4 ms·

There is an awful lot of sympathy for the drug company in this thread. You are correct, research and approval is expensive. But at some point there is a limit.

There is an awful lot of sympathy for the drug company in this thread. You are correct, research and approval is expensive. But at some point there is a limit. Things like insulin are long paid off, and the pricing there has generated controversy. People have been charged $1000 a month for it [1]. What’s fair? They are screaming out to be regulated when they behave so badly, and that’s what’s happened with insulin. [1] https://www.thelancet.com/journals/landia/article/PIIS2213-8587(22)00251-0/fulltext https://www.thelancet.com/journals/landia/article/PIIS2213-8...

pstrateman 3y ago
Insulin isn't a single product. If you're not distinguishing between insulin extracted from a horse circa 1922 and a modern synthetic analog, well that's just not being honest. There's good arguments that the modern synthetic analogs are overpriced, but that's a more subtle argument.
- lostlogin 3y ago
  The situation described in that Lancet article doesn’t seem very subtle. And if the US is able to impose maximum pricing that is so much lower, it would seem likely that price gouging was occurring.
  - pstrateman 3y ago
    The lancet 'article' doesn't actually say anything. It's just a political hack job.
- zachmu 3y ago
  When people complain about being forced to pay thousands a month for insulin, they're talking about the newest synthetic insulins that were developed very recently at substantial costs. They could take the older insulins for $50 a month, no one is stopping them. It's just that those older products are less convenient.
  - lostlogin 3y ago
    So why is older insulin more expensive in the US than elsewhere, by a large margin? https://www.visualcapitalist.com/cost-of-insulin-by-country/ https://www.visualcapitalist.com/cost-of-insulin-by-country/ https://www.rand.org/pubs/research_reports/RRA788-2.html https://www.rand.org/pubs/research_reports/RRA788-2.html https://worldpopulationreview.com/country-rankings/cost-of-insulin-by-country https://worldpopulationreview.com/country-rankings/cost-of-i...
    - pstrateman 3y ago
      Only the last one makes the distinction between modern synthetics and basic insulin. Frankly the US pays for the cost of the research while the rest of the world just pays for the cost of production. If you want to fix the cost of insulin products (and many other drugs) in the US you need to figure out how to make everybody else pay for the true costs. Edit: also your last source there doesn't even know what it's talking about Novolin is a generic brand name for 3 distinct products that have distinct pricing.
      - lostlogin 3y ago
        The argument that the US is paying for everyone else’s drugs is often made in defence of big pharma, but their profits make it hard to swallow. In recent times the US hasn’t really shown any other other signs of chasing socialist policy where it subsidises the rest of the world.
        hackernewds 3y ago
        perhaps most of the research would not be incentivized in a socialist society? it's not like the talent doesn't exist elsewhere, but US embrace of capitalism is a factor in the research development research.
      - ToucanLoucan 3y ago
        > Frankly the US pays for the cost of the research while the rest of the world just pays for the cost of production. Oh come the fuck on, this has been the talking point since the early 2000's. Surely nobody still believes this horse shit. Phizer by itself raked in 50 billion last year alone.
- tacticalturtle 3y ago
  One bit of nuance here is that you cannot buy FDA approved non-human insulin in the U.S. That’s not because of an action by the FDA, but just that the manufacturers stopped selling it between 1998 and 2006: https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/questions-and-answers-importing-beef-or-pork-insulin-personal-use#Q-1 https://www.fda.gov/drugs/frequently-asked-questions-popular... So your only option is to buy the modern day synthetic analogs - or illegally import the old stuff, which the FDA notes here it has the right to block, but may allow under exceptional circumstances.
throwup238 3y ago
That limit is the length of a patent (plus/minus some factors like extensions and time to market). That's been the deal ever since the FDA was a thing. It's nothing new. My understanding is that the controversy is over a newer type of fast acting insulin that's not yet generic. In general insulin is really cheap, but the really nice new stuff makes life a lot easier for diabetics so everyone wants it.
- jauntywundrkind 3y ago
  Turns out many many of the drug companies have been abusing the systems. The feds created a process for handling drug patents, and companies keep filing extenuating patents on existing stuff, and they also have been submitting not just drugs but devices to the registry illegally too, to hold monopoly. No one has guarded the registry. FTC is finally taking some charge, after all the other agencies (patent office, FDA) have failed to do any enforcement. Really good recent write up by the usual king of company & capitalism watching, https://www.thebignewsletter.com/p/monopoly-round-up-how-ftc-chair-lina https://www.thebignewsletter.com/p/monopoly-round-up-how-ftc...
pfdietz 3y ago
> There is an awful lot of sympathy for the drug company in this thread. And for good reason.
acchow 3y ago
> Things like insulin are long paid off, and the pricing there has generated controversy. People have been charged $1000 a month for it [1]. Humalog and NovoLog both have expired patents. There are newer, better insulins. But these drugs were state of the art just 25 years ago.
- lostlogin 3y ago
  The older products are much more expensive in the US too. It’s price gouging, and that’s when regulation has been imposed. The newer products are cheaper elsewhere in the world. The US is getting ripped off by big pharma.
  - Scandiravian 3y ago
    First of, I think that health-care prices in the US are horrible and have terrible consequences for patients However, the blame doesn't lie with pharmaceutical companies. They're not selling their products cheaper elsewhere because they hate the US and love other countries They're doing it because the US has created a system that benefits corporations more than its citizens. If blame needs to be distributed it lies with the people in power who built these systems and those who gave them that power Healthcare in Europe is cheaper because the population fought for it, sometimes literally
    - aaomidi 3y ago
      And they’re actively lobbying to keep it that way.
      - Scandiravian 3y ago
        Which they can do because the US has created a system that incentivizes companies to lobby for their own interests over that of the US population
sheepscreek 3y ago
I can think of two reasons on how we got here: 1. Expensive drugs are expensive to compete again. Any new entrant will have an uphill climb. They will need a new way to solve the problem, so it doesn’t infringe on the incumbents patents. 2. Drug manufacturing is still a niche business. In many other advanced industries, the tooling has become commoditized leading to a lower bar for entry and increase in competition. Repairing phone displays and soldering memory modules is now possible at home. Pharma is still waiting for that 3D printer/indie moment. I don’t know if it’s even possible - we’re talking about chemicals and amino acids here. Every drug will need a different set of ingredients (not that different from cooking food).
huytersd 3y ago
You can have selective outrage. Insulin is clearly overpriced. Semaglutide, maybe not as much.
huytersd 3y ago
[flagged]
- deleted 3y ago
  [deleted]
credit_guy 3y ago
> But at some point there is a limit. But we are nowhere close to that point. Ozempic is going off patent in 2031. It is a new drug, and it happens to be a miracle drug. Why should the company that brought the drug to market not monetize on it?
hackernewds 3y ago
so should they charge $1b for the first pill and then $5 thereon? what is the argument you're making?
sizzle 3y ago
Wonder how many of these folks are on big pharma’s payroll and feel a need to defend those profiting in the billions from patented blockbuster drugs. Thankfully Biosimilars are eating away at patented drug molecules/biologics to reduce prices.
basch 3y ago
Not only are there different types of insulin, but there are different types of delivery mechanisms. "Convenience" is continually being "innovated." Approval of biosimilars, state laws capping price, and manufacturer out of pocket max are driving down the price over the last 4 years. https://www.goodrx.com/healthcare-access/research/how-much-does-insulin-cost-compare-brands https://www.goodrx.com/healthcare-access/research/how-much-d...

