http://www.nbcnews.com/business/economy/epipen-price-hike-has-parents-kids-allergies-scrambling-ahead-school-n633071
How do we depend on market forces when there is no market? Doesn't a monopoly effectively short circuit free market economics?
Discuss.....
Extra credit: Keep this out of Religion, Politics, and Flame Wars. O0
I suspect the price increase goes hand in hand with the legislation requiring it be stocked in Public Schools. If the Public Education System is paying for it, then why not jack-up your prices and get in on the big payoff?
Which, of course, brings up the question of "Just because you can, does that mean you should?"
Are corporations expected to exercise the same sort of moral and ethical restraints we expect from individual human beings? (This is an especially interesting question given SCOTUS' definition of corporations as "people" in relationship to free speech and political campaign contributions.)
Screwing your neighbor may be legal but is it really the right thing to do?
Quote from: DoctorQuest on August 23, 2016, 10:23:02 AM
Screwing your neighbor may be legal but is it really the right thing to do?
Depends on the neighbor. :P
It'll be interesting to see what reason's Mylan come up with for this.
A couple of interesting things I've heard today on this.
1. The prices on these have been going up for a few years now. It is just starting to be seen by consumers because of the higher deductibles and people are now looking at their bills closer.
2. The CEO of Mylan is Heather Bresch. She's the daughter of Joe Manchin. Joe Manchin the a Democratic US Senator from WV.
The Epipen problem is what you get in a horrible regulatory state. It is very time consuming (think many, many years) to get anything approved by the FDA and the process is amazingly expensive. This is true even if the drug has been around forever and the technology is well known.
When you raise the entry cost barriers due to excessive regulation, you get de-facto monopolies set up by the government. Monopoly pricing is easy to determine what the profit maximizing price is. For Epipen's, nobody who does not have to have one will get one. For those who need them, it can potentially save their life. Thus highly inelastic demand and the need for multiple producers to keep prices low. But the cost of entry for a new producer is so high due to the government, you get horrible pricing situations in the market.
And I'm saying this as a guy who has to have Epipens with them whenever they hunt. If I step on a yellow jacket nest or get bitten by a rattlesnake or copperhead, I'm likely to die before I can get to the emergency room.
In sum, the problem is the US Government preventing competition due to a hyper-regulatory State.
I was intrigued by an article I read on this as well and it turns out to not be a simple problem. Here is the lead author on a new paper dealing witht his and policys quote
Quote"I continue to be impressed by the complexity of the issue. It is not as easy as saying, 'Let's let Medicare negotiate for Part D drugs,' or any simple fix," said Dr. Aaron Kesselheim, an associate professor at Harvard Medical School and associate physician at Brigham and Women's Hospital, who was lead author of the paper.
Here is an abstract of his paper
http://www.ncbi.nlm.nih.gov/pubmed/27552619
My daughter has an Epipen - nut allergy - but as is the NHS in the UK, it's free. O0
I think it gets replaced fairly regularly - like every 6 months? Which seems rather a waste - but they've got a "life span" on them :knuppel2:
Quote from: airboy on August 24, 2016, 12:48:38 PM
The Epipen problem is what you get in a horrible regulatory state. It is very time consuming (think many, many years) to get anything approved by the FDA and the process is amazingly expensive. This is true even if the drug has been around forever and the technology is well known.
When you raise the entry cost barriers due to excessive regulation, you get de-facto monopolies set up by the government. Monopoly pricing is easy to determine what the profit maximizing price is. For Epipen's, nobody who does not have to have one will get one. For those who need them, it can potentially save their life. Thus highly inelastic demand and the need for multiple producers to keep prices low. But the cost of entry for a new producer is so high due to the government, you get horrible pricing situations in the market.
And I'm saying this as a guy who has to have Epipens with them whenever they hunt. If I step on a yellow jacket nest or get bitten by a rattlesnake or copperhead, I'm likely to die before I can get to the emergency room.
In sum, the problem is the US Government preventing competition due to a hyper-regulatory State.
What regulations would you remove to solve the problem?
Quote from: DoctorQuest on August 25, 2016, 11:19:17 AM
Quote from: airboy on August 24, 2016, 12:48:38 PM
The Epipen problem is what you get in a horrible regulatory state. It is very time consuming (think many, many years) to get anything approved by the FDA and the process is amazingly expensive. This is true even if the drug has been around forever and the technology is well known.
