3 ms·

Ah I see. So as long as we append the word "type", we're free to throw phrases into completely non-sensical contexts? How convenient. Kidding aside, your use

Ah I see. So as long as we append the word "type", we're free to throw phrases into completely non-sensical contexts? How convenient. Kidding aside, your use of the phrase here indicates a fundamental misunderstanding. This isn't "similar" to trickle-down. This has nothing to do with it whatsoever. You might as well call it "fascist" or "colonialist". It's jibberish. Try this: You can find the Hopkins paper that Rayiner cited at https://sci-hub.tw/10.1056/nejmms1411398 https://sci-hub.tw/10.1056/nejmms1411398. It's a consice description of the causes of the ongoing dearth of generic biologic (non-small-molecule) medicines. Read that. It's only five pages. Then tell me how the various possible ways to limit the monopoly position of incumbent insulin makers -- patent reform, lowered regulatory barriers for new competitors, whatever -- would constitute a "trickle down type" giveaway to said incumbents. Tell me how that makes any sense at all. > Profit-driven drug companies will obviously focus on things that make money, e.g. superficial/vanity related things, not what's necessarily aligned with public interests. Just for fun, give me some examples of drugs that are merely "superficial/vanity related". I think you're trying to construct a straw man. It's certainly true that the free-market does not guarantee alignment with the public interest. It's also true that over-regulation is one of things that causes such misalignments. In this case, a strong regulatory framework around biosimilars may be unavoidable due to their extreme complexity (again, read the paper). But if there are regulatory hurdles that can safely be removed, and thus allow generic drug makers to enter the market with cheaper alternatives, how exactly would that be unfair or unjust for anybody?

jahaja 7y ago
The template of trickle down economics I'm referring to is the method where the already wealthy/profiting and so on, is given immediate benefits under the premise of vague and long-term benefits for the many. This method of upwards redistribution has been applied repeatedly time and time again, and tax cuts in the style of trickle down economics are just one instance of it. > Just for fun, give me some examples of drugs that are merely "superficial/vanity related". I think you're trying to construct a straw man. Once again, it was one example, I was mainly thinking about hair loss or other male things caused by men, historically and still, earning more. My main point was that the profit motive causes this kind of skew: "Scientific publications brought the evidence that there was a lack of news drugs for diseases that cause high mortality and morbidity among people living in poor areas. One showed that only 1.1% of new drugs were approved specifically for neglected diseases over a period of 25 years (1975 to 1999) despite the fact that these diseases represented 11.4% of the global burden" > It's certainly true that the free-market does not guarantee alignment with the public interest. It's also true that over-regulation is one of things that causes such misalignments. I would argue that "free-markets" is the exact reason for anti-competitive regulations, among others, in the form of regulatory capture, which is inherent with capitalism.
- nate_meurer 7y ago
  Regardless of how you want to redefine the phrase trickle down, your use of it here betrays a fundamental misunderstanding of the subject. If it's possible to reduce the regulatory burden of the approval process for biosimilar insulin so as to allow generic makers to compete more easily, this will REDUCE the monopoly power of the large incumbent drug companies. I don't know if you're being deliberately obtuse, but I can't say this any more clearly. > Once again, it was one example, I was mainly thinking about hair loss or other male things caused by men, historically and still, earning more. Right, so it was a bullshit distraction that can safely be ignored. > My main point was that the profit motive causes this kind of skew... Which has exactly nothing to do with insulin, or the larger problem of building a manufacturing base for complex biosimilar medicines that's big, efficient, and safe enough to not bankrupt us. Regulations are necessary and powerful tools that, if wielded clumsily, can easily kill that manufacturing base. Making sure those regulations are suited to the task is not "trickle down" in any way whatsoever.
  - jahaja 7y ago
    > Regardless of how you want to redefine the phrase trickle down, your use of it here betrays a fundamental misunderstanding of the subject Care to explain how it doesn't fit the template I described? > this will REDUCE the monopoly power of the large incumbent drug companies This is at best naive. The approval process isn't the problem. Government granted monopolies are. > Which has exactly nothing to do with insulin Uhm, yes, and that was in response to the free-market nonsense, not insulin.
    - nate_meurer 7y ago
      > The approval process isn't the problem. Government granted monopolies are. You're still not understanding. Overly burdensome approval processes are part of what creates government granted monopolies. In other words, those two things go together. For example, if you're familiar with the approval pipeline for generics in the U.S., you'll remember that the main component of an ANDA filing is proving equivalence. Regulations require the evaluation to be based not just on the chemical description of the brand name medicine, but on actual physical samples. A separate regulation subjects any medicine with serious side effects to the REMS program, which restricts its distribution to narrow channels of the drug maker's choosing. Furthermore, the regulation allows companies to voluntarily subject a drug to REMS-type treatment even in the absence of serious side effects. The result of these twisted regulations is that a large incumbent drug maker can easily deprive smaller generic makers from getting the samples they need to pursue approval. This is just one example. REMS and other regulations allow incumbent drug makers other ways to block prospective generic makers. These abuses are common, and according to one study cited by the FTC, if we removed or reformed some these regulations, it would save Americans billions of dollars a year. [1] Now read this slowly and carefully: these government regulations help to preserve big pharma monopolies. Read the citation below. Read the paper cited earlier. Read anything. If you have any evidence of your own to support your positions -- studies, papers, anything -- I'd be interested to hear it. Otherwise I'm done with this. 1 - https://accessiblemeds.org/sites/default/files/2018-09/REMS_WhitePaper_September2018%5B2%5D.pdf https://accessiblemeds.org/sites/default/files/2018-09/REMS_...

