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pfife

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It’s always been about profit, but it seems now that making , say , 5x the cost previously, they’re looking to make a profit of 100x the cost.

It’s insulin. They are not spending research and development $$$ on this drug. 

The only difference between the 1990’s and now is that the percentage of the population needing the drug has increased, so they’re gouging the population.

It is amoral that a person dies because they can’t come up with the $500 cost for a drug that previously cost $5.

(my numbers aren’t anything but a light memory of what I paid for insulin for my cat, compared to what the young man who died couldn’t afford for a month)

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1 hour ago, smr-nj said:

It just makes no sense to me that a drug as old as insulin (nothing different than it was 40 years ago) can cost astronomically higher than it was 15 years ago.

 I’m not getting it. 

Or, I’m not believing the pharma’s explanation/justification.

 

I agree with you.  

This article explains it better than I did.    The thing is that the vial you buy now isn’t necessarily the exact same as what you bought 40 years ago.  But that old one is no longer made, and the new one may or may not be better.

https://www.statnews.com/2019/02/19/no-generic-insulin-who-is-to-blame/

At the same time, it is harder and more expensive for a new company to pick up the old formulation and make it due to government regulations.   

Several other interesting articles on that site as well.

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37 minutes ago, smr-nj said:

It is amoral that a person dies because they can’t come up with the $500 cost for a drug that previously cost $5.

Capitalism is inherently amoral.  It benefits people as a whole more often than not, but it's an economic system beset in greed - and if companies can get away with something people would consider to be immoral and profit, they will do it 100% of the time.

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55 minutes ago, Melody said:

I agree with you.  

This article explains it better than I did.    The thing is that the vial you buy now isn’t necessarily the exact same as what you bought 40 years ago.  But that old one is no longer made, and the new one may or may not be better.

https://www.statnews.com/2019/02/19/no-generic-insulin-who-is-to-blame/

At the same time, it is harder and more expensive for a new company to pick up the old formulation and make it due to government regulations.   

Several other interesting articles on that site as well.

In summary the article claims:

The big three have made a number of minor changes to keep their top of the line products patent protected, have filed extensively to protect what they perceive to be their space, and charge at rates enabling revenues an order to orders of magnitudes greater than was the case 20 years ago (i.e. enjoying monopoly profits).

Older formulations, of which there are generics, *and often are as effective as current top of the line product*, are not often prescribed by doctors because doctors prefer to 'prescribe the most up to date medicine' (my synopsis).  I very strongly suspect a significant part of this mindset is the marketing the big three directs toward doctors.

But, according to the article, the FDA might be most at fault because Insulin products were reclassified in 2010 with the reclassification going into effect in 2020, which has created uncertainty and delays in generic development.

I am not in the field, but it reads a lot to me like the big three in insulin are profiting massively and using the FDA uncertainty to sell the idea that is the root cause of where we are today.  It also reads as though if doctors would simply recommend / prescribe proven generics responsibly, it would go a long way to resolving this issue as well.

Not knowing anything about the writer or publication, I'd guess there was a motivation to pin more this situation more on the FDA than is fair or appropriate.  Or alternately got sold a bill of goods.

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39 minutes ago, Mr. Bigglesworth said:

 

Older formulations, of which there are generics, *and often are as effective as current top of the line product*, are not often prescribed by doctors because doctors prefer to 'prescribe the most up to date medicine' (my synopsis). 

This suspect the physician's situation is complex. Doctors face a lot of pressures beyond just marketing to prescribe the best standard of care, and diabetes is a disease with such heavy side effects that achieving optimum blood sugar levels is not a triviality. I imagine many doctors actually have ideological opposition to prescribing lesser treatment for less well to do patients - even though they may be contributing to the paradoxical situation of those less well-to-do patients not getting treatment at all. There is a sense in which the Doctor can honestly say he did his best for his patient and the rest of the system failed him/her.

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3 hours ago, Mr. Bigglesworth said:

In summary the article claims:

The big three have made a number of minor changes to keep their top of the line products patent protected, have filed extensively to protect what they perceive to be their space, and charge at rates enabling revenues an order to orders of magnitudes greater than was the case 20 years ago (i.e. enjoying monopoly profits).

