

WalterBright wrote: post #114
genderwhy wrote: post #60

This is great news. Honestly, I hope to see more nationalization of widely used services (or whatever the equivalent word for nationalization is at state or municipal levels.) Municipal broadband, power, roads, schools, post, housing, and healthcare? It's long overdue, and with an appropriate amount of funding has been shown to be effective at controlling costs and delivering moderately good quality in most cases. A…

> has been shown to be effective at controlling costs That has never happened. What does happen is the cost is borne by the taxpayer rather than the user of the service. The "warping" of the profit motive in the insulin case is entirely caused by government interference and regulation (by making it nearly impossible for competitors to spin up and make insulin).

There are many cases where the government can produce things at cost and bankrupt for profit companies. It's not always effective but the situation is quite dire at this point

Re: Insulin is way too expensive. California has a solution: Make its own

#124

Post by Spooky23 »

WalterBright wrote: post #114
genderwhy wrote: post #60

This is great news. Honestly, I hope to see more nationalization of widely used services (or whatever the equivalent word for nationalization is at state or municipal levels.) Municipal broadband, power, roads, schools, post, housing, and healthcare? It's long overdue, and with an appropriate amount of funding has been shown to be effective at controlling costs and delivering moderately good quality in most cases. A…

> has been shown to be effective at controlling costs That has never happened. What does happen is the cost is borne by the taxpayer rather than the user of the service. The "warping" of the profit motive in the insulin case is entirely caused by government interference and regulation (by making it nearly impossible for competitors to spin up and make insulin).

Not really. The internet is an example of what happens when you suck margin out of high margin businesses like content creators. India is an example for pharmaceuticals.

If the state takes a commodity and sells it on a cost plus or cost basis, it’s going to kill investment in the spaces and collapse the margin.

At this point, we’re killing people and bankrupting states and employees with out of control costs. Making an example out of insulin would fix that and constrain some of the players in the market.

Re: Insulin is way too expensive. California has a solution: Make its own

#125

Post by vkou »

smt88 wrote: post #23
bhawks wrote: post #19

Big pharma has totally pwnd the regulations the government enforces on the prescription drug market ensuring they have monopoly pricing power. Why wait for CA to spin up it's own insulin manufacturing industry - just do not prosecute the import/manufacturing and resale of insulin - like it did for medical marijuana in the 90s?

Manufacturing in the US is better for the US economy and looks much better if you're someone trying to get re-elected.

That's second fiddle to the real reason for why we're in the current state of affairs - fleecing the public is much better for the vendors, and it's much better for a politician trying to get re-elected to go along with it.

"Domestic manufacturing" is just a talking point to fig-leaf the real goal.

Re: Insulin is way too expensive. California has a solution: Make its own

#126

Post by coldpie »

bhawks wrote: post #68
ars wrote: post #59

Earlier quoted context omitted.

I've heard the part of the tweaks multiple times, and no one has ever explained why competitors can't just make the perfectly fine untweaked version.

Insulin is typically delivered by a pump device that monitors patients blood sugar levels and doses accordingly. The pump is a medical device too that is manufactured by the drugco. It only accepts insulin vials from drugco. It's like the inkjet printers that refuse to use ink from other vendors.

Ehhh. Pumps are common, but they're not universal (I don't use one).

Re: Insulin is way too expensive. California has a solution: Make its own

#127

Post by basch »

davikr wrote: post #97
outworlder wrote: post #83

Earlier quoted context omitted.

> Newer versions of insulin are "better" than generic insulin: easier to take, fewer side effects, etc. Even that is debatable. At least Sanofi has been known to fund some rosy articles about their Lantus® product. When the EU looked into it (for similar initiatives) they were not able to find the large 'performance' gap that was suggested between that insulin and alternatives.

As far as I know, the major difference between insulin types is not their performance, but how long they take to act, when they peak and for how long they have an effect. Some types of insulin, like glargine (as in Lantus®) can be more convenient due to their long-acting response that lasts for an entire day. I suppose off-patent insulin could be produced with some degree of inconvenience to the consumer because they…

Long acting insulin is exactly what this entire debate has always been about. Generic standard insulin has been cheap at walmart forever. They even sell cheap rapid acting ReliOn.

People want long acting insulin cheap. (short-, intermediate-, rapid-, and long-acting, ultra-long-acting (42h) insulin are the main categories.) Long acting insulin was the product that had a price jump at the end of 2017.

I am pretty sympathetic to the non long acting stuff not being good enough. Expecting people to monitor hour after hour, and only calling it an inconvenience really downplays how tedious it is to stay alive.

Re: Insulin is way too expensive. California has a solution: Make its own

#128

Post by basch »

olliej wrote: post #76
r3trohack3r wrote: post #69

> Though insulin generally costs less than $10 per dose to produce, some versions of the drug have a list price above $200. This is in part because, in the US, a warped market has allowed three companies to dominate the insulin business. > With California leading the way, a handful of states are considering trying to disrupt the market for essential medications, starting with insulin. The plan would be to manufacture…

You know developing insulin doesn't require violating patents, right? And the price of insulin in the US is entirely an artifact of monopoly behavior by a small number of pharmaceutical companies? The ability to mass produce insulin at negligible cost has been around for decades, they guy who discovered it made it patent free even. Only in the US do companies get away with this kind of price gouging, and only because…

Insulin is cheap.

Long acting insulin is not.

They are different products, and the formers patent being free has nothing to do with the later innovations being locked down.

Re: Insulin is way too expensive. California has a solution: Make its own

#130

Post by [deleted] »

projektfu wrote: post #96
r3trohack3r wrote: post #69

> Though insulin generally costs less than $10 per dose to produce, some versions of the drug have a list price above $200. This is in part because, in the US, a warped market has allowed three companies to dominate the insulin business. > With California leading the way, a handful of states are considering trying to disrupt the market for essential medications, starting with insulin. The plan would be to manufacture…

A lot of formerly protected insulins, e.g. insulin glargine, are off patent now. The remaining moat for generics consists of FDA approval, delivery system patents, and manufacturing process patents/trade secrets. For a generic insulin to get FDA approval it needs bioequivalence which is a lot like running the original safety and effect studies over again, while dealing with spurious injunctions and the like from the…

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