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EpiPen Price Rise Sparks Concern for Allergy Sufferers

well.blogs.nytimes.com

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Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#361

Post by usefulcat »

tcbawo wrote: post #342
skywhopper wrote: post #281

Earlier quoted context omitted.

You can be sure that Wellpoint has also negotiated a good rate on Epi-pens. This price-gouging affects people who don't have prescription drug coverage or those who are enrolled in HSA plans that force you to pay for the first few thousand dollars worth of prescriptions at retail prices. And there are a lot of people being funnelled into HSAs by their employers.

My children have a need for epipens. With our insurance, it is still prohibitively expensive. After hearing about the cost in GB, I'm considering making a trip to London to stock up

Don't the pens expire after a year?

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#362

Post by tcbawo »

usefulcat wrote: post #361
tcbawo wrote: post #342

Earlier quoted context omitted.

My children have a need for epipens. With our insurance, it is still prohibitively expensive. After hearing about the cost in GB, I'm considering making a trip to London to stock up

Don't the pens expire after a year?

Yes, they do. Unfortunately, you tend to need several per child (minimum one for school, one for home). So, these costs quickly multiply.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#363

Post by dredmorbius »

refurb wrote: post #181
bobdole1234 wrote: post #121

Earlier quoted context omitted.

Not so much fixed as "Canada doesn't insist that everyone make separate deals so everyone can get fucked harder". It turns out when you have millions of people dealing together as a block, they have much more bargaining power.

That's not why Canada gets better prices. United Healthcare has 42M members which is bigger than the entire population of Canada.

It's not merely size. It's size-relative-to-market.

Canada negotiates with drugs suppliers. Supplier says "take a hike". Canada says, "OK, you're out of the market", turns to next drug supplier.

Canada here has right-of-refusal, and can negotiate, as a single block entity, with ability to restrict market, to each. The drugs company which finds those terms acceptable has a market.

A bloc of 42 million in the US is only about 12% of the total market. The discussion there still leaves another 290M possible customers for a drugs vendor. Hence the strength is with the vendors.

If US Medicare had rights to exclusively negotiate drugs deals (it doesn't), this would change tremendously. Similarly for single payor.

Which is precisely why the entire medical services industry is so mortally opposed to it. They'd lose absolutely all market leverage. They know this.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#364

Post by dredmorbius »

sevenless wrote: post #30

How many people will this price hike kill? I'm sure that's estimable. What would be morally justified, to stop it?

There are from 30-950 cases per 100,000 people per year.

Or an 0.03% to 0.9% incidence rate. That sets an upper bound on deaths. It corresponds to about 100,000 to 3 million exposures per year. If 10% of those were potentially fatal without treatment, you'd be looking at 10,000 to 300,000 deaths/year. Keep in mind I just pulled 10% out of my ass.

You'd want to see how many people or cases would be untreated at the higher price level. But the information certainly supports the notion of thousands of deaths.

At 1,000 deaths, that's about 1.6 million in profits per corpse for Mylan, based on $1.6 billion in additional profit.

http://rnspeak.com/case-study/anaphylactic-shock-case-study-...

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#365

Post by clarkmoody »

clavalle wrote: post #356
clarkmoody wrote: post #333

Earlier quoted context omitted.

> markets can drift far from the ideal even absent of government interference But only government interference can lock the market in that state in perpetuity, eliminating the corrective forces of price and competition. > Are we to believe that information asymmetry is all rooted in government interference? Of course not. But businesses that are able to satisfy more consumers through better transparency are going to…

>But only government interference can lock the market in that state in perpetuity, eliminating the corrective forces of price and competition. Again a very strong statement with only faith that government is bad to back it up. Market power can become dominant in such a way that it can lock market distortions in as well. See: monopoly >But businesses that are able to satisfy more consumers through better transparency…

> See: monopoly

Please. Even in the classic case of Standard Oil, they lost massive amounts of market share even before the government started interfering in their business.

