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To the commenters suggesting that the FDA should do more to punish this company, consider another alternative: if the FDA actually did less to begin with (while

To the commenters suggesting that the FDA should do more to punish this company, consider another alternative: if the FDA actually did less to begin with (while still investigating and providing information transparency), we'd probably be better off. Instead of relying on the government to fix the situation with slow legislation (which usually ends up with enough loopholes to be circumvented anyway), we should allow the industry to function as an actual free(ish) market. If that were the case, we would already have dozens of better EpiPen alternatives as a result of the previous shenanigans from these companies. In other industries, when a company's product is clearly defective, inferior or overpriced, they lose market share and are forced to either improve the product or go out of business. But when the government plays the role of (slow, expensive, often corrupt) "gatekeeper", that is what creates these abusive monopolies.

carlmr 9y ago
Yes and no, industry also has it's fair share of monopolies that gatekeep themselves. If a company becomes big and powerful enough it can write tailored legislation and corrupt the right people so that other competitors have no chance. In this case I'd say you're probably right because the EpiPen is a very simple product, so you'd find a lot of potential competitors, even some with good enough funding to contend with the current market players. However with more complicated medical devices it's harder and harder to compete, because you need so much upfront research money, that you in fact always get a anti-competitive monopoly or oligopoly.
- curiousgeorgio 9y ago
  > you need so much upfront research money, that you in fact always get a anti-competitive monopoly or oligopoly Industries with high R&D costs may be more prone to the formation of natural monopolies, but in most cases that's a better scenario than the coercive monopolies created as a byproduct of government regulation. It could be argued that the tech industry, as one example, has similarly high R&D costs (at least in certain fields), and Apple, Google, Microsoft, etc. have all been blamed for monopolistic practices, but even then, the tech world operates in a much healthier market environment than the healthcare or pharmaceutical industries. Personally, I'd feel more confident being treated in a theoretical Apple hospital (heck, I'd even go for the cheaper Android version) than any of our real-world hospitals with shiny government seals of approval (and more inefficiencies than one can imagine) - as long as I can rely on a decent level of transparency in safety/quality/pricing of those options.
steeve 9y ago
What exactly is preventing another company for creating an EpiPen clone?
- mjevans 9y ago
  Probably payouts from the current manufacturer to stay out of the market. Those payoffs are probably greater than the profit they could make as an off-brand generic. Requiring financial transparency among all possible parties to regulators and banning collusion like the above would actually be the correct way to ensure the market functions properly.
- curiousgeorgio 9y ago
  The FDA. Or at least, the FDA has made it extremely expensive and time-consuming for any competitor who wishes to enter the market. The argument is that a high bar of safety requirements protects consumers (and I'll admit it does to some degree, however inefficiently), but a free market system is more efficient at producing the results that people actually care about (quality, safety, affordability, etc). Also, patents - another government-run monopoly-maker that should be eliminated.
  - steeve 9y ago
    I don't buy the regulatory argument. See my previous answers. Patents, indeed, are a much more efficient way of keeping a monopoly, that's their whole point after all. But I don't a link with regulations in that case.
  - matthewmacleod 9y ago
    a free market system is more efficient at producing the results that people actually care about (quality, safety, affordability, etc) You have no evidence to support that view; where are the free markets full of safe, high-quality, low-cost medicines? Nowhere. Markets are brilliant, but they are not flawless. All of our experience suggests that they need robust, independent regulation to avoid negative outcomes. There is plenty of scope for talking about how time-to-market for drugs can be improved, or other steps that can be taken to reduce regulatory burden where it's causing problems. But this whole 'let the free market sort it out' is the worst kind of high-school libertarianism.
anigbrowl 9y ago
Thalidomide.
Clubber 9y ago
I remember reading about EpiPen when they did their price hike. The main reason they were able to do it is the FDA had given them (intentionally or not) a de-facto monopoly in the US. https://mises.org/blog/lack-epipen-competitors-fdas-fault https://mises.org/blog/lack-epipen-competitors-fdas-fault Of course, we don't want just anyone to be able to package up anything and sell it (unless it's the nutrition industry, for some reason) but at the same time, the EpiPen business isn't good for the country either. What's funny, is this company did the same thing as Shkreli, but does their CEO get the same treatment?
- artursapek 9y ago
  What treatment? Nothing happened Shkreli in response to what he did with Daraprim. His criminal trial had nothing to do with it. That's a common misconception thanks to our bottom-feeding media.
  - Clubber 9y ago
    His public and constant grilling by the media. You certainly didn't hear endless stories about "Pharma Chick," who is the good senator's daughter. I'm aware that the "Pharma Bro" was convicted of securities fraud after tripling his investors investments.
    - artursapek 9y ago
      Ah, ok, we're in agreement.
    - throwawayjava 9y ago
      > I'm aware that the "Pharma Bro" was convicted of securities fraud after tripling his investors investments. "Well you see, your honor, I did try to murder the man. But I failed, and the half hour run he took trying to escape me kick-started a healthy lifestyle that added years to his life. So, I did try to murder him, but in the end everyone benefited." This post-facto justification is like something out of an SNL skit.
AlexandrB 9y ago
> In other industries, when a company's product is clearly defective, inferior or overpriced, they lose market share and are forced to either improve the product or go out of business. No, they really aren't. [1][2][3] [1] https://en.m.wikipedia.org/wiki/United_States_v._Microsoft_Corp https://en.m.wikipedia.org/wiki/United_States_v._Microsoft_C.... [2] https://m.phys.org/news/2005-06-amd-sues-intel-monopoly-abuses.html https://m.phys.org/news/2005-06-amd-sues-intel-monopoly-abus... [3] http://money.cnn.com/2015/03/19/technology/google-monopoly-ftc/index.html http://money.cnn.com/2015/03/19/technology/google-monopoly-f...
- curiousgeorgio 9y ago
  In none of those cases did the government actually step in and do anything to break up those "monopolies" (other than perhaps an insignificant "slap on the wrist" in Microsoft's case). So if the government didn't solve those problems, what did? Answer: innovation and competition from other market players.
  - AlexandrB 9y ago
    > Answer: innovation and competition from other market players. I'm not sure what you're referring to. AMD was on its deathbed a few years ago and Intel still has a near-monopoly on desktop and server CPUs. Google continues to be a monopoly on search and website ads. Microsoft has fallen somewhat, but you could argue that this was only due to pressure from regulators (e.g. browser bundling ban in Europe and when Microsoft was funding Apple to keep the perception of competition alive).
    - curiousgeorgio 9y ago
      And how exactly are these so-called "near-monopolies" hurting consumers? Last I checked, nobody is forced to use Google for search, and people have a choice between buying Intel or AMD processors. Just because a company makes better products than other companies, that doesn't make it abusive or detrimental to society (in fact, quite the opposite is true). If Intel's prices were unreasonable, no one would buy their processors and the next best alternative (AMD or otherwise) would steal their market share. Same with Google and Microsoft.
scott_s 9y ago
There are plenty of clearly defective products in a barely regulated health-adjacent industry that don't lose marketshare: the entire supplement industry, including homeopathic and "herbal" remedies. Relying on free markets to regulate themselves depends on rational consumers. But we are not rational.
- lowbloodsugar 9y ago
  Its not really a problem for me if people buy homeopathic remedies. It is a problem for me that I can't buy cheap, effective epipen alternatives.
jcranberry 9y ago
What, exactly, are you suggesting the FDA do less of? Are you suggesting that pharmaceutical companies should be allowed to bring their products straight to the market? Or just that their clinical trials process should be relaxed?

