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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

#221

Post by jwbwater »

GrumpyNl wrote: post #141
Someone1234 wrote: post #8

I'm really past the whole "pharma need to charge high prices to fund research" line of argument. Aside from being factually untrue (research funding is dwarfed by marketing for example[0]), it is also arguing for a continued unhealthy relationship with pharmaceutical care. A large amount of research is currently publicly funded. Either via public academic research or directly. When that research bears fruit it is oft…

We should start open sourcing for meds.

It would be interesting if there was a way to inform people about effective options that are not profitable enough to receive much attention in our current system.

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

#222

Post by vasilipupkin »

everyone tearing their hair out over this: the effect of the law is just that insurance overall will be somewhat more expensive in Illinois. There won't be any effect on research or innovation or anything else. Everyone will have to chip in a bit to make sure people with diabetes don't go without insulin. I don't see this is as a big disaster. Illinois has much bigger problems than this.

If people foregoing insulin because of out of pocket cost is a problem in Illinois, fixing it could have positive effects, including positive fiscal effects. So net cost is probably quite small.

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

#223

Post by a1369209993 »

UnFleshedOne wrote: post #182
ikeboy wrote: post #104

Earlier quoted context omitted.

https://www.fdareview.org/issues/theory-evidence-and-example... This provides what to me is compelling evidence that the efficacy requirement by the FDA is wasteful.

> Thus, he concluded, “(the) penalties imposed by the marketplace on sellers of ineffective drugs prior to 1962 seem to have been enough of a deterrent to have left little room for improvement by a regulatory agency” Amount of homeotherapy currently on the shelves bring "penalties imposed by the marketplace on sellers of ineffective drugs" into a sharp contrast... People will take pure water if you tell them it works…

> People will take pure water if you tell them it works.

To be fair, if you tell them it works, people will take pure water and show noticable improvments over non-treatment. Personally I just take the placebo effect directly though.

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

#224

Post by choward »

andrewla wrote: post #102

Unfortunately, this does not act as a price control. This just mandates that insurance companies cap the out-of-pocket expense; it does nothing to affect the retail or wholesale price of insulin except insofar as insurance companies can push back on drug manufacturers. Net effect of this is yet to be seen, since it doesn't go into effect until 2021, but one possibility is that insurance companies will only cover vari…

You're right. This is terrible. Here's an excerpt from the bill:

> Provides that insurers that provide coverage for prescription insulin drugs must limit the total amount an insured is required to pay for a covered prescription insulin drug to $100

This will create way more problems than it solves. It continues to hide the true cost from the consumer. This doesn't affect the pharmaceutical companies or insurance companies at all. What it will due is just make the insurance companies charge everyone a little more. The corporations are not affected whatsoever.

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

#225

Post by slowhand09 »

mumblemumble wrote: post #99
ikeboy wrote: post #43

Earlier quoted context omitted.

When it costs billions to develop a new drug due to onerous testing regulations, that's what happens. Ultimately returns in every industry tend towards zero. If we made it cheaper to develop new drugs it would extend the lifespan of the industry somewhat but not indefinitely. At some point diminishing returns take over and investment must go down.

Given that closer research is finding that a lot of popular drugs and treatments actually do more harm than good, I don't think it's so easy to characterize the current testing regulations as onerous. The current regime in the USA didn't happen for nothing. It's well-known now that pharma companies had long been exploiting the file drawer effect and p-hacking to inflate the apparent safety and efficacy of their drugs…

I concur with this completely. Disclosure: I was a contract IT worker at FDA.

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

#226

Post by [deleted] »

aantix wrote: post #210
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.

How does it mislead? They can be sued for making false claims. There's no value in doing so, especially in a high profile medication. Why would you spend a couple billion dollars on research/marketing, years of research, to bring something to market only to shoot yourself in the foot by making false claims?

[deleted]

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

#227

Post by djpowell »

vasilipupkin wrote: post #185
save_ferris wrote: post #139

Earlier quoted context omitted.

> Theoretically, price caps can be set low enough that no one will produce and sell an item. But studies show that the US currently pays as much as 7x what the UK does for insulin[0]. How can insulin be so cheap in some places but so expensive in others to the point that manufacturers stop making it? 0: https://insulinnation.com/treatment/u-s-pays-much-uk-insulin...

because UK subsidizes it. But UK residents pay 33% of GDP in taxes vs US pays only 27%, according to this https://www.oecd.org/tax/tax-policy/global-revenue-statistic... so it comes out of the higher taxes.

Those prices have nothing to do with subsidies. It is showing that the NHS pays a fraction of the US prices for the same insulins.

Diabetics are exempt from all out-of-pocket prescription charges though, so that part is subsidized.

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

#228

Post by rayiner »

alamortsubite wrote: post #189
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…

> Drug development is high tech work. If the government could do it well, while squeezing out the profit margins, there would be no reason for the government not to run Google or Netflix. I agree we don't need a state-run version of Google or Netflix, but how does their being "high-tech" in any way preclude that? NASA seems like a great counter-example.

Capital intensive R&D—getting highly skilled workers into a run and having them work in making things that don’t exist and may not necessarily be possible—is a specific type of work. That type of work is similar both in pharma and Silicon Valley. If the government could do that efficiently, there would be no reason not to have a public version of a Google.

Focusing on whether we “need” a state-run version of Google misses the point. It’s not the nature of the product that matters. If the government could run Google as efficiently, and we could squeeze out the profit margin in the process, why shouldn’t the government run Google? We have Google as a private company not because we believe certain products and services should be “given” to the private sector, but because we believe certain types of work are more efficiently handled by the private sector.

NASA is not a good counterexample. NASA (and DARPA) are managerial organizations. The Apollo lander was designed and built by Rockwell and the Saturn V rocket was designed and built by Boeing.

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

#229

Post by Ericson2314 »

Someone1234 wrote: post #8

I'm really past the whole "pharma need to charge high prices to fund research" line of argument. Aside from being factually untrue (research funding is dwarfed by marketing for example[0]), it is also arguing for a continued unhealthy relationship with pharmaceutical care. A large amount of research is currently publicly funded. Either via public academic research or directly. When that research bears fruit it is oft…

I'm fine with purely public research funding, but if we need extra incentives for "last mile" applied research, drug bounties are wholely better for the public and pharmaceutical industry alike.

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

#230

Post by jwbwater »

nodesocket wrote: post #84
Someone1234 wrote: post #8

I'm really past the whole "pharma need to charge high prices to fund research" line of argument. Aside from being factually untrue (research funding is dwarfed by marketing for example[0]), it is also arguing for a continued unhealthy relationship with pharmaceutical care. A large amount of research is currently publicly funded. Either via public academic research or directly. When that research bears fruit it is oft…

My mother has diabetes and pays quite a bit for her insulin in California. I however am not sure government enforced price caps are the way to go. Today, people neglect to factor in the law of unintended consequences, and instead stand on a pedestal of moral superiority argument. What happens if price caps do reduce research. It’s no coincidence that the US has the best pharma companies and develops some of the most…

Agree price caps are not the solution. Don't agree about US big pharma. Novartis is a Swiss multinational, Roche also Swiss, Bayer is a German multinational, Glaxo Smith Kline is a British multinational... Big pharma is a global, or at least Euro-American effort.
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