4 ms·

You are completely misunderstanding the argument. Lets say the current price for insulin is $200. I see this margin, and say "I can produce insulin for cheaper

You are completely misunderstanding the argument. Lets say the current price for insulin is $200. I see this margin, and say "I can produce insulin for cheaper, and I'm happy with selling it for $50". The government is placing restrictions on new competitors, so I can't just come in and sell insulin for $50. There is a restriction on competition, which causes artificial prices

jahaja 7y ago
The presumption is that it's actually the regulations that prevents the competition, which haven't at all been made clear. How about patents for example? How about the cheap prices of Europe?
- tptacek 7y ago
  The presumption is that the regulations add a major cost hurdle to delivering unencumbered insulin products at lower prices, because that is in fact what they do.
  - jahaja 7y ago
    Are drug companies operating at a loss in Europe?
    - tptacek 7y ago
      I think you're trying to construct a straw man. Nobody on this thread is suggesting that pharma be deregulated. Rather, Rayiner pointed to a specific regulatory problem that may be contributing to the price of insulin. Whether or not drug companies operate at a loss in Europe is immaterial to that point.
      - jahaja 7y ago
        I'm not sure what straw man that would be? I haven't suggested that either. What I'm implying is that Europe have regulations too, and that the price difference is not in proportion to the difference in regulatory strictness.
        tptacek 7y ago
        You have presented no evidence to support that argument, which has appeared late in your discussion, out of the blue, which discussion you opened with a snarky, dismissive one-liner.
        jahaja 7y ago
        I should be the one providing evidence that the following example is disproportionate with regards to regulatory differences between US and Europe? "West, 30, has had type 1 diabetes since she was three years old. Back in Seattle, where she used to live, she typically paid $70 per month for insulin and another $130 for pump supplies. That was a relative steal in the U.S., made possible by her excellent health insurance, which she got through her employer. But still, it was a financial strain. In Germany, she pays about €10, roughly $11. Every three months." The extraordinary claim is that that vast price disparity is in proportion, so the burden of evidence rests on you.
        nate_meurer 7y ago
        I posted this citation a few comments earlier, but I'll put it here too for posterity: https://accessiblemeds.org/sites/default/files/2018-09/REMS_WhitePaper_September2018%5B2%5D.pdf https://accessiblemeds.org/sites/default/files/2018-09/REMS_... It's a good summary of the costs of one type of overly burdensom regulation in the U.S. drug market, and was cited by the FTC in congressional testimony. There are other problems to be sure, but the anti-competitive effect of our over-wrought regulatory framework is widely recognized to be a problem by both liberal and conservative policy makers. There's plenty more material out there you're able to use google for five minutes. At this point, though, I'm confident that you're interested only in polemics, rather than actually learning anything about the issue.
        jahaja 7y ago
        This is why the neoliberal fantasy of "let's just remove regulations and let the "free-market" work its magic" is naive at best: https://www.washingtonpost.com/business/economy/why-humiras-price-keeps-rising-despite-fda-approval-of-generic-competition/2020/01/07/549ed0ce-2e3a-11ea-bcb3-ac6482c4a92f_story.html https://www.washingtonpost.com/business/economy/why-humiras-... "Humira’s price has defied gravity — and been ensconced as a frequent rhetorical target on Capitol Hill — through AbbVie’s aggressive use of patents and deals with generic manufacturers to forestall competition." "Humira was approved by the FDA in 2002 and its core patents expired in 2016, according to the Biosimilars Council, a division of the Association for Accessible Medicines, which represents generic manufacturers. But AbbVie won dozens of additional patents — what critics call a “patent thicket” — that extended the exclusive market for the drug to as late as 2034, the council said." I'm not saying that there isn't high costs involved in the approval process, what I'm saying is that it is disproportionate to the price difference. What actually makes a difference is government regulations on another level, mainly price controls, like in Europe. Just to make it clear, I'm very much in favour of generics, but the focus should be patents and price control, not small fish like REMS (from your link "consumers pay an extra $1.8 billion in out-of-pocket costs.", which furthermore is a number the authors have every interest to inflate) or removing burdensome, but appropriate, approval regulations, possibly threatening public safety.
- rayiner 7y ago
  Drugs in Europe aren’t “cheap.” https://ihsmarkit.com/solutions/us-price-gouging-pharmaceutical-industry.html https://ihsmarkit.com/solutions/us-price-gouging-pharmaceuti... > Based on our analysis of prices in regulated markets, the United States paid on average more than 50% that other developed markets. Of course, that figure is before discounts: > Hence, while US pharmaceutical reference prices are typically higher than most counterparts, it does not mean that the US also ultimately pays higher prices than other countries – a fine but important distinction. But even taking the 50% figure at face value, that suggests we could cut our drug spending to German levels (from $1,200 per person per year to $800). That’s not the kind of huge delta you see when it comes to things like inpatient services (surgeries that cost 5-10x as much). It’s also not that much compared to the $5,000-6,000 more we spend on healthcare overall per person compared to Germany.
  - jahaja 7y ago
    With regards to the topic, insulin. It's certainly cheap by comparison.