pstrateman 3y ago

Insulin isn't a single product. If you're not distinguishing between insulin extracted from a horse circa 1922 and a modern synthetic analog, well that's just not being honest. There's good arguments that the modern synthetic analogs are overpriced, but that's a more subtle argument.

lostlogin 3y ago
The situation described in that Lancet article doesn’t seem very subtle. And if the US is able to impose maximum pricing that is so much lower, it would seem likely that price gouging was occurring.
- pstrateman 3y ago
  The lancet 'article' doesn't actually say anything. It's just a political hack job.
zachmu 3y ago
When people complain about being forced to pay thousands a month for insulin, they're talking about the newest synthetic insulins that were developed very recently at substantial costs. They could take the older insulins for $50 a month, no one is stopping them. It's just that those older products are less convenient.
- lostlogin 3y ago
  So why is older insulin more expensive in the US than elsewhere, by a large margin? https://www.visualcapitalist.com/cost-of-insulin-by-country/ https://www.visualcapitalist.com/cost-of-insulin-by-country/ https://www.rand.org/pubs/research_reports/RRA788-2.html https://www.rand.org/pubs/research_reports/RRA788-2.html https://worldpopulationreview.com/country-rankings/cost-of-insulin-by-country https://worldpopulationreview.com/country-rankings/cost-of-i...
  - pstrateman 3y ago
    Only the last one makes the distinction between modern synthetics and basic insulin. Frankly the US pays for the cost of the research while the rest of the world just pays for the cost of production. If you want to fix the cost of insulin products (and many other drugs) in the US you need to figure out how to make everybody else pay for the true costs. Edit: also your last source there doesn't even know what it's talking about Novolin is a generic brand name for 3 distinct products that have distinct pricing.
    - lostlogin 3y ago
      The argument that the US is paying for everyone else’s drugs is often made in defence of big pharma, but their profits make it hard to swallow. In recent times the US hasn’t really shown any other other signs of chasing socialist policy where it subsidises the rest of the world.
      - hackernewds 3y ago
        perhaps most of the research would not be incentivized in a socialist society? it's not like the talent doesn't exist elsewhere, but US embrace of capitalism is a factor in the research development research.
    - ToucanLoucan 3y ago
      > Frankly the US pays for the cost of the research while the rest of the world just pays for the cost of production. Oh come the fuck on, this has been the talking point since the early 2000's. Surely nobody still believes this horse shit. Phizer by itself raked in 50 billion last year alone.
tacticalturtle 3y ago
One bit of nuance here is that you cannot buy FDA approved non-human insulin in the U.S. That’s not because of an action by the FDA, but just that the manufacturers stopped selling it between 1998 and 2006: https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/questions-and-answers-importing-beef-or-pork-insulin-personal-use#Q-1 https://www.fda.gov/drugs/frequently-asked-questions-popular... So your only option is to buy the modern day synthetic analogs - or illegally import the old stuff, which the FDA notes here it has the right to block, but may allow under exceptional circumstances.

