5 ms·

Why doesn't competition step in and increase the supply of insulin, thereby decreasing its cost? If insulin is 1/8th the cost elsewhere why can't I import it fr

Why doesn't competition step in and increase the supply of insulin, thereby decreasing its cost? If insulin is 1/8th the cost elsewhere why can't I import it from overseas and sell it locally, making arbitrage profits? Is there something other than regulatory capture going on here? If not it's less a case of "because they can" and more a case of "because others can't".

9HZZRfNlpR 6y ago
Because your cheaper product needs to be fda proved, which either is extremely expensive or these is some huge cartel conspiracy. Probably the first.
StreamBright 6y ago
Short answer: because of regulations. Just to give you an example how ridiculous the US health care is. I used to live in California and I had an inflamed wisdom tooth. It cost me so much to get it out (fully insured, premium+, high income insurance) that the amount I had to pay __after__ insurance (out of pocket) would have been enough to buy a ticket to go to Europe, visit a random country get the operation done, fully pay for (without insurance coverage) it and fly home to Cali.
- deleted 6y ago
  [deleted]
- mrkstu 6y ago
  The state of Utah flies employees to Mexico to fill prescriptions there because: "The cost difference is big enough that the state's program can pay for each patient's flight, provide them with a $500-per-trip bonus, and still save tens of thousands of dollars" https://www.pharmacist.com/article/utah-sends-employees-mexico-lower-prescription-prices https://www.pharmacist.com/article/utah-sends-employees-mexi...
- Barrin92 6y ago
  >would have been enough to buy a ticket to go to Europe, visit a random country get the operation done, fully pay for (without insurance coverage) it and fly home to Cali. This isn't even uncommon among people in Europe. A lot of people from Western Europe get on a 50 bucks Ryanair flight to Hungary or Romania, get their dental work done and fly back home.
  - StreamBright 6y ago
    The difference is the price of ticket to fly over a continent + the Atlantic Ocean vs fly over few countries. On the top of that, the other reason why people in some Western Countries (for example Ireland) do this is very surprising: quality of service. Ireland used to not have emergency dental service and even the general dentistry was not that great while being much more expensive (not US level though) than in Hungary, Romania or Poland. There is an entire industry specialised in Hungary and Poland to server Western clients.
- cloverich 6y ago
  FWIW health insurance and dental insurance are very different - dental insurance is always separate from health insurance and often covers very little, often nothing beyond checkups. The last time I had a plan offerred it covered up to $1200... but cost $100 a month. The cost was actually equivalent to the price of checkups. I'm not sure why this played out the way it did -- probably because it is procedure focused.
  - StreamBright 6y ago
    FYI the dental insurance company forced me to submit the claim against the general insurance company and only wanted to deal with the case when it bounced back. I had a premium dental insurance at the time. This is what insurance companies can do in the USA and most people who are moving that are not aware of it, because it is so unimaginable that one of the richest countries of the west has an insurance system like that.
- deleted 6y ago
  [deleted]
getridofregss 6y ago
And this is the REAL issue. If I was allowed to start a pharma company as easily as I could start a software company then you bet I would be doing that instead of SAAS. I can guarantee that prices would be lower than the rest of the world, and that American pharma companies would be top-of-market in international markets as well. But, the mafioso in-bed-with-the-gov-and-politicians absolutely corrupt elitist-owned system that we have in America is ruining this country. And to all the people downvoting the "regulation" comments: You are being COMPLETELY intellectually dishonest, and you know it. Game theory validates that regulatory capture is 100% the issue. The Universe and nature work by a set of laws that has been investigated since the 50s with Von Neumann, Nash, etc. It is time that we stop telling ourselves that some politicians in government are going to magically create legal algorithms that outperform the laws of the nature. It is dangerous, immoral, and stupid and it ends up only protecting and embedding the existing corrupt elite for life.
- tomp 6y ago
  I generally agree with the sentiment but you definitely go too far. > Game theory validates that regulatory capture is 100% the issue. Regulatory capture cannot be the issue because it exists pretty much everywhere (in the Western world, I guess), yet US prices/insurance/medical spending is higher than in e.g. Europe. Maybe it's the US flavour of regulatory capture - that's an option - but then you should be railing against that, not pulling a fake reductio ad game theory argument out of your sleeve - I mean, what do you propose as the alternative, an unregulated drug market? I mean, I'm very much in that direction - I believe all drugs should be legal and accessible, the only restriction I'd put on the "freely" part of "freely accessible" (e.g. new/experimental drugs only if you're dying, hard drugs like heroin only if you go through 6 months of classes & psychiatric evaluation, etc.) - but even that's clearly still a "regulated market" (e.g. disallows misleading advertising).
- hnracer 6y ago
  I'm curious about the details of this for insulin. Is it a problem with one political party or with both? Does the pharma oligopoly control the politicians through donations/funding? Or is there a legitimate IP protection reason that the pharma companies have that justifies the lack of competition for insulin provision?

