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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

#231

Post by dominotw »

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…

Intelligence sq had a debate on this a while ago

https://www.intelligencesquaredus.org/debates/blame-big-phar...

Good arguments from both sides.

> Pharma companies are profiting off of your tax dollars and then turning around and profiting off of you too.

> the taxpayer could do it at nearly 0% margin?

Adds lots of nuance to blanket/false statements.

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

#232

Post by jxramos »

efa wrote: post #172
sorrymate wrote: post #2

Best line in the very short article “Health care is a right for all, not a privilege and that is why I am so proud that we created an insulin price cap that successfully puts patients above profit,” according to Gov. JB Pritzker.

I hate the constant misuse of the word "right". How would a country guarantee this right? What if every doctor in the US quit tomorrow? What if I decided to live on the top of a mountain where there is no population? How does the government guarantee my right to healthcare? Rights are around restrictions. I have the right NOT to be killed. I have a right NOT to be silenced. When something requires someone else doing…

Negative rights seem to be those more amenable to guarantees since they ask little. The guarantee of positive rights assumes a bunch of prerequisites from what I understand (some of which like healthcare are predicated on a ton of upfront infrastructure and training and availability and so forth). https://en.wikipedia.org/wiki/Negative_and_positive_rights

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

#233

Post by nate_meurer »

jahaja wrote: post #187
tptacek wrote: post #136

Earlier quoted context omitted.

No, his solution is to dial competition back up by reducing regulatory barriers to new entrants, competition being the thing that tends to actually produce durable price decreases in markets, and is, for instance, the reason virtually everyone in the country has a phone in their pocket that only rich people had just 12 years ago. You can't coherently and simultaneously believe that markets are inefficiently pricing i…

This is the classical "tricke down economy" type of solution. Give companies, who are additionally acting unethically, a guaranteed and direct profit increase and _hope_ that it solves itself in the long-term. Surely it depends on the barriers and how much of a cut those actually are in practice. Furthermore, private corps aren't the only way drugs can be invented.

No, trickle-down refers very specifically to tax breaks tailored narrowly to the wealthy, in hopes that they will in turn distribute their wealth via increased employment of capital and, ultimately, labor. Since its origins in Gilded Age populist political writing and depression era popular media, it has never meant anything else, and it has nothing to do with the subject at hand.

> Give companies, who are additionally acting unethically, a guaranteed and direct profit increase...

No, lowering barriers to competition doesn't give anyone guaranteed profit. It reliably does the opposite, depriving incumbent companies of their monopolies.

> Furthermore, private corps aren't the only way drugs can be invented.

Nobody -- literally nobody -- would dispute that. The question is whether the government is able to do the various parts of drug development as efficiently as the private sector. This is not a simple analysis, but I think the answer is more often than not, No.

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

#234

Post by shpongled »

jahaja wrote: post #187
tptacek wrote: post #136

Earlier quoted context omitted.

No, his solution is to dial competition back up by reducing regulatory barriers to new entrants, competition being the thing that tends to actually produce durable price decreases in markets, and is, for instance, the reason virtually everyone in the country has a phone in their pocket that only rich people had just 12 years ago. You can't coherently and simultaneously believe that markets are inefficiently pricing i…

This is the classical "tricke down economy" type of solution. Give companies, who are additionally acting unethically, a guaranteed and direct profit increase and _hope_ that it solves itself in the long-term. Surely it depends on the barriers and how much of a cut those actually are in practice. Furthermore, private corps aren't the only way drugs can be invented.

You are completely misunderstanding the argument.

Lets say the current price for insulin is $200. I see this margin, and say "I can produce insulin for cheaper, and I'm happy with selling it for $50". The government is placing restrictions on new competitors, so I can't just come in and sell insulin for $50. There is a restriction on competition, which causes artificial prices

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

#235

Post by stevehawk »

ptah wrote: post #42
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…

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

It's banned in all countries except 2 I believe

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

#236

Post by shpongled »

throwlaplace wrote: post #88
stochastician wrote: post #37

Earlier quoted context omitted.

Comments like this always make me sad. Not just because I disagree with them (I do!) or that I think they are claiming certainty about facts in dispute (I think they are ! [1, 2] ) but because they make no mention of trade-offs. We can vehemently disagree about these things, get our information from different sources, and advocate for different policies, but hopefully we can all agree that there _would_ be tradeoffs?…

whenever anyone casts doubt on the idea that healthcare (or pharma) could be cheaper (and implicitly that the tradeoffs would be worth it) my simple response is: then please tell me how does every other western nation accomplish it? overall healthcare goals are met and for less money (in aggregate and individually) all around the world. in which way is america exceptional except insofar as exactly that here business…

Every other western nation can accomplish it because the US is paying for, and performing the vast majority of drug discovery research (publicly and privately funded). US citizens are subsidizing the healthcare of all of those other countries.

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

#237

Post by tialaramex »

monadic2 wrote: post #181
refurb wrote: post #169

Earlier quoted context omitted.

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…

I would imagine you’d need to draw a correlation between advertisements and quality of care and successful treatment rate; awareness and involvement aren’t positive or negative per se. Secondly, I see too many damn branded pens in my doctor’s office to be under the illusion that the marketing is only directed at the patients. I can’t count the number of times I’ve been prescribed medication just to have it swapped ou…

So, the reason they've got branded pens is that the drug reps are allowed to give them pens, so they do. Trivial low value gift. Historically the doctor wouldn't remember HealthyHeart brand beta blockers because of the 40 cent pen but because they paid for his two week safari. Most of the world banned that, but not so very long ago. My nurse friend didn't spend a penny of her own money on big birthday events when she was younger, drug reps paid for everything. (In the NHS system some nurses have full prescribing powers I presume some US nurses likewise but even if not it's the same for doctors)

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

#238

Post by jwbwater »

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…

The politicians solution: create another law. The economists solution: create more competition, probably by getting rid of some laws. I guess JB Pritzker knows more about politics than about economics.

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

#239

Post by djpowell »

topspin wrote: post #217
ikeboy wrote: post #67

Earlier quoted context omitted.

You can buy the formulation that was invented in 1923 for cheap. It's newer formulations that are expensive, and those are still protected by patents.

That just raises more questions. Are these "newer formulations" a meaningful improvement over everything else (in particular those for which patents have expired) created during the past 97 years, as opposed to ploys to maintain IP? The tactic involved here is using regulatory capture, near monopoly control of supply and IP law to limit what is available for prescription use to expensive products.

Mostly, yes. The newer insulins (well they've been around for 20 years) have molecules which are engineered be faster acting so that they reduce peaks in blood sugar after meals; or longer lasting, so they can provide a more predictable background coverage.

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

#240

Post by XnoiVeX »

sorrymate wrote: post #2

Best line in the very short article “Health care is a right for all, not a privilege and that is why I am so proud that we created an insulin price cap that successfully puts patients above profit,” according to Gov. JB Pritzker.

Ignoring the right versus privilege debate, It's just humane to provide resonably priced access to a drug that was invented many decades ago the price of which was artificially kept high by abuse of the patent system. The R&D cost of which is certainly fully amortized by now.
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