When you raise the entry cost barriers due to excessive regulation, you get de-facto monopolies set up by the government. Monopoly pricing is easy to determine what the profit maximizing price is. For Epipen's, nobody who does not have to have one will get one. For those who need them, it can potentially save their life. Thus highly inelastic demand and the need for multiple producers to keep prices low. But the cost of entry for a new producer is so high due to the government, you get horrible pricing situations in the market.
And I'm saying this as a guy who has to have Epipens with them whenever they hunt. If I step on a yellow jacket nest or get bitten by a rattlesnake or copperhead, I'm likely to die before I can get to the emergency room.
In sum, the problem is the US Government preventing competition due to a hyper-regulatory State.
What regulations would you remove to solve the problem?
Please reasonable questions have no place here during a heated rant....shame on you ;)
All Your Allergic Salvation Belong To Us.
Quote from: Con on August 25, 2016, 03:50:13 PM
Quote from: DoctorQuest on August 25, 2016, 11:19:17 AM
What regulations would you remove to solve the problem?
Please reasonable questions have no place here during a heated rant....shame on you ;)
http://thehill.com/blogs/pundits-blog/healthcare/292438-competition-is-the-cure-for-epipens-price-hike
QuoteWhat's preventing competition is not lack of demand, but regulatory costs imposed by the Food and Drug Administration. One company estimates that it would cost them at least $1.5 million dollars to develop an EpiPen alternative and push it through clinical trials.
What can be done? Imposing a price cap on epinephrine autoinjectors would only discourage future competitors. Instead, we should make it cheaper and easier to bring alternatives to market.
Congress could offer the U S Food and Drug Administration (FDA) priority review vouchers for companies that launch competitors for single-source generics. Given the high cost of clinical trials, conditional approvals for promising medicines could also allow companies to recoup some of their upfront costs and generate revenue, while collecting final data on safety and efficacy. Another option is to list more medicines for over-the-counter use, reducing the need for expensive prescriptions.
http://www.nytimes.com/2016/08/25/business/mylan-raised-epipens-price-before-the-expected-arrival-of-a-generic.html
QuoteWhat has further fueled the increases is that the expected generic, from Teva, was unexpectedly rejected by the Food and Drug Administration. And a nongeneric alternative, Sanofi's Auvi-Q, was pulled from the market last year because of dosing problems.
So rather than a last grasp for profits, Mylan has a near monopoly now, allowing it to continue the price increases for at least another year.
QuoteOne question that remains is why EpiPen is protected by patents since it has been on the market since the 1980s. The active ingredient, epinephrine — a hormone made by the body and also known as adrenaline — was first isolated more than 100 years ago.
But EpiPen is protected by patents on the device, particularly the safety cap on the needle. The patents are held by Meridian Medical Technologies, which is now part of Pfizer. One such patent, which was asserted in litigation trying to block Teva's entry into the market, expires in 2025.
It is not clear why the F.D.A. did not approve Teva's product. Teva has said that the agency found "certain major deficiencies" and that its product will not reach the market until next year at the earliest.
Quote from: DoctorQuest on August 25, 2016, 11:19:17 AM
Quote from: airboy on August 24, 2016, 12:48:38 PM
The Epipen problem is what you get in a horrible regulatory state. It is very time consuming (think many, many years) to get anything approved by the FDA and the process is amazingly expensive. This is true even if the drug has been around forever and the technology is well known.
When you raise the entry cost barriers due to excessive regulation, you get de-facto monopolies set up by the government. Monopoly pricing is easy to determine what the profit maximizing price is. For Epipen's, nobody who does not have to have one will get one. For those who need them, it can potentially save their life. Thus highly inelastic demand and the need for multiple producers to keep prices low. But the cost of entry for a new producer is so high due to the government, you get horrible pricing situations in the market.
And I'm saying this as a guy who has to have Epipens with them whenever they hunt. If I step on a yellow jacket nest or get bitten by a rattlesnake or copperhead, I'm likely to die before I can get to the emergency room.
In sum, the problem is the US Government preventing competition due to a hyper-regulatory State.
What regulations would you remove to solve the problem?
The FDA should have a hyper-streamlined approval process for competitive entry after a patent has expired. It would be simple enough to have a company post a $5 million bond to pay off manufacturing defects for the first 3 years. The actual cost of such a bond would be very low. Or, they could have approved drug manufacturers all of which can manufacture generics of any type by posting said bond.
Patents are PUBLIC DOCUMENTS!! You can download and read them. That is why we have patents!! But the FDA puts a hyper expensive and onerous process to produce competitive products.
