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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

#281

Post by vkou »

rayiner wrote: post #207
learc83 wrote: post #152

Earlier quoted context omitted.

Of course you can find examples of where the private sector outperforms government. And I can provide counter examples. I just moved to a much smaller city (in the same region) with gigabit municipal internet. For the same price that I was paying comcast for 50 mbps internet, I now have 20 times the speed with no data caps. The market works great until it doesn't. The interstate system, and the military are 2 prime e…

I’m not just giving examples. Education and infrastructure are two of the big pillars of why we have government in the first place, and US government bodies have failed miserably on both fronts despite enormous funding. As to municipal internet—its great until it’s not. Maryland has municipal cable systems that were built a couple of decades ago, and they have struggled to keep up with the DOCSIS upgrade treadmill. A…

> I’m not just giving examples. Education and infrastructure are two of the big pillars of why we have government in the first place, and US government bodies have failed miserably on both fronts despite enormous funding.

I would posit that the only thing that is a bigger failure than the public school system, is the private school system.

It's numbers look good, but that's largely because private schools are more expensive, and also opt out of educating problem students.

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

#282

Post by AdrianB1 »

aplummer wrote: post #30
toomuchtodo wrote: post #22

Earlier quoted context omitted.

Insulin is a generic. No one is required to be compensated. Pharma had their chance to be reasonable. That time has passed. Not to say that we shouldn’t appropriate intellectual property when necessary (eminent domain or not respecting a patent, as has happened in India and Canada), it’s just not necessary in this case. That doesn’t make us Venezuela, that makes us pragmatic.

The inventor gave the patent away for $1 because it would have been unethical to profit from it. That’s still true.

There are different generations of insulin; the old ones are cheap, the latest ones are not. I would like to see every inventor give the patents away for free, it would be great in a way, I just don't know who will invent anything new because these days the marginal cost of improving products is astronomical. For example, building a log cabin 200 years ago was tiny, both in cost of raw materials and work. Now the cost of a house is huge, not only because different materials are used, more complex manufacturing processes are needed, but who wants to live in a log cabin? Same comparison with insulin, there is cheap insulin and expensive insulin, people want the expensive one to be cheap. Not always possible.

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

#283

Post by jahaja »

tptacek wrote: post #269
jahaja wrote: post #259

Earlier quoted context omitted.

Sigh, this is such a typical HN response, "I read everything literally and need to explain what it _actually_ means". I wrote _type_, as in similar. I know the origin. > This is not a simple analysis, but I think the answer is more often than not, No. Why not? Profit-driven drug companies will obviously focus on things that make money, e.g. superficial/vanity related things, not what's necessarily aligned with public…

Because in most markets, one of the more straightforward ways to make money is to deliver products more efficiently, split the reduced cost basis with the customer, and outcompete incumbents. You're not doing your argument any favors with this "typical HN response" stuff. Have a discussion with people on the thread or don't; it is fine for you to simply disagree and walk away.

And in many markets it's not. Well-run state companies, that exists, and have existed for a long long time, efficiency is not a problem and they can focus their efforts and money on what's important, not profits and marketing.

Don't tone police me please. I find it rude to assume ignorance and go on explaining. Did you miss the whole mansplaining wave?

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

#284

Post by jahaja »

tptacek wrote: post #273
jahaja wrote: post #262

Earlier quoted context omitted.

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.

Are drug companies operating at a loss in Europe?

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

#285

Post by rjmunro »

justinzollars wrote: post #247

I think this is a naive approach. We could price cap anything. Homes in San Francisco for example. The result will be rationing and shortages. It won't solve the fundamental problem. They key to bringing prices down is to remove barriers of entry. We need to flood the market with more insulin, or with my SF housing example flood the market with many more houses.

This isn't that sort of price cap, as far as I can see. It's a law for insurance companies saying that if you want to insure people in this state, you must cover the cost of insulin from your general insurance pool, not from the individuals who need it (except for the first $100 / month).

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

#287

Post by malandrew »

vkou wrote: post #275
beamatronic wrote: post #203

Earlier quoted context omitted.

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.

FWIW, a medicine I have been taking since 2003 is still not available in all other countries except the US and Canada (and it's only recently become available in Canada). It's still the only effective treatment for my condition.

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

#288

Post by fr0sty »

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…

> 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

I'm reasonably cynical about lots of things, but I would be absolutely shocked if a pharmacist can give you 90days of pills when handed a 30day (no refills) prescription.

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

#289

Post by vmchale »

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…

> except insofar as insurance companies can push back on drug manufacturers.

Can they? The insurance companies are mandated to buy it now

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