throwup238 3y ago

That limit is the length of a patent (plus/minus some factors like extensions and time to market). That's been the deal ever since the FDA was a thing. It's nothing new. My understanding is that the controversy is over a newer type of fast acting insulin that's not yet generic. In general insulin is really cheap, but the really nice new stuff makes life a lot easier for diabetics so everyone wants it.

jauntywundrkind 3y ago
Turns out many many of the drug companies have been abusing the systems. The feds created a process for handling drug patents, and companies keep filing extenuating patents on existing stuff, and they also have been submitting not just drugs but devices to the registry illegally too, to hold monopoly. No one has guarded the registry. FTC is finally taking some charge, after all the other agencies (patent office, FDA) have failed to do any enforcement. Really good recent write up by the usual king of company & capitalism watching, https://www.thebignewsletter.com/p/monopoly-round-up-how-ftc-chair-lina https://www.thebignewsletter.com/p/monopoly-round-up-how-ftc...

pfdietz 3y ago

> There is an awful lot of sympathy for the drug company in this thread. And for good reason.

acchow 3y ago

> Things like insulin are long paid off, and the pricing there has generated controversy. People have been charged $1000 a month for it [1]. Humalog and NovoLog both have expired patents. There are newer, better insulins. But these drugs were state of the art just 25 years ago.

lostlogin 3y ago
The older products are much more expensive in the US too. It’s price gouging, and that’s when regulation has been imposed. The newer products are cheaper elsewhere in the world. The US is getting ripped off by big pharma.
- Scandiravian 3y ago
  First of, I think that health-care prices in the US are horrible and have terrible consequences for patients However, the blame doesn't lie with pharmaceutical companies. They're not selling their products cheaper elsewhere because they hate the US and love other countries They're doing it because the US has created a system that benefits corporations more than its citizens. If blame needs to be distributed it lies with the people in power who built these systems and those who gave them that power Healthcare in Europe is cheaper because the population fought for it, sometimes literally
  - aaomidi 3y ago
    And they’re actively lobbying to keep it that way.
    - Scandiravian 3y ago
      Which they can do because the US has created a system that incentivizes companies to lobby for their own interests over that of the US population

sheepscreek 3y ago

I can think of two reasons on how we got here: 1. Expensive drugs are expensive to compete again. Any new entrant will have an uphill climb. They will need a new way to solve the problem, so it doesn’t infringe on the incumbents patents. 2. Drug manufacturing is still a niche business. In many other advanced industries, the tooling has become commoditized leading to a lower bar for entry and increase in competition. Repairing phone displays and soldering memory modules is now possible at home. Pharma is still waiting for that 3D printer/indie moment. I don’t know if it’s even possible - we’re talking about chemicals and amino acids here. Every drug will need a different set of ingredients (not that different from cooking food).

huytersd 3y ago

You can have selective outrage. Insulin is clearly overpriced. Semaglutide, maybe not as much.

huytersd 3y ago

[flagged]

deleted 3y ago
[deleted]

credit_guy 3y ago

> But at some point there is a limit. But we are nowhere close to that point. Ozempic is going off patent in 2031. It is a new drug, and it happens to be a miracle drug. Why should the company that brought the drug to market not monetize on it?

hackernewds 3y ago

so should they charge $1b for the first pill and then $5 thereon? what is the argument you're making?

sizzle 3y ago

Wonder how many of these folks are on big pharma’s payroll and feel a need to defend those profiting in the billions from patented blockbuster drugs. Thankfully Biosimilars are eating away at patented drug molecules/biologics to reduce prices.

basch 3y ago

Not only are there different types of insulin, but there are different types of delivery mechanisms. "Convenience" is continually being "innovated." Approval of biosimilars, state laws capping price, and manufacturer out of pocket max are driving down the price over the last 4 years. https://www.goodrx.com/healthcare-access/research/how-much-does-insulin-cost-compare-brands https://www.goodrx.com/healthcare-access/research/how-much-d...