Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

EpiPen Price Rise Sparks Concern for Allergy Sufferers

well.blogs.nytimes.com

Post reply on HN
Print view View original

131–140 of 367 posts

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#131

Post by ceejayoz »

foota wrote: post #96
ceejayoz wrote: post #93

Earlier quoted context omitted.

> Does the government ban us from purchasing cheaper, inferior cars just because higher-priced cars are substantially safer? Yes?

But also no, I can be a used car with lower safety features than mandated for new cars I believe

Yes, and you can use an expired or recalled medication. I'm not sure how that's relevant.

The used car will also need to pass an annual safety inspection here in NY, at least, as it's required to meet some minimum safety standards.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#132

Post by drworm »

gradstudent wrote: post #68
xnor wrote: post #42

If people don't want to buy two epipen there's always that neat trick for multiple doses in precarious locations far from hospitals. It is a well known hack taught in wilderness medicine training. https://www.youtube.com/watch?v=luultUD0eK0

If you have something concrete to say then say it. You're only lowering the quality of the conversation by making vague assertions in the style of "one weird trick" followed by mystery links to random places on the web.

How is this lowering the quality of the conversation? This is an insightful comment with a relevant video that shows that each Epipen actually contains 4 or 5 doses of epinephrine. Certainly relevant, as we are discussing how people nationwide are struggling to obtain enough of this drug.

Also, I would hardly call a link to YouTube "a mystery link to a random place on the web".

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#133

Post by rdtsc »

schmidty wrote: post #81
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…

How is government protecting a monopoly free market exactly?

Why is it protecting a monopoly? Why doesn't it say "this EpiPen can't cost more than $30"?

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#134

Post by ceejayoz »

derekp7 wrote: post #98
ceejayoz wrote: post #93

Earlier quoted context omitted.

> Does the government ban us from purchasing cheaper, inferior cars just because higher-priced cars are substantially safer? Yes?

Even though there are cars with a 5-star safety rating, you can still get ones with a 4-star or even 3-star ratings. So I would say the answer to the original question "Does the government prevent you from buying less safe cars" is "No".

In both situations, the government sets a minimum permissible safety standard to sell the product. Medications and medical devices are allowed to kill/injure, but only to a point. Same with cars.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#135

Post by refurb »

sriram_sun wrote: post #19
eliben wrote: post #10

If the product is decades-old, why haven't generic variants appeared? Something seems to be missing from this article.

There are generics. What is patented is the delivery mechanism. I've had to administer it twice. You take the cap off and just push it into the thigh. The top part moves back and the needle pushes through.

I'm pretty sure this isn't true. There are plenty of self-injector designs and many of them are off patent.

The real reason is that other companies have screwed up getting their devices approved. Other versions of Epi-pen were on the market and they were pulled since they didn't work.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#136

Post by refurb »

tw04 wrote: post #70
shanacarp wrote: post #43

Earlier quoted context omitted.

so why aren't there more case manufactures

For the same reason there were no competitors to daraprim before Martin Shkreli decided to be a complete ja. When the price is low enough that there's little profit to be had, nobody bothers competing because it's not worth the time, money, and effort to get FDA approval. When the price gets jacked up like that, you will find generics pop up quickly. The problem is the window between the price hike and when generics…

Hmmm... from your description, it sounds like the market is working, just not fast enough for everyone.

It's not worth it for a company to develop their own Epi-pen since profits are so low. Eventually enough drop out that one manufacturer raises the price. Significant profits result which attracts other competitors. Prices drop.

Would you just prefer the gov't to step in and set the price? What happens if companies decide it's not worth the effort? Have the gov't force them to produce the product?

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#137

Post by DSMan195276 »

derekp7 wrote: post #109
DSMan195276 wrote: post #87

Earlier quoted context omitted.

I don't really think you know all the history here. There are other companies who have/are attempting to create competitors to EpiPen. A few of them weren't able to get passed by the FDA, and one of them passed the FDA in 2012 but was recalled because of the product misfiring. The EpiPen problem seems to be much less an FDA problem then it is a problem with manufacturing, other companies don't seem to be able to make…

What about buying 5 of them that are $20 bucks a piece? Maybe they can be made in a stackable format, so it would be easy to carry 5 of them. If one misfires, snap it off and use the next one in the stack.

That only works if you can actually tell if it misfired or not - if you're administering it to someone else, you may simply not be able to. With that, part of the problem was that the misfires would deliver some of the drug but not all, and only sometimes would completely fail to deliver any of the drug. Telling if you got 50% vs. 100% would probably be tough - and even if you could, if you took two because the first gave you 50%, you might end-up getting a big overdose or still get an underdose. So having multiple of those pens really just doesn't solve the problem if the pens themselves are unreliable.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#138

Post by rdtsc »

jdpedrie wrote: post #83
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…

That's silly. How do you propose to "evaluate what is better, healthier, more rational"? I suppose some panel of experts could give you their best approximation, but it will always be sub-optimal. Markets exist in order to answer these questions, and they answer them by delegating the decision to every person involved in the decision, not by hoping a designated person can make a guess that's close enough. It appears…

> Markets exist in order to answer these questions,

Well in this case it answered that the price should be $600. This means people, kids, astamatics are going to die at some point in higher numbers because of that.

I say the market is drunk or evil and should not be allowed to make medical decisions.

But because it has a religious following, we don't want to make it angry so we can't say "we mandate EpiPen cost to be $25". Instead we dance around it and say "oh we'll create this health insurance thing, and then that will pay for it". But only if you work. Or ... if you don't you have to buy it anyway, or you have to pay a penalty. But unless you are old, then we kind a let you off the hook a bit and you sign up for this other thing. All of that is done in paper and in how it is presented to the public because we don't want to upset the free market gods.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#139

Post by refurb »

PhasmaFelis wrote: post #49
ccleve wrote: post #16

Earlier quoted context omitted.

There are really two villains here, Mylan, of course, but more importantly, the FDA. FDA regulations make the cost of bringing a new medical device to the market absurd. There are no competitors because the time and effort to bring a competing device is so ridiculously high that it doesn't pay to do so. I have a child with a peanut allergy. I am worried every damn day of my life. I see articles about people who die e…

It's a really difficult balance to strike with the FDA. Too strict and you get situations like this, too lenient and you get thalidomide. It's hard to come up with a single set of rules that will rush forward all good, effective medication, block all dangerous medication, and continue to do so despite constantly changing technology and understanding. Clearly the epipen thing is a huge problem, and if the FDA can fix…

Exactly! I wouldn't want to be working at the FDA to be honest. On one hand you get blamed when an unsafe drug hits the market and the next day get blamed because you're holding up innovative.

They can't win!

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#140

Post by ancap »

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…

I can think of many products which are life-saving which are readily available from countless producers for relatively cheap. The difference here is just as gwright has pointed out and you have a corpus of regulation which makes this particular product more expensive and/or chokes out competition.

The only sectors of the economy where significant, lasting shortages occur are the ones most heavily regulated.

Post reply on HN