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Governor Newsom announces California will make its own insulin
- racecar789 4y agoI'm not sure it will be successful, but I am glad the governor is doing something. Not seeing much effort in Washington in regards to healthcare.
- CoastalCoder 4y agoI'm curious about liability. My understanding (maybe wrong) is that for private drug manufacturers, the risk of lawsuits provides a strong incentive for safe, effective products. Would a California-run facility have similar incentives?
- ggm 4y agoThey'd have exactly the same incentives, because they'd be bound in exactly the same regulatory environment. the F in FDA is for food. the other F in FDA is the silent (Federal) in front of it. its the US FDA. Its federal. Drug safety regulation is federal. It's a federal agency of the Department of Health and Human Services.
- yonaguska 4y agoUnless they get the Pfizer or Moderna treatment by labeling it as an emergency. Then there'd be zero liability.
- anarazel 4y agoThose were under a law that applies to vaccines only, afaiu. And even there it's not an absolute immunity, just a much higher bar. "willful misconduct". See https://en.m.wikipedia.org/wiki/Public_Readiness_and_Emergency_Preparedness_Act https://en.m.wikipedia.org/wiki/Public_Readiness_and_Emergen... It's not an area I know well, but I am not aware of a similar grant if immunity for medication in general.
- zeruch 4y agoThe California facility would still be bound by the same standards (if anything, California is more not less stringent on things like that) and the risks are still the same.
- mdavis6890 4y ago
- hourago 4y agoit's obvious that many medical supplies have an inelastic demand so are easily manipulated. When the market fails governments need to step in.
- lsldjdndk 4y ago
- toomuchtodo 4y agoAbsolutely. https://mattstoller.substack.com/p/buckraking-did-a-medical-monopolist https://mattstoller.substack.com/p/buckraking-did-a-medical-... https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm https://www.accessdata.fda.gov/scripts/drugshortages/default...
- magila 4y agoHealthcare is the most heavily regulated industry in the US. Many of those regulations were written specifically to minimize or eliminate the influence of market forces. You can't reasonably say the market has failed when it has been so tightly constrained by regulation.
- workingon 4y agoHow is healthcare in the countries with very little health care regulations?
- s1artibartfast 4y agoCheap!
- hourago 4y agoDeadly!
- infamouscow 4y ago
- refurb 4y agoDoesn’t make a lot of sense. Generic insulin’s are already being made. Why not just buy those?
- witheld 4y agoPresumably they're going to make good insulin people can actually use, rather than pig insulin that practically doesn't work.
- s1artibartfast 4y agoI don't give the CA government the benefit of the doubt. I'm guessing it will be generic and the high speed rail will be used to deliver it.
- refurb 4y agoNo they aren’t. They’re making a generic of an existing insulin. The same stuff other companies make.
- oneoff786 4y agohttps://www.healthline.com/diabetesmine/why-is-there-no-generic-insulin https://www.healthline.com/diabetesmine/why-is-there-no-gene... It’s complicated
- sbierwagen 4y agoThat doesn't seem to answer the question? It lists a bunch of biosimilar insulin analogues but doesn't say why California wouldn't buy them instead of manufacturing their own molecule.
- dragonwriter 4y agoCalifornia is not going to manufacture their own molecule, they are going to contract with someone, seems likely to be CivicaRx.
- av3csr 4y agoThis site seems to be provide a through price analysis of insulin nowadays https://www.goodrx.com/healthcare-access/research/how-much-does-insulin-cost-compare-brands https://www.goodrx.com/healthcare-access/research/how-much-d...
- hnburnsy 4y agoThanks, that is a great analysis, especially the details on modern insulin. What would be even better to know is what people are paying. It is well known that the AWP or average retail price in this case is not close to average price paid.
- defrost 4y agoOutside of the US: >> October 12, 2020 - Insulin prices are more than eight times higher in the US than in 32 comparable, high-income nations combined, according to a new RAND Corporation study. >> In 2018, the average insulin prices in the US was $98.70, compared to $6.94 in Australia, $12.00 in Canada, and $7.52 in the UK. US Compared to Similar Nations: https://pharmanewsintel.com/news/insulin-prices-8x-higher-in-the-us-compared-to-similar-nations https://pharmanewsintel.com/news/insulin-prices-8x-higher-in...
- gvavlerg 4y ago
- gvavlerg 4y ago
- gvavlerg 4y ago
- RcouF1uZ4gsC 4y ago> and the other $50 million will be spent on a Califronia-based insulin manufacturing facility. Knowing California, all the $50 million will be spent on environmental reviews and lawsuits brought by NIMBYs.
