Martin Shkreli Style Tactics are on the Rise with Drug Companies

Forum adverts like this one are shown to any user who is not logged in. Join us by filling out a tiny 3 field form and you will get your own, free, dakka user account which gives a good range of benefits to you:

No adverts like this in the forums anymore.
Times and dates in your local timezone.
Full tracking of what you have read so you can skip to your first unread post, easily see what has changed since you last logged in, and easily see what is new at a glance.
Email notifications for threads you want to watch closely.
Being a part of the oldest wargaming community on the net.

If you are already a member then feel free to login now.

**whembly**

I find this a bit odd... I tried looking into the price catalogue and I'm not seeing any major cost increases.

EpiPens has always been expensive and the insurance companies/government generally provides the consumer some subsidies benefit.

Keep in mind, that many manufacturers TRIED to make competing EpiPen products w/o replicating the patents.

Epi is a really unstable product and the EpiPen manufacturers nailed the delivery method.

Plus, Obamacare slapped an additional tax on it as it's considered a "medical device'.

Interestingly, that Mylan CEO Heather Bresch is the daughter of a Democratic senator, Joe Manchin of West Virginia... so we'll see how long this outrage lasts.

EDIT: I just looked at the insulins... and yup, they're going up. Not sure how to explain that one... and sure does look to be some price gouging.

**whembly**

Ouze wrote:
whembly wrote:
Plus, Obamacare slapped an additional tax on it as it's considered a "medical device'.

Interestingly, that Mylan CEO Heather Bresch is the daughter of a Democratic senator, Joe Manchin of West Virginia... so we'll see how long this outrage lasts.

EDIT: I just looked at the insulins... and yup, they're going up. Not sure how to explain that one... and sure does look to be some price gouging.

October 2007, $100 - Mylan acquires Epipen.
October 2008, $110
September 2009, $125 - ACA introduced in the house.
March 2010, $150 - ACA signed into law.
June 2011, $175
January 2011 $185
July 2012, $210
January 2013, $250
January 2014, $300 - ACA medical device tax of 2.3% is finalized by the IRS
May 2014, $350
January 2015, $450
December 2015, $450 - ACA medical device tax has 2 year moratorium issued.
January 2016, $550
May 2016, $600

Yeah, tell me more about how Obamacare's medical device tax did this.

You may be right about that...

I only pointed out the medical device tax, so I can get a free dig at the ACA.

I found out later in my enterprise that we have a contract with the distributors that's cheaper, that's why I "didn't see it in my catalogue".

General question to you and the thread.

Is the outrage simply because this is a life saving drug?

Or, is it that all drug prices is too damn high?

I'm in the camp of the latter.. if, you're in the camp of the former... man, don't look at the prices for cancer/infusion drugs.

**whembly**

Ouze wrote:
Definitely the latter. I want single payer, or at least something close to it - epipens are $100 in Canada and the price hasn't budged in years.

I'd also like to see, much like Canada, stricter controls - nearly a ban, really - on drug advertisements. It's out of control.

Aye... exactly.

That's why I don't even accept the swags that Pharmacy rep tries to give me. I know it's a losing battle, but all the gak cost money and it has to come somewhere.

Also, some honest review/re-write of FDA regulations. I don't think the public truly appreciates how a) difficult to get new drugs approved (driving up the final cost) and b) regulations that were tailor made to protect big Pharma.

Oh... and the ridiculous patent laws simple needs to be redone.

**whembly**

With reasonable regulation BigWaaagh.

EDIT: Also, I found out more why insulin's price is increasing...

The various insulins goes through frequent drug shortages. (I'm saying this, at least in part, may explain why insulins are going up by virtue of supply & demand).

US is an obese country and the number of diagnosed diabetes patients is increasing rapidly.

**whembly**

Kilkrazy wrote:
It has happened because US medical consumers are an easy kill for a profit oriented medical system.

Given the resistance to Obamacare, etc, it's not surprising that this situation should arise. The US public has only itself to blame for not insisting on a proper first world medical system.

Obamacare has does absolutely nothing about the rising cost, it's just adds a fethton of additional regulation onto the existing system.

And the "first world medical system" nomenclature is ridiculous.

Cost is an issue... yes. But, the level of care is not.

**whembly**

sebster wrote:

To put it another way, the current Russian economy is worth $1.1 trillion. The total welfare budget in the US, govt healthcare, social security, all that stuff, is $2.1 trillion. The socialist part of the US economy is about twice the size of the total Russian economy.

Exhibit A why we love seb's post.

Also, to swing this thread back to the topic a bit, Mylan to offer GENERIC Epipen at Half Price.

Public outcry, for once, actually fething worked.

But, let's not congratulate ourselves yet... the underlining framework that allowed this issue in the first place is still a problem. Namely the IP laws, massive FDA regulation and other onerous protectionist practices.

EDIT: dammit, ninja'ed by Tanner

**whembly**

Ahtman wrote:
whembly wrote:
Also, to swing this thread back to the topic a bit, Mylan to offer GENERIC Epipen at Half Price.

Public outcry, for once, actually fething worked.

That was listed earlier actually. Cutting the price in half after raising the price several hundred percent isn't much of a victory. If something was $10 and you raised the price to $600 and people got upset (and more importantly you lost the company three billion in investments) so you cut the price to $300 you still aren't near $10.

