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Illinois governor signs law capping insulin costs at $100 per month

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Re: Illinois governor signs law capping insulin costs at $100 per month

#191

Post by adamsea »

refurb wrote: post #169
Ididntdothis wrote: post #148

Earlier quoted context omitted.

But medical advertising doesn’t inform the patient. Often it misleads. It has no value. Having medical information in public would be good so people can learn themselves but advertising provides no value.

FDA has done research into it and it clearly provides some value. Other highlights of the surveys include: Most physicians agreed that because their patient saw a DTC ad, he or she asked thoughtful questions during the visit. About the same percentage of physicians thought the ad made their patients more aware of possible treatments. Many physicians thought that DTC ads made their patients more involved in their heal…

If the true goal is to educate the patient, I'm 100% certain there are more effective and ethical ways to accomplish that goal other than for-profit advertising (which by definition cannot be unbiased).

Re: Illinois governor signs law capping insulin costs at $100 per month

#192

Post by cjfd »

zentiggr wrote: post #86
cjfd wrote: post #39

It may very well be quite true that the price of insulin is too high but price controls really are not that great. If the price now is to high, $100 probably still is too high. Also, in the more general case (not for insulin, obviously) pharma does need to recover its research costs and who is going to say what is a good price and what not. You know, capitalism actually kind of works and price controls just don't. Th…

You're way overthinking this. What needs to happen is, again and again with health care issues, transparency. Manufacturers should be required to declare and with audits prove how much they're spending to manufacture everything. Then everyone can see the price they're being charged and figure in their head what sort of markup they are being charged. Then we can start to push back on the companies need to recoup prima…

Actually, I think in practice my solution is much simpler than yours. For yours to work it is a precondition that these audits are of good quality. Perhaps they will be and perhaps not but at the very least we can note that the pharma companies have large incentives to game them. Also, the question becomes how much of a markup is reasonable. Clearly, for more innovative research more markup would be acceptable than for less innovative research if both of these would lead to working medicine. Innovativeness would need to be quantified for each and every medicine separately. This does not sound like an easy task.

I really am surprised that I am getting more downvotes than upvotes here. I think people are too emotional about this. I also note that a post dropping f-bombs is not getting downvoted which it really should be. It is not very mature.

Re: Illinois governor signs law capping insulin costs at $100 per month

#193

Post by snapetom »

chimeracoder wrote: post #171
snapetom wrote: post #47

Earlier quoted context omitted.

> government negotiated prices That's what we don't have in the US. You can certain make the case that we should, but that's a separate argument. Now we have a situation where we have a flat out price control, and it's going to have unintended consequences written all over it. All these arguments for "look at Europe" doesn't fly in health economics. There are not subtle differences in the US legally, infrastructurall…

> All these arguments for "look at Europe" doesn't fly in health economics. There are not subtle differences in the US legally, infrastructurally, and culturally. Not to mention: European countries wouldn't be able to negotiate those prices if the US market didn't exist. Pharmaceutical companies - many of whom are based in Europe - know that they'll make most of their revenue from the US, which is not only the single…

Yes, very true.

Further, in general, the drug release schedules are US -> Europe -> Asia. This is primarily for two reasons - the FDA approval process is the most rigorous in the world. It would not be outrageous to classify European drug approval process as "rubberstamping" if the drug has already received FDA approval. Essentially, the US pays the R&D of the drug costs for the rest of the world.

The second reason is that without price controls, the US price is the closest thing to a market price for that drug. Sorry, but ultimately the prices of the drug comes down to how much a life is, or more accurately, how it affects the quality of life. When price negotiations between pharma and European governments start, both sides use that data. It would be very interesting if the US went single payer to see how it would affect the European drug prices (my guess it goes up).

Side note: Asia has always been third due to underdeveloped markets and legal systems. Further Japan has in the past (I think they just got rid of it in the last 5 years) a law where drugs need to be tested on Japanese citizens before approval.

Re: Illinois governor signs law capping insulin costs at $100 per month

#194

Post by badrequest »

thinkcontext wrote: post #179
ptah wrote: post #42

Earlier quoted context omitted.

> research funding is dwarfed by marketing for example i really believe pharma advertising should be banned

I don't disagree but by far the largest amount of marketing is spent targeting doctors not patients. Every few years they get caught sending them on junkets, paying them kickbacks disguised as fake speaking gigs, hiring cheerleaders or strippers as "sales associates", etc

We should make doctor kickbacks from pharmaceuticals illegal too.

Re: Illinois governor signs law capping insulin costs at $100 per month

#195

Post by cat199 »

ikeboy wrote: post #107
nradov wrote: post #95

Earlier quoted context omitted.