Older formulations, of which there are generics, *and often are as effective as current top of the line product*, are not often prescribed by doctors because doctors prefer to 'prescribe the most up to date medicine' (my synopsis).  I very strongly suspect a significant part of this mindset is the marketing the big three directs toward doctors.

But, according to the article, the FDA might be most at fault because Insulin products were reclassified in 2010 with the reclassification going into effect in 2020, which has created uncertainty and delays in generic development.

I am not in the field, but it reads a lot to me like the big three in insulin are profiting massively and using the FDA uncertainty to sell the idea that is the root cause of where we are today.  It also reads as though if doctors would simply recommend / prescribe proven generics responsibly, it would go a long way to resolving this issue as well.

Not knowing anything about the writer or publication, I'd guess there was a motivation to pin more this situation more on the FDA than is fair or appropriate.  Or alternately got sold a bill of goods.

Reading other articles on that site, they don't seem to shy away from slamming pharmaceutical companies or their lobbies.  Just nothing facts.  If there is a good chance that after investing in the necessary studies, etc. required for FDA approval, that said application might be dropped before approved because of how long the process takes, only a dumb dumb would invest in it.  

I don't know much about insulin, but can say relative to other non biologic drugs that sometimes the older generic while having the same end result, involves a whole lot of testing and management.  For example, my husband is on Warfarin.  We have to very carefully monitor and manage his diet for Vitamin K foods.  He is currently fairly stable, so only needs a blood test (INR) once a month.  But we have been through times when he was having to go twice a week to have blood drawn, esp. when our pharmacy had changed generic suppliers and he was adjusting to the change.    There are newer, albeit patent and more expensive, medications that are not K sensitive and do not need the blood testing.  But, alas, if we choose to use them we not only pay full retail but it doesn't apply to our deductible.    Sometimes quality of life has value, and in the case of all that testing etc. it's pretty difficult for those who are maybe still working so have to take time off work, or those who have difficulty being transported to the lab appointments.  Or who just don't have control over what diet they are served.    In this case, we decided to suck it up.  It is just a PITA for us.  But for some, it makes compliance very, very difficult.

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22 minutes ago, pfife said:

Fyi....

 

Jesus Christ. 

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4 minutes ago, smr-nj said:

Jesus Christ. 

Ironically, that will be the Republican answer to health care. That and thoughts and prayers.

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11 minutes ago, smr-nj said:

Jesus Christ. 

yep it's pretty damn terrible.

the Republic party sucks

 

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On 5/24/2019 at 10:06 AM, pfife said:

Fyi....

 

Gone: GOP chances to retain the Senate or regain the House if they get their way. 

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Looks like another stunning success for capitalism and free market.   The invisible hand must have been busy elsewhere... 

 

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1 hour ago, pfife said:

Looks like another stunning success for capitalism and free market.   The invisible hand must have been busy elsewhere... 

 

 Knew  a student that interned at Pfizer one summer when they were still in A^2. Came back in the fall and changed his research focus because he was turned off with what he saw of pharma in just that little time.

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I have interviewed for several pharma jobs over the years.  It always made me feel dirty.  I am happy to be in academia.  

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https://thehill.com/policy/healthcare/452092-judge-rules-against-trump-on-drug-pricing-disclosures?fbclid=IwAR0AbKTj6v_DM76URbldBbzAUkgWo0U96AS1pHWNyWzzSomX7MEJJgZSWWg

I kind of liked this HHS proposed policy on drug pricing transparency.    Judge has kicked it back to congress, which means nothing will be done because ... lobbyist campaign cash.  

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There are a lot of laws all around the country mandating cost transparency for medical procedures, I wonder how this could impact those.

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2 hours ago, Melody said:

https://thehill.com/policy/healthcare/452092-judge-rules-against-trump-on-drug-pricing-disclosures?fbclid=IwAR0AbKTj6v_DM76URbldBbzAUkgWo0U96AS1pHWNyWzzSomX7MEJJgZSWWg

I kind of liked this HHS proposed policy on drug pricing transparency.    Judge has kicked it back to congress, which means nothing will be done because ... lobbyist campaign cash.  

it's pretty clear black letter law, and agency just can't order anyone to do something for which they have no legal authority. The Trump admin is no more competent at working a good policy through Congress and implementing it properly as law, than any of its bad ones.

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