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Why hundreds of decades-old yet vital drugs are nearly impossible to find
- RecycledEle 3y agoThen Pfizer had a tornado destroy a building and 50,000 pallets of medications: https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.wcnc.com/amp/article/weather/severe-weather/pfizer-rocky-mount-north-carolina-tornado-damage-severe-weather-outbreak-nash-county/275-eb35781b-ac79-4399-955a-dcecebb1bb31&ved=2ahUKEwjKkMCU6Z2AAxUqlGoFHYOMBoUQFnoECDMQAQ&usg=AOvVaw013jAnh19ixjlOkfqJbAZY https://www.google.com/url?sa=t&source=web&rct=j&opi=8997844... It's going to get worse.
- rationalist 3y agoThat URL can be cleaned up to this: https://www.wcnc.com/article/weather/severe-weather/pfizer-rocky-mount-north-carolina-tornado-damage-severe-weather-outbreak-nash-county/275-eb35781b-ac79-4399-955a-dcecebb1bb31 https://www.wcnc.com/article/weather/severe-weather/pfizer-r... Not sure if there is any tracking in the alphanumeric garbage at the end, but deleting it outright causes it to 404.
- RecycledEle 3y agoThank You
- mgdlbp 3y agoThe UUID is all that's significant, technically may be watermarked still https://wcnc.com/article/a/b/c-eb35781b-ac79-4399-955a-dcecebb1bb31 https://wcnc.com/article/a/b/c-eb35781b-ac79-4399-955a-dcece... Of course, this url is now assuredly unique
- HocusLocus 3y agoThis is shorter and it works http://bit.ly/21S8BqX http://bit.ly/21S8BqX
- rationalist 3y agoThe idea was to clean it and not have the unnecessary Google jump in there and possibly any tracking after a "?" element, not to make it as short as possible. I'm not going to click on a URL shortener from a stranger that redirects to who-knows-where.
- patmorgan23 3y agoAlso the bitly is definitely doing tracking
- HocusLocus 3y agoI know, I try to do that when sharing links too. I remember way back when Google results used to link directly to pages. Actually I was just trying to Rickroll-you-by-proxy. A shorter link to the same site as GP's that is a real news story of people being Rickrolled by QR codes on fake parking tickets. Only reason I used the site's own shortner is the URL would have given it away. Besides it was longer.
- freedude 3y ago"I’m a health economist who has studied the pharmaceutical industry for the past 15 years. I believe the drug shortage problem illustrates a major shortcoming of capitalism." He is arguing against his own point. The problem is a lack of supply but he is promoting the wrong political answer to a politically generated problem. In a purely capitalist economy a lack of supply would cause prices to go increase and the market would respond accordingly. This industry is highly regulated. In some cases for good reason. Regulation always stifles capitalism and results in less profit for the manufacture. The fix for to much regulation is less regulation, not more.
- majormajor 3y agoDo you have a citation for regulation causing the low prices as opposed to competition? What's the distribution between commercial payers and government ones? In a perfectly competitive market the margin you can squeeze from a generic drug will shrink and shrink, and that can also cause reduced investment in new supply if you have more profitable alternatives and you don't have an infinite supply of investment in production capabilities. This argument looks pretty unappealing either way, though: "the problem with vital drugs is that they're too affordable to too many people who need them". Good luck with that political platform.
- radicalace 3y agowhat? you said perfect markets reduce margins and cause people to make less of something… so the concept of a market is invalid in your opinion? this is completely incorrect. supply doesnt wink out of existence in the presence of demand just because margins got thinner and thinner. sometimes supply will disappear for various reasons, or maybe margins were super thin and some huge player made an irresponsible bet, but the market restores supply immediately in these cases just like all other cases. what you are saying is complete nonsense.
- nradov 3y agoWhat you are saying is complete nonsense in the case of prescription drugs. It is impossible to restore supply immediately. The reality is that even for generic drugs it usually takes years to get high volume production running with full regulatory approval.
- freedude 3y agothe actual title of the article is... "Blame capitalism? Why hundreds of decades-old yet vital drugs are nearly impossible to find" Which shows its inherent political bias.
- malfist 3y agoNot to mention horrible grammar. I was over here trying to figure out which drugs are "hundreds of decades old" only thing I could think of was aspirin.
- giraffe_lady 3y agoIf you want an environment where it's never correct to blame capitalism what you're at is several steps past mere political bias I think.
- hayst4ck 3y agoBlaming political bias denies actual objective truth. Calling something bias is not very different than saying "well, it's the other teams idea." Rather than saying something is wrong, it is instead called bias. Calling it bias removes the duty to analyze the information and its relationship to truth. Bias just describes positions on an Overton window and shortcuts critical thinking.
