24hourcampfire.com
24hourcampfire.com
Previous Thread
Next Thread
Print Thread
Hop To
Page 1 of 4 1 2 3 4
Joined: May 2001
Posts: 18,286
Steve Online Content OP
Campfire Ranger
OP Online Content
Campfire Ranger
Joined: May 2001
Posts: 18,286

Drugs vs. Chairs

Quote


EpiPens, useful medical devices which reverse potentially fatal allergic reactions, have recently quadrupled in price, putting pressure on allergy sufferers and those who care for them. Vox writes that this “tells us a lot about what’s wrong with American health care” – namely that we don’t regulate it enough:

The story of Mylan’s giant EpiPen price increase is, more fundamentally, a story about America’s unique drug pricing policies. We are the only developed nation that lets drugmakers set their own prices, maximizing profits the same way sellers of chairs, mugs, shoes, or any other manufactured goods would.

Let me ask Vox a question: when was the last time that America’s chair industry hiked the price of chairs 400% and suddenly nobody in the country could afford to sit down? When was the last time that the mug industry decided to charge $300 per cup, and everyone had to drink coffee straight from the pot or face bankruptcy? When was the last time greedy shoe executives forced most Americans to go barefoot? And why do you think that is?

The problem with the pharmaceutical industry isn’t that they’re unregulated just like chairs and mugs. The problem with the pharmaceutical industry is that they’re part of a highly-regulated cronyist system that works completely differently from chairs and mugs.

If a chair company decided to charge $300 for their chairs, somebody else would set up a woodshop, sell their chairs for $250, and make a killing – and so on until chairs cost normal-chair-prices again. When Mylan decided to sell EpiPens for $300, in any normal system somebody would have made their own EpiPens and sold them for less. It wouldn’t have been hard. Its active ingredient, epinephrine, is off-patent, was being synthesized as early as 1906, and costs about ten cents per EpiPen-load.

Why don’t they? They keep trying, and the FDA keeps refusing to approve them for human use. For example, in 2009, a group called Teva Pharmaceuticals announced a plan to sell their own EpiPens in the US. The makers of the original EpiPen sued them, saying that they had patented the idea epinephrine-injecting devices. Teva successfully fended off the challenge and brought its product to the FDA, which rejected it because of “certain major deficiencies”. As far as I know, nobody has ever publicly said what the problem was – we can only hope they at least told Teva.

In 2010, another group, Sandoz, asked for permission to sell a generic EpiPen. Once again, the original manufacturers sued for patent infringement. According to Wikipedia, “as of July 2016 this litigation was ongoing”.

In 2011, Sanoji asked for permission to sell a generic EpiPen called e-cue. This got held up for a while because the FDA didn’t like the name (really!), but eventually was approved under the name Auvi-Q, (which if I were a giant government agency that rejected things for having dumb names, would be going straight into the wastebasket). But after unconfirmed reports of incorrect dosage delivery, they recalled all their products off the market.

This year, a company called Adamis decided that in order to get around the patent on devices that inject epinephrine, they would just sell pre-filled epinephrine syringes and let patients inject themselves. The FDA rejected it, noting that the company involved had done several studies but demanding that they do some more.

Also, throughout all of this a bunch of companies are merging and getting bought out by other companies and making secret deals with each other to retract their products and it’s all really complicated.

None of this is because EpiPens are just too hard to make correctly. Europe has eight competing versions. But aside from the EpiPen itself, only one competitor has ever made it past the FDA and onto the pharmacy shelf – a system called Adrenaclick.

And of course there’s a catch. With ordinary medications, pharmacists are allowed to interpret prescriptions for a brand name as prescriptions for the generic unless doctors ask them not to. For example, if I write a prescription for “Prozac”, a pharmacist knows that I mean anything containing fluoxetine, the chemical ingredient sold under the Prozac brand. They don’t have to buy it directly from Prozac trademark-holder Eli Lilly. It’s like if someone asks for a Kleenex and you give them a regular tissue, or if you suggest putting something in a Tupperware but actually use a plastic container made by someone other than the Tupperware Corporation.

EpiPens are protected from this substitution. If a doctor writes a prescription for “EpiPen”, the pharmacist must give an EpiPen-brand EpiPen, not an Adrenaclick-brand EpiPen. This is apparently so that children who have learned how to use an EpiPen don’t have to relearn how to use an entirely different device (hint: jam the pointy end into your body).

