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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

#181

Post by ProjectInsulin »

coldpie wrote: post #94
ProjectInsulin wrote: post #87

Earlier quoted context omitted.

Hi Rayiner, you are spot on with your analysis. My name is Eric, and my non-profit, Project Insulin, is tackling this problem head-on as well. We are developing a biosimilar insulin and will distribute it directly to patients at cost. The drug development process is still expensive but much cheaper because of the Biologics Act that was passed in 2020. When going through the FDA approval process, biosimilar insulin ma…

Hi Eric! I'm a T1D and so super interested in this space. Can you comment on whether it is the case that "modern" insulins (Lantus and Humalog/Novolog, in my case) are both covered by current patents, and also considerably better for patient outcomes (faster acting, more predictable -> lower A1c) than non-covered insulins? That is my understanding for why cheap, high quality insulins are not available, but I'd love t…

Hi as some of the others have already mentioned Lantus is off patent. My organization is focused on insulin glargine but there are generic versions of insulin lispro and aspart. Which is the generic/biosimilar version of humalog/novolog. We decided to stick with glargine first and transition to the other versions as we progress.

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

#182

Post by CodeWriter23 »

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…

What you’re missing here, just like how everything runs in California (and perhaps in most places), the government won’t be in the business of manufacturing insulin. They will choose a winner to be the subcontractor to produce the product. That firm will meet a price point for the duration of the contract and then renegotiate. Or go into the market like the other players.

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

#183

Post by ProjectInsulin »

atlasunshrugged wrote: post #166
ProjectInsulin wrote: post #87

Earlier quoted context omitted.

Hi Rayiner, you are spot on with your analysis. My name is Eric, and my non-profit, Project Insulin, is tackling this problem head-on as well. We are developing a biosimilar insulin and will distribute it directly to patients at cost. The drug development process is still expensive but much cheaper because of the Biologics Act that was passed in 2020. When going through the FDA approval process, biosimilar insulin ma…

Hey Eric, somewhat tangential question -- why is it that seemingly all precursor manufacturing is done in China or India? Is it just a low-cost game or are regulations making it too expensive to do in the U.S. or something else?

This is a great question. Simply it is a lot cheaper to make drugs in China + India. The APIs cost less, and the workforce is cheaper. With regards to regulations I don't want to generalize but it has been well documented that it is hard for the FDA to regulate drugs being produced outside of the United States.

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

#184

Post by OkayPhysicist »

miguelazo wrote: post #118
rayiner wrote: post #75

Earlier quoted context omitted.

> 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. Where? The US has among the highest percentage of kids going to government owned and operated schools. We have plenty of government housing as well (projects). Nearly all of ou…

There are many causes of lackluster public education, and funding is definitely one of them. Another huge one is the ability of parents who have the time and resources to divert their children (likely already at a huge advantage) to private and charter schools, thereby skewing the public school below the median in a vicious circle. I’ve seen this exact dynamic play out in many of the cities I have lived. It’s also wh…

It's difficult to overstate just how huge selection bias can get in the education space. I went to a high school in the Bay Area, one of a handful in my city. (1) Houses in our attendance area were ~$500,000+x more expensive than ones right across the street in another attendance area, because our school was "better". Why was it better? Because the parents paying an extra half million dollars to get their kid into a better school were going to make sure their kid did better, come hell or high water. So there were lots and lots and lots of after-school tutoring centers, where students would get taught the highschool material in advance, so that they would already know it forward and back when they were tested on it. Which makes the school test well, and thus look better than the other schools in the area, raising housing prices. x += $100,000; GOTO (1).

The actual quality of the education was substandard, but there is something to be said for being embedded in an environment where academic failure was simply not considered an option.

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

#185

Post by tptacek »

kmeisthax wrote: post #180
arcticbull wrote: post #119

Earlier quoted context omitted.

Its easy to point at what doesn't work well, there's tons and tons of things that work great that nobody talks about. Municipal broadband: the best broadband in the entire United States is provided by the municipality of Chattanooga. [1] Post: The USPS is the most trusted brand in the United States, above FedEx and UPS. [2] Transit: The New York City Subway is the 3rd largest metro rail system on earth after London a…

American schooling sucks because it's beholden to political objectives contrary to the interests of educating children. Look at the manufactured controversy over "intelligent design" a few decades back, or the current controversies over transgender bathroom access, or Florida's censorship of material in school libraries[0]. Municipal broadband and the post works well because the US is good at building infrastructure.…

None of this has anything to do with why school sucks. Schooling sucks because it's erratically funded.