9HZZRfNlpR 6y ago

Because your cheaper product needs to be fda proved, which either is extremely expensive or these is some huge cartel conspiracy. Probably the first.

StreamBright 6y ago

Short answer: because of regulations. Just to give you an example how ridiculous the US health care is. I used to live in California and I had an inflamed wisdom tooth. It cost me so much to get it out (fully insured, premium+, high income insurance) that the amount I had to pay __after__ insurance (out of pocket) would have been enough to buy a ticket to go to Europe, visit a random country get the operation done, fully pay for (without insurance coverage) it and fly home to Cali.

deleted 6y ago
[deleted]
mrkstu 6y ago
The state of Utah flies employees to Mexico to fill prescriptions there because: "The cost difference is big enough that the state's program can pay for each patient's flight, provide them with a $500-per-trip bonus, and still save tens of thousands of dollars" https://www.pharmacist.com/article/utah-sends-employees-mexico-lower-prescription-prices https://www.pharmacist.com/article/utah-sends-employees-mexi...
Barrin92 6y ago
>would have been enough to buy a ticket to go to Europe, visit a random country get the operation done, fully pay for (without insurance coverage) it and fly home to Cali. This isn't even uncommon among people in Europe. A lot of people from Western Europe get on a 50 bucks Ryanair flight to Hungary or Romania, get their dental work done and fly back home.
- StreamBright 6y ago
  The difference is the price of ticket to fly over a continent + the Atlantic Ocean vs fly over few countries. On the top of that, the other reason why people in some Western Countries (for example Ireland) do this is very surprising: quality of service. Ireland used to not have emergency dental service and even the general dentistry was not that great while being much more expensive (not US level though) than in Hungary, Romania or Poland. There is an entire industry specialised in Hungary and Poland to server Western clients.
cloverich 6y ago
FWIW health insurance and dental insurance are very different - dental insurance is always separate from health insurance and often covers very little, often nothing beyond checkups. The last time I had a plan offerred it covered up to $1200... but cost $100 a month. The cost was actually equivalent to the price of checkups. I'm not sure why this played out the way it did -- probably because it is procedure focused.
- StreamBright 6y ago
  FYI the dental insurance company forced me to submit the claim against the general insurance company and only wanted to deal with the case when it bounced back. I had a premium dental insurance at the time. This is what insurance companies can do in the USA and most people who are moving that are not aware of it, because it is so unimaginable that one of the richest countries of the west has an insurance system like that.
deleted 6y ago
[deleted]

getridofregss 6y ago

And this is the REAL issue. If I was allowed to start a pharma company as easily as I could start a software company then you bet I would be doing that instead of SAAS. I can guarantee that prices would be lower than the rest of the world, and that American pharma companies would be top-of-market in international markets as well. But, the mafioso in-bed-with-the-gov-and-politicians absolutely corrupt elitist-owned system that we have in America is ruining this country. And to all the people downvoting the "regulation" comments: You are being COMPLETELY intellectually dishonest, and you know it. Game theory validates that regulatory capture is 100% the issue. The Universe and nature work by a set of laws that has been investigated since the 50s with Von Neumann, Nash, etc. It is time that we stop telling ourselves that some politicians in government are going to magically create legal algorithms that outperform the laws of the nature. It is dangerous, immoral, and stupid and it ends up only protecting and embedding the existing corrupt elite for life.

tomp 6y ago
I generally agree with the sentiment but you definitely go too far. > Game theory validates that regulatory capture is 100% the issue. Regulatory capture cannot be the issue because it exists pretty much everywhere (in the Western world, I guess), yet US prices/insurance/medical spending is higher than in e.g. Europe. Maybe it's the US flavour of regulatory capture - that's an option - but then you should be railing against that, not pulling a fake reductio ad game theory argument out of your sleeve - I mean, what do you propose as the alternative, an unregulated drug market? I mean, I'm very much in that direction - I believe all drugs should be legal and accessible, the only restriction I'd put on the "freely" part of "freely accessible" (e.g. new/experimental drugs only if you're dying, hard drugs like heroin only if you go through 6 months of classes & psychiatric evaluation, etc.) - but even that's clearly still a "regulated market" (e.g. disallows misleading advertising).
hnracer 6y ago
I'm curious about the details of this for insulin. Is it a problem with one political party or with both? Does the pharma oligopoly control the politicians through donations/funding? Or is there a legitimate IP protection reason that the pharma companies have that justifies the lack of competition for insulin provision?