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EpiPen Price Rise Sparks Concern for Allergy Sufferers

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Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#201

Post by gwright »

Ironchefpython wrote: post #182
gwright wrote: post #128

Earlier quoted context omitted.

The non-trivial entry costs are there because of regulations and the legal environment regarding liability. You can view the high price as the free-market finding the intersection of supply and demand given the regulatory and legal constraints but that seems like a less than useful way of understanding 'free-market'.

> You can view the high price as the free-market finding the intersection of supply and demand given the regulatory and legal constraints but that seems like a less than useful way of understanding 'free-market'. Stop using regulation as a stalking horse for your argument. Everything you need to know about the price of epi pens you can derive from inelastic demand (people don't want to die), and barriers to entry (co…

Let me see if I can be a bit clearer. A market with high barriers to entry that are defined by regulations and legislative constraints is not a free market. It is a market, just not a free market.

Blaming high prices in this situation on a failure of the market mechanism is simply inaccurate. The high prices are a result of the constraints that prevent competition and the emergence of a free market.

I'm not sure what to say about your assertion that price isn't a component of a competitive market. Certainly competitors try to compete on 'value' of which price is a component among many others (ease of use, features, reputation, availability, etc.).

I don't know what you are defining as 'unregulated markets', but I'm not advocating for the removal of legal frameworks that prevent fraud, negligence, collusion, and so on.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#202

Post by sevenless »

harryh wrote: post #77
sevenless wrote: post #30

How many people will this price hike kill? I'm sure that's estimable. What would be morally justified, to stop it?

I dunno. I bet it's a pretty small number. Fewer than 100 people die per year in the US from anaphylaxis and it's hard to find evidence that this number has risen along with the price of the EpiPen. At the top end maybe the answer to your question is a dozen or so. About the same order of magnitude as the number of people that die due to dog bites. It's really small.

Fair enough. Maybe it's not such a big deal then.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#203

Post by WalterBright »

Ironchefpython wrote: post #200

> selling service contracts, [...] The price is still $0 and there are still no regulations on it. I assume at this point that you're being paid to shill some political viewpoint on the internet, because you just explained that the price of software isn't actually zero, because it's unusable (to the customers that buy a service contract) without a service contract, and creating a company that employs the developers t…

You're making quite a vast assumption that service contracts mean the software is unusable without them. Red Hat Linux is just one counterexample.

A further vast assumption is that your arguments are so compelling that anyone not convinced must be a paid shill.

There are many software consultants who charge over $10,000/day for doing training. Many companies find them worthwhile when amortized over a roomful of engineers. Those consultants aren't suckering anyone in by giving them free software, in fact, they don't provide any software whatsoever.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#204

Post by eropple »

Ironchefpython wrote: post #200

> selling service contracts, [...] The price is still $0 and there are still no regulations on it. I assume at this point that you're being paid to shill some political viewpoint on the internet, because you just explained that the price of software isn't actually zero, because it's unusable (to the customers that buy a service contract) without a service contract, and creating a company that employs the developers t…

> I assume at this point that you're being paid to shill some political viewpoint on the internet

I don't agree with Walter on this issue, but a cursory Google of who you're talking to should indicate how ridiculous this statement is. You are profoundly out of line and you owe him an apology. (You'd owe anyone an apology, but this is particularly silly of you.)

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#205

Post by WalterBright »

Ironchefpython wrote: post #199
WalterBright wrote: post #197

Earlier quoted context omitted.

> have increased in price to capture the consumer surplus It is quite a remarkable coincidence that medical costs angled steeply upward immediately after heavy regulation and government involvement in it began. > I can maintain a monopoly It'll be pretty hard to swallow $1 million/year in losses to do so. You'd have to maintain those losses to beat back even a small competitor, who would have proportionally smaller l…

> It is quite a remarkable coincidence that medical costs angled steeply upward immediately after heavy regulation and government involvement in it began. Regulation didn't give people more money to spend on medicine. Offshoring jobs to China drive down prices of consumer goods to make more money available as a consumer surplus that could be captured by healthcare. If the price of food increased, the price of housing…

> could be captured by healthcare.