carlmr 9y ago

Yes and no, industry also has it's fair share of monopolies that gatekeep themselves. If a company becomes big and powerful enough it can write tailored legislation and corrupt the right people so that other competitors have no chance. In this case I'd say you're probably right because the EpiPen is a very simple product, so you'd find a lot of potential competitors, even some with good enough funding to contend with the current market players. However with more complicated medical devices it's harder and harder to compete, because you need so much upfront research money, that you in fact always get a anti-competitive monopoly or oligopoly.

curiousgeorgio 9y ago
> you need so much upfront research money, that you in fact always get a anti-competitive monopoly or oligopoly Industries with high R&D costs may be more prone to the formation of natural monopolies, but in most cases that's a better scenario than the coercive monopolies created as a byproduct of government regulation. It could be argued that the tech industry, as one example, has similarly high R&D costs (at least in certain fields), and Apple, Google, Microsoft, etc. have all been blamed for monopolistic practices, but even then, the tech world operates in a much healthier market environment than the healthcare or pharmaceutical industries. Personally, I'd feel more confident being treated in a theoretical Apple hospital (heck, I'd even go for the cheaper Android version) than any of our real-world hospitals with shiny government seals of approval (and more inefficiencies than one can imagine) - as long as I can rely on a decent level of transparency in safety/quality/pricing of those options.

steeve 9y ago

What exactly is preventing another company for creating an EpiPen clone?

