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EpiPen Price Rise Sparks Concern for Allergy Sufferers

well.blogs.nytimes.com

41–50 of 367 posts

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#41
post #28
post #18

One of the early on-line responses was "maybe we can figure out how to 3D print these cases". It turns out that an Epi-pen is just a plastic safety housing around a normal syringe. Some discussions: https://www.reddit.com/r/news/comments/4y5481/cost_of_epipen... https://www.reddit.com/r/3Dprinting/comments/4y7f26/epipen_f...

That second discussion got heated quite fast. I agree with the downvoters though. 3D printing a medical device is not something to take lightly. Edit: Here's why I agree. You download this design from the internet, and 3D print the parts. You then assemble it. Awesome! Some time later, you get an allergic reaction. You use the pen, but it fails to work correctly. Who's responsible? The designer? You (if you're alive)…

Semi-yes, semi-no. The epi-pen case is specially made to try and get people to shoot it into themselves/other people correctly. They are super color coded and once triggered can't be untriggered

Other than that, they could be 3-d printed or whatever is cheapest by many providers

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#43
post #23

Earlier quoted context omitted.

Thanks, so this is the missing information. The article misleadingly says the medication is decades-old, where actually the pen itself is patented.

The patent is expired: https://www.google.com/patents/US4031893 Courtesy ceejayoz below: https://news.ycombinator.com/item?id=12340464

so why aren't there more case manufactures

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#44

This is one of those devices that also should be low cost because businesses, locations, ect should have them as well as individuals (many people can have first time deadly allergic reactions, including as adults) That the price for the case is expensive just rose as random is serious business. There really is no need for it to be so expensive

What would be the layman-evaluatable criteria for using it on a person with no history of allergy?

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#46

They don't produce EpiPen's as a generic in India because the Indian medical community does not recommend self-administration of epinephrine. If you're that much in need though, you can buy pre-filled epinephrine syringes for intramuscular injection - just keep in mind the ease-of-use of an EpiPen won't be available. You have to take the time to take off the cap, insert and inject the medicine.

what happens if someone goes into anaphylaxis?

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#47
post #16

Earlier quoted context omitted.

There are really two villains here, Mylan, of course, but more importantly, the FDA. FDA regulations make the cost of bringing a new medical device to the market absurd. There are no competitors because the time and effort to bring a competing device is so ridiculously high that it doesn't pay to do so. I have a child with a peanut allergy. I am worried every damn day of my life. I see articles about people who die e…

So, The FDA, because they require drug and device makers to demonstrate efficacy and safety by going through a rigorous clinical trial process, are evil? Really? I also find your comment pretty uninformed considering that the FDA just paved the way for generic drug makers to basically "knock-off" super expensive biologic drugs like Humira and Enbrel which were previously covered by similar patents. The FDA has it's p…

> So, The FDA, because they require drug and device makers to demonstrate efficacy and safety by going through a rigorous clinical trial process, are evil? Really?

Yes, if the process is so rigorous and expensive that it drives the cost of drugs beyond the reach of people who need them, and it hampers the effective functioning of the free market. And I think it's widely accepted that's far more expensive to bring a drug to market here than it is elsewhere in the world.

The FDA believes its mission should be to ensure that drugs are safe and effective. That is wrongheaded. Instead, it should undertake a rational risk/benefit approach. Rather than saying that no drug gets through the filter unless it's safe (as demonstrated through reams of evidence), it should ask, how much risk should we tolerate in exchange for how much benefit?

In the case of Epipens, there's little risk, because epinephrine is an old, widely-used drug. There is some risk that it will be mis-administered by a less-than-perfect device, but the fact is that a $10 bottle of epinephrine and a $1 syringe can save a life. It is offensive that the FDA thinks it should get in the way of the distribution of such things.

I was in Colorado last summer and took my son horseback riding. Our tour guide was allergic to bee stings, but she was just scraping by financially, and couldn't afford an Epipen. She'd been stung before, and her throat had tightened, but fortunately she happened to have an old, expired pen from before the price went up and so she survived. But now she was going out bare. We gave her one my son's pens. It won't last long. It's possible that she won't last long either.

You want evidence this is an evil system? There it is.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#48

The US is subsidizing the rest of the world. When Canada decrees that the price of something will by X, then guess who pays?

Do these things actually cost more than $100 to manufacture? The US isn't subsidizing the rest of the world with this, we're subsidizing the shareholders of a single company.

I've seen this argument made regarding American health care costs in general. Everyone else pays much less because we're subsidizing them, the argument goes. Except that American medical R&D spending is about $500/year per capita, while the gap in health care costs is thousands. That's some combination of waste and people getting rich off of other people's suffering.

This product could pretty clearly be sold at a profit at the old price. But they can make more money if they charge more. People will die because they can't afford it anymore? Fuck 'em, apparently.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#49
post #16

Why haven't competitors entered the market with cheaper products?

There are really two villains here, Mylan, of course, but more importantly, the FDA. FDA regulations make the cost of bringing a new medical device to the market absurd. There are no competitors because the time and effort to bring a competing device is so ridiculously high that it doesn't pay to do so. I have a child with a peanut allergy. I am worried every damn day of my life. I see articles about people who die e…

It's a really difficult balance to strike with the FDA. Too strict and you get situations like this, too lenient and you get thalidomide. It's hard to come up with a single set of rules that will rush forward all good, effective medication, block all dangerous medication, and continue to do so despite constantly changing technology and understanding.

Clearly the epipen thing is a huge problem, and if the FDA can fix it, they need to do so ASAP or be ordered to do so by Congress. But I'm hesitant to say that their only motivation is petty bureaucracy.

Re: EpiPen Price Rise Sparks Concern for Allergy Sufferers

#50
post #35
post #28

Earlier quoted context omitted.

That second discussion got heated quite fast. I agree with the downvoters though. 3D printing a medical device is not something to take lightly. Edit: Here's why I agree. You download this design from the internet, and 3D print the parts. You then assemble it. Awesome! Some time later, you get an allergic reaction. You use the pen, but it fails to work correctly. Who's responsible? The designer? You (if you're alive)…

Dying because you can't afford a device you need is also not something to take lightly. It may not be a good idea, but blame should lie with the manufacturer for raising the price to such ridiculous levels.

Not condoning this behavior at all, but don't we see this with the lack of equal access to drugs all the time? :(
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