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EpiPen Price Rise Sparks Concern for Allergy Sufferers

well.blogs.nytimes.com

251–260 of 367 posts

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#251

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…

Thank you for mentioning adrenaclick. Generics have been completely missing from the public debate. While epipen price gouging is very real, and a problem, there is one short term solution for allergy sufferers: demand an Rx for the generic. They are under $200 (source: checkyourmeds.com). Vote with your wallet!!

Looks like the differences are: extra safety cap and Epipen brand has an auto-retracting needle.

https://m.youtube.com/watch?v=LRgqwgCh4Fs

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#252
post #130
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)…

I rather dislike the (frequently American) immediate viewpoint of assigning blame/responsibility in the case of a failure, and thus who can someone sue. This isn't an uncommon viewpoint at all, rather it seems to be the first that many go to.

Responsibility (blame) is not the same thing as "who can I sue?"

For one thing, finding the source of the problem, or whatever warped thought process resulted in it, is a good place to start fixing things.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#253
post #235

Earlier quoted context omitted.

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.

You misread the WWII example which was considered completely ok. In different war: "In 1952, President Harry Truman seized 88 steel mills across the country, asserting that unyielding owners were determined to provoke an industry-wide strike that would cripple the Korean War effort. That forced nationalization did not last long, since the Supreme Court ruled 6-2 the action an unconstitutional abuse of presidential power." (You might want to read it vs skim.)

Also of note, their are thousands of examples in history, this is just referencing a few hundred to make a point.

PS: It's also worth noting that the mob example was taking control not just ownership. These companies where money laundering for example so they needed to remove people from the payroll who did not work there.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#254

Earlier quoted context omitted.

Scarcity demands innovation. I don't think its being taken lightly; more like, "a private company is gouging medical users and the government won't step in". Not left with many options when your life depends on it. EDIT: Alternatively, a "better" temporary solution would be to arrange for the import of these from Canada, where the price is fixed by the government.

Well the cheaper and more effective solution would be to carry around a syringe and a small bottle of epinephrine.

The autoinjector provides value for people that don't do IM administration every day. It's rugged, sterile, can be used right through clothing if necessary, and provides the right amount of force to go through to the muscle. The kit might also include a practice injector for training the user.

Oh and it's probably a little hard to handle a bottle and syringe on yourself while you're suffocating.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#256

Why haven't competitors entered the market with cheaper products?

I'm confused about this myself. I used to receive EpiPen brand auto-injectors. At some point, I started receiving Lineage Therapeutics auto-injectors (supposedly an Adrenaclick generic) instead. According to [0] they are _not_ equivalent to EpiPens according to the FDA. I'm not sure if my primary care physician or my old pharmacist (CVS chain) are at fault for not informing me of the differences. My generic prescript…

They're not equivalent (that is, it can't be freely substituted by a dispenser) only because the devices are mechanically different. Knowing how to use an EpiPen doesn't mean knowing how to use an Adrenaclick, even if they are aministering the same drug in the same dose using more-or-less the same kind of mechanism. It's that "more-or-less" that's the key; since they differ in the way they're used and administration is quite time-sensitive, you can't assume that a person trained to use an EpiPen will be able to use an Adrenaclick properly when the time comes (or vice versa).

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#257

Why haven't competitors entered the market with cheaper products?

The epi pen wasn't extremely expensive until recently, so competitors had to take a different and riskier angle to make it in the market. Perhaps now a carbon copy will do well.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#258

Earlier quoted context omitted.

Scarcity demands innovation. I don't think its being taken lightly; more like, "a private company is gouging medical users and the government won't step in". Not left with many options when your life depends on it. EDIT: Alternatively, a "better" temporary solution would be to arrange for the import of these from Canada, where the price is fixed by the government.

Well the cheaper and more effective solution would be to carry around a syringe and a small bottle of epinephrine.