- pmarreck 3y agoI've been out of 1 important drug (with another’s availability being spotty for months now) for a month thanks to these shortages, and I wasn’t supposed to go from the highest dosage down to zero so quickly. This all seems like a major f___up by someone.
- d136o 3y agoAre there any chemical precursors these drugs all have in common that could have been exhausted by something else that is more important to manufacture? Alternatively is supply being commandeered somehow? So much weird stuff is happening with supply chains that it feels like the US is purposefully being squeezed.
- nebula8804 3y agoWell can we quantify how conditions are faring in other countries across a host of industries? I've been hearing energy and food prices are through the roof in the UK much worse than the US. Not sure how true it is today but we would need some one to one comparison to see if the US is specifically being squeezed. Its not out of the realm: Biden has pissed off a lot of people from the Saudis, to the Chinese.
- MandieD 3y agoI’ve sometimes had to go to multiple pharmacies over the last few years to fill various “common” prescriptions in Germany, and even once accepted a different drug at a pharmacist’s suggestion - German pharmacists have a lot of discretion. It’s not just the US.
- throwawaymobule 3y agoIt's slightly worse in the US, since dispensing generics instead of what's literally prescribed is illegal.
- RecycledEle 3y agoImagine a US-China war where China's oil supply is cut off by the US Navy, and China refuses to export the precursors to pharmaceuticals. About 2/3rds of US adults take at least one prescription medication.
- gnu8 3y ago[flagged]
- tlow 3y agoNot sure why this is so heavily downvoted. USA medical system prefers sick people because they're more profitable. For example, type 2 diabetes is reversible...
- meepmorp 3y ago> For example, type 2 diabetes is reversible... Sometimes, but not always. I know at least a couple type 2 diabetics who aren't overweight, eat generally healthy diets, and get regular exercise - but still require medication to control their blood sugar. And that's leaving aside the very real difficulties most people have in making the lifestyle changes necessary to affect the disease.
- nradov 3y agoEating a generally healthy diet isn't enough. Research has shown that type-2 diabetes can be reversed in many patients by following a specific protocol focused on nutritional ketosis. Have the diabetics you know tried following the approach documented here under medical supervision? https://www.virtahealth.com/research https://www.virtahealth.com/research
- meepmorp 3y agoNo, but: > 60% of patients enrolled one year attained an HbA1c below 6.5% without the use of diabetes medications other than metformin. 60% reversal without medication except for the major frontline medication for type 2 diabetes doesn't make it sound like a miracle cure, tbh. And it's still has the "major lifestyle changes that are typically hard for people" problem.
- AlgorithmicTime 3y ago[dead]
- scottLobster 3y agoIn short, it's because if the MBAs that head large corporations were dieticians they'd try to make everyone anorexic to save on their grocery bills. If they were home builders they'd remove half the shingles from the roof and one hinge from every door, as well as remove the handles from toilets forcing you to open the tank every time you wanted to flush. Of course they would personally pocket all the savings, and use it to buy for themselves everything they deny to everyone else in the name of "efficiency". I guarantee you none of the pharmaceutical company execs are going to miss one dose of their meds.
- candiodari 3y agoActually it's the MBAs at the government that want the cheapest price for every drug, and are unwilling to pay even tiny amounts for things like supply security. For instance, if the government changed it's rules that price is a competition, and instead of the order going 100% to the "winner", it would go 70% to the winner, 20% to the second place, 10% to the third, that would help a lot.
- Buttons840 3y agoThat's a good idea. We'd have to be careful that 1st, 2nd, and 3rd place aren't actually the same company though (perhaps under different names / legal identities).
- scottLobster 3y agoYou say that like the government is the only buyer in town. That said I wouldn't mind an award scheme like that, government should support an entire economic ecosystem, not pick exclusive winners and losers. Big military contracts tend to be intentionally split among multiple defense contractors for this very reason. However, looking at other sectors, somehow Toyota and Honda seem to make decent money off of low-margin Corollas and Civics with superior build quality, but American car manufacturers are ditching their sedans because they "aren't profitable enough". Many of our supply chain issues strike me as something similar. American business leaders love to claim "hate the game not the player" when they do something predatory, but then bitch and moan when the government occasionally tries to make the game less predatory. Likewise they'll cheat, but when regular people try to cheat as well they get called out with "yeah we cheated but two wrongs don't make a right!". Funny how that 1st wrong is always in their favor, and it's only the 2nd wrong that isn't allowed to happen and must be punished. I don't trust the government, but I trust the private sector even less. Never mind that private sector lobbying is half the reason I don't trust the government.