According to Wikipedia:

  In 1904, Standard controlled 91 percent of production and 
  85 percent of final sales. [...] Due to competition from 
  other firms, their market share had gradually eroded to 70 
  percent by 1906 which was the year when the antitrust case 
  was filed against Standard, and down to 64 percent by 1911 
  when Standard was ordered broken up and at least 147 refining 
  companies were competing with Standard including Gulf, Texaco, 
  and Shell. It did not try to monopolize the exploration and 
  pumping of oil (its share in 1911 was 11 percent).
So when the "white knight" trust busters of government finally got their way, Standard was down to 64% market share. Hardly a monopoly at that point.

> What about businesses that poison the environment in secret?

If we had property in the air and water, then if business harms your property, you have recourse against them. As it stands, the air and water are unowned, which means that they are a permanent tragedy of the commons.

As to your ideas about perfect market competition, etc: real markets are dynamic and vibrant, with new technology disrupting old ways of doing business and new consumer preferences forcing business to adjust. That's fine if some theoretical market theory says in equilibrium, profits tend toward zero, but we live in the real world, so that will never be the case with free markets.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#366

Post by incongruity »

hackuser wrote: post #354
incongruity wrote: post #247

Earlier quoted context omitted.

If they're significantly cheaper, carry 2 or 3. If you're at a 90% level, you will be almost assured of cheaply having one work, assuming the error/failures are random. Yes, this is sub-optimal in a life or death situation, but it's a reasonable counter to unreasonably high EpiPen pricing. Moreover, if this becomes common practice or if it's even feared as plausible, it could help reduce EpiPen pricing.

> this is sub-optimal in a life or death situation I think that rules it out. Imagine a family member, or anyone, dying because of your sub-optimal solution.

I am allergic to bee stings, myself and, to be honest, I don't agree with you.

The best solution is the one you can actually carry with you – if you can't afford the EpiPen, this system would be far, far better than nothing.

Further, while anaphylaxis is a life threatening situation, it isn't a situation where, if recognized in a timely manner, 10 seconds more to pull out the second or even 3rd home-brew auto-injector would kill the patient.

Next, the widespread existence and feasibility of a home-brew option would itself exert significant pricing pressure on the original EpiPen thereby making it more affordable for everyone and thus less likely that I would even need to actually make one.

Lastly, I would, in fact, use the above hypothesized home-brew option for my kids or wife (if they were alergic), if we couldn't afford an EpiPen or as a way of making sure we always had one available.

As I argued, having multiple devices cheaply on hand makes failure of one an okay thing. If they have a 10% failure rate (which itself is a high failure rate even for this scenario), having 3 on hand would mean you'd have one-tenth of one percent odds of all three failing. Add a 4th and you get down to 0.01% – get the individual reliability down to 5% failure rate and 3 devices would give you 0.0125% odds of failure. Those are actually pretty good odds. Moreover, I'm not sure what the traditional EpiPen's reliability is, but I'd bet it's not that much better than a 0.000125 failure rate.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#367

Post by clavalle »

clarkmoody wrote: post #365
clavalle wrote: post #356

Earlier quoted context omitted.

>But only government interference can lock the market in that state in perpetuity, eliminating the corrective forces of price and competition. Again a very strong statement with only faith that government is bad to back it up. Market power can become dominant in such a way that it can lock market distortions in as well. See: monopoly >But businesses that are able to satisfy more consumers through better transparency…

> See: monopoly Please. Even in the classic case of Standard Oil, they lost massive amounts of market share even before the government started interfering in their business. According to Wikipedia: In 1904, Standard controlled 91 percent of production and 85 percent of final sales. [...] Due to competition from other firms, their market share had gradually eroded to 70 percent by 1906 which was the year when the anti…

So, the free market where it fits your narrative of the evils of intervention and real markets where your free market narrative breaks down. If you follow your last real market argument a little further, you'll find my positions.
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