The testing regulations are not onerous. They are necessary to ensure that new medications are both safe and effective. I often see vague complaints about the regulations, but no one seems to have specific suggestions about how to lower drug development costs while still protecting patients.

https://www.fdareview.org/issues/theory-evidence-and-example... Specific suggestion: get rid of efficacy requirement, keep safety requirement. Let doctors decide what works, as they currently do for off-label uses just fine.

so, in effect, subsidize pharma via selling placebo effect?

Re: Illinois governor signs law capping insulin costs at $100 per month

#196

Post by jessaustin »

Wow, Pritzker is on a roll. Legalizing pot, reviving horse racing, now defending diabetics. Why can't my state have a good governor? Do we need to send a bunch of former governors to prison first? I'm willing to do that! Heck, I think most people would be fine with Greitens in prison...

Re: Illinois governor signs law capping insulin costs at $100 per month

#197

Post by eigenrick »

Someone1234 wrote: post #158
dehrmann wrote: post #125

Earlier quoted context omitted.

> When [publicly funded] research bears fruit it is often given away almost at-cost Publicly funded research should be given away, royalty-free, to the public. Universities aren't in the business of...business.

But it isn't. It is licensed to an exclusive drug manufacturer who has a de facto monopoly on the new drug. If it were protected with drug patents then those patents licensed for free to all generic manufacturers, that would be a massive improvement.

That's because the drug manufacturer has to spend a billion dollars performing clinical trials which might still fail. Even with some research already performed, this is still a huge risk. Not to mention the fact that the research still needs to be turned into something producible and consistently deliverable to the patient.

Re: Illinois governor signs law capping insulin costs at $100 per month

#198

Post by harryh »

michael_j_ward wrote: post #173
rayiner wrote: post #54

Earlier quoted context omitted.

Ironically, insulin is a great example of why your premise is false: Insulin replacement was developed a century ago, being first discovered by a government entity (U of Toronto). Private companies commercialized the treatments in the 1940s and 1950s, developing long acting forms that could be administered in a single injection per day. Since then, pharmaceutical companies have made continuous improvements with fewer…

In addition to reducing regulatory barriers that prevent generic producers, why is no one suggesting altering the pharmaceutical intellectual property system? Twenty years to hold monopoly production rights is an obscene amount of time. Yes, reducing that twenty to say five will reduce capital investments in drug research, but it will also alter the structure of those investments. Investing in improvements at the mar…

The vast majority of drugs wouldn't even make it out of the FDA approval process before the patent expired if you set the term to 5 years.

Re: Illinois governor signs law capping insulin costs at $100 per month

#199

Post by bildung »

rayiner wrote: post #78
toomuchtodo wrote: post #38

Earlier quoted context omitted.

I don’t demand my roads, libraries, or other public goods turn a profit. I wouldn’t demand the same of public pharma research (NIH, DARPA). Perhaps the market is not designed for this sort of endeavor (drug research). Let government stand in where the market has failed.

Except the market has succeeded fantastically. In my lifetime alone, AIDS and HepC went from death sentences to chronic conditions. Many forms of leukemia went from fatal to highly treatable. Meanwhile, what has the government done? The trip from DC to New York on Amtrak is slower today than it was in 1960. In 1980, DC’s Metro had self driving trains. They had to shut that down in 2009 due to lack of maintenance and…

> Except the market has succeeded fantastically. In my lifetime alone, AIDS and HepC went from death sentences to chronic conditions. Many forms of leukemia went from fatal to highly treatable.

Meanwhile, what has the government done?

Exactly that: "NIH funded the majority of support for HIV/AIDS, infectious disease and oncology research." https://www.thebalance.com/who-funds-biomedical-research-266...

Re: Illinois governor signs law capping insulin costs at $100 per month

#200

Post by chimeracoder »

mattrp wrote: post #124
snapetom wrote: post #47

Earlier quoted context omitted.

> government negotiated prices That's what we don't have in the US. You can certain make the case that we should, but that's a separate argument. Now we have a situation where we have a flat out price control, and it's going to have unintended consequences written all over it. All these arguments for "look at Europe" doesn't fly in health economics. There are not subtle differences in the US legally, infrastructurall…

Along similar lines, I read a study nearly twenty years ago and I wish I could find it for these very recurring government vs market debates. The study evaluated prices between single payer countries and found that it wasn’t the collective bargaining that reduced prices in those countries. They observed that there was no correlation between the size of the single payer and pricing. Rather, it was that the pharma adju…

> Edit: another thought comes to mind - has anyone compared the size of health insurers in the US and compared their purchasing power to government run single payers? I’d hazard a guess that United Health for example probably dwarfs entire single payers of some governments.

Medicare alone covers more patients than NHS England does. (Very few countries in Europe actually have single-payer healthcare; the four UK countries are the exception, not the rule).

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