Why wouldn't it be captured by farmers? or carmakers?

> all of financial theory AND history

Can you give case history of a company that maintained a monopoly via periodic dumping to bankrupt any competitors? I'm not aware of one, and no, Standard Oil is not one (see the book "Titan" about it). I've read many econ/history books, and none them put forward your dumping theory. Do you have a book reading list?

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#206

Post by Animats »

leereeves wrote: post #51
Animats wrote: post #13

Earlier quoted context omitted.

They did. Windgap[1] took venture capital, took state funding from Massachusetts back in 2012, and didn't ship the product. Cool web site, though. Sanofi tried, but their product misfired at least 26 times and was recalled.[2] Teva tried, and their product was rejected by the FDA because of problems; they're going to try again with a new model in 2017.[3] [1] http://www.windgapmedical.com/ [2] https://www.auvi-q.com/…

Three companies tried and failed? It sounds like it's harder than we might think to make this work. Given that, and the low volumes, it might not be that profitable even at $600 per sale.

The companies that tried to enter the business were drug companies, not device companies. No expertise in volume manufacturing of medical-grade injection-molded plastic devices. There are companies which can do that.[1] There are automatic inspection technologies which can detect even minor flaws.[2] But the typical injection molding vendor isn't that good.

Consider the typical failure rate of ball-point pens. That's consumer-grade injection molding.

[1] http://www.advancedmt.com/wp-content/uploads/2012/10/amt_med... [2] http://www.vision-systems.com/articles/print/volume-9/issue-...

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#207

Post by [deleted] »

JshWright wrote: post #154
invaliddata wrote: post #146

The adrenaclick generic is much cheaper than the epipen, with or without insurance. Although technically different epinephrine auto injectors cannot be substituted (you can only be prescribed the one written by your doctor, or its generic equivalent), practically speaking the only difference between the epipen and the adrenaclick design is the instructions for use. I would hope there isn't a case of doctors being una…

I don't understand why a prepackaged vial/syringe kit isn't readily available for epinephrine. It works just fine for glucagon... http://www.childrenwithdiabetes.com/d_0n_022.htm We're literally talking about $1 worth of epinephrine, a $0.50 syringe, and a couple cents worth of injection molded plastic case...

[deleted]

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#208

Post by cheald »

rdtsc wrote: post #67
sevenless wrote: post #30

How many people will this price hike kill? I'm sure that's estimable. What would be morally justified, to stop it?

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…

The reason that EpiPens are expensive is because they're patent protected. In this case, regulatory protection that is the explicit issue. Demand for the product is clearly there; supply is not, not because there is nobody willing to provide it, but because the government prevents would-be competitors from doing so.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#209

Post by rangibaby »

greenknight wrote: post #186
niels_olson wrote: post #129

Earlier quoted context omitted.

Surely design files can be signed...

Sure... but then there is the problem of the end user. Is there 3D printer correctly calibrated? will miscalibration effect its end use? how can you test to make sure the printed design is working as intended? Can the printed plastic withstand direct sunlight for days on end? Some printed plastics become brittle over time in sunlight (PLA for instance).

When the difference is $1 vs $600, I think a lot of people would be willing to take that risk, especially for something that is basically an unexpected expense; I doubt any allergic people are getting stung by bees on purpose.

Most people I know couldn't handle a sudden $600 expense like a car repair without help from someone like their parents (I'm mid-20s living in JP).

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#210

Post by icebraining »

Ironchefpython wrote: post #177
ancap wrote: post #140

Earlier quoted context omitted.

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.

> The only sectors of the economy where significant, lasting shortages occur are the ones most heavily regulated. So you're saying that Petroleum Exporting Countries would never say... create an Organization intended to increase the price of oil? Or the DeBeers wouldn't collude with diamond producers to limit the availability of diamonds to increase the price? Or that manufacturers and distributors of light bulbs, ly…

So you're saying that Petroleum Exporting Countries would never say... create an Organization intended to increase the price of oil?

How does that help your case? The members of that organization are governments, not companies. OPEC is regulation.

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