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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

#381

Post by jahaja »

tptacek wrote: post #377
jahaja wrote: post #284

Earlier quoted context omitted.

Are drug companies operating at a loss in Europe?

I think you're trying to construct a straw man. Nobody on this thread is suggesting that pharma be deregulated. Rather, Rayiner pointed to a specific regulatory problem that may be contributing to the price of insulin. Whether or not drug companies operate at a loss in Europe is immaterial to that point.

I'm not sure what straw man that would be? I haven't suggested that either. What I'm implying is that Europe have regulations too, and that the price difference is not in proportion to the difference in regulatory strictness.

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

#382

Post by nate_meurer »

jahaja wrote: post #375
nate_meurer wrote: post #351

Earlier quoted context omitted.

Ah I see. So as long as we append the word "type", we're free to throw phrases into completely non-sensical contexts? How convenient. Kidding aside, your use of the phrase here indicates a fundamental misunderstanding. This isn't "similar" to trickle-down. This has nothing to do with it whatsoever. You might as well call it "fascist" or "colonialist". It's jibberish. Try this: You can find the Hopkins paper that Rayi…

The template of trickle down economics I'm referring to is the method where the already wealthy/profiting and so on, is given immediate benefits under the premise of vague and long-term benefits for the many. This method of upwards redistribution has been applied repeatedly time and time again, and tax cuts in the style of trickle down economics are just one instance of it. > Just for fun, give me some examples of dr…

Regardless of how you want to redefine the phrase trickle down, your use of it here betrays a fundamental misunderstanding of the subject. If it's possible to reduce the regulatory burden of the approval process for biosimilar insulin so as to allow generic makers to compete more easily, this will REDUCE the monopoly power of the large incumbent drug companies. I don't know if you're being deliberately obtuse, but I can't say this any more clearly.

> Once again, it was one example, I was mainly thinking about hair loss or other male things caused by men, historically and still, earning more.

Right, so it was a bullshit distraction that can safely be ignored.

> My main point was that the profit motive causes this kind of skew...

Which has exactly nothing to do with insulin, or the larger problem of building a manufacturing base for complex biosimilar medicines that's big, efficient, and safe enough to not bankrupt us. Regulations are necessary and powerful tools that, if wielded clumsily, can easily kill that manufacturing base. Making sure those regulations are suited to the task is not "trickle down" in any way whatsoever.

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

#383

Post by amyjess »

TurkishPoptart wrote: post #367
amyjess wrote: post #249

Earlier quoted context omitted.

I'm a trans woman. It's widely acknowledged in the trans community that most of us have to teach our doctors what meds to prescribe, what starting doses are common, and how to interpret lab results to determine how to titrate the dosage. Most of us have read the Encdocrine Society's clinical guidelines for HRT cover to cover, because we have to be the experts. And half the time, it turns into a fight. At one point, I…

Q: If you say you are a trans woman, does that mean you are transitioning from MtF?

Yes.

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

#384

Post by koolba »

cgiles wrote: post #358
koolba wrote: post #355

Earlier quoted context omitted.

> 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…

> This would be abused like any other slush fund. That's a Fully Generic Argument against any pool of government money for any purpose. The law could be written in such a way that the money is allocated for this specific purpose. > Plus there’s a natural adverse selection bias as all the “really good” patents will go the private route. A valid critique. The long-term goal, of course, would be to expand the program an…

> And you don't think this would negatively impact the rate of drug development? I do. Price controls are also a very drastic step in terms of American law. They tend to have...undesirable side-effects.

I do think that will happen. Quite frankly I don’t care.

Access to today’s existing treatments at affordable prices would do much more for the masses then any new research will provide in their lifetimes. In short: its worth it

Longer term I think the prices will stabilize (higher for the world, lower for the USA) and research costs will align as well. Until that happens the common man would still be better off.

> If I were pondering general solutions in the area of what you are talking about, I'd prefer laws drastically limiting the amount and type of marketing pharma can do. And ideally supplement that with FDA-provided, more objective material for consumers and MDs about the actual, objective benefits and risks of various drugs.

