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EpiPen Price Rise Sparks Concern for Allergy Sufferers

well.blogs.nytimes.com

241–250 of 367 posts

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#241
post #67

Earlier quoted context omitted.

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…

That's silly. How do you propose to "evaluate what is better, healthier, more rational"? I suppose some panel of experts could give you their best approximation, but it will always be sub-optimal. Markets exist in order to answer these questions, and they answer them by delegating the decision to every person involved in the decision, not by hoping a designated person can make a guess that's close enough. It appears…

Enough rhetoric.

"Ah, but what do you propose, eh, Mr. Expert?"

-"Oh, maybe this?"

"AHA! This flaw would prevent that from being a workable solution. Keep the status quo!"

As if (a) understanding that there is a problem necessarily means that one must understand the solution, or (b) as if we live in a vacuum and this hasn't been addressed by dozens of other nations.

It has been addressed. In a dozen different ways, with different pros and cons. I can't tell you if the British or German or Japanese method is better, but I can tell you that we're the only schmucks going bankrupt to avoid death by bee-sting.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#242

Meanwhile, in single-payer Britain the NHS pays £26 ($35). https://www.evidence.nhs.uk/formulary/bnfc/current/3-respira...

"Unfortunately this site is only available from Great Britain." - but the Google Cache works: https://webcache.googleusercontent.com/search?q=cache%3Ahttp...

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#243

Earlier quoted context omitted.

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…

Both Teva and Sanofi have other drugs using auto-injectors in the market.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#244
post #235

Earlier quoted context omitted.

When was this done, and how did it go?

It's surprisingly frequent, though generally short lived. Legal and profitable mob run businesses are taken over vs shut down then resold once the books are clean. During World War II, Washington seized dozens of companies including railroads, coal mines and, briefly, the Montgomery Ward department store chain. http://www.nytimes.com/2008/10/13/business/worldbusiness/13i... Banks are probably the most common but it c…

So, we have:

- Seizing companies literally run by criminal organizations.

- A single time during war when companies were nationalized, and which was then ruled "an unconstitutional abuse of presidential power".

- A bailout of the shareholders and creditors of failed companies.

The only relevant one seems to be the second, and the outcome in the courts doesn't sound promising.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#245
post #28
post #18

One of the early on-line responses was "maybe we can figure out how to 3D print these cases". It turns out that an Epi-pen is just a plastic safety housing around a normal syringe. Some discussions: https://www.reddit.com/r/news/comments/4y5481/cost_of_epipen... https://www.reddit.com/r/3Dprinting/comments/4y7f26/epipen_f...

That second discussion got heated quite fast. I agree with the downvoters though. 3D printing a medical device is not something to take lightly. Edit: Here's why I agree. You download this design from the internet, and 3D print the parts. You then assemble it. Awesome! Some time later, you get an allergic reaction. You use the pen, but it fails to work correctly. Who's responsible? The designer? You (if you're alive)…

On the other hand, it doesn't have to work 100% of the time to be viewed as a threat, economically. Make it widespread, make it reasonably effective and you will likely succeed in driving the price of the certified EpiPen.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#246

Meanwhile, in single-payer Britain the NHS pays £26 ($35). https://www.evidence.nhs.uk/formulary/bnfc/current/3-respira...

Even at retail (i.e. just walk into pharmacy with your prescription and buy it like you'd buy a coffee) they are £50 per pen/£90 for two [1] ($66/$118 at today's USD-GBP rate)

The weird healthcare system in the US is one of the main reasons I've resisted calls to relocate there for work. Stories like this are just really off putting.

1 - https://onlinedoctor.lloydspharmacy.com/uk/allergy/epipen

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#247

Earlier quoted context omitted.

Semi-yes, semi-no. The epi-pen case is specially made to try and get people to shoot it into themselves/other people correctly. They are super color coded and once triggered can't be untriggered Other than that, they could be 3-d printed or whatever is cheapest by many providers

Consider also reliability: What if some 3D-printed part breaks? What if it sticks when it gets hot or cold, or after a few hot/cold cycles, or after some flexing in a pocket? The first 90% of quality is easy ... Think of the difference between the quality needed for a mobile game app and the software that flies airplanes.

If they're significantly cheaper, carry 2 or 3. If you're at a 90% level, you will be almost assured of cheaply having one work, assuming the error/failures are random.

Yes, this is sub-optimal in a life or death situation, but it's a reasonable counter to unreasonably high EpiPen pricing. Moreover, if this becomes common practice or if it's even feared as plausible, it could help reduce EpiPen pricing.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#248
post #28

Earlier quoted context omitted.

That second discussion got heated quite fast. I agree with the downvoters though. 3D printing a medical device is not something to take lightly. Edit: Here's why I agree. You download this design from the internet, and 3D print the parts. You then assemble it. Awesome! Some time later, you get an allergic reaction. You use the pen, but it fails to work correctly. Who's responsible? The designer? You (if you're alive)…

> You use the pen, but it fails to work correctly. Who's responsible? You are responsible for making decisions for yourself. If you think a 3D printed pen is not safe, buy the more expensive one. Don't hedge every decision you make against who you'd be able to sue if it goes wrong.

I was going to reply and say this, but you said it first :)

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#249

Earlier quoted context omitted.

Given the proper age, teaching kids to use syringe/vials or having a school nurse that can administer epinephrine would be a much cheaper alternative. EpiPens are purely about the delivery mechanism. Stabbing a syringe into your thigh and injecting a predetermined amount of epinephrine into your leg isn't majorly complicated. Maybe having a single pen on the kid and vials/syringes at the school would be a cheaper opt…

I don't think you've ever seen a child in Anaphylactic Shock if you think all you need to do is train the child to use a vial and needle. Even training school personnel is not a great idea - While an ER nurse or paramedic can handle it because they give injections every day, a teacher or even a school nurse may go for years without ever needing to do an epinephrine injection and the stress and inexperience may make t…

Is there a reason the syringes can't be pre-filled so that the step of filling from the vial needn't be done under pressure?

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#250
post #98

Earlier quoted context omitted.

Even though there are cars with a 5-star safety rating, you can still get ones with a 4-star or even 3-star ratings. So I would say the answer to the original question "Does the government prevent you from buying less safe cars" is "No".

In both situations, the government sets a minimum permissible safety standard to sell the product. Medications and medical devices are allowed to kill/injure, but only to a point. Same with cars.

The Government doesn't forbid you, the consumer, from buying questionable cars. It's the manufacturer who is restricted by Government regarding what cars they can sell.
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