5 ms·

This doesn't feel like the right platform for DIY. When someone needs an EpiPen, it's because they might be dying. Presumably, a large and well-capitalized orga

by sp527 10y ago

This doesn't feel like the right platform for DIY. When someone needs an EpiPen, it's because they might be dying. Presumably, a large and well-capitalized organization will have tested their device extensively and can offer better guarantees about it actually working (I should stress presumably). There are a lot of ways in which the hacker mindset can be beneficial to society, but this particular application feels like an ethical gray area.

mrg3_2013 10y ago
I too felt the same. The intent is good - but the idea that someone could/should rely on a DIY EpiPen doesn't jive well with me.
- AstralStorm 10y ago
  Start a company making these?
franciscop 10y ago
While I agree for people who can afford it, this is probably aimed to people who can totally not afford the real deal and would be left with nothing otherwise. Also it is a hack, since the best way would be to reduce the price of the good one.
- wyaeld 10y ago
  Its not much of a hack - take a medically approved auto injector - take a medically approved needle - put the needle on a different syringe - put the syringe in the injector It's still all medical grade parts isn't it?
  - AstralStorm 10y ago
    Technically, the whole design needs certification. And you cannot verify one that's made by Joe Random. (also the hygiene during assembly)
lostpass 10y ago
I can't source it right now, but somewhere I read something along the lines of: "studies show 3/5 epipen usages are done improperly and are ineffective"
ankurdhama 10y ago
Hacker mindset doesn't mean a duct tape solution.
bisby 10y ago
The headline says "to expose corporate greed" The premise is that $57 was the old price. and they bumped it up to $318. And a DIY group can pull it off for $30, without economy of scale. From wikipedia "In 2007 when Mylan acquired the rights to market the product, annual sales of all epinephrine autoinjectors were about $200M and EpiPen had around 90% of the market; in 2015 the market size was around $1.5B and Mylan still had about 90% of the market"... $1.5B annually... So if FDA testing costs them $10,000,000 anually, thats still less than 1% of their revenue. That means that with economy of scale, and dispersing the cost of testing over several million sales, they could easily produce a product for $30. But they don't because they dont really care about saving lives, they care about getting paid. They would prefer people die than them make less money. Completely not about "hey do it this cheap easier way" but "heres the rock solid proof that a $300 (even $60) EpiPen is stupid"
- sp527 10y ago
  You know that's probably what they're getting at, but you have to admit it's dangerous to present their point in this way. I don't think it's a stretch to argue that if you offer an instruction manual for making something, some people will make it (and some of them will do so incorrectly).
  - jacobwcarlson 10y ago
    That's an odd slippery slope argument to make on a site called "Hacker News."
    - sp527 10y ago
      Uh actually most people on here understand you don't hack "mission critical" (involving peoples' lives).
      - CamperBob2 10y ago
        Why not? Governments and corporations do it every day.
tjohns 10y ago
I interpret this as more of a political statement, rather than something you'd actually want to rely on. That said, it looks like this is just reusing an existing off-the-shelf autoinjector used for insulin. If it fails, you could remove the needle and inject manually. The biggest risks I see here is making sure the epinephrine stays sterile, and that the dosage is correct. (To be clear: Either of these could have serious consequences.)
moosey 10y ago
I do want to agree with you, and while watching the video I thought a lot about the risks involved. However, the realities of the world applied to ethics requires me to disagree with my knee jerk reaction. The fact is that many families are dealing with the fallout from the fact that they can't afford these life saving devices, and this option gives them a reusable $30 solution to the problem (the needles can't be reused, but the spring can). This is important given that they need to be replaced every year, apparently. The not-so-grey ethical issue is the cost of these devices, and the fact that there are people who are too poor (medicare doesn't cover them, according to the article) to get them. Until we build a system that prevents this unjust situation, it is my opinion that there is nothing questionable about this 'hack'.
- sp527 10y ago
  Actually, I'd rather see the system be corrected than a bifurcation in deaths due to anaphylactic shock according to income level, because Mylan decides to just accept the deadweight loss of poor DIY'ers instead of lowering their prices. That said, USG may be too beholden to Big Pharma at this point for anything to be done.
Cozumel 10y ago
More of a grey area than lobbying to make it illegal for schools to not stock epipens and then jacking the price up 400% and giving yourself a 671% pay raise? Not to mention the CEO is a senators daughter. Costs should cover R&D but this is outright greed and in an industry where it's literally peoples lives at stake it can't be allowed to continue. http://www.bloomberg.com/politics/articles/2016-08-24/the-senator-s-daughter-who-raised-prices-on-anti-allergy-epipen http://www.bloomberg.com/politics/articles/2016-08-24/the-se... https://www.theguardian.com/business/2016/aug/24/epipen-ceo-hiked-prices-heather-bresch-mylan https://www.theguardian.com/business/2016/aug/24/epipen-ceo-...
- sp527 10y ago
  Oh I don't disagree at all. But that has very little to do with whether or not it's ethically responsible to propose an untested method for constructing a device that would only be needed in life-threatening situations.
- mason240 10y ago
  >Not to mention the CEO is a senators daughter. So? Is she just not supposed to work?
  - jrock08 10y ago
    There's a lot of space between the conflict of interest that arises when you lobby congress for a change that would help the company you are the CEO of while your father is a senator and not working.
    - mason240 10y ago
      So do you have list of places that she isn't allowed to work in? You are basically saying that she needs to be kept below a glass ceiling because of who her father is.
    - deleted 10y ago
      [deleted]
robbrown451 10y ago
True, but there are many people who have EpiPens that don't "need" them per se. I have one for my daughter, because her mom (my ex) pressured the doctor to prescribe them for her, even though all she had was a small rash on her face when she ate her very first egg. (the doctor said Benadryl was sufficient for that) Since then I have (with a great bit of care, and an EpiPen handy) given her increasingly large doses of eggs, never seeing a problem, till she now eats eggs like everyone else. But still her mom is fearful and gets new EpiPens prescribed every so often. The point is, it isn't all black and white. If a kid has a severe allergy, sure, make sure you have a real EpiPen and carry it with you always. For those borderline cases, well, something like this might be fine. Having it reduces a really small risk even more. Another interesting point: even if a kid has a severe food allergy, they are still more likely to die from a car accident than from an allergic reaction. Some people lose perspective. http://well.blogs.nytimes.com/2013/12/06/food-allergies-less-deadly-than-accidents/ http://well.blogs.nytimes.com/2013/12/06/food-allergies-less...