I’m for eliminating all medical advertisement but still feel the lowest worldwide pricing is needed. Nobody advertises insulin but the average diabetic in the USA pays 5-6x more than in other countries.

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

#385

Post by harryh »

michael_j_ward wrote: post #314
harryh wrote: post #198

Earlier quoted context omitted.

The vast majority of drugs wouldn't even make it out of the FDA approval process before the patent expired if you set the term to 5 years.

The number was merely an example. The alteration I proposed would be equivalently applicable to "5 years post FDA approval."

The typical window with today's regulatory framework is 7-12 years. Your proposal certainly changes that some, but it's not nearly as dramatic as your original framing of "reduce it from 20 to 5 years."

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

#386

Post by efa »

creaghpatr wrote: post #205
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…

>How would a country guarantee this right? Via its taxpayers of course.

And if no is willing to provide the healthcare? Force them?

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

#388

Post by Consultant32452 »

idoh wrote: post #372
Consultant32452 wrote: post #329

Earlier quoted context omitted.

Off patent drugs are fungible in the sense that if Tylenol starts charging too much I can buy acetaminophen from anyone. Drug patents only last about 10 years. Fix evergreening at the patent office and your concerns are taken care of. Fixing evergreening is a much smaller action than cannibalizing an entire industry, which should be a last resort.

Makes sense to me. If evergreening is fixed, then theoretically in ten years time every drug on the market right now could be available as a generic at generic prices.

I think there's a lot of other great options on the table too. For example, we could form an international alliance with countries like Canada, Germany, UK, Japan... If a drug is legal/approved in one of those countries not only is it approved here automatically but we can also buy drugs from those countries.

We could further lower the barrier to entry for patients to get drugs by forcing the least dangerous varieties to be over the counter. For example, there's little reason an Albuterol inhaler requires a prescription. It's basically impossible to OD on and is not addictive.

Even if these specific ideas aren't the right solutions, I think we've been forced into a false dichotomy of basically the status quo or nationalization. I think we can be much more creative.

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

#389

Post by jahaja »

nate_meurer wrote: post #382
jahaja wrote: post #375

Earlier quoted context omitted.

The template of trickle down economics I'm referring to is the method where the already wealthy/profiting and so on, is given immediate benefits under the premise of vague and long-term benefits for the many. This method of upwards redistribution has been applied repeatedly time and time again, and tax cuts in the style of trickle down economics are just one instance of it. > Just for fun, give me some examples of dr…

Regardless of how you want to redefine the phrase trickle down , your use of it here betrays a fundamental misunderstanding of the subject. If it's possible to reduce the regulatory burden of the approval process for biosimilar insulin so as to allow generic makers to compete more easily, this will REDUCE the monopoly power of the large incumbent drug companies. I don't know if you're being deliberately obtuse, but I…

> Regardless of how you want to redefine the phrase trickle down, your use of it here betrays a fundamental misunderstanding of the subject

Care to explain how it doesn't fit the template I described?

> this will REDUCE the monopoly power of the large incumbent drug companies

This is at best naive. The approval process isn't the problem. Government granted monopolies are.

> Which has exactly nothing to do with insulin

Uhm, yes, and that was in response to the free-market nonsense, not insulin.

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

#390

Post by michael_j_ward »

Consultant32452 wrote: post #388
idoh wrote: post #372

Earlier quoted context omitted.

Makes sense to me. If evergreening is fixed, then theoretically in ten years time every drug on the market right now could be available as a generic at generic prices.

I think there's a lot of other great options on the table too. For example, we could form an international alliance with countries like Canada, Germany, UK, Japan... If a drug is legal/approved in one of those countries not only is it approved here automatically but we can also buy drugs from those countries. We could further lower the barrier to entry for patients to get drugs by forcing the least dangerous varietie…

Hey since you seem to be familiar with the "evergreening" process, would you mind weighing in on my question above? [0]

[0] https://news.ycombinator.com/item?id=22184942

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