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

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

vox.com

Post reply on HN
Print view View original

191–200 of 273 posts

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

#191

Post by hwillis »

TEP_Kim_Il_Sung wrote: post #173

Or just abolish the FDA? They're the ones keeping competitively priced insulin out of the market. https://mises.org/wire/patents-legal-monopolies-and-high-pri...

This "article" has one paragraph dedicated to actually explaining why drugs are expensive, and it says it's because of patents.

It also tries to blur between patents and exclusivity. Exclusivity is usually 3 years (5 for new antibiotics and new chemical entities). Patents are 20. Exclusivity is a very small portion of intellectual property protection. I would call that dishonest.

The FDA does not control drug patents, the patent office does. Abolishing the FDA would do practically nothing to reduce IP protections, but would eliminate all the other things they do, like making sure drugs work and don't kill people.

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

#192

Post by dmitriid »

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…

> At what level should the government step in and subsidize or control this quality of life improvement? At what level should its creators be rewarded?

You assume that creators are rewarded.

In Sweden you get the insulin and pens for free (that is, you've paid for it with your taxes).

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

#193

Post by coredog64 »

fallingfrog wrote: post #137

For context: the patent on insulin was sold in 1923 to the university of Toronto for one dollar because the inventor felt it was unethical to use this invention to make egregious profits off people who had no alternative. This is 100 year old technology. It's not a manufacturing, regulatory, or technological issue. It's just monopoly pricing and greed.

See comments above for more details on how the expensive insulin being discussed here isn’t the animal-derived insulin isolated 100 years ago

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

#194

Post by basch »

ProjectInsulin wrote: post #189
basch wrote: post #165

Earlier quoted context omitted.

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 f…

I assume when you say 1996, you mean Humalog/insulin lispro? That falls in the rapid category, but I feel like most of the conversation about people wanting cheap modern insulin is the long acting right? The primary quality of life improvement people seek is having to inject only once a day, plus extra if diet requires?

I was dating 20 years from glargine (invented 1994, approved 2000), which is technically still patent protected somehow, despite biosimilars being approved. It takes a while too for Doctors to switch over when new paradigms are delivered. The real metric should be when long acting overtook intermediate acting prescriptions.

For anyone looking for history of modern insulin. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045187/

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

#195

Post by LarryMullins »

skyyler wrote: post #11
MisterBastahrd wrote: post #8

Earlier quoted context omitted.

[flagged]

Could someone against the idea of providing food for children at school explain their position? I'm interested to hear why you think children should go hungry if their parents don't give them cash to bring to school.

The premise is bullshit, schools in America always give the kids lunch whether or not they have money that day. Kids who forget their money still get fed, the schools insist on it. Even if the kid pleads that he's just not hungry today, the school will put a tray of in front of him anyway. If the kid isn't getting free lunches already through the National School Lunch Act (which gives free or reduced price lunches to 30 million kids a year), then the money they owe will be recorded and their parents will be asked to pay it later. If the parents can't pay, the kid will be signed up for free lunches reimbursed by the federal government. But at no point does the school not give the kid a lunch.

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

#196

Post by coredog64 »

HDThoreaun wrote: post #89
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…

Insulin is off patent. There are new versions that offer a variety of benefits under patent, but just generic insulin can be made by anyone who passes the governments regulations. Walmart is known for offering generic insulin at lower prices.

Walmart presumably has a bulk sales deal with Novo Nordisk. The latter actually produces the “ReliOn” brand sold at Walmart.

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

#197

Post by coredog64 »

fallingfrog wrote: post #136
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…

The inventor of insulin sold the patent in 1923 to the University of Toronto for one dollar so that nobody could take advantage of people in the way that's currently being done. This is 100 year old technology. It has nothing to do with development cost. https://www.vox.com/2019/4/3/18293950/why-is-insulin-so-expe...

There’s not a single word in that entire article that calls out that modern insulin products are not the same animal-derived insulin that was isolated 100 years ago.

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

#198

Post by projektfu »

peyton wrote: post #147
RcouF1uZ4gsC wrote: post #133

Earlier quoted context omitted.

>. 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.

Thank you. Insulin, being a biological, can't prove equivalence through just equivalent pharmacokinetics and contents.

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

#199

Post by basch »

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…

>insulin glargine, are off patent now.

In the U.S.A. is expected to expire on 2027-07-05.

How did something invented in 1994/2000, get patented in 2009? https://patents.google.com/patent/US8048854B2/en%3C/

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

#200

Post by hwillis »

taftster wrote: post #178
TEP_Kim_Il_Sung wrote: post #173

Or just abolish the FDA? They're the ones keeping competitively priced insulin out of the market. https://mises.org/wire/patents-legal-monopolies-and-high-pri...

That's a bit like saying we should defund the police. It's thought provoking and grabs headlines. It even has some merit, but it's ultimately not the solution. Reform the FDA, sure I can support that. The FDA, from my perspective, plays such a huge and important role in our society and showcases the exact things we need from our government. They are an example of a government entity that mostly gets the job done righ…

In 1938, the FDA started reviewing and approving drugs.

In 1960, Richardson-Merrell applied for approval for a drug called Thalidomide, a cancer treatment. They had clinical trials that included pregnant women. They were rejected six times.

In the UK, The Distillers Company (Biochemicals) Ltd, a subsidiary of Distillers Co. Ltd marketed thalidomide as Distaval, a remedy for morning sickness. Their advertisement claimed that "Distaval can be given with complete safety to pregnant women and nursing mothers without adverse effect on mother or child ... Outstandingly safe Distaval has been prescribed for nearly three years in this country."

By 1962, over 10,000 children (most in west germany) were born with crippling disabilities caused by thalidomide. Over 2,000 died.

Frances Oldham Kelsey was awarded the medal for Distinguished Federal Civilian Service by President John F. Kennedy for rejecting the drug.

Post reply on HN