7 ms·

My daughter, like many kids, has an allergy that requires us to have epipens on hand. There was a good article the other day about how the owner of epipen have

My daughter, like many kids, has an allergy that requires us to have epipens on hand. There was a good article the other day about how the owner of epipen have raised the price of epipen from $57/pen in 2007 to over $400/two-pack of pens today. I don't think you can get just one pen, btw. I think the difference is they didn't raise the price in one fell swoop. Frogs in boiling water, etc, etc. http://www.bloomberg.com/news/articles/2015-09-23/how-marketing-turned-the-epipen-into-a-billion-dollar-business http://www.bloomberg.com/news/articles/2015-09-23/how-market...

pragone 11y ago
In EMS, there's been a big push to allow basic EMTs to draw Epi up from a vial to administer it, precisely to avoid the absurd costs associated with EpiPens. I don't know if that would be an option for individuals; perhaps it's something you can talk to your doctor about
rexf 11y ago
In my anecdotal experience, the price of asthma inhalers (Albuterol) have gone up significantly, which sucks since they have a limited shelf-life & it's common to have multiple (car, office, bedroom, etc). Like epipen-countered allergies, asthma is a life & death situation. From a quick web search, this site[1] shows: > To go from inhalers that cost 5 dollars to 60 dollars especially for those who don’t have prescription drug coverage has been awful. As a consumer, I can either forgo inhalers or use expired ones (instead of spending $$$ to keep them current). [1] http://www.dailystrength.org/health_blogs/dr-orrange/article/your-inhaler-expensive-green-at-price http://www.dailystrength.org/health_blogs/dr-orrange/article...
- grecy 11y ago
  Could you not buy them from another country? A quick trip across the border in either direction will save you a ton of money, and I'm sure you can mail order it too.
  - eli 11y ago
    Not that it is frequently prosecuted in the US, but in many (most?) countries it is illegal to import pharmaceuticals without a license.
    - grecy 11y ago
      asthma inhalers are considered a pharmaceutical?
  - ekianjo 11y ago
    > mail order This carries the risk of fakes, though. I mean fakes are everywhere in the first place, but through mail order the risk significantly increases.
    - grecy 11y ago
      I think the chances are very low when buying from a developed country.
- fpgeek 11y ago
  From what I recall, there was a big price increase for asthma inhalers when they switched from CFCs to other propellants. That being said, I thought the new propellants were going to go generic after a few years. Has that not happened yet? Or did people / insurance companies adapt to the higher prices so that the new generics can charge more than the old ones?
  - semi-extrinsic 11y ago
    I always used non-propellant inhalers when I was a kid (in Europe). I believe they are called Diskus-type. Why do you need propellants?
    - jrockway 11y ago
      I don't think albuterol is available in that form. Here's a study where a company that makes generics is testing that, I think: https://clinicaltrials.gov/ct2/show/NCT01857323 https://clinicaltrials.gov/ct2/show/NCT01857323. It's from 2013. The drugs in Diskus form are typically steroids. Steroids are to prevent attacks, albuterol is to stop attacks that have already started.
      - semi-extrinsic 11y ago
        No, I had both albuterol (ventolin) and steroids (flutide) in diskus form. Edit: link to picture: http://bloggfiler.no/tcmn.blogg.no/images/441858-8-1265834547754.jpg http://bloggfiler.no/tcmn.blogg.no/images/441858-8-126583454...
- JeremyNT 11y ago
  The sorry state of asthma medication is a tragedy that could have completely been avoided. For a long time, asthma medication was not under patent protection. The FDA, however, outlawed all generic asthma medication because it contained CFCs [0] in the late 00's, and the replacement delivery system was newly eligible for patent protection simply due to using a different propellant. [1] This wasn't some amazing new advancement in the drug formula, they just changed how it got into your lungs - ostensibly due to environmental concerns. This case is a damning indictment of patent law and in how we handle externalities generally. The environmental cost of CFCs was an externality that no drug manufacturer ever had to pay. What's the solution to that problem? Of