by sp527 10y ago

mrg3_2013 10y ago

I too felt the same. The intent is good - but the idea that someone could/should rely on a DIY EpiPen doesn't jive well with me.

AstralStorm 10y ago
Start a company making these?

franciscop 10y ago

While I agree for people who can afford it, this is probably aimed to people who can totally not afford the real deal and would be left with nothing otherwise. Also it is a hack, since the best way would be to reduce the price of the good one.

wyaeld 10y ago
Its not much of a hack - take a medically approved auto injector - take a medically approved needle - put the needle on a different syringe - put the syringe in the injector It's still all medical grade parts isn't it?
- AstralStorm 10y ago
  Technically, the whole design needs certification. And you cannot verify one that's made by Joe Random. (also the hygiene during assembly)

lostpass 10y ago

I can't source it right now, but somewhere I read something along the lines of: "studies show 3/5 epipen usages are done improperly and are ineffective"

ankurdhama 10y ago

Hacker mindset doesn't mean a duct tape solution.

bisby 10y ago

The headline says "to expose corporate greed" The premise is that $57 was the old price. and they bumped it up to $318. And a DIY group can pull it off for $30, without economy of scale. From wikipedia "In 2007 when Mylan acquired the rights to market the product, annual sales of all epinephrine autoinjectors were about $200M and EpiPen had around 90% of the market; in 2015 the market size was around $1.5B and Mylan still had about 90% of the market"... $1.5B annually... So if FDA testing costs them $10,000,000 anually, thats still less than 1% of their revenue. That means that with economy of scale, and dispersing the cost of testing over several million sales, they could easily produce a product for $30. But they don't because they dont really care about saving lives, they care about getting paid. They would prefer people die than them make less money. Completely not about "hey do it this cheap easier way" but "heres the rock solid proof that a $300 (even $60) EpiPen is stupid"

sp527 10y ago
You know that's probably what they're getting at, but you have to admit it's dangerous to present their point in this way. I don't think it's a stretch to argue that if you offer an instruction manual for making something, some people will make it (and some of them will do so incorrectly).
- jacobwcarlson 10y ago
  That's an odd slippery slope argument to make on a site called "Hacker News."
  - sp527 10y ago
    Uh actually most people on here understand you don't hack "mission critical" (involving peoples' lives).
    - CamperBob2 10y ago
      Why not? Governments and corporations do it every day.