If you know anything at all about doctors, you know that they have way too much institutional inertia to change from writing one word on a prescription pad to writing a totally different word on a prescription pad, especially if the second word is almost twice as long, and especially especially if it’s just to do something silly like save a patient money. I have an attending who, whenever we are dealing with anything other than a life-or-death matter, just dismisses it with “Nobody ever died from X”, and I can totally hear him saying “Nobody ever died from paying extra for an adrenaline injector”. So Adrenaclick continues to languish in obscurity.

So why is the government having so much trouble permitting a usable form of a common medication?

There are a lot of different factors, but let me focus on the most annoying one. EpiPen manufacturer Mylan Inc spends about a million dollars on lobbying per year. OpenSecrets.org tells us what bills got all that money. They seem to have given the most to defeat S.214, the “Preserve Access to Affordable Generics Act”. The bill would ban pharmaceutical companies from bribing generic companies not to create generic drugs.

Did they win? Yup. In fact, various versions of this bill have apparently failed so many times that FDA Law Blog notes that “insanity is doing the same thing over and over again and expecting different result”.

So let me try to make this easier to understand.

Imagine that the government creates the Furniture and Desk Association, an agency which declares that only IKEA is allowed to sell chairs. IKEA responds by charging $300 per chair. Other companies try to sell stools or sofas, but get bogged down for years in litigation over whether these technically count as “chairs”. When a few of them win their court cases, the FDA shoots them down anyway for vague reasons it refuses to share, or because they haven’t done studies showing that their chairs will not break, or because the studies that showed their chairs will not break didn’t include a high enough number of morbidly obese people so we can’t be sure they won’t break. Finally, Target spends tens of millions of dollars on lawyers and gets the okay to compete with IKEA, but people can only get Target chairs if they have a note signed by a professional interior designer saying that their room needs a “comfort-producing seating implement” and which absolutely definitely does not mention “chairs” anywhere, because otherwise a child who was used to sitting on IKEA chairs might sit down on a Target chair the wrong way, get confused, fall off, and break her head.

(You’re going to say this is an unfair comparison because drugs are potentially dangerous and chairs aren’t – but 50 people die each year from falling off chairs in Britain alone and as far as I know nobody has ever died from an EpiPen malfunction.)

Imagine that this whole system is going on at the same time that IKEA spends millions of dollars lobbying senators about chair-related issues, and that these same senators vote down a bill preventing IKEA from paying off other companies to stay out of the chair industry. Also, suppose that a bunch of people are dying each year of exhaustion from having to stand up all the time because chairs are too expensive unless you’ve got really good furniture insurance, which is totally a thing and which everybody is legally required to have.

And now imagine that a news site responds with an article saying the government doesn’t regulate chairs enough.




Carpe' Scrotum
BP-B2

Joined: Aug 2002
Posts: 19,060
Campfire Ranger
Offline
Campfire Ranger
Joined: Aug 2002
Posts: 19,060
It is not only in the medical community, this whole lobbying is out of control. It is just buying Congressmen to screw the people, no matter what section is doing it. miles


Look out for number 1, don't step in number 2.
Joined: Jun 2010
Posts: 3,529
Campfire Tracker
Offline
Campfire Tracker
Joined: Jun 2010
Posts: 3,529
Thanks for the link. That explains a lot about why some drug prices skyrocket. Effectively, Mylan has a monopoly; one they pay a lot to maintain. However, the word is getting out about AdrenaClick and if enough doctors and patients start specifying it the jig will be up for Mylan.

Joined: Aug 2007
Posts: 19,495
G
g5m Offline
Campfire Ranger
Offline
Campfire Ranger
G
Joined: Aug 2007
Posts: 19,495
Their price for epipen is simply unconscionable.

They used to less than $50. (A long time ago). And there's less than a dollar's worth of epinephrine in them. Plus the price of an injector.


Retired cat herder.


Joined: Mar 2004
Posts: 20,770
2
Campfire Ranger
Online Content
Campfire Ranger
2
Joined: Mar 2004
Posts: 20,770
I used to carry an Epi-pen. When the last one expired the co pay for a new one was $630.00.

I now carry 2 pre drawn syringes in a toothbrush holder. The cost of the same medication used in an Epi-pen was $7.oo.

I have never liked needles much but for a savings of $623.00 every 6 Months I now know how to give myself a shot.


Please don't feed the trolls!
IC B2

Joined: Oct 2004
Posts: 24,634
Campfire Ranger
Offline
Campfire Ranger
Joined: Oct 2004
Posts: 24,634
Before the hikes, they were like $50.00. Now they're over $600.00. So Mylan is "doing us all a favor" and they'll bring out a "Generic" epi pen for around $300.00. Man, they sure have big hearts don't they? They cut the price in half for us. Now it's only 7x the price as it as before...What swell guys.

