Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Insulin is way too expensive. California has a solution: Make its own

vox.com

Post reply on HN
Print view View original

91–100 of 273 posts

Re: Insulin is way too expensive. California has a solution: Make its own

#91

Post by gnicholas »

dmreedy wrote: post #25
yonran wrote: post #15

I listened to the Vox The Weeds podcast interviewing the same author and was frustrated that his many explanations seemed disconnected. Since old insulin patents have expired, is it that you are allowed to buy generic insulin but there are no manufacturers, or that you not allowed to buy generic insulin because recent advancements are so good that doctors won’t prescribe the old stuff anymore? And no one will make ge…

You are allowed to buy generic/affordable "older" varieties of insulin. It can be got at Walmart for $25 per vial. It is a "regular insulin" as opposed to the more modern insulin analogs; a functional but inferior technology that requires a very restrictive and rigid diet, as opposed to modern combinations of fast and slow acting analogs that allow for something closer to a "normal", albeit carb-cautious diet. It wil…

So is CA going to make the new kind or the old kind? If people don't want the old kind, then I hope they're making the new kind!

Re: Insulin is way too expensive. California has a solution: Make its own

#92

Post by aidenn0 »

recursive wrote: post #71
jeffbee wrote: post #26

Earlier quoted context omitted.

California has a vast and robust sprawling network of socialized transportation, the budget for which has doubled in the past 2 years to consume 7% of the annual state budget. Think I am talking about high speed rail? No, just the freeway department, which spends 40x more every year and the economic sustainability of which is never even obliquely questioned. In short, California has plenty of appetite for socialism,…

> 40x more every year Am I reading this right? Are you saying that each decade, the California freeway department multiplies their budget by a quadrillion ? If their budget was $1 in 2013, they would now be spending more money than there exists in the world? I'm going to request a source for that.

I think GP is saying that CA spends 40x on freeways as compared to public transit.

Re: Insulin is way too expensive. California has a solution: Make its own

#93

Post by [deleted] »

olliej wrote: post #76
r3trohack3r wrote: post #69

> Though insulin generally costs less than $10 per dose to produce, some versions of the drug have a list price above $200. This is in part because, in the US, a warped market has allowed three companies to dominate the insulin business. > With California leading the way, a handful of states are considering trying to disrupt the market for essential medications, starting with insulin. The plan would be to manufacture…

You know developing insulin doesn't require violating patents, right? And the price of insulin in the US is entirely an artifact of monopoly behavior by a small number of pharmaceutical companies? The ability to mass produce insulin at negligible cost has been around for decades, they guy who discovered it made it patent free even. Only in the US do companies get away with this kind of price gouging, and only because…

[deleted]

Re: Insulin is way too expensive. California has a solution: Make its own

#94

Post by coldpie »

ProjectInsulin wrote: post #87
rayiner wrote: post #73

Earlier quoted context omitted.

> I don't understand. My understanding of why insulin is so expensive: intellectual property laws are enforced by the government preventing businesses without that intellectual property to compete in the space. That’s not an accurate understanding of intellectual property specifically. Insulin isn’t like a pill, where once you have a chemical formula you can make millions of them very cheaply. It’s a biologic, an art…

Hi Rayiner, you are spot on with your analysis. My name is Eric, and my non-profit, Project Insulin, is tackling this problem head-on as well. We are developing a biosimilar insulin and will distribute it directly to patients at cost. The drug development process is still expensive but much cheaper because of the Biologics Act that was passed in 2020. When going through the FDA approval process, biosimilar insulin ma…

Hi Eric! I'm a T1D and so super interested in this space. Can you comment on whether it is the case that "modern" insulins (Lantus and Humalog/Novolog, in my case) are both covered by current patents, and also considerably better for patient outcomes (faster acting, more predictable -> lower A1c) than non-covered insulins? That is my understanding for why cheap, high quality insulins are not available, but I'd love to be informed if it is not the case! Thank you for your work in this area!

Re: Insulin is way too expensive. California has a solution: Make its own

#95

Post by jeffbee »

aidenn0 wrote: post #92
recursive wrote: post #71

Earlier quoted context omitted.

