Live data from Hacker News

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

nbc15.com

71–80 of 422 posts

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

#71

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…

  Pharma companies are profiting off of your tax dollars
No. Pharma companies are paying taxes collectively which are then used to fund basic research they can all benefit from.

Another way to do it would be to form a consortium like SEMATECH [1].

If the government didn't tax and regulate companies and people so highly they would have more left over to join voluntary associations and do the same thing.

[1] https://en.wikipedia.org/wiki/SEMATECH

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

#72
post #21

Earlier quoted context omitted.

You're looking at the wrong data. You need to look at return on capital. Right now the return on capital in pharma is below the cost of capital and it's trending towards zero. The inevitable result is significantly lower funding for research. https://endpts.com/pharmas-broken-business-model-an-industry...

This is some random person's calculation of industry returns. A person who says he works for a pharma company and doesn't link to any actual data. https://www.linkedin.com/in/kelvinstott/

He has sources for the data. You can look those up.

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

#73
post #14

Earlier quoted context omitted.

How will people lose their insulin over this?

If you can only charge $100, but it costs $110, what happens isn't that it gets sold at $100 anyhow. What happens is that it doesn't get sold. Nobody has an obligation to manufacture insulin. I'm not saying the costs are $110. I don't know. I'm just explaining why this can result in lost insulin.

It sells in Europe for much cheaper. There is absolutely a market for insulin for under $100/mo in many western countries.

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

#74

Earlier quoted context omitted.

I am really anxious for the people that will lose their insulin because of this...

How will people lose their insulin over this?

Let's say that you write a bill "you can't sell insulin for over $100". If insulin sellers refuse to sell for less than $100, there's no insulin available.

However, the bill might also say that insurance companies must keep the out-of-pocket costs under $100 or that the state will make up any amount over $100.

In reality, it seems unlikely to harm insulin availability since most jurisdictions have cheap insulin and the cost in the US seems to be significantly higher.

Theoretically, price caps can be set low enough that no one will produce and sell an item. If you capped the price of computers at $100, no one would be making and selling computers and you wouldn't be able to find a computer without going to the black market. Countries like Venezuela have tried price caps on goods and what has happened is that those goods can't be found. Retailers won't sell items for less than they can get them from a supplier and suppliers won't sell for that price, possibly due to the cost of inputs, production, shipping, etc.

In this case, there's evidence that prices have been inflated unfairly with insulin and therefore this just hurts suppliers' margin without really changing availability. However, there is the potential that suppliers won't work with the price restriction. Let's say that you're CVS and you're buying an insulin drug from BigPharmCo at $150. Illinois has a new law such that you can't sell insulin for more than $100 so you tell BigPharmCo that you need supplies at $60 so that you can sell it for $100 and pay for stores, employees, etc. BigPharmCo decides that they'd rather not sell it to you at $60 because they'd rather write off Illinois sales all together rather than reduce their price to $60. Illinois is only about 4% of the US population. If you lower your price to $60, you're losing 60% of your revenue. If you write off Illinois, you're only losing 4% of your revenue.

Now, you might argue that they'd only have to give CVS a discount on supplies for Illinois, but that would be hard to enforce. It seems legal to ship medical stuff across states. Would it be legal to prevent someone from entering into interstate commerce they've always been accustomed to? I have no idea. Maybe suppliers would only supply a certain amount they deemed necessary for the Illinois population to CVS at the discounted price. However, then why wouldn't CVS just stop selling in Illinois and sell the discounted insulin for a higher price in other states?

Even if one can prevent cross-state shipment of insulin, suppliers might deem it worth their while to make an example out of Illinois. If they don't make an example out of Illinois, other states will likely follow. They might get some bad press, but at some point the state would need to act to protect the welfare of its people and repeal the restriction.

I'm not saying that any of these things are good or righteous. It's just harder to force people to do what you want than many people think. Given that forms of insulin are generic, maybe the answer is that we need more generic manufacturers to make it competitive.