This is not complicated to solve - except by the idiot US government.
I wouldn't be surprised to find that some of those onerous FDA regulations were actually created at the behest of big Pharma itself to keep competitors (especially smaller ones) from getting in on the fun.
Quote from: Nefaro on August 25, 2016, 03:59:55 PM
All Your Allergic Salvation Belong To Us.
Somebody set up us the Epipen!
You have no chance to survive make your time...HA HA HA
Quote from: Staggerwing on August 25, 2016, 06:52:21 PM
I wouldn't be surprised to find that some of those onerous FDA regulations were actually created at the behest of big Pharma itself to keep competitors (especially smaller ones) from getting in on the fun.
It would not surprise me.
Alternative explanation - power mad bureaucrats. That also happens.
Quote from: airboy on August 25, 2016, 06:10:20 PM
Quote from: DoctorQuest on August 25, 2016, 11:19:17 AM
Quote from: airboy on August 24, 2016, 12:48:38 PM
The Epipen problem is what you get in a horrible regulatory state. It is very time consuming (think many, many years) to get anything approved by the FDA and the process is amazingly expensive. This is true even if the drug has been around forever and the technology is well known.
When you raise the entry cost barriers due to excessive regulation, you get de-facto monopolies set up by the government. Monopoly pricing is easy to determine what the profit maximizing price is. For Epipen's, nobody who does not have to have one will get one. For those who need them, it can potentially save their life. Thus highly inelastic demand and the need for multiple producers to keep prices low. But the cost of entry for a new producer is so high due to the government, you get horrible pricing situations in the market.
And I'm saying this as a guy who has to have Epipens with them whenever they hunt. If I step on a yellow jacket nest or get bitten by a rattlesnake or copperhead, I'm likely to die before I can get to the emergency room.
In sum, the problem is the US Government preventing competition due to a hyper-regulatory State.
What regulations would you remove to solve the problem?
The FDA should have a hyper-streamlined approval process for competitive entry after a patent has expired. It would be simple enough to have a company post a $5 million bond to pay off manufacturing defects for the first 3 years. The actual cost of such a bond would be very low. Or, they could have approved drug manufacturers all of which can manufacture generics of any type by posting said bond.
Patents are PUBLIC DOCUMENTS!! You can download and read them. That is why we have patents!! But the FDA puts a hyper expensive and onerous process to produce competitive products.
This is not complicated to solve - except by the idiot US government.
Good idea. I wish any hearings on the subject would address these sorts of issues. I can wish, can't I?
I still feel it is a fascinating question around how much is too much profit, especially at the expense of folks with a medical problem. I don't have a good answer. I have never held a monopoly on anything so I can't really relate to those who do and can exploit it. After reading OJD's article I stumbled upon this one. Among other things it does talk about Mylan's lobbying of legislation that works in it's favor.
http://thehill.com/blogs/congress-blog/healthcare/293388-pricing-of-epipens-merits-scrutiny-committee-hearings
And this is completely unrelated. I just like the A-10. O0
http://thehill.com/policy/defense/293379-mccain-and-allies-cheer-report-criticizing-plans-to-retire-the-a-10
It's really a new program by the Government to get our DNA samples to test our compatibility with Alien DNA for the Hybrid Creation Program. Am I the only one here that watched, 'X-Files'?
Saw this in Facebook
"YOU DON'T NEED EPIPEN! Ask your doctor to prescribe an amp of epinephrine and a tuberculin syringe and teach you to use it. Cost: $10."
We need to have an epipen for my youngest boy as he's severely allergic to egg. They are extremely expensive in here in NZ as there is no govt. funding for them so it's cheaper to buy them from Britain and get them shipped over.
(https://scontent.xx.fbcdn.net/v/t1.0-9/14067465_1202583633095410_6638241094623891960_n.jpg?oh=e74b0981d23c6c5ef7d848ebcb57d2cf&oe=58459839)
Thanks. I needed that.
Mad Magazine can't afford a proof reader?
This reminds me of what happened a couple of years ago here in the U.S. Overnight the prices of pharmaceuticals from some companies skyrocketed. My druggist told me some drugs cost ten times what they had before the hike! Imagine receiving an order that had cost a couple of hundred dollars yesterday costing $2,000 today! And it was just before the section of Obamacare took effect that froze the prices of certain medications, according to my local pharmacist.