mjevans 9y ago
Probably payouts from the current manufacturer to stay out of the market. Those payoffs are probably greater than the profit they could make as an off-brand generic. Requiring financial transparency among all possible parties to regulators and banning collusion like the above would actually be the correct way to ensure the market functions properly.
curiousgeorgio 9y ago
The FDA. Or at least, the FDA has made it extremely expensive and time-consuming for any competitor who wishes to enter the market. The argument is that a high bar of safety requirements protects consumers (and I'll admit it does to some degree, however inefficiently), but a free market system is more efficient at producing the results that people actually care about (quality, safety, affordability, etc). Also, patents - another government-run monopoly-maker that should be eliminated.
- steeve 9y ago
  I don't buy the regulatory argument. See my previous answers. Patents, indeed, are a much more efficient way of keeping a monopoly, that's their whole point after all. But I don't a link with regulations in that case.
- matthewmacleod 9y ago
  a free market system is more efficient at producing the results that people actually care about (quality, safety, affordability, etc) You have no evidence to support that view; where are the free markets full of safe, high-quality, low-cost medicines? Nowhere. Markets are brilliant, but they are not flawless. All of our experience suggests that they need robust, independent regulation to avoid negative outcomes. There is plenty of scope for talking about how time-to-market for drugs can be improved, or other steps that can be taken to reduce regulatory burden where it's causing problems. But this whole 'let the free market sort it out' is the worst kind of high-school libertarianism.

anigbrowl 9y ago

Thalidomide.

Clubber 9y ago

I remember reading about EpiPen when they did their price hike. The main reason they were able to do it is the FDA had given them (intentionally or not) a de-facto monopoly in the US. https://mises.org/blog/lack-epipen-competitors-fdas-fault https://mises.org/blog/lack-epipen-competitors-fdas-fault Of course, we don't want just anyone to be able to package up anything and sell it (unless it's the nutrition industry, for some reason) but at the same time, the EpiPen business isn't good for the country either. What's funny, is this company did the same thing as Shkreli, but does their CEO get the same treatment?

artursapek 9y ago
What treatment? Nothing happened Shkreli in response to what he did with Daraprim. His criminal trial had nothing to do with it. That's a common misconception thanks to our bottom-feeding media.
- Clubber 9y ago
  His public and constant grilling by the media. You certainly didn't hear endless stories about "Pharma Chick," who is the good senator's daughter. I'm aware that the "Pharma Bro" was convicted of securities fraud after tripling his investors investments.
  - artursapek 9y ago
    Ah, ok, we're in agreement.
  - throwawayjava 9y ago
    > I'm aware that the "Pharma Bro" was convicted of securities fraud after tripling his investors investments. "Well you see, your honor, I did try to murder the man. But I failed, and the half hour run he took trying to escape me kick-started a healthy lifestyle that added years to his life. So, I did try to murder him, but in the end everyone benefited." This post-facto justification is like something out of an SNL skit.

AlexandrB 9y ago

> In other industries, when a company's product is clearly defective, inferior or overpriced, they lose market share and are forced to either improve the product or go out of business. No, they really aren't. [1][2][3] [1] https://en.m.wikipedia.org/wiki/United_States_v._Microsoft_Corp https://en.m.wikipedia.org/wiki/United_States_v._Microsoft_C.... [2] https://m.phys.org/news/2005-06-amd-sues-intel-monopoly-abuses.html https://m.phys.org/news/2005-06-amd-sues-intel-monopoly-abus... [3] http://money.cnn.com/2015/03/19/technology/google-monopoly-ftc/index.html http://money.cnn.com/2015/03/19/technology/google-monopoly-f...

curiousgeorgio 9y ago
In none of those cases did the government actually step in and do anything to break up those "monopolies" (other than perhaps an insignificant "slap on the wrist" in Microsoft's case). So if the government didn't solve those problems, what did? Answer: innovation and competition from other market players.
- AlexandrB 9y ago
  > Answer: innovation and competition from other market players. I'm not sure what you're referring to. AMD was on its deathbed a few years ago and Intel still has a near-monopoly on desktop and server CPUs. Google continues to be a monopoly on search and website ads. Microsoft has fallen somewhat, but you could argue that this was only due to pressure from regulators (e.g. browser bundling ban in Europe and when Microsoft was funding Apple to keep the perception of competition alive).
  - curiousgeorgio 9y ago
    And how exactly are these so-called "near-monopolies" hurting consumers? Last I checked, nobody is forced to use Google for search, and people have a choice between buying Intel or AMD processors. Just because a company makes better products than other companies, that doesn't make it abusive or detrimental to society (in fact, quite the opposite is true). If Intel's prices were unreasonable, no one would buy their processors and the next best alternative (AMD or otherwise) would steal their market share. Same with Google and Microsoft.

scott_s 9y ago

There are plenty of clearly defective products in a barely regulated health-adjacent industry that don't lose marketshare: the entire supplement industry, including homeopathic and "herbal" remedies. Relying on free markets to regulate themselves depends on rational consumers. But we are not rational.

lowbloodsugar 9y ago
Its not really a problem for me if people buy homeopathic remedies. It is a problem for me that I can't buy cheap, effective epipen alternatives.

jcranberry 9y ago

What, exactly, are you suggesting the FDA do less of? Are you suggesting that pharmaceutical companies should be allowed to bring their products straight to the market? Or just that their clinical trials process should be relaxed?