Again, I don't think shortages are likely to happen. GoodRx shows generic Humalog available for under $70, but many others are much more expensive. I don't know enough about insulin prices to really know what will happen. However, in many instances, price caps haven't been really effective at helping people.

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

#75
post #67

Earlier quoted context omitted.

> When it costs billions to develop a new drug due to onerous testing regulations, that's what happens. This does not explain the increase in cost of insulin, which was invented in 1923.

You can buy the formulation that was invented in 1923 for cheap. It's newer formulations that are expensive, and those are still protected by patents.

https://en.wikipedia.org/wiki/Regular_insulin

> In the United Kingdom 1,000 iu costs the NHS £7.48, while in the United States this amount is about $134.00.

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

#76
post #42

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 i really believe pharma advertising should be banned

It is where I live, so weird visiting the US and seeing "ask your doctor for" adverts.

If I asked my GP for a specific medication they'd look at me like an alien.

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

#77
post #54

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…

Ironically, insulin is a great example of why your premise is false: Insulin replacement was developed a century ago, being first discovered by a government entity (U of Toronto). Private companies commercialized the treatments in the 1940s and 1950s, developing long acting forms that could be administered in a single injection per day. Since then, pharmaceutical companies have made continuous improvements with fewer…

>Instead of “scrapping” the industry, wouldn’t it make more sense to, as a first step, get rid of regulatory roadblocks that prevent competitors from producing out of patent drugs?

What's your solution for drugs that aren't out of patent?

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

#78
post #33

Earlier quoted context omitted.

This suggests that something is very wrong with the market. The costs of development and production (even ignoring failures) are way below revenue, which means that return on capital should be very positive. Somehow most of the money is going into overhead. One might debate whether the overhead constitutes corruption, but it should be able to be reduced.

I don’t demand my roads, libraries, or other public goods turn a profit. I wouldn’t demand the same of public pharma research (NIH, DARPA). Perhaps the market is not designed for this sort of endeavor (drug research). Let government stand in where the market has failed.

Except the market has succeeded fantastically. In my lifetime alone, AIDS and HepC went from death sentences to chronic conditions. Many forms of leukemia went from fatal to highly treatable.

Meanwhile, what has the government done? The trip from DC to New York on Amtrak is slower today than it was in 1960. In 1980, DC’s Metro had self driving trains. They had to shut that down in 2009 due to lack of maintenance and the unions. Spending on public education, adjusted for inflation, per student since 1960. But achievement hasn’t budged one inch. If the drug industry has failed, what words are in the English language for what the government has done?

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

#79
post #14

Earlier quoted context omitted.

How will people lose their insulin over this?

If you can only charge $100, but it costs $110, what happens isn't that it gets sold at $100 anyhow. What happens is that it doesn't get sold. Nobody has an obligation to manufacture insulin. I'm not saying the costs are $110. I don't know. I'm just explaining why this can result in lost insulin.

In most of the world people can get a month's supply of insulin for less than $100/ month. It's not more expensive to manufacture here, there is just more profit-taking.

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

#80

Earlier quoted context omitted.

So the next step is to nationalize the facility that manufactures it, the testing of it, the distribution of it. All taxpayers will pay for it. And the ubiquitous govt will have to compensate the drug companies for the taking of their intellectual property. Welcome to Venezuela.

Insulin is a generic. No one is required to be compensated. Pharma had their chance to be reasonable. That time has passed. Not to say that we shouldn’t appropriate intellectual property when necessary (eminent domain or not respecting a patent, as has happened in India and Canada), it’s just not necessary in this case. That doesn’t make us Venezuela, that makes us pragmatic.

Generic Insulin is already cheap, around $100. It is the newer more effective versions that pharma companies have come up with recently that are more expensive.

One can't argue that the pharma companies are bringing no value, and then demand their specific product because the generic isn't good enough.

https://www.snopes.com/fact-check/insulin-walmart-vial/

Post reply on HN