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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

#341

Post by chimeracoder »

marriedWpt wrote: post #312
chimeracoder wrote: post #200

Earlier quoted context omitted.

> Edit: another thought comes to mind - has anyone compared the size of health insurers in the US and compared their purchasing power to government run single payers? I’d hazard a guess that United Health for example probably dwarfs entire single payers of some governments. Medicare alone covers more patients than NHS England does. (Very few countries in Europe actually have single-payer healthcare; the four UK count…

Medicare isn't one gigantic entity though. You get a Medicare provider, with an insurance company that you work with. Yeah there's lots of layers of bureaucracy.

> Medicare isn't one gigantic entity though.

Correct

> You get a Medicare provider, with an insurance company that you work with.

Well, no, the majority of Medicare patients still receive their inpatient and outpatient benefits through Medicare. A (growing) minority receive their Medicare benefits through a private insurer.

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

#342

Post by nybble41 »

rjmunro wrote: post #297
nybble41 wrote: post #154

Earlier quoted context omitted.

The actual bill[1] says (more or less) that insurance policies that include prescription drug coverage must cover insulin with a maximum of $100 out-of-pocket expense to the insured for a 30-day supply (page 12 lines 12-18). That $100 limit is indexed to the medical component of the Consumer Price Index (page 13 lines 1-6). It doesn't directly affect the amount suppliers receive, and the state isn't offering to reimb…

Do we have any idea how much higher the premiums are likely to be? Google says there are 1.5-3 million insulin users in the USA - lets call it 1% of the population. Let's say that their drugs cost $300 / month, but they pay $100. The extra $200 will be shared between 100 people's premiums, so $2 extra per month.

The media is citing 1.3 million in Illinois alone with diabetes requiring insulin (out of about 12M population; over 10%) and at least some cases where the cost is over $1000 per month. Assuming it averages out to $300 per month as you said, however, that's still $20/mo. extra per person assuming the difference is distributed uniformly across all insured individuals, and that all individuals in the state are insured.

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

#343

Post by rayiner »

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?

Drugs in Europe aren’t “cheap.” https://ihsmarkit.com/solutions/us-price-gouging-pharmaceuti...

> Based on our analysis of prices in regulated markets, the United States paid on average more than 50% that other developed markets.

Of course, that figure is before discounts:

> Hence, while US pharmaceutical reference prices are typically higher than most counterparts, it does not mean that the US also ultimately pays higher prices than other countries – a fine but important distinction.

But even taking the 50% figure at face value, that suggests we could cut our drug spending to German levels (from $1,200 per person per year to $800). That’s not the kind of huge delta you see when it comes to things like inpatient services (surgeries that cost 5-10x as much). It’s also not that much compared to the $5,000-6,000 more we spend on healthcare overall per person compared to Germany.

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

#344

Post by keldaris »

cgiles wrote: post #337
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…

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 ver…

> 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.

Do you think they actually believe any of this nonsense? I would have assumed the rehearsed political phrasing is just the public veneer over something to the effect of "and if I endorse this, X lobby group(s) will steer Y amount of PAC funding to my primary opponent and eat me alive".

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

#345

Post by ikeboy »

mrnobody_67 wrote: post #220
nradov wrote: post #95

Earlier quoted context omitted.

The testing regulations are not onerous. They are necessary to ensure that new medications are both safe and effective. I often see vague complaints about the regulations, but no one seems to have specific suggestions about how to lower drug development costs while still protecting patients.

Actually they are ineffective. Tons of drugs have been approved, only to be later pulled off the shelves. So despite the massive cost, delays, etc. the process has failed at least 35 (!) times: https://prescriptiondrugs.procon.org/fda-approved-prescripti...

That page says it's about drugs withdrawn for safety concerns. That's different from the typical complaint, which is efficacy trials that are overly expensive.

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

#346

Post by homonculus1 »

jxramos wrote: post #232
efa wrote: post #172

Earlier quoted context omitted.

I hate the constant misuse of the word "right". How would a country guarantee this right? What if every doctor in the US quit tomorrow? What if I decided to live on the top of a mountain where there is no population? How does the government guarantee my right to healthcare? Rights are around restrictions. I have the right NOT to be killed. I have a right NOT to be silenced. When something requires someone else doing…

Negative rights seem to be those more amenable to guarantees since they ask little. The guarantee of positive rights assumes a bunch of prerequisites from what I understand (some of which like healthcare are predicated on a ton of upfront infrastructure and training and availability and so forth). https://en.wikipedia.org/wiki/Negative_and_positive_rights

"Positive right" is just political marketing for privileges. Universality is implicit in the notion of rights, e.g. treatment that every human has a valid claim not to be subjected to and which must be observed in order to have a civil, liberal society. The enumeration of specific protections may have to change with technology, but the underlying principles do not short of radical psychological/physiological alteration as a species. If we abandon that concept then rights have no meaning, they're just a list of popular demands which can shift arbitrarily, and including privileges does just that.

It's obvious why people are in favor of them of course, but we have to be honest about what it is we're asking for and why instead so we can make a rational analysis of it, instead of torturing the intellectual and moral foundations of our culture to make something outside of it fit. And it's foolish not to be suspicious that politicians' incentives have basically everything to do with making promises that get votes, and basically nothing to do with actually making the system work long-term.

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

#347

Post by daenz »

AdrianB1 wrote: post #255
gruez wrote: post #16

Earlier quoted context omitted.

Other developed countries have price controls (more specifically, government negotiated prices) and it seems to be working well for them.

Real case: Romania. We put a price control in place, thousands of drugs are no longer available. My brother works for a distributor (they import and distribute, so they don't have any control) and told me the government report on 1200 drugs that disappeared from pharmacies in the past 3-4 years are the important ones, in total there are over 5000 they can no longer import because the controlled price is lower than th…

Well the next step is clearly to force manufacturers to produce and sell the goods in marketplaces that they cannot negotiate in. /s

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

#348

Post by [deleted] »

TallGuyShort wrote: post #336
toomuchtodo wrote: post #302

Earlier quoted context omitted.

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.

[deleted]

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

#349

Post by sterlind »

cgiles wrote: post #337
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…

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 ver…

aren't there some diabetics that need the newer types of insulin? is it really true that all diabetics could take the generic, classical insulin without any problems, and suffer no health consequences?

I mean I doubt they pay hundreds of dollars just to sport the Mylan brand like like a Gucci purse..

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

#350

Post by frandroid »

cgiles wrote: post #337
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…

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 ver…

> Say $1B/yr

That's not even a lot of money, in the U.S. context.

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