Joined: Nov 2003
Posts: 67,554
Campfire Kahuna
Offline
Campfire Kahuna
Joined: Nov 2003
Posts: 67,554
simplistic and sophomoric. There is so much more than that at play with drug prices. If you think prices are too high, in general, it's because of the FDA or the DOJ. Both drive the price. Blame a politician, a bureaucrat or a lawyer, not the company that makes and sells the product. They make very little on it, and on stuff like EpiPen, probably lose money.


Sam......

Joined: Aug 2005
Posts: 10,639
Campfire Outfitter
Online Content
Campfire Outfitter
Joined: Aug 2005
Posts: 10,639
Bob Brinker really went off on this last week on his Moneytalk show. Pure BS.


A true sportsman counts his achievements in proportion to the effort involved and fairness of the sport. - S. Pope
Joined: Feb 2009
Posts: 16,109
A
add Online Content
Campfire Ranger
Online Content
Campfire Ranger
A
Joined: Feb 2009
Posts: 16,109
Originally Posted by Mannlicher
They make very little on it, and on stuff like EpiPen, probably lose money.


Yeah, probably a loss leader strategy.


Epstein didn't kill himself.

"Play Cinnamon Girl you Sonuvabitch!"

Biden didn't win the election.
Joined: Oct 2004
Posts: 24,634
Campfire Ranger
Offline
Campfire Ranger
Joined: Oct 2004
Posts: 24,634
But in this case, they were making money selling them well under $100. There were no NEW regulations on the company, no changes to their cost to produce...but there were new regulations for schools.

Seems the price hike came right after Mylan's lobbyists successfully pushed through a bill that requires epi-pens in schools in 11 states. So now that it's mandatory, why not raise the price by over 600%?

But yeah, it's everyone but the pharmaceutical company's fault.

IC B3

Joined: Aug 2005
Posts: 43,691
Campfire 'Bwana
Offline
Campfire 'Bwana
Joined: Aug 2005
Posts: 43,691
Some people need pictures.

[Linked Image]

And if the company drops the price of the EpiPen, the CEO and executives are likely to lose millions of dollars each in incentive bonuses.

CEO's dad is Senator Manchin of West Virginia.


The Savage 99 Pocket Reference”.
All models and variations of 1895’s, 1899’s and 99’s covered.
Also dates, checkering, engraving.. Find at www.savagelevers.com
Joined: Jun 2008
Posts: 18,304
Campfire Ranger
Offline
Campfire Ranger
Joined: Jun 2008
Posts: 18,304
Each Epi-Pen has 0.3 mg of epi in it. Nowadays that's about 3 bucks worth of epinephrine. I've been giving that dose in the ER for 30 years now, for allergic reactions, when it was warranted. MYLAN is price gouging the crap out of people who's lives, and who's children's lives, depend on the availability of this apparatus. Not surprisingly, the CEO's yearly salary has increased from 2 million dollars to 19 million dollars during the same time period that the price has increased for the Epi-Pens. This is pure greed and nothing more.


Every day on this side of the ground is a win.
Joined: Jan 2012
Posts: 6,864
B
Campfire Tracker
Offline
Campfire Tracker
B
Joined: Jan 2012
Posts: 6,864
Originally Posted by antlers
This is pure greed and nothing more.


While that's certainly a part, you're naive to think that's the only thing that allows this to happen.

The makers have a monopoly on the market, supported by the government (read: FDA). It takes $2M-3M to get the FDA to LOOK at your new drug, and a literal semi trailer of paperwork (read: more $$ for lawyers, doctors, researchers, etc). the makers have a corner on the market thanks to the federal government. They're only charging $630 because they can get away with it due to the (.gov supported) high barrier (read: $$) to enter the market. To think it's only greed is naive, possibly stupid. You'd be doing the same, simply because you could and should, were you the CEO with a board of directors and shareholders to please. If you didn't, you'd be replaced as CEO. Welcome to America, "capitalism," and the government mucking everything up.


Originally Posted by Bristoe
It's about like this:

"Do you puff peters?"

"Hell no!"

"NAZI!!!"


Joined: Jun 2008
Posts: 18,304
Campfire Ranger
Offline
Campfire Ranger
Joined: Jun 2008
Posts: 18,304
Originally Posted by bigfish9684
Originally Posted by antlers
This is pure greed and nothing more.