jahaja 7y ago

The presumption is that it's actually the regulations that prevents the competition, which haven't at all been made clear. How about patents for example? How about the cheap prices of Europe?

tptacek 7y ago
The presumption is that the regulations add a major cost hurdle to delivering unencumbered insulin products at lower prices, because that is in fact what they do.
- jahaja 7y ago
  Are drug companies operating at a loss in Europe?
  - tptacek 7y ago
    I think you're trying to construct a straw man. Nobody on this thread is suggesting that pharma be deregulated. Rather, Rayiner pointed to a specific regulatory problem that may be contributing to the price of insulin. Whether or not drug companies operate at a loss in Europe is immaterial to that point.
    - jahaja 7y ago
      I'm not sure what straw man that would be? I haven't suggested that either. What I'm implying is that Europe have regulations too, and that the price difference is not in proportion to the difference in regulatory strictness.
      - tptacek 7y ago
        You have presented no evidence to support that argument, which has appeared late in your discussion, out of the blue, which discussion you opened with a snarky, dismissive one-liner.
        jahaja 7y ago
        I should be the one providing evidence that the following example is disproportionate with regards to regulatory differences between US and Europe? "West, 30, has had type 1 diabetes since she was three years old. Back in Seattle, where she used to live, she typically paid $70 per month for insulin and another $130 for pump supplies. That was a relative steal in the U.S., made possible by her excellent health insurance, which she got through her employer. But still, it was a financial strain. In Germany, she pays about €10, roughly $11. Every three months." The extraordinary claim is that that vast price disparity is in proportion, so the burden of evidence rests on you.
        nate_meurer 7y ago
        I posted this citation a few comments earlier, but I'll put it here too for posterity: https://accessiblemeds.org/sites/default/files/2018-09/REMS_WhitePaper_September2018%5B2%5D.pdf https://accessiblemeds.org/sites/default/files/2018-09/REMS_... It's a good summary of the costs of one type of overly burdensom regulation in the U.S. drug market, and was cited by the FTC in congressional testimony. There are other problems to be sure, but the anti-competitive effect of our over-wrought regulatory framework is widely recognized to be a problem by both liberal and conservative policy makers. There's plenty more material out there you're able to use google for five minutes. At this point, though, I'm confident that you're interested only in polemics, rather than actually learning anything about the issue.
        jahaja 7y ago
        This is why the neoliberal fantasy of "let's just remove regulations and let the "free-market" work its magic" is naive at best: https://www.washingtonpost.com/business/economy/why-humiras-price-keeps-rising-despite-fda-approval-of-generic-competition/2020/01/07/549ed0ce-2e3a-11ea-bcb3-ac6482c4a92f_story.html https://www.washingtonpost.com/business/economy/why-humiras-... "Humira’s price has defied gravity — and been ensconced as a frequent rhetorical target on Capitol Hill — through AbbVie’s aggressive use of patents and deals with generic manufacturers to forestall competition." "Humira was approved by the FDA in 2002 and its core patents expired in 2016, according to the Biosimilars Council, a division of the Association for Accessible Medicines, which represents generic manufacturers. But AbbVie won dozens of additional patents — what critics call a “patent thicket” — that extended the exclusive market for the drug to as late as 2034, the council said." I'm not saying that there isn't high costs involved in the approval process, what I'm saying is that it is disproportionate to the price difference. What actually makes a difference is government regulations on another level, mainly price controls, like in Europe. Just to make it clear, I'm very much in favour of generics, but the focus should be patents and price control, not small fish like REMS (from your link "consumers pay an extra $1.8 billion in out-of-pocket costs.", which furthermore is a number the authors have every interest to inflate) or removing burdensome, but appropriate, approval regulations, possibly threatening public safety.
rayiner 7y ago
Drugs in Europe aren’t “cheap.” https://ihsmarkit.com/solutions/us-price-gouging-pharmaceutical-industry.html https://ihsmarkit.com/solutions/us-price-gouging-pharmaceuti... > Based on our analysis of prices in regulated markets, the United States paid on average more than 50% that other developed markets. Of course, that figure is before discounts: > Hence, while US pharmaceutical reference prices are typically higher than most counterparts, it does not mean that the US also ultimately pays higher prices than other countries – a fine but important distinction. But even taking the 50% figure at face value, that suggests we could cut our drug spending to German levels (from $1,200 per person per year to $800). That’s not the kind of huge delta you see when it comes to things like inpatient services (surgeries that cost 5-10x as much). It’s also not that much compared to the $5,000-6,000 more we spend on healthcare overall per person compared to Germany.
- jahaja 7y ago
  With regards to the topic, insulin. It's certainly cheap by comparison.