- morninglight 3y agoThere is a difference in the government's willingness and ability to develop and stockpile: 1. essential medicines that can save lives and promote well being and 2. weapons that are intended to maim and kill other humans. In a democracy, the voters are responsible for that difference. The WHO list of Essential Medicines is a very low bar that any advanced nation should be able to exceed. The fact that something as common as albuterol is currently in shortage, is a national disgrace. It seems that Executive Order 13944 has had little impact. https://www.fda.gov/about-fda/reports/executive-order-13944-list-essential-medicines-medical-countermeasures-and-critical-inputs https://www.fda.gov/about-fda/reports/executive-order-13944-...
- hayst4ck 3y ago> In a democracy, the voters are responsible for that difference. Yes and no. We delegate power to representatives to mediate that difference, and they ultimately delegate it to a bureaucracy, hopefully filled by experts in a particular area. These bureaucracies are then funded proportional to the quality of voter chosen leadership. So I would say voters are responsible for choosing the level of corruption when they vote, but our votes are red or blue, we don't get any kind of say in resource distribution past that unless we are beauracracy/institution participants ourselves.
- sproketboy 3y ago[dead]
- bsder 3y agoEither you bust monopolies, or this is what you get. At this point, the US medical system has become a sequence of monopolies at every level. These are the consequences. Every company with more than 20% market share in a vertical should split in half. Having 5 or 6 companies in every vertical would solve most of the monopoly problems.
- patmorgan23 3y agoDon't forget about the monopsony problems. Large buyers distort markets faster. 10% buying power means you could drop a market player's revenue by 10%, how many businesses could weather that? (See Amazons "Project gazelle" for this in practice)
- WheelsAtLarge 3y agoIt comes down to profit. Low to negative profit equals no medications. We need to give incentives to manufactures to produce the meds. Years ago , the Orphan Drug Act law passed by Congress in 1983 incentivized the development of drugs to treat rare diseases. It worked. It has produced numerous drugs to treat rare diseases. They are very expensive but they exist vs not existing at all. If we can get a similar act that would give incentives to manufacture these vital drugs at a reasonable price then it would be a win for everyone. My first guess would be to have a minimum price that's equal to manufacture cost plus 15% profit. People are going to automatically oppose it because it will raise prices but the fact is we live in a capitalist system that produces nothing unless it produces a profit too. I would rather have the drugs available that save lives and pay a bit more than not having them at all.
- andrekandre 3y ago> have a minimum price that's equal to manufacture cost plus 15% profit. > the fact is we live in a capitalist system the gov't setting a fixed profit rate doesn't sound like capitalism to me...
- sillywalk 3y agoIt's called a cost+ contract.
- clarge1120 3y ago“Life-saving Drugs are too Inexpensive to Produce” It’s a ridiculous headline, I know. But, that is the gist of this article. It just doesn’t say so. Pharmaceutical drugs, and the pharmaceutical industry is highly regulated. It is very expensive to comply with drug manufacturing and distribution regulations. Those regulatory expenses are so high that it is simply not profitable enough for any company to produce these cheap generic drugs at a sustainable profit. It doesn’t make sense for a pharmaceutical company to comply with all regulations and make a profit on inexpensive, generic drugs. The real headline is “Generic Drugs are Over Regulated, Making Them too Expensive to Produce”
- jtbayly 3y agoYour claim doesn’t make sense any more to me than the claim in the article. Costly regulation should simply drive the cost of generics up until they are profitable at a new price. Your claim is that the market cannot deal with increased costs of a product.
- chii 3y ago> Your claim is that the market cannot deal with increased costs of a product. which might be true, if the person cannot afford it at this higher price, despite needing the medication. For example, the gov't subsidies for these people aren't high enough. Despite what people might think, medication and healthcare is not absolutely inelastic.
- Incipient 3y agoAlso deregulation doesn't always end well. Especially for a product in ingesting, I'm all for tight controls.
- anizan 3y agoThis has a lot to do with the oligopoly in pharmacy benefit managers. top 3 PBMs account for 79% of all prescriptions dispensed in 2020. These companies in turn negotiate hard with generic manufacturers that often they sell at a loss and aren't motivated to produce for America.
- patmorgan23 3y agoYeah, kick backs/rebates to PBMs should be illegal. The only compensation they should get is from the insurance plan that hired them to negotiate on their behalf. Even then PBMs are always going to be a centralizing force in the drug market leading toward a monopsony(single buyer market). Buying power is going to distort faster than large sells (10% of market buying force is very powerful, will 10% of marketing selling share is big but can be worked around)
- known 3y ago[dead]