tjohns 10y ago

I interpret this as more of a political statement, rather than something you'd actually want to rely on. That said, it looks like this is just reusing an existing off-the-shelf autoinjector used for insulin. If it fails, you could remove the needle and inject manually. The biggest risks I see here is making sure the epinephrine stays sterile, and that the dosage is correct. (To be clear: Either of these could have serious consequences.)

moosey 10y ago

I do want to agree with you, and while watching the video I thought a lot about the risks involved. However, the realities of the world applied to ethics requires me to disagree with my knee jerk reaction. The fact is that many families are dealing with the fallout from the fact that they can't afford these life saving devices, and this option gives them a reusable $30 solution to the problem (the needles can't be reused, but the spring can). This is important given that they need to be replaced every year, apparently. The not-so-grey ethical issue is the cost of these devices, and the fact that there are people who are too poor (medicare doesn't cover them, according to the article) to get them. Until we build a system that prevents this unjust situation, it is my opinion that there is nothing questionable about this 'hack'.

sp527 10y ago
Actually, I'd rather see the system be corrected than a bifurcation in deaths due to anaphylactic shock according to income level, because Mylan decides to just accept the deadweight loss of poor DIY'ers instead of lowering their prices. That said, USG may be too beholden to Big Pharma at this point for anything to be done.

Cozumel 10y ago

More of a grey area than lobbying to make it illegal for schools to not stock epipens and then jacking the price up 400% and giving yourself a 671% pay raise? Not to mention the CEO is a senators daughter. Costs should cover R&D but this is outright greed and in an industry where it's literally peoples lives at stake it can't be allowed to continue. http://www.bloomberg.com/politics/articles/2016-08-24/the-senator-s-daughter-who-raised-prices-on-anti-allergy-epipen http://www.bloomberg.com/politics/articles/2016-08-24/the-se... https://www.theguardian.com/business/2016/aug/24/epipen-ceo-hiked-prices-heather-bresch-mylan https://www.theguardian.com/business/2016/aug/24/epipen-ceo-...

sp527 10y ago
Oh I don't disagree at all. But that has very little to do with whether or not it's ethically responsible to propose an untested method for constructing a device that would only be needed in life-threatening situations.
mason240 10y ago
>Not to mention the CEO is a senators daughter. So? Is she just not supposed to work?
- jrock08 10y ago
  There's a lot of space between the conflict of interest that arises when you lobby congress for a change that would help the company you are the CEO of while your father is a senator and not working.
  - mason240 10y ago
    So do you have list of places that she isn't allowed to work in? You are basically saying that she needs to be kept below a glass ceiling because of who her father is.
  - deleted 10y ago
    [deleted]

robbrown451 10y ago

True, but there are many people who have EpiPens that don't "need" them per se. I have one for my daughter, because her mom (my ex) pressured the doctor to prescribe them for her, even though all she had was a small rash on her face when she ate her very first egg. (the doctor said Benadryl was sufficient for that) Since then I have (with a great bit of care, and an EpiPen handy) given her increasingly large doses of eggs, never seeing a problem, till she now eats eggs like everyone else. But still her mom is fearful and gets new EpiPens prescribed every so often. The point is, it isn't all black and white. If a kid has a severe allergy, sure, make sure you have a real EpiPen and carry it with you always. For those borderline cases, well, something like this might be fine. Having it reduces a really small risk even more. Another interesting point: even if a kid has a severe food allergy, they are still more likely to die from a car accident than from an allergic reaction. Some people lose perspective. http://well.blogs.nytimes.com/2013/12/06/food-allergies-less-deadly-than-accidents/ http://well.blogs.nytimes.com/2013/12/06/food-allergies-less...