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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

#331

Earlier quoted context omitted.

I'm fine with purely public research funding, but if we need extra incentives for "last mile" applied research, drug bounties are wholely better for the public and pharmaceutical industry alike.

Disclaimer: I work in big pharma as a biologist and nobody asks me anything about pricing or broad strategy I don't hate the idea of bounties, but someone has to decide what bounties to offer, and the current system for deciding that is whether money can be made in that area. It's not perfect, but at least broadly it means that there is an incentive for treatments for conditions that affect a lot of people and ones w…

Good answers. I would say research grants and bounties are both subject to regularity capture. Bounties are high stakes and thus more worth being corrupted, but also fewer and hopefully more in the public eye and so exposed to more scrutiny.

But, as I led with, I'd be fine with just purely public research leading to generic drugs. Drug bounties are just the "post-capitalist" fallback plan if the old school state-bureaucratic approach isn't work.

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

#332

Earlier quoted context omitted.

Ah, yes. The famous American pharma companies Roche, Novartis, Bayer, GlaxoSmithKline and Sanofil come to mind...

Yes... Johnson & Johnson, Pfizer, AbbVie, Bristol-Myers Squibb, Eli Lilly, Biogen, Abbott, the list goes on and on.

If the US only competes with and does not clearly and utterly surpass Europe (while serving the American people much less effectively), then how can your argument stand?

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

#334

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 In an industry with high fixed costs, marketing may in fact reduce the cost per consumer. Using software as an example, you can't just take the marketing costs per customer and subtract that from the price. If 1,000,000 in marketing brings in 3,000,000 in extra revenue, that marketing didn't cost customers anything. It could even allow the software company to char…

> In an industry with high fixed costs, marketing may in fact reduce the cost per consumer.

I do not believe this is generally true.

In any case, it clearly doesn't apply to insulin provision for diabetes patients - a captive market.

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

#335

everyone tearing their hair out over this: the effect of the law is just that insurance overall will be somewhat more expensive in Illinois. There won't be any effect on research or innovation or anything else. Everyone will have to chip in a bit to make sure people with diabetes don't go without insulin. I don't see this is as a big disaster. Illinois has much bigger problems than this. If people foregoing insulin b…

That can’t be right.

> “Health care is a right for all, not a privilege“

Insurance has to be free too!

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

#336

Earlier quoted context omitted.

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.

I’m not sure what to say if you’re not happy that democracy isn’t static. The only thing in the world that is constant is change. You call it “pretend”, but the results you take issue with appear to be very real.

That's one of my complaints about democracy. Something doesn't have to be real for people to vote like it's real. There's no contract that says anybody owes anyone anything else at a specific price.

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

#337

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…

I work in medical research and mostly agree with this, but there are two major problems I see preventing this from becoming a reality:

1) Academic medical research is simply not well tooled, right now, to do the later stages of drug development. What pharma does well and academia does not, is basically optimization of candidates. They do it through high-throughput screens and medicinal chemistry. Those things are very expensive and not publishable, so...academics don't do them. And everyone with the expertise works in pharma.

2) Clinical trials are freaking expensive. My institute has developed several drug candidates and the same process necessarily applies every time. The public-funded researcher basically HAS to either sell the patent to pharma or start a company and raise the many millions required to do a trial. The amount of money required is way out of range of current grant funding. If they want to see their drug get to patients, and of course they do, there is literally no other way right now except partnering with pharma.

When I get a chance to talk to politicians about how to fix this, I always make the same pitch. Step #1 should be to give a huge wad of money to the FDA. Say $1B/yr. Then you tell the FDA: every year, pick the 50 most promising drug candidates. Publicly fund the clinical trials, and the public will own the patent. Give some cash to the inventor and the institute to incentivize them to do this scheme and not sell to pharma.

Politicians, both left and right, look at me like I'm from Mars when I propose this. Those on the left think high drug costs are all about greed and not our broken system, and those on the right have unwavering faith that "free" markets will always solve everything.

And with insulin specifically, there is another problem: diabetics won't take the generic insulin that has been off-patent for years now. They must have the fancy and more convenient version. Mark my words, the fact that Americans must always have the absolute best thing, cost be damned, will become a major issue if we ever get single-payer.

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

#338

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…

You're right. This is terrible. Here's an excerpt from the bill: > Provides that insurers that provide coverage for prescription insulin drugs must limit the total amount an insured is required to pay for a covered prescription insulin drug to $100 This will create way more problems than it solves. It continues to hide the true cost from the consumer. This doesn't affect the pharmaceutical companies or insurance comp…

Wouldn't it be much more meaningful for the Sate of Illinois to say they will buy a State-managed insulin supply, for which they will guarantee access by State residents at $x/Month?

Easy to make something unallowed on paper. Much harder, and more meaningful, with Skin in the Game, to actually go out and do what they may think their rules will accomplish.

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

#339

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…

Comments like this always make me sad. Not just because I disagree with them (I do!) or that I think they are claiming certainty about facts in dispute (I think they are ! [1, 2] ) but because they make no mention of trade-offs. We can vehemently disagree about these things, get our information from different sources, and advocate for different policies, but hopefully we can all agree that there _would_ be tradeoffs?…

Considering you brought in feelings into the equation, I want to express the reason I'm sad. I'm sad that antibiotics are not profitable enough to be researched and we're slowly but steadily heading into antibiotic-resistance hell as we're losing the arms race with bacteria thanks to capitalist healthcare.

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

#340
Even at that level, it's a markup that even Apple has never come close too. Yes, this is a start, but it is the back of the field and has a long way to go. Sadly it won't be until 2030 when that happens, which AFAIK is when patents expire.

https://www.businessinsider.com/insulin-prices-could-be-much...

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