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As opioid overdoses exact a higher price, communities ponder who should be saved

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Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#31

Earlier quoted context omitted.

Resources are finite. For a less dire example, when people stop making progress in physical therapy, insurance stops paying for it. Not because there is no chance they will benefit from further therapy, but to control costs.

>Resources are finite. But the important point is what exactly is making this drug scarce for local authorities. Opiod addicts are not rapidly consuming all the reserves of the drug on earth; companies have just set high prices and left the people to take the burden. Accepthing that this resource is scarce for governments means inherently agreeing with the price set by the pharmaceutical company - and I don't think t…

As someone pointed out in a sibling to my comment, the prices aren't high for generics.

So if they are spending for the branded version something else is going on.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#32

Earlier quoted context omitted.

Naloxone is already generic and basically free, government officials just like buying the branded version so they can get kickbacks while complaining about the cost.

Ugh. That is sickening. Since it seems like you have some expertise in the area, is this antipattern actually codified In regulations, or more of a de-facto/status quo thing?

> is this antipattern actually codified In regulations, or more of a de-facto/status quo thing?

A lot of drug purchasing things are codified. For example, Medicare is banned from negotiating drug pricing with manufactures. So even though they're buying billions of dollars worth of drugs in bulk, they're literally paying the retail price, which is just whatever the Pharma companies ask for.

In terms of why they're buying the branded version in the first place, not entirely sure what the exact situation is right now. I'm sure someone will write a great article on it in a few years though after all the money has already been siphoned off.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#34
post #11

Earlier quoted context omitted.

If you totally discount the good manufacturing practices and traceability that pharmaceuticals have to follow, sure you can hack together a cheap substitute that might not work when the chips are down Except for biologics, many drugs are not that expensive to manufacture. The cost is in proving they will do what they say they do on the package.

Do you really believe that it costs upwards of 4000 dollars to track a little box with medication in it? For that money I hope each box comes with a solar rechargeable smartphone that sends a gps beacon every half hour.

It's not the tracking, it's the super long and expensive regulatory process, and the cost of researching the drugs. Remember that for every successful drug, there are probably many that the company spent lots of money working on, and didn't end up working out. Someone has to pay for those failed ones as well.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#35

Compare it to the money US spent on Afghanistan invasion and the explosion in opium production there. Where do you think the production goes and who is running the operations? Wouldn't it be fair to divert part of those budgets to help civilians in US to cope with the results? The bitter thing is that even Trump will boost military budgets, not much change here from the previous regime.

I agree about the costs of war (though I think Iraq was a war of choice, to the detriment of the campaign in Afghanistan) but "nearly all of the heroin available in the United States comes from Mexico and South America." [0]

This problem was also started with prescription meds, due to deception by pharma companies and lack of attention and mismanagement by the medical professions and government.

This sheriff is an asshole. He says he doesn't want his deputies carrying Narcan playing paramedic, does he also not want them trained in administering CPR or basic first aid?

[0] http://www.politifact.com/truth-o-meter/statements/2016/sep/...

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#36
There is a big controversy about this in the area of Ohio I am from (overdose capital of the U.S., Coincidentally). A sheriff who presides over a country near my home is loudly deriding the use of Narcan, saying it will not be used by his deputies, due to moral and financial concerns.

Needless to say, I have lost 8 high school classmates to the epidemic at last count, and of those, 5 had been revived multiple times. So I can see both sides. There is no easy answer, and this problem will not go away on it's own.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#37

Earlier quoted context omitted.

Do you really believe that it costs upwards of 4000 dollars to track a little box with medication in it? For that money I hope each box comes with a solar rechargeable smartphone that sends a gps beacon every half hour.

It's not the tracking, it's the super long and expensive regulatory process, and the cost of researching the drugs. Remember that for every successful drug, there are probably many that the company spent lots of money working on, and didn't end up working out. Someone has to pay for those failed ones as well.

How does that explain that the autoinjector was $690 in 2014 but $4500 today?

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#38
post #21
post #9

Earlier quoted context omitted.

100 years ago, politicians were tricked into trusting organized crime to tend to the health of people who are drawn to opiates. Those politicians are dead & gone, but we're still stuck with their mistake. My mother broke her wrist 6 months ago, and was given opiates to deal with the pain of having a plate put in her wrist. She did not become an opiate addict. I presume she managed to avoid becoming a junky because sh…

By "organized crime," I assume you mean something other what's traditionally thought of as organized crime, e.g. the Mafia, but I can't tell what. > I presume she managed to avoid becoming a junky because she has a pretty stable day-to-day life. While circumstance and upbringing are factors for addition, I think it's accepted that there is also a biological component; your mom may be inherently less prone to becoming…

> By "organized crime," I assume you mean something other what's traditionally thought of as organized crime, e.g. the Mafia, but I can't tell what.

The Mafia and other manifestations of "traditional" organized crime is exactly what I was referring to.

Two years ago, when a new friend was teaching me about her addictions, I bought Johann Hari's book, Chasing the Scream: The First and Last Days of the War on Drugs [2]. Hari says that after heroin was made very difficult to obtain (circa 1915), organized crime became the supplier for most addicts.

The Los Angeles Times Op-Ed A 1930s California story shows why the war on drugs is a failure also covers how the Mafia swooped in to supply the needs of addicts [2]. This is the primary article I was thinking of when I wrote the quip you responded to.

[1] http://chasingthescream.com/

[2] http://www.latimes.com/opinion/op-ed/la-oe-hari-california-d...

> > I presume she managed to avoid becoming a junky because she has a pretty stable day-to-day life.

> While circumstance and upbringing are factors for addition, I think it's accepted that there is also a biological component; your mom may be inherently less prone to becoming addicted to opiates.

My mother is inherently less prone to becoming an addict because she has meaningful things to do: job, family, friends, trips, etc. My friend who taught me about addictions (mentioned above) was vulnerable to the street pharmacy because she was exposed to meth amphetamine as a pre-teen, and her brain chemistry never fully recovered. She says she was very depressed as a child/teen, and was made suicidal by her doctor when he injected her with Depo-Provera around age 20 (this is a chemical castration drug used for 3 months of "birth control"). This friend is doing well now because I provided the "connection" that Johann Hari says is so important for helping addicts out of their pit.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#39
post #37

Earlier quoted context omitted.

It's not the tracking, it's the super long and expensive regulatory process, and the cost of researching the drugs. Remember that for every successful drug, there are probably many that the company spent lots of money working on, and didn't end up working out. Someone has to pay for those failed ones as well.

How does that explain that the autoinjector was $690 in 2014 but $4500 today?

[deleted]

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#40
post #2

(this article can be read by searching for the title on http://twitter.com/ , then opening the link in a private window) > Two doses of an injectable form of naloxone, Evzio, cost $4,500, up from $690 in 2014. The price of other forms of the drug, including the nasally administered Narcan, typically range from $70 to $150 per dose, officials say. The cost of naloxone [1] is an insignificant part of the cost of revivi…

After struggling with alcoholism for decades I used Naltrexone to stop drinking five or six years ago. It wasn't a simple taper but when I had my last drink it was easier to walk away from than anything I could have ever imagined before I did it.
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