- enahs-sf 4y agoSometimes I feel like this is the endgame where the US overall kind of declines but California starts managing itself better and operates almost like an independent country. Probably wishful thinking but would be great.
- Ericson2314 4y agoYeah if California gets it shit together and de facto secedes, that would be really good. And I say that as someone who left California for the northeast.
- gandalfgeek 4y agoI can’t relate at all to that sentiment. California has got to be one of the most bloated and wasteful state governments in the entire US. High taxes and nothing to show for it. The entrenched far left seems bent on destroying the middle class, driving out business, regulating everything to death and displacing merit as a selection factor. Whatever glory Cali has— tech, entertainment, farming, weather, natural beauty— is in spite of govt rather than because of it.
- raldi 4y agoHigh taxes on newcomers. Nearly nonexistent taxes on dynastic families.
- peter422 4y agoCalifornia income tax has no carve outs for capital gains so I don’t know where you got that idea. Rich people specifically don’t like California because of the taxes (as compared to other No or low income tax states). I assume you are referring to property taxes, but undoubtedly any “dynastic” family is going to have more tax liability from income than from property value.
- raldi 4y agoRich people love California, and all the other blue states with high income tax: https://www.statista.com/statistics/294941/largest-ratio-millionaire-households-per-capita-us/ https://www.statista.com/statistics/294941/largest-ratio-mil...
- awinter-py 4y agointeresting contrast vs the us congress, which is trying a price cap as with every build-vs-buy problem, you don't know if you'll actually be able to do it until you do it. I'm wondering what a state government has ever done that is as complex as manufacturing a medicine -- maybe road building / big water projects? if they succeed it would be a new chapter in state capacity + really exciting, especially if they are transparent about accounting and show that they're not warping the market I think biohacker group open insulin https://openinsulin.org/ https://openinsulin.org/ was founded in oakland -- they're working on lispro, the fast-acting kind in humalog the humalog plant in puerto rico cost 200-500 million dollars in the early 2000s [1]. there are 3+ million californians w/ diabetes (per diabetes.org), and it costs north of $5k per year per person, so that's like 15 billion. you don't have to dent that # much to get ROI on this. 1. https://www.pharmaceutical-technology.com/projects/eli_lilly/ https://www.pharmaceutical-technology.com/projects/eli_lilly...
- UncleEntity 4y ago> … and show that they're not warping the market Arguably the whole point of this is to warp the market by picking the winner and giving them all the business in the state. Though, chances are this will just turn into a taxpayer subsidized boondoggle like every other time the politicians pick the winner.
- mpyne 4y ago"Picking the winner" would imply the state forcing market participants to buy the state's insulin. As long as they're not forcing people to buy their insulin then what they're doing is more akin to setting a price floor (assuming they are selling at cost rather than subsidizing a loss). But hey if it's going to be a boondoggle then the private sector should have nothing to fear from competition here, right?
- shapefrog 4y agoActually what they are doing is pure capitalism. There is a product that can be made for $1 that is being sold for $100. They are going to make it and sell it for $2 and you can chose to buy it from their "startup" calinsulin inc for $2 or pay megacorp inc $100 for their one. Shockingly megacrop inc. are crying that it is socialism to make only $1 and that noble capitalists like them are doing it right and making $99.
- ipnon 4y agoHow hard would it be to found an insulin startup? This seems like the kind of problem designed to be intractable, the "busy work" of bureaucratic private health care systems.
- Ericson2314 4y agoI'm told Marc Cuban is failing right now, but I don't think that dude ever did anything difficult.
- usrn 4y agoIt sounds to me like the modern process is just working up GMO yeast matabolites. I feel like the main issue is probably going to be patents and not something technical.
- colinmhayes 4y agoCan’t you use older recipes?
- usrn 4y agoMy understanding is that the older stuff is actually cheap, it's just much harder to manage and that's what people don't like.
- idealmedtech 4y agoMost older expired IP insulin just isn't very convenient to use for most people; it requires more intense participation from the people using it, so you tend to get worse results (imagine if you had to actively think about breathing in enough oxygen every single waking hour of your life -- it's exhausting). The longer acting, more specialized insulins are still heavily patented. When insulin takes longer to work, the person using it has to think less about the insulin and actually gets to live their life rather than think about blood sugar all day. Now, if you closed the loop and used older insulins, you'd have good control and less issues since a computer would bear the cognitive load, but glucose control, especially in the outpatient setting, is ridiculously hard. If you think you can solve it though, give it a shot. It's a multi billion dollar market and a lot of lives you can improve.
- s1artibartfast 4y agoTalk is cheap. Let's see how the costs compare.