That makes too much sence for the FDA, AMA lobby, big pharma, and very entity/persons that makes a killing off health care.

As to the simplicity the EpiPen, I once used it, and under stress didn't do it right.

When I was younger I was very interested in medicine. In college finished all pre-med courses. Interned at a Coroner's office, etc. Even spent some time in med school. Very familiar with giving a subdermal injection.

Now my father had a bad asthma attack years ago. I knew he was in poor health, so my stress level was high. He blurted out where the EpiPen was kept. I got the device, didn't have time to read the instructions, and just stuck it in his thigh. I apparently pulled it out too quick--just wasn't thinking, and nervous. I pulled it out so quick, because I was scared, felt the device was foolproof, and felt weird hurting my father. We luckey had enother one around, and injected him longer this time. If I was forced to use a syringe, their would be no assuming. "I need to get the drug into the syring. I then need to empty the syring into his thigh. Done?"

Well it didn't work, and he ended up in the emergency room. He survived.

I drove home feeling guilty, and still do today.

I always felt a kit with a single dosed bottles of epinephrine, and a syringe would make intuitive sence to a lot of people? I know I would have felt more comfortable that night.

I honestly think the powers at be underestimate the abilities of the average person, especially a person who's had an previous asthma attack. If a doctor/nurse spent a minute showing a patient how to injection themselfs with epinephrine; I don't think most would ever forget. Plus--we have all watched injections given on the boob tube? "But the average person would probally jab the syringe in the Carotid artery, or pull a Pulp fiction." They could jam it into a carotid, even with a EpiPen--with enough effort/stupidity?

I hope in the future we have over the counter life saving medications over the counter, including naloxone.

Demand passing a basic test if worried about consumers hurting themselfs? Something like a CPR certification? If the patient can pass, they can buy cheap medications over the counter? They don't need fancy propriatiatry drug delivery gadgets in so many cases.

I really think the only way to bring down medicine costs will be to make many drugs OTC, and demand basic competency exams if worried about ineptitude? There will always be people out there that will find a way to abuse/overdose/screw up dosesages on medication. Let's just try it for a year? Especially with certain life saving drugs. How many diabetics die each year because they don't have a prescription for insulin, and couldn't get to a hospital?

I used to have so much respect for any sector of the health care; now I look at most of them with utter discontent.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#259

Earlier quoted context omitted.

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…

I wonder why glucagon isn't done in the same format as EpiPens are. I'm a T1 diabetic and I have one glucagon vial at work and one at home. In the case I go low (barely responsive low) someone has to go grab it from the fridge (it needs to be there) load the syringe and use it on me. When people sleep over I teach them how to use it and I do something like a show and tell at job from time to time so new people know a…

It's not just 'load' the syringe. There's a liquid and a powder that has to be mixed. First, the liquid is injected into the powder. Remember to remove the protective cap from the vial and the two protective caps from the needle (apparently, people frequently forget the one on the vial and break the syringe). Then, mix by rolling, not shaking, for 30 seconds. Then, withdraw the mixture into the syringe and inject it.

Not only does it need to be kept refrigerated, the shelf-life isn't that long to begin with (about a year).

I'm also a T1D and there's a reason that, despite the various seizures I've had in my lifetime, I've never received Glucagon.

Cake icing squirted between your gum and cheek also works (although everything ends up sticky and blue by the end of it).

Edit: I didn't mean to sound like you didn't know what you were talking about, I just wanted to expand on what you were saying about 'show and tell'

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#260
post #149

Earlier quoted context omitted.

> Would you just prefer the gov't to step in and set the price? What happens if companies decide it's not worth the effort? Have the gov't force them to produce the product? Cut out the private market and have the government manufacture it directly.

Can you give me some examples where the gov't has come in as a manufacturer and it's actually gone well?

They've done pretty well in the power sector. One could argue that most power (electric) companies are really just state run shells.

https://en.wikipedia.org/wiki/Hoover_Dam

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