> 40x more every year Am I reading this right? Are you saying that each decade, the California freeway department multiplies their budget by a quadrillion ? If their budget was $1 in 2013, they would now be spending more money than there exists in the world? I'm going to request a source for that.

I think GP is saying that CA spends 40x on freeways as compared to public transit.

I am saying that every single year Caltrans spends 40x the budget of the high speed rail.

This does not count the budgets of the DMV and CHP which are 3x and 4x the HSR budget respectively.

Re: Insulin is way too expensive. California has a solution: Make its own

#96

Post by projektfu »

r3trohack3r wrote: post #69

> Though insulin generally costs less than $10 per dose to produce, some versions of the drug have a list price above $200. This is in part because, in the US, a warped market has allowed three companies to dominate the insulin business. > With California leading the way, a handful of states are considering trying to disrupt the market for essential medications, starting with insulin. The plan would be to manufacture…

A lot of formerly protected insulins, e.g. insulin glargine, are off patent now. The remaining moat for generics consists of FDA approval, delivery system patents, and manufacturing process patents/trade secrets. For a generic insulin to get FDA approval it needs bioequivalence which is a lot like running the original safety and effect studies over again, while dealing with spurious injunctions and the like from the company with the name brand. If you get to the finish line as a private company, you're going to price it where you can get some of the market but not get into a price war with the name brand.

California, on the other hand, is paying a lot of money to Novo Nordisk et al, and would benefit from reaching a low average price. They can afford to go through the approval process with all the important insulin analogs. And they won't go bankrupt in court before it pays off.

Re: Insulin is way too expensive. California has a solution: Make its own

#97

Post by davikr »

outworlder wrote: post #83
gamblor956 wrote: post #74

Earlier quoted context omitted.

Insulin pricing isn't entirely IP issue; it's been out of protection and available as a generic for many decades now. The issue is that while insulin is actually quite cheap to make once you get started, the startup-costs associated with getting to that point are quite hefty: lab real estate, equipment to make and purify, FDA fees, etc. Newer versions of insulin are "better" than generic insulin: easier to take, fewe…

> Newer versions of insulin are "better" than generic insulin: easier to take, fewer side effects, etc. Even that is debatable. At least Sanofi has been known to fund some rosy articles about their Lantus® product. When the EU looked into it (for similar initiatives) they were not able to find the large 'performance' gap that was suggested between that insulin and alternatives.

As far as I know, the major difference between insulin types is not their performance, but how long they take to act, when they peak and for how long they have an effect. Some types of insulin, like glargine (as in Lantus®) can be more convenient due to their long-acting response that lasts for an entire day.

I suppose off-patent insulin could be produced with some degree of inconvenience to the consumer because they might have to take more doses per day, but they should work nonetheless.

Re: Insulin is way too expensive. California has a solution: Make its own

#99

Post by zackees »

r3trohack3r wrote: post #69

> Though insulin generally costs less than $10 per dose to produce, some versions of the drug have a list price above $200. This is in part because, in the US, a warped market has allowed three companies to dominate the insulin business. > With California leading the way, a handful of states are considering trying to disrupt the market for essential medications, starting with insulin. The plan would be to manufacture…

[dead]

Re: Insulin is way too expensive. California has a solution: Make its own

#100

Post by [deleted] »

ProjectInsulin wrote: post #87
rayiner wrote: post #73

Earlier quoted context omitted.

> I don't understand. My understanding of why insulin is so expensive: intellectual property laws are enforced by the government preventing businesses without that intellectual property to compete in the space. That’s not an accurate understanding of intellectual property specifically. Insulin isn’t like a pill, where once you have a chemical formula you can make millions of them very cheaply. It’s a biologic, an art…

Hi Rayiner, you are spot on with your analysis. My name is Eric, and my non-profit, Project Insulin, is tackling this problem head-on as well. We are developing a biosimilar insulin and will distribute it directly to patients at cost. The drug development process is still expensive but much cheaper because of the Biologics Act that was passed in 2020. When going through the FDA approval process, biosimilar insulin ma…

[deleted]
Post reply on HN