4 ms·

Huh! So we had an affordable solution all around but it was illegal ?

by tn13 10y ago

maxerickson 10y ago
No, it was not illegal. Marketing and consumer behavior contributed to people not seeking out the cheaper option.
- tn13 10y ago
  So it was not EpiPen that was fleecing people but people enamoured by marketing strategies wanted to pay 10x more ?
  - maxerickson 10y ago
    4x. By volume, it was mostly insurance or non person entities (school systems and the like, by gov mandate) that paid for it. Of course when insurance pays everyone pays through their premiums, but that's where the consumer behavior comes in, who cares what it costs if it is covered.
- adventured 10y ago
  It was illegal. By law CVS could not prescribe the generic Adrenaclick in place of the EpiPen, if the prescription was for an EpiPen. Classic case of the government causing abusive artificially high prices for consumers through bad regulation.
  - maxerickson 10y ago
    I read the other comment as thinking that generic Adrenaclick (the low cost alternative) was illegal. It wasn't. A prescription written for Epipen still can't be filled with generic Adrenaclick, so "was illegal" isn't a great description of that situation. It's hardly complicated to ask a doctor to write a different prescription, so that's why I talked about consumer behavior and marketing. Given that the different mechanisms require different training, I am somewhat forgiving of the "as written" requirement for auto-injectors.
  - Spivak 10y ago
    First, pharmacies don't prescribe anything, they dispense medication. Second, if you voiced how expensive EpiPens are to your pharmacist they would not only recommend the generic, but (so long as they're not swamped) call your doctor right there at the desk to get the prescription changed. The government's position might be considered overly cautious but I agree with it in this case, the two injectors are sufficiently different that they're not drop-in replacements for each other.
    - steamer25 10y ago
      Every pharmacist and, moreover, every consumer capable of conducting a transaction with said pharmacists is also capable of spending the two minutes* required to evaluate the difference between these two auto injectors. Evaluating the distinction doesn't require anything close to an advanced degree but it's not legal for anyone who isn't credentialed to vend/dispense/trade/exchange/grant/supply/provide the still-very-effective, much cheaper alternative based solely on the customer's informed demand--doing so would be "illegal". Yes, if your highly-trained, well-payed, in-demand pharmacist has the time and interest; they can work through the call tree until he reaches your highly-trained, well-payed, in-demand doctor; who would've wrote a more general prescription in the first place if it didn't increase their chances of being sued, and get the prescription changed. The problem is, apparently, that hasn't happened often enough--probably because it doesn't happen for free. Someone ends up paying for it e.g., the doctor and pharmacologist, other patients, the insurer and their other clientele or the tax payer--multiplied times however many epinephrine injectors are sold in a given year. There are few incentives to economize in the chain of payers because health-care is an unlimited 'right' that should be provided for by someone (everyone) else: https://en.wikipedia.org/wiki/Tragedy_of_the_commons https://en.wikipedia.org/wiki/Tragedy_of_the_commons * Link from above: https://www.youtube.com/watch?v=LRgqwgCh4Fs https://www.youtube.com/watch?v=LRgqwgCh4Fs
    - tn13 10y ago
      Honestly even if they are different what matters to me is whether the difference is worth $$$$$. The government certified highly trained doctor seems to have simply overlooked that a cheaper and almost as good alternative existed!

Huh! So we had an affordable solution all around but it was illegal ?

by tn13 10y ago

Huh! So we had an affordable solution all around but it was illegal ?

maxerickson 10y ago

No, it was not illegal. Marketing and consumer behavior contributed to people not seeking out the cheaper option.

tn13 10y ago
So it was not EpiPen that was fleecing people but people enamoured by marketing strategies wanted to pay 10x more ?
- maxerickson 10y ago
  4x. By volume, it was mostly insurance or non person entities (school systems and the like, by gov mandate) that paid for it. Of course when insurance pays everyone pays through their premiums, but that's where the consumer behavior comes in, who cares what it costs if it is covered.
adventured 10y ago
It was illegal. By law CVS could not prescribe the generic Adrenaclick in place of the EpiPen, if the prescription was for an EpiPen. Classic case of the government causing abusive artificially high prices for consumers through bad regulation.
- maxerickson 10y ago
  I read the other comment as thinking that generic Adrenaclick (the low cost alternative) was illegal. It wasn't. A prescription written for Epipen still can't be filled with generic Adrenaclick, so "was illegal" isn't a great description of that situation. It's hardly complicated to ask a doctor to write a different prescription, so that's why I talked about consumer behavior and marketing. Given that the different mechanisms require different training, I am somewhat forgiving of the "as written" requirement for auto-injectors.
- Spivak 10y ago
  First, pharmacies don't prescribe anything, they dispense medication. Second, if you voiced how expensive EpiPens are to your pharmacist they would not only recommend the generic, but (so long as they're not swamped) call your doctor right there at the desk to get the prescription changed. The government's position might be considered overly cautious but I agree with it in this case, the two injectors are sufficiently different that they're not drop-in replacements for each other.
  - steamer25 10y ago
    Every pharmacist and, moreover, every consumer capable of conducting a transaction with said pharmacists is also capable of spending the two minutes* required to evaluate the difference between these two auto injectors. Evaluating the distinction doesn't require anything close to an advanced degree but it's not legal for anyone who isn't credentialed to vend/dispense/trade/exchange/grant/supply/provide the still-very-effective, much cheaper alternative based solely on the customer's informed demand--doing so would be "illegal". Yes, if your highly-trained, well-payed, in-demand pharmacist has the time and interest; they can work through the call tree until he reaches your highly-trained, well-payed, in-demand doctor; who would've wrote a more general prescription in the first place if it didn't increase their chances of being sued, and get the prescription changed. The problem is, apparently, that hasn't happened often enough--probably because it doesn't happen for free. Someone ends up paying for it e.g., the doctor and pharmacologist, other patients, the insurer and their other clientele or the tax payer--multiplied times however many epinephrine injectors are sold in a given year. There are few incentives to economize in the chain of payers because health-care is an unlimited 'right' that should be provided for by someone (everyone) else: https://en.wikipedia.org/wiki/Tragedy_of_the_commons https://en.wikipedia.org/wiki/Tragedy_of_the_commons * Link from above: https://www.youtube.com/watch?v=LRgqwgCh4Fs https://www.youtube.com/watch?v=LRgqwgCh4Fs
  - tn13 10y ago
    Honestly even if they are different what matters to me is whether the difference is worth $$$$$. The government certified highly trained doctor seems to have simply overlooked that a cheaper and almost as good alternative existed!