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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

#141

Post by bombcar »

basch wrote: post #115
rayiner wrote: post #73

Earlier quoted context omitted.

> I don't understand. My understanding of why insulin is so expensive: intellectual property laws are enforced by the government preventing businesses without that intellectual property to compete in the space. That’s not an accurate understanding of intellectual property specifically. Insulin isn’t like a pill, where once you have a chemical formula you can make millions of them very cheaply. It’s a biologic, an art…

People dont want insulin (traditional insulin.) They want fancy insulin (modern insulin), because it is convenient. They want modern rapid and long acting insulin. They want pens. Maybe people want the inhalable powder. Those innovations exist outside the original insulin patent. They are also mixing other drugs with the insulin. >Average retail prices of Novolin and Humulin (traditional short- and intermediate-actin…

Yeah, you can do some quite easy motte-and-bailey with it.

Everyone will agree that (cheap, out of patent) insulin should be available to all; it's literally lifesaving.

But then switching that to the (modern, convenient) insulin should be available to all is a bit of a slight of hand, especially when it is NOT a "you will die without this" but a "you will have more hassle taking medication to not die" scenario.

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

#142

Post by fallingfrog »

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).

In this case the regulation is certainly being pushed by the pharma companies themselves as they wish to use regulation as a means of eliminating their competition so they can charge monopoly prices. So less regulation is not going to help, rather, the political influence of the corporations is the problem. Doing an end run around the whole mess by simply producing your own insulin will rapidly cause collapse in prices as those companies will suddenly have competition, even if from a state run agency. It's happened many times before.

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

#143

Post by legitster »

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…

Also, no one is paying sticker price. When I was uninsured I often payed less out of pocket costs for care and medicine because so many automatic discounts kicked in.

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

#144

Post by AnIdiotOnTheNet »

ggreer wrote: post #56
genderwhy wrote: post #50

Earlier quoted context omitted.

"All these safety regulations slow down the free market! Anyone should be able to make and sell insulin! If it's poisonous, people just won't buy that!"

I mean… the FDA could drastically reduce the price of drugs and prevent shortages by allowing imports of medicines approved in the EU or Canada.

We could also just nationalize the drug industry. Public funds pay for research already don't they? Why even let corporations in on this, just do it all ourselves and let the sociopaths go exploit adtech or some shit that's less likely to get people killed.

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

#145

Post by basch »

worik wrote: post #140

Why can California not import Indian I nsulin? I thought thr Indian pharmaceutical industry was well able to make it, why not just buy it?

So we make a law that says a product's intellectual property is protected and cant be copied. Someone in another country copies it, without paying. Then it's legal to import it?

Seems like a very roundabout way when we could just ignore intellectual property laws directly, at home. The same applies to "importing things from Canada." Why the ruse?

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

#146

Post by zaroth »

basch wrote: post #127
davikr wrote: post #97

Earlier quoted context omitted.

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 symp…

T1D patients use both types if they are self-injecting. The long acting covers your basal rate (baseline) and the fast acting covers carbs you eat.

Or if you have a pod or pump then you can use only the rapid acting and the software will drip it slowly to cover your basal need over the 24h.

Trying to use just the fast acting with self-injections doesn’t work because you go high overnight while you’re sleeping, and even during the day you would have to be injecting every 3 hours to keep up. (E.g. when your pump controller dies on vacation and all you have on hand is rapid-acting)

Source: I have two kids with T1D.

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

#147

Post by peyton »

RcouF1uZ4gsC wrote: post #133
projektfu wrote: post #96

Earlier quoted context omitted.

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…

>. 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 That is incorrect. A bioequivalence study is much simpler and cheaper than the original safety and efficacy studies. You do not need to prove that safety and efficacy of the drug, only that you are delivering the equivalent of the originally studied drug at the same doses.…

No, the submission packages for anything chronically administered (like insulin follow-on) are way more comprehensive.

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

#148

Post by HWR_14 »

ceejayoz wrote: post #131
Kon-Peki wrote: post #117

Earlier quoted context omitted.

If the parliamentarian is "overruled" for political reasons, the likely outcome is that the Senate grinds to a halt, not that the majority party gets to pass desired legislation that otherwise wouldn't pass. The job of the parliamentarian is to interpret the rules and give advice about what is allowed and what is not. Sure, they can be wrong. But if you don't like the rules, change them. Because any self-governing bo…

> But if you don't like the rules, change them. That's what the vote to overrule the parlimentarian essentially does, for that one vote. Both parties have done so for judicial confirmations. https://en.wikipedia.org/wiki/Nuclear_option ; "a parliamentary procedure that allows the Senate to override a standing rule by a simple majority" > Any legislation the Senate "passes" in violation of its own rules doesn't actual…

Both sides changed the rules concerning judicial appointments. In both cases this was understood to be a change in actual Senate rules, not a one time override. As demonstrated by the fact that there were many appointments under the new rules without additional votes.

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

#149

Post by zaroth »

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.

My insulin pumps take any insulin I fill it with. I’ve never heard of pumps that only take a specifically manufactured vial. Which one are you referring to?

Also, the pump manufacturer is not the same company as the insulin manufacturer.

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

#150

Post by vippy »

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…

nah, that's some goofy libertarian take. easier to blame the government than monopolistic behavior by pharma corporations and private actors.
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