Quote from: bayonetbrant on August 26, 2016, 04:01:13 PM
(https://scontent.xx.fbcdn.net/v/t1.0-9/14067465_1202583633095410_6638241094623891960_n.jpg?oh=e74b0981d23c6c5ef7d848ebcb57d2cf&oe=58459839)
The screed Brant posted is totally inaccurate.
The FDA has repeatedly turned down generic epipens. Europe has 8 different Eippen device providers.
Blame the government for setting up a useless monopoly. Blame liberals (I know Brant just copied something he saw) for not understanding the fundamentals of microeconomics. And yes, Blame Obama for putting idiots in charge of the FDA.
Here is a link to a detailed discussion, with references, about how the FDA and Federal Government Regulation created and maintained the Epipen monopoly:
http://slatestarcodex.com/2016/08/29/reverse-voxsplaining-drugs-vs-chairs/
But of course, the "solution" is even more government regulation and investigations - not allowing competition on a common device.
Quote from: airboy on August 30, 2016, 01:31:17 PM
The FDA has repeatedly turned down generic epipens. Europe has 8 different Eippen device providers.
This is one of those things that's never made any sense. I understand that countries have their own standards, but why, if the EU has approved a device/drug, does the FDA not either approve at that time or fast track it. Same goes with something approved in the US and EU can then approve it or fast track.
Quote from: airboy on August 30, 2016, 01:31:17 PM
The screed Brant posted is totally inaccurate.
The FDA has repeatedly turned down generic epipens. Europe has 8 different Eippen device providers.
Blame the government for setting up a useless monopoly. Blame liberals (I know Brant just copied something he saw) for not understanding the fundamentals of microeconomics. And yes, Blame Obama for putting idiots in charge of the FDA.
Here is a link to a detailed discussion, with references, about how the FDA and Federal Government Regulation created and maintained the Epipen monopoly:
http://slatestarcodex.com/2016/08/29/reverse-voxsplaining-drugs-vs-chairs/
But of course, the "solution" is even more government regulation and investigations - not allowing competition on a common device.
I might be wildly off the mark but I think the Mad Magazine graphic was meant as humor, not a call to action aimed at endless hoards of zombified liberal activists and their lists of congressional contacts.
Personally I think pharmaceutical companies are one of the major drivers of how f*cking awful our healthcare system is. $600 for an Epipen? Thousands of dollars each for cancer medication pills? It's a ridiculous and utter rip-off across the board.
I believe that these companies could damn well cure most any disease out there, especially if they pooled their efforts, but they won't if there's no profit margin in it. They especially wouldn't create a "cure for ____" for any reason, since once it's cured, their profits on it would disappear.
I've thought a simple solution would be to make all pharmaceutical companies non-profit, but I heard the counter-argument made that they'd lose their drive for innovation, then. I can see that, but having worked for a medical non-profit company for six years, my impression is there's plenty of folks in it for the good of the work, not to get rich. And making giant billion-dollar pharmaceuticals non-profits would be, while hilarious and come-uppance to the Nth degree, fought tooth and nail by them of course.
As long as they can get away with it, they'll charge what people have to pay to get it. In the case of Epipens, they have a patent on the delivery system.
But one really has to wonder what corporate dumbass thought it was a brilliant idea to more than double the cost of something people need to, you know, not die every day, instead of just slightly increasing it. "Oh, no, nobody will complain! They'll pay it anyway if they don't want to die! Muwahahahahaha!"
The entire "half off coupon" thing is a gigantic insult. They're still jacking the price up for two pens, by about 300% even with that nonsense.
God I hate pharmaceutical companies. :D
Quote from: Banzai_Cat on August 31, 2016, 06:49:59 AM
Personally I think pharmaceutical companies are one of the major drivers of how f*cking awful our healthcare system is. $600 for an Epipen? Thousands of dollars each for cancer medication pills? It's a ridiculous and utter rip-off across the board.
I believe that these companies could damn well cure most any disease out there, especially if they pooled their efforts, but they won't if there's no profit margin in it. They especially wouldn't create a "cure for ____" for any reason, since once it's cured, their profits on it would disappear.
I've thought a simple solution would be to make all pharmaceutical companies non-profit, but I heard the counter-argument made that they'd lose their drive for innovation, then. I can see that, but having worked for a medical non-profit company for six years, my impression is there's plenty of folks in it for the good of the work, not to get rich. And making giant billion-dollar pharmaceuticals non-profits would be, while hilarious and come-uppance to the Nth degree, fought tooth and nail by them of course.
As long as they can get away with it, they'll charge what people have to pay to get it. In the case of Epipens, they have a patent on the delivery system.