course it's not to tax or fine manufacturers who continuing to pollute, no: it's to reward some pharma companies with a fresh monopoly for altering the medication such that it doesn't deplete the ozone layer. Congratulations on the amazing new drug you developed! You're now doing the bare minimum that should be required to be a citizen of the planet by not actively destroying it with pollutants! Here's your reward, a monopoly, with which you can extract money from the (mostly poor) asthma sufferers who no longer have affordable medication. I don't understand why this wasn't a bigger story. [0] http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm080446.htm http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/u... [1] http://www.nytimes.com/2013/10/13/us/the-soaring-cost-of-a-simple-breath.html?nl=todaysheadlines&emc=edit_th_20131013&_r=1 http://www.nytimes.com/2013/10/13/us/the-soaring-cost-of-a-s...
eitally 11y ago
My wife had a great job at a family controlled, small drug company named King Pharmaceuticals. They were based in Bristol, TN, and had fewer than 1000 employees. King developed, owned the patents on, and sold the epipen. Of course, what happened next is exactly what you'd expect. Pfizer made a bid for a hostile takeover and the shareholders approved it. What was the first order of business on day 0? Exactly what you'd expect: lay off 90% of the King employees and more than double the price of epipens. Why? Because they could. I have deep appreciation for pharmaceutical research, but it's folly to imagine any of it's ultimately driven by anything but profits. The exception may be the fewer-every-year small pharmas. Btw, after Pfizer laid her off, my wife went to work for Salix, another small-but-successful pharma based in Raleigh that specializes in GI drugs. Guess what happened after barely over a year? Valeant bought Salix and laid off 90% of the workforce. Valeant is far worse than Pfizer, too. Their entire business proposition is finding "under-performing" drugs, buying the companies, then cutting costs and doing a better job marketing them. It's working so far, but has cost a lot of good folks their jobs/careers.
- subway 11y ago
  I have deep appreciation for pharmaceutical research, but it's folly to imagine any of it's ultimately driven by anything but profits. I disagree with you. I remain convinced that research is driven by the curious geeks with a passion for solving the problem at hand. Research is, unfortunately, funded by profiteering assholes.
  - HarryHirsch 11y ago
    The market does not allow people like Roy Vagelos, Sigurd Varian or Bill Packard to thrive today, all we get instead is locusts like Valeant and Shkreli. That's the reality. The incentives are completely messed up, and there is no path to improvement.
  - theophrastus 11y ago
    I worked for big pharma and medium (sized) pharma, i discovered several new chemotypes to treat pathologies, all eventually patented. i never got a dime, because that was the terms of my employment. i watched the market price rise on many of the pharmaceuticals i had worked on each time they were sold, placed under new contracts, and re-sold. Our salaries didn't rise as a result, our equipment wasn't modernized. Where did that extra profit go? "It's all fungible", one suit told me at a company meeting; but you're correct, our normally fixed salaries did filter down through the growing salaries of "profiteering assholes".
thrownaway2424 11y ago
And they expire after a year.
- barking 11y ago
  Where I once worked we were obliged by law to keep a huge range of medications in a dedicated emergency kit. In the years I was there none were ever used or needed. The drugs ranged from salbutamol to adrenaline to glucagon, steroids, tablets for angina etc, etc. In the mandatory refresher courses we were also quietly advised that with our level of emergency experience and thus diagnostic ability we were far more likely to do harm than good with these and so there were only a couple of items in the kit that we should ever even think of using. Only one company was approved for the supply of these kits and they'd regularly contact us advising that such and such now needed replacing and invoice us. Not only was it onerously expensive but what was really annoying was that they never supplied anything with a full shelf life. Stuff that might have several years shelf life would commonly be supplied with a year or even less left to expiry.