Wealthy families arrange to live in suburbs designed explicitly to cordon their children off from there less wealthy peers, each time setting up a vicious cycle where homes in those school districts derive much of their value from school funding, creating an incentive for an ever-increasing levy for de-facto private schools.

Meanwhile, big city school districts are relatively well funded (teachers in the largest cities have surprisingly strong compensation) but poor management. Not everything that Republicans say about teacher unions is wrong, and there is an extent to which management of city public schools is set up to allow schools with high parental engagement (= greater parent wealth) to succeed while others fail.

Simultaneously, if you look at school districts in poorer exurbs or, worst of all, downstate/upstate rural districts, teachers really are making the wages that TV shows make jokes about, supplies are scarce and enrichment classes (in some places) nonexistent.

These are structural problems, not culture-war-of-the-moment problems.

I'm not high-horsing any of this; my kids went to school in Oak Park, IL; I believe every full-time teacher at OPRF makes a six figure salary. Oak Park is essentially a pair of extremely well funded school districts (K-8 and high school) with a fire and police department tacked onto the side.

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

#186

Post by 6nf »

ProjectInsulin wrote: post #87
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…

Hi Rayiner, you are spot on with your analysis. My name is Eric, and my non-profit, Project Insulin, is tackling this problem head-on as well. We are developing a biosimilar insulin and will distribute it directly to patients at cost. The drug development process is still expensive but much cheaper because of the Biologics Act that was passed in 2020. When going through the FDA approval process, biosimilar insulin ma…

Why is insulin not expensive in other countries?

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

#187

Post by anonuser123456 »

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…

If you study the insulin pricing issue carefully, you will find that largely the problem is government, not the market.

The profit motive coupled with competition works very well to keep prices low.

You need only realize the following; European firms stand at the ready to supply insulin at well below US prices today, but are prevented from doing so by the FDA. And they can do so and still turn a profit.

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

#188

Post by dmreedy »

favaq wrote: post #72
Gene5ive wrote: post #37

How do people live with themselves charging 20 times the production cost of an essential medicine?

Let's not pretend almost all diabetics didn't get in that situation themselves.

I pray that you never have to encounter the wrong end of a System

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

#189

Post by ProjectInsulin »

basch wrote: post #165
spiznnx wrote: post #160

Earlier quoted context omitted.

I do want to bring up that insulin management is extremely taxing to individuals, and hard to get right. See https://news.ycombinator.com/item?id=30376777 for previous discussion. Obviously the costs involved in implementing these technologies should be part of the discussion, but I don't think it's unreasonable to want to make anything that eases management of diabetes way more affordable.

Which is what the conversation should be, and how it should be framed. The press writing "life saving insulin" headlines takes away from the ability to discuss that: within the last decade or two, modern improvements made the process of managing diabetes significantly easier and else stressful. The drug companies gave everybody a taste of an easier life, and then jacked up the price, saying "pay us more or go back to…

I would like to point out that these fancy insulins have been around since 1996. I do agree that there is cheaper insulin available, but as others mentioned there is a significant change in quality. But I agree with you that the conversation should be affordable high quality insulin.

Another piece of the insulin ad drug saga that I haven't seen many people discuss here is the distribution of drugs. The distribution from manufacturers to patients is incredibly inefficent with a variety of middle organizations increasing the cost associated with distributing the insulin and those costs are pushed down onto patients. Our website has a simplified graph showing the current model vs what we plan on doing: https://projectinsulin.org/why-insulin/

For a more in-depth look the Wall Street Journal has a great video from 2019: https://www.wsj.com/video/series/news-explainers/how-drug-pr...

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

#190

Post by ProjectInsulin »

hertzdog wrote: post #151
ProjectInsulin wrote: post #87

Earlier quoted context omitted.

Hi Rayiner, you are spot on with your analysis. My name is Eric, and my non-profit, Project Insulin, is tackling this problem head-on as well. We are developing a biosimilar insulin and will distribute it directly to patients at cost. The drug development process is still expensive but much cheaper because of the Biologics Act that was passed in 2020. When going through the FDA approval process, biosimilar insulin ma…

Hi Eric, my name is Francesco. In the last three years we industrialized a novel method for producing biosimilar insulin (in Italy). We are an international team and I really would like to contact you. Can you write to the email you find on my profile?

Hi Francesco looks like you found me! I will respond to your email shortly :)
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