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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

#271

Post by TallGuyShort »

toomuchtodo wrote: post #159
TallGuyShort wrote: post #157

Earlier quoted context omitted.

I never signed a social contract. Can you point me to the text? I'd like to read it, since apparently it keeps requiring me to relinquish my rights.

Google for your local, state, and federal law. Your continued presence in the jurisdiction indicates your acceptance of the implicit contract defined by these laws. If it doesn’t vibe with your beliefs (which is fair!), there are other jurisdictions available for consideration, a visa and plane ticket away.

The laws are not the contract. I already moved where I did because I liked the laws. But the damned things keep changing because of this social contract. If the laws were the social contract, your parent comment wouldn't make sense either. Not liking the laws is one thing. Justifying new ones because of this pretend contract is another.

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

#272

Post by throwaway_tech »

chimeracoder wrote: post #178
throwaway_tech wrote: post #149

Earlier quoted context omitted.

In the US, we have something similar (but evil) that people don't know or refuse to acknowledge. A Doctor writes a script, and then a pharmacist (not on their own, but at the direction of an insurance company) suggests a change typically to benefit the insurer (for example changing a name brand to a generic or changing 30 days to 90 days so the patient doesn't get seen by the doctor again for 90 days for additional t…

> for example changing a name brand to a generic In most states, the law explicitly requires the pharmacist to fill a prescription with a generic (if available) unless the doctor specifically writes "dispense as written". Not allows - requires . The purpose of these laws is to protect patients - in the overwhelming majority of cases, the generic and brand name drugs are equivalent for patients, so patients save money…

>The purpose of these laws is to protect patients

Its not the patients that lobbies for these laws...it is the insurers, and its to lower their costs.

Its also why the insurers pay the pharmacists a bonus for these changes, if it was about costs to the patient, the bonuses (money back) would go to the patient.

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

#273

Post by tptacek »

jahaja wrote: post #262
shpongled wrote: post #234

Earlier quoted context omitted.

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

The presumption is that it's actually the regulations that prevents the competition, which haven't at all been made clear. How about patents for example? How about the cheap prices of Europe?

The presumption is that the regulations add a major cost hurdle to delivering unencumbered insulin products at lower prices, because that is in fact what they do.

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

#274

Post by ryanmercer »

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

But I like cartoons telling me about amazing drugs I desperately need in my life while someone soothingly mentions oily rectal leakage [1], compulsive gambling [2], and suicide [3] as potential side effects!

[1] https://www.drugs.com/sfx/orlistat-side-effects.html

[2] https://time.com/4317182/abilify-aristada-aripiprazole-sex-g...

[3] https://www.health.com/condition/depression/medications-depr...

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

#275

Post by vkou »

beamatronic wrote: post #203
ptah wrote: post #42

Earlier quoted context omitted.

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

It seems like there is a perception by these companies that there is a discoverability problem. If they are truly making a useful and safe drug, there should be a market for it. Instead of marketing, shouldn’t there be a way to make all products and services more discoverable? By doctors in this case and generically in the larger sense. Incidentally, I have had two occasions where I wanted to search for a product by…

> It seems like there is a perception by these companies that there is a discoverability problem.

The rest of the world manages to 'discover' that these drugs exist on the market just fine, yet pharma advertising is banned in most of it.

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

#276

Post by AdrianB1 »

mytailorisrich wrote: post #19
save_ferris wrote: post #5

Earlier quoted context omitted.

How will people lose their insulin over this?

If the law simply prevents prices higher than $100 in Illinois then manufacturers and distributors might stop selling in the state or only take orders from the state if they have surplus. Either of which might hit availability in the state, especially if the industry tries to make an example out of this. I guess it also depends on the profit margin at that price and how it compares with the "market price". Edit: Care…

The downvotes are because the opinion you have is not popular, not because it is wrong. You may be right, you may be wrong, that is less important these days.

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

#277

Post by ars »

throwaway_tech wrote: post #258
ars wrote: post #188

Earlier quoted context omitted.