jahaja 7y ago

The template of trickle down economics I'm referring to is the method where the already wealthy/profiting and so on, is given immediate benefits under the premise of vague and long-term benefits for the many. This method of upwards redistribution has been applied repeatedly time and time again, and tax cuts in the style of trickle down economics are just one instance of it. > Just for fun, give me some examples of drugs that are merely "superficial/vanity related". I think you're trying to construct a straw man. Once again, it was one example, I was mainly thinking about hair loss or other male things caused by men, historically and still, earning more. My main point was that the profit motive causes this kind of skew: "Scientific publications brought the evidence that there was a lack of news drugs for diseases that cause high mortality and morbidity among people living in poor areas. One showed that only 1.1% of new drugs were approved specifically for neglected diseases over a period of 25 years (1975 to 1999) despite the fact that these diseases represented 11.4% of the global burden" > It's certainly true that the free-market does not guarantee alignment with the public interest. It's also true that over-regulation is one of things that causes such misalignments. I would argue that "free-markets" is the exact reason for anti-competitive regulations, among others, in the form of regulatory capture, which is inherent with capitalism.

nate_meurer 7y ago
Regardless of how you want to redefine the phrase trickle down, your use of it here betrays a fundamental misunderstanding of the subject. If it's possible to reduce the regulatory burden of the approval process for biosimilar insulin so as to allow generic makers to compete more easily, this will REDUCE the monopoly power of the large incumbent drug companies. I don't know if you're being deliberately obtuse, but I can't say this any more clearly. > Once again, it was one example, I was mainly thinking about hair loss or other male things caused by men, historically and still, earning more. Right, so it was a bullshit distraction that can safely be ignored. > My main point was that the profit motive causes this kind of skew... Which has exactly nothing to do with insulin, or the larger problem of building a manufacturing base for complex biosimilar medicines that's big, efficient, and safe enough to not bankrupt us. Regulations are necessary and powerful tools that, if wielded clumsily, can easily kill that manufacturing base. Making sure those regulations are suited to the task is not "trickle down" in any way whatsoever.
- jahaja 7y ago
  > Regardless of how you want to redefine the phrase trickle down, your use of it here betrays a fundamental misunderstanding of the subject Care to explain how it doesn't fit the template I described? > this will REDUCE the monopoly power of the large incumbent drug companies This is at best naive. The approval process isn't the problem. Government granted monopolies are. > Which has exactly nothing to do with insulin Uhm, yes, and that was in response to the free-market nonsense, not insulin.
  - nate_meurer 7y ago
    > The approval process isn't the problem. Government granted monopolies are. You're still not understanding. Overly burdensome approval processes are part of what creates government granted monopolies. In other words, those two things go together. For example, if you're familiar with the approval pipeline for generics in the U.S., you'll remember that the main component of an ANDA filing is proving equivalence. Regulations require the evaluation to be based not just on the chemical description of the brand name medicine, but on actual physical samples. A separate regulation subjects any medicine with serious side effects to the REMS program, which restricts its distribution to narrow channels of the drug maker's choosing. Furthermore, the regulation allows companies to voluntarily subject a drug to REMS-type treatment even in the absence of serious side effects. The result of these twisted regulations is that a large incumbent drug maker can easily deprive smaller generic makers from getting the samples they need to pursue approval. This is just one example. REMS and other regulations allow incumbent drug makers other ways to block prospective generic makers. These abuses are common, and according to one study cited by the FTC, if we removed or reformed some these regulations, it would save Americans billions of dollars a year. [1] Now read this slowly and carefully: these government regulations help to preserve big pharma monopolies. Read the citation below. Read the paper cited earlier. Read anything. If you have any evidence of your own to support your positions -- studies, papers, anything -- I'd be interested to hear it. Otherwise I'm done with this. 1 - https://accessiblemeds.org/sites/default/files/2018-09/REMS_WhitePaper_September2018%5B2%5D.pdf https://accessiblemeds.org/sites/default/files/2018-09/REMS_...