But one really has to wonder what corporate dumbass thought it was a brilliant idea to more than double the cost of something people need to, you know, not die every day, instead of just slightly increasing it. "Oh, no, nobody will complain! They'll pay it anyway if they don't want to die! Muwahahahahaha!"
The entire "half off coupon" thing is a gigantic insult. They're still jacking the price up for two pens, by about 300% even with that nonsense.
God I hate pharmaceutical companies. :D
I worked for 24 years in the pharmaceutical industry in analytical research. We worked somewhat differently than many analytical research departments in that we worked on a drug from its inception to its introduction to market and sometimes beyond. We developed the methods of analysis for the drug substance and the drug product(s). We did the chemical and physical characterization of the drug substance. We did the clinical release testing of the drug substance and the drug product as well as setting up and doing the stability studies on these materials. I have worked with research organic chemists, development organic chemists, pharmacists, chemical engineers, toxicologists, regulatory affairs, sales and marketing. I have had interaction with the FDA, foreign regulatory agencies and the DEA. I have worked on antibiotics, antivirals, pain meds as well as other types of drugs. Once a drug started development, in my experience, one in eleven got to market. Of the ten that do not get to market, you could spend tens of millions to half a billion dollars on them. The sooner you kill a development drug the better. One of our drugs that got to market, had to be pulled because it started showing severe side effects. It was in less than 1% of the users and one foreign regulatory requested it not be pulled, but it was.
The vast majority of the people I have worked with want to put, out safe and effective drugs. Are there bad actors out there? Yes, but they are few and far between, but they do seem to congregate in upper management. The idea that drug companies can put out drugs with no side effects or they can create a cure for any disease they wish to, is a bunch of excrement.
I appreciate that, Labbug. My own opinion is based on a lot of other things that I've not disclosed, such as having two close family members die because of cancer, and noting how ridiculously expensive the drugs are. I'm obviously quite biased. I can, however, appreciate it being put into perspective like that.
Quote from: Labbug on August 31, 2016, 10:12:30 AM
Once a drug started development, in my experience, one in eleven got to market. Of the ten that do not get to market, you could spend tens of millions to half a billion dollars on them. The sooner you kill a development drug the better. One of our drugs that got to market, had to be pulled because it started showing severe side effects. It was in less than 1% of the users and one foreign regulatory requested it not be pulled, but it was.
Working from home and usually have one of the news/business channels on. You'd be surprised how many commercials there are for lawsuits for FDA approved drugs that later were found to have a side effect.
Am I correct in that in these cases the FDA isn't responsible even though they approved the drug for use?
Quote from: OJsDad on August 31, 2016, 10:34:14 PM
Quote from: Labbug on August 31, 2016, 10:12:30 AM
Once a drug started development, in my experience, one in eleven got to market. Of the ten that do not get to market, you could spend tens of millions to half a billion dollars on them. The sooner you kill a development drug the better. One of our drugs that got to market, had to be pulled because it started showing severe side effects. It was in less than 1% of the users and one foreign regulatory requested it not be pulled, but it was.
Working from home and usually have one of the news/business channels on. You'd be surprised how many commercials there are for lawsuits for FDA approved drugs that later were found to have a side effect.
I'm I correct in that in these cases the FDA isn't responsible even though they approved the drug for use?
They are responsible for approval and are not libel for any of the adverse effects of the drug. To give the FDA its due, they are in a rough position. They are criticized both for the time it takes for approval and if they approve a drug that turns out to have problems. One of the reasons side effects are not always seen, is the limited number of people in the clinical trials. If my memory is correct, you have 15,000 to 20,000 people in all of the clinical trials before approval. There is good chance you will not see some the side effects in the clinical trial population. About 50% of the cost of development is in the clinical trials. Also clinical trials usually continue after approval.
As a nurse for 20+ years, I can tell you ALL drugs have side-effects and there is no such thing as a completely safe drug. Some side-effects can only be discovered by using the drug over a longer period of time than the drug trials the FDA uses. It's just the nature of medicine. It doesn't mean we should avoid new drugs nor should we sue over every new one either.
Depakote was a 'new drug' originally used for treatment of seizures. Only after using it for years was it discovered that it worked better than the drug of choice, Lithium, that was used for Bi-Polar Disorder. That turned out to be a very good thing as Lithium was a very dangerous drug to use. Depakote is now the drug of choice for Bi-Polar Disorder but only because it had a totally unforeseen effect.