That's not something similar, and has nothing whatsoever to do with what you replied to. And there's nothing wrong with switching from brand name to generic, and most patients don't need to see their doctor every 30 days, and if they do, they can still make an appointment. The length of the drug prescription does not control the appointment - and anyway you can just call and they'll extend the prescription on the pho…

>And there's nothing wrong with switching from brand name to generic, and most patients don't need to see their doctor every 30 days, and if they do, they can still make an appointment. For patients with chronic conditions if the doctor determines the patient should be seen to evaluate their condition in 30 days before a new script is written, insurers having pharmacists effect a change to 90, is a direct interferenc…

If the Dr. wants to see the patient in 30 days then they setup an appointment for that.

I don't understand why you think the length of a prescription controls the appointments. It doesn't, it has nothing whatsoever to do with that.

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

#278

Post by jonlucc »

joey_bob wrote: post #246
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…

Wait, so government funding supports the drug through the whole discovery and FDA validation process then just hands it off to the pharma companies? That seems broken

No, that's exceedingly rare. That kind of thing that only happens for super rare diseases, maybe like the ebola vaccine that was quickly developed over the past few years, where the economics are very upside down for companies to do the development.

What is way more common is that scientists from around the world, mostly funded by public money produce research that might implicate a particular pathway or target for a particular disease. Scientists in companies see those publications and try to verify the result, then make a drug for it. The process of making the drug, testing tens of thousands of compounds, making sure efficacy and safety margin are maximized, running clinical trials, and producing the drug with good yields is almost always done by companies.

The government can do stuff like funding studies on new uses for off-patent drugs, fund various parts of that development, and reduce regulatory burden to tilt the economics for companies to make drugs for a disease, but that mostly happens to do stuff that wouldn't happen in the normal system in which companies have to make money making drugs.

Disclaimer: I work in pharma, but in biology, not anywhere near the budget-making

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

#279

Post by chimeracoder »

throwaway_tech wrote: post #272
chimeracoder wrote: post #178

Earlier quoted context omitted.

> for example changing a name brand to a generic In most states, the law explicitly requires the pharmacist to fill a prescription with a generic (if available) unless the doctor specifically writes "dispense as written". Not allows - requires . The purpose of these laws is to protect patients - in the overwhelming majority of cases, the generic and brand name drugs are equivalent for patients, so patients save money…

>The purpose of these laws is to protect patients Its not the patients that lobbies for these laws...it is the insurers, and its to lower their costs. Its also why the insurers pay the pharmacists a bonus for these changes, if it was about costs to the patient, the bonuses (money back) would go to the patient.

> Its not the patients that lobbies for these laws...it is the insurers, and its to lower their costs.

I mean, no, patients don't lobby for them because patients don't really lobby en masse for healthcare policy in general, but patients definitely are the ones who benefit from them.

There are some cases where the relationship between insurers and patients is adversarial. This is not one of them.

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

#280

Post by larkost »

eigenrick wrote: post #197
Someone1234 wrote: post #158

Earlier quoted context omitted.

But it isn't. It is licensed to an exclusive drug manufacturer who has a de facto monopoly on the new drug. If it were protected with drug patents then those patents licensed for free to all generic manufacturers, that would be a massive improvement.

That's because the drug manufacturer has to spend a billion dollars performing clinical trials which might still fail. Even with some research already performed, this is still a huge risk. Not to mention the fact that the research still needs to be turned into something producible and consistently deliverable to the patient.

No one is arguing that drug companies don't have work, and a lot of it, to do developing a promising drug (that is generally what comes out of university research) into a marketable one. Nor is anyone saying that that process is cheap.

However, the amount of money that goes into finding those promising drugs (collectively, including all the failures in those stages) is much greater than the work that drug companies do in testing and developing them (collectively, including failures).

Right or wrong, most of that research is government funded, and then the (monetary) rewards of all that spending generally flow entirely to the drug companies (often with some reward going to the University who hosted the research). So the drug companies wind up with Hughe effective subsidies, and little of the down-side of early drug development or basic research.

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