To think it's only greed is naive, possibly stupid.

lol

AOL Time Warner, WorldCom, Enron, Tyco, Arthur Andersen, and MYLAN...'masters' of capitalism.

lol some more


Every day on this side of the ground is a win.
Joined: Jan 2002
Posts: 12,192
Campfire Outfitter
Offline
Campfire Outfitter
Joined: Jan 2002
Posts: 12,192
Don't know if it's true, but I heard yesterday that you can buy the drug at a local drugstore, buy a syringe, and make one yourself on the cheap


















Joined: May 2001
Posts: 18,286
Steve Online Content OP
Campfire Ranger
OP Online Content
Campfire Ranger
Joined: May 2001
Posts: 18,286
Originally Posted by Tracks
Don't know if it's true, but I heard yesterday that you can buy the drug at a local drugstore, buy a syringe, and make one yourself on the cheap


You have to get a script from your doc for the epinephrine itself.


Carpe' Scrotum
Joined: May 2008
Posts: 25,307
A
Campfire Ranger
Offline
Campfire Ranger
A
Joined: May 2008
Posts: 25,307
Originally Posted by Mannlicher
simplistic and sophomoric. There is so much more than that at play with drug prices. If you think prices are too high, in general, it's because of the FDA or the DOJ. Both drive the price. Blame a politician, a bureaucrat or a lawyer, not the company that makes and sells the product. They make very little on it, and on stuff like EpiPen, probably lose money.


Lolol. That's the silliest thing I've heard in awhile. Simplistic and sophomoric not to mention ignorant and uninformed describes the quoted post.


�Politicians are the lowest form of life on earth. Liberal Democrats are the lowest form of politician.� �General George S. Patton, Jr.

---------------------------------------------------------
~Molɔ̀ːn Labé Skýla~
Joined: Jan 2012
Posts: 6,864
B
Campfire Tracker
Offline
Campfire Tracker
B
Joined: Jan 2012
Posts: 6,864
Originally Posted by AcesNeights
Originally Posted by Mannlicher
simplistic and sophomoric. There is so much more than that at play with drug prices. If you think prices are too high, in general, it's because of the FDA or the DOJ. Both drive the price. Blame a politician, a bureaucrat or a lawyer, not the company that makes and sells the product. They make very little on it, and on stuff like EpiPen, probably lose money.


Lolol. That's the silliest thing I've heard in awhile. Simplistic and sophomoric not to mention ignorant and uninformed describes MY post.


Fixt.

So lemme get this right, the FDA plays ABSOLUTELY NO PART in how the price of EpiPen got so high?


Originally Posted by Bristoe
It's about like this:

"Do you puff peters?"

"Hell no!"

"NAZI!!!"


Joined: Nov 2003
Posts: 18,262
J
Campfire Ranger
Offline
Campfire Ranger
J
Joined: Nov 2003
Posts: 18,262
wonder if a convention of states will ever happen. Fed.Gov is out of control.


Joined: Jan 2012
Posts: 6,864
B
Campfire Tracker
Offline
Campfire Tracker
B
Joined: Jan 2012
Posts: 6,864
My god, why in the world doesn't someone just start making epipen knockoffs and sell them for $20 a pop? Someone could get rich in this market. I mean, there's no barrier to entry AT ALL!! Especially not the FDA approval process...


Originally Posted by Bristoe
It's about like this:

"Do you puff peters?"

"Hell no!"

"NAZI!!!"


Page 1 of 4 1 2 3 4

Moderated by  RickBin 

Link Copied to Clipboard
YB23

Who's Online Now
693 members (10gaugemag, 10ring1, 12308300, 007FJ, 160user, 10Glocks, 84 invisible), 2,768 guests, and 1,306 robots.
Key: Admin, Global Mod, Mod
Forum Statistics
Forums81
Topics1,187,637
Posts18,398,939
Members73,817
Most Online11,491
Jul 7th, 2023


 







Fish & Game Departments | Solunar Tables | Mission Statement | Privacy Policy | Contact Us | DMCA
Hunting | Fishing | Camping | Backpacking | Reloading | Campfire Forums | Gear Shop
Copyright © 2000-2024 24hourcampfire.com, Inc. All Rights Reserved.
Powered by UBB.threads™ PHP Forum Software 7.7.5
(Release build 20201027)
Responsive Width:

PHP: 7.3.33 Page Time: 0.090s Queries: 15 (0.005s) Memory: 0.9108 MB (Peak: 1.0901 MB) Data Comp: Zlib Server Time: 2024-03-28 17:00:36 UTC
Valid HTML 5 and Valid CSS