- adolph 4y agoThis is a pretty interesting public-private partnership proposal that Newsom seems to have been working on for a while. Budget Request Summary HCAI requests one-time $100 million General Fund, available until 2025-26, for the CalRx Biosimilar Insulin initiative. Through a contract partnership, the State would invest $50 million towards the development of low-cost biosimilar insulin products, an additional $50 million towards a California-based insulin manufacturing facility. HCAI also requests $2.8 million General Fund, over four years, for state operations to fulfill requirements of the partnership, including monitoring, oversight, and legal compliance. The insulin products are expected to be widely available to Californians, through a variety of outlets. https://esd.dof.ca.gov/Documents/bcp/2223/FY2223_ORG4140_BCP5779.pdf https://esd.dof.ca.gov/Documents/bcp/2223/FY2223_ORG4140_BCP...
- s1artibartfast 4y agoIs there any discussion of price caps?
- hnburnsy 4y agoHere are the budget details on this... https://esd.dof.ca.gov/Documents/bcp/2223/FY2223_ORG4140_BCP5779.pdf https://esd.dof.ca.gov/Documents/bcp/2223/FY2223_ORG4140_BCP... "This proposal will use $50 million in funding to enter into a partnership with a contract manufacturer to develop and bring to market interchangeable biosimilar insulin products in both vial and pen form." "This proposal also includes an additional $50 million for the construction of an insulin manufacturing facility based in California. CalHHS will partner with the Governor’s Office of Business and Economic Development (GO-Biz), leveraging its expertise in business investment services such as site review, permit assistance, and other related activities. CalHHS will lean on GO-Biz’s expertise to mitigate risk and properly execute the proposed manufacturing facility, if CalRx proceeds with this component of the project."
- beebmam 4y agoOnly $50 million for something that seems so socially important? Sounds like an easy win to me.
- sli 4y agoEspecially for a state with such massive budget surplus.
- justinbaker84 4y agoI think a more relevant take is "how are they going to accomplish this with only $50 million? California can't even build high speed rail with a budget in 10s of billions of dollars and more than a decade of time.
- j16sdiz 4y agoThis is just building one plant in one nebourhood. High speed rail involve lots more private land use and local regulations.
- SubjectToChange 4y agoAnd what exactly is the proper amount of time and money for California high speed rail? I doubt you can give an answer that isn't practically bullshit.
- yes_really 4y ago
- chasil 4y ago
- metadat 4y agoPoor choice of example. Oracle is still very much in California. Literally zero offices have been shuttered and they've been hiring like crazy. Austin is an expansion.
- Dracophoenix 4y ago> Outsourcing would be financially expedient, but that would be the end of executive aspirations. Suspicions regarding Newsom's motive notwithstanding, outsourcing production to foreign countries is in fact a more difficult endeavor due to strict controls on pharmaceutical imports by the FDA.
- bushbaba 4y agoIt’s also in the states interest to bring businesses into its tax basis. Those local manufacturers will hire local, spend local. Each dollar the state provides will cycle through many local businesses.
- zeruch 4y agoYou have karma to burn, but I don't think that's the take you think it is.
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- oaiey 4y agoThat is a far stretch when a few items are produced by the state to call the society/state a communistic construct. Especially when California hosts so many very capitalistic companies. They intervened in a disfunctional market and take care of their citizens. That is what a state has to do for their citizens.
- kepler1 4y agoI'm quite liberal on most topics, but I dreaded expecting to read that California state government was going to spin up some office of pharma manufacturing with all the state employees that entails. Thank god it's only talking about hiring a contract manufacturer to do this. Next, the question is, will it institute enough protections that someone doesn't take advantage of the cheap prices and sell them for profit elsewhere...
- TedShiller 4y agoFree stuff isn't actually free. It gets paid for with inflation.
- ifelsethenyeah 4y agoThis is genius (sort-of). It solves a specific and practical need without being too grandiose. In the long term, an independent, non-profit, social enterprise, government-sponsored entity would be a better vehicle for this because whichever states, federal (Medicare, Medicaid, VA), pension funds, AARP, and/or insurance companies could back it in order to reduce their costs. It's far better to pool the risks, minimize duplicated effort, and reap the rewards using scale. This is how pharmaceuticals and healthcare should be delivered for nonelective care. The leading US industry lobby, PhRMA, will do everything in its power to kill it in some manner whether through the legal system, traditional advertising, and/or social media. https://truthout.org/articles/pharma-breaks-lobbying-record-defending-high-drug-prices-and-vaccine-patents/ https://truthout.org/articles/pharma-breaks-lobbying-record-...
- narrator 4y agoThey will probably end up failing at this because of politics and waste enormous amounts of money, give up and instead import insulin from China or India and resell it, which would actually work.
- bergenty 4y agoI’d be kinda happy if Newsom were president.