pragone 11y ago

In EMS, there's been a big push to allow basic EMTs to draw Epi up from a vial to administer it, precisely to avoid the absurd costs associated with EpiPens. I don't know if that would be an option for individuals; perhaps it's something you can talk to your doctor about

rexf 11y ago

In my anecdotal experience, the price of asthma inhalers (Albuterol) have gone up significantly, which sucks since they have a limited shelf-life & it's common to have multiple (car, office, bedroom, etc). Like epipen-countered allergies, asthma is a life & death situation. From a quick web search, this site[1] shows: > To go from inhalers that cost 5 dollars to 60 dollars especially for those who don’t have prescription drug coverage has been awful. As a consumer, I can either forgo inhalers or use expired ones (instead of spending $$$ to keep them current). [1] http://www.dailystrength.org/health_blogs/dr-orrange/article/your-inhaler-expensive-green-at-price http://www.dailystrength.org/health_blogs/dr-orrange/article...

grecy 11y ago
Could you not buy them from another country? A quick trip across the border in either direction will save you a ton of money, and I'm sure you can mail order it too.
- eli 11y ago
  Not that it is frequently prosecuted in the US, but in many (most?) countries it is illegal to import pharmaceuticals without a license.
  - grecy 11y ago
    asthma inhalers are considered a pharmaceutical?
- ekianjo 11y ago
  > mail order This carries the risk of fakes, though. I mean fakes are everywhere in the first place, but through mail order the risk significantly increases.
  - grecy 11y ago
    I think the chances are very low when buying from a developed country.
fpgeek 11y ago
From what I recall, there was a big price increase for asthma inhalers when they switched from CFCs to other propellants. That being said, I thought the new propellants were going to go generic after a few years. Has that not happened yet? Or did people / insurance companies adapt to the higher prices so that the new generics can charge more than the old ones?
- semi-extrinsic 11y ago
  I always used non-propellant inhalers when I was a kid (in Europe). I believe they are called Diskus-type. Why do you need propellants?
  - jrockway 11y ago
    I don't think albuterol is available in that form. Here's a study where a company that makes generics is testing that, I think: https://clinicaltrials.gov/ct2/show/NCT01857323 https://clinicaltrials.gov/ct2/show/NCT01857323. It's from 2013. The drugs in Diskus form are typically steroids. Steroids are to prevent attacks, albuterol is to stop attacks that have already started.
    - semi-extrinsic 11y ago
      No, I had both albuterol (ventolin) and steroids (flutide) in diskus form. Edit: link to picture: http://bloggfiler.no/tcmn.blogg.no/images/441858-8-1265834547754.jpg http://bloggfiler.no/tcmn.blogg.no/images/441858-8-126583454...
JeremyNT 11y ago
The sorry state of asthma medication is a tragedy that could have completely been avoided. For a long time, asthma medication was not under patent protection. The FDA, however, outlawed all generic asthma medication because it contained CFCs [0] in the late 00's, and the replacement delivery system was newly eligible for patent protection simply due to using a different propellant. [1] This wasn't some amazing new advancement in the drug formula, they just changed how it got into your lungs - ostensibly due to environmental concerns. This case is a damning indictment of patent law and in how we handle externalities generally. The environmental cost of CFCs was an externality that no drug manufacturer ever had to pay. What's the solution to that problem? Of course it's not to tax or fine manufacturers who continuing to pollute, no: it's to reward some pharma companies with a fresh monopoly for altering the medication such that it doesn't deplete the ozone layer. Congratulations on the amazing new drug you developed! You're now doing the bare minimum that should be required to be a citizen of the planet by not actively destroying it with pollutants! Here's your reward, a monopoly, with which you can extract money from the (mostly poor) asthma sufferers who no longer have affordable medication. I don't understand why this wasn't a bigger story. [0] http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm080446.htm http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/u... [1] http://www.nytimes.com/2013/10/13/us/the-soaring-cost-of-a-simple-breath.html?nl=todaysheadlines&emc=edit_th_20131013&_r=1 http://www.nytimes.com/2013/10/13/us/the-soaring-cost-of-a-s...

eitally 11y ago

My wife had a great job at a family controlled, small drug company named King Pharmaceuticals. They were based in Bristol, TN, and had fewer than 1000 employees. King developed, owned the patents on, and sold the epipen. Of course, what happened next is exactly what you'd expect. Pfizer made a bid for a hostile takeover and the shareholders approved it. What was the first order of business on day 0? Exactly what you'd expect: lay off 90% of the King employees and more than double the price of epipens. Why? Because they could. I have deep appreciation for pharmaceutical research, but it's folly to imagine any of it's ultimately driven by anything but profits. The exception may be the fewer-every-year small pharmas. Btw, after Pfizer laid her off, my wife went to work for Salix, another small-but-successful pharma based in Raleigh that specializes in GI drugs. Guess what happened after barely over a year? Valeant bought Salix and laid off 90% of the workforce. Valeant is far worse than Pfizer, too. Their entire business proposition is finding "under-performing" drugs, buying the companies, then cutting costs and doing a better job marketing them. It's working so far, but has cost a lot of good folks their jobs/careers.

subway 11y ago
I have deep appreciation for pharmaceutical research, but it's folly to imagine any of it's ultimately driven by anything but profits. I disagree with you. I remain convinced that research is driven by the curious geeks with a passion for solving the problem at hand. Research is, unfortunately, funded by profiteering assholes.
- HarryHirsch 11y ago
  The market does not allow people like Roy Vagelos, Sigurd Varian or Bill Packard to thrive today, all we get instead is locusts like Valeant and Shkreli. That's the reality. The incentives are completely messed up, and there is no path to improvement.
- theophrastus 11y ago
  I worked for big pharma and medium (sized) pharma, i discovered several new chemotypes to treat pathologies, all eventually patented. i never got a dime, because that was the terms of my employment. i watched the market price rise on many of the pharmaceuticals i had worked on each time they were sold, placed under new contracts, and re-sold. Our salaries didn't rise as a result, our equipment wasn't modernized. Where did that extra profit go? "It's all fungible", one suit told me at a company meeting; but you're correct, our normally fixed salaries did filter down through the growing salaries of "profiteering assholes".

thrownaway2424 11y ago

And they expire after a year.

barking 11y ago
Where I once worked we were obliged by law to keep a huge range of medications in a dedicated emergency kit. In the years I was there none were ever used or needed. The drugs ranged from salbutamol to adrenaline to glucagon, steroids, tablets for angina etc, etc. In the mandatory refresher courses we were also quietly advised that with our level of emergency experience and thus diagnostic ability we were far more likely to do harm than good with these and so there were only a couple of items in the kit that we should ever even think of using. Only one company was approved for the supply of these kits and they'd regularly contact us advising that such and such now needed replacing and invoice us. Not only was it onerously expensive but what was really annoying was that they never supplied anything with a full shelf life. Stuff that might have several years shelf life would commonly be supplied with a year or even less left to expiry.