The big deal here is that they're offering a GENERIC.

That pulls in more coverage/subsidies such that the consumers won't pay as much. It's MUUUUUUUUCH easier to get a GENERIC medication on your prescription coverage's formulary (meaning, it'd just be your co-pay).

**whembly**

Tannhauser42 wrote:
whembly wrote:
It's MUUUUUUUUCH easier to get a GENERIC medication on your prescription coverage's formulary (meaning, it'd just be your co-pay).

Well, let's see how easier it will really be to get these generics. I would not be surprised if they produced the generic in much more limited numbers.

Something that still boggles my mind. Are these things completely mechanical, as on, no electronic components? If so, there's no way they can cost as much to make as a smartphone or video game console (and those things have massive r&d and marketing costs, too). Charging such a high price really is nothing but monopolistic greed.

Don't dismiss the mechanical engineering with these epipens.

It has to deliver the expressed dose every time. Some of the other competitors couldn't pass the FDA test in this regards.

However, you're right in the sense that availability can be an issue. (it still is with insulins and vaccines)

There's still shortages of NARCAN (opiate antidote) that is hurting many ED depts in the states...

**whembly**

Ouze wrote:
Frazzled wrote:
Ouze wrote:
Frazzled wrote:
Evidently there is no competitive market as the Fed government won't permit other entities to sell a similar product. If you have a government monopoly you can set the price. Thanks Obama.

There isn't a government sanctioned monopoly on Epipens, just a nearly de facto one.

The FDA settled with Mylan to allow generics nearly 2 years ago. Every very similar competitor so far has dropped the ball somehow - one didn't do enough research before release and was rejected by the FDA, and another got recalled. Even despite that, you can right now get Adrenaclick for about $70 a dose, or if you want to do a little more work, you can get a prescription for epinephrine and just fill a syringe with it for a few bucks per dose.

However, if you want to shift the argument over to Obama dropping the public option - I'd be right there with you.

The FDA sets the conditions of the testing. Its a defacto monopoly. You have to love government monopolies and crony capitalism.
yes the price increases suck and are unconscionable. Thats what happens when there are no competitors.

You'd have to show me that the FDA stacked the testing in order to pick winners and losers in the marketplace, rather than to have testing prove the generics are safe, effective, and equivalent. Maybe that's happened, but I haven't seen that.

Sometimes there are some medications that simply don't get competitors by dint of various manufacturing peculiarities - like the flu vaccine, which is difficult and time consuming to manufacture, which means there are only a few companies who can afford to chase the profit left at the margins of a large R&D and production outlay. Yet do you see flu vaccines spiking in price? Not really. I think the invisible hand is invisible because it doesn't exist.

Anyway, no point in arguing it because if we follow this train long enough, we both agree anyway - we both want fully socialized healthcare iirc your previous posts.

The flu vaccine isn't a great example... it is, however, perfect example of crony capitalism (government award contracts worth billions), and those companies are obviously making serious bank.

But, with respect to FDA approval to new flu vaccines, it's the same process every year... only that the new strains of the virus is introduced. It can be dangerous, moreso than other types of vaccinations, but it's proven to save lives by several order of magnitude. Hence why the manufacturers are enjoying some for a liability shield by Congress.

Getting some new drug on the market to be one of the first to treat a disease... man, it's fething onerous.

My sister works for one of the major Clinical Research companies in the world... and these companies get oodles of cashola to help drug companies comply with FDB regulations.

It's been about five years, and she's still on the program about this new hepatitis treatment that appears to be a fething cure.

So, yes, the FDA does have a job to do. But, at times, they're their own worst enemy.

**whembly**

sebster wrote:
whembly wrote:
Getting some new drug on the market to be one of the first to treat a disease... man, it's fething onerous.

It doesn't have to be as expensive as it is to bring drugs on to the market. Federal regulations aren't as effective as they should be, but that is only one part of the problem.
http://www.nature.com/news/busting-the-billion-dollar-myth-how-to-slash-the-cost-of-drug-development-1.20469

The not-for-profit in the article have put 6 new treatments on to the market, for $290 million. Normal process costs around a billion for a single drug. The company's results include combination treatments of existing drugs, but its also managed to get new drugs tested and put on the market for around $60 million from start to finish. The company thinks it could average $110m to $170m per new drug, even including the cost of failed drugs.

Now admittedly the company in question, DNDi, is using some methods that can't necessarily be scaled up to the industry as a whole. For instance they often form partnerships with drug labs who give them access to new chemicals that aren't economic for the labs because they only deal with diseases poor countries have. They get these chemicals on the cheap, while anything with commercial viability in the West is sold to major drug companies at a huge price. And because DNDi is small scale and not for profit it can generally negotiate much better terms with its partners, than those partners will charge to large, commercial operations.

But the work of DNDi has shown lots of places where existing drug companies can reform their practices to bring the cost per new drug way down. Dropping non-viable or un-needed drugs much earlier in the process. The other thing is to focus on drugs that have very clear needs rather than drugs that have slight benefits over existing medications. Having a clear need lowers the hurdles you need to jump to prove safety and efficacy, and it also results in drugs not being abandoned late in the process because they turned out to be no better than existing medications.

Anyhow, it's an interesting article, well worth a read.

That is a great article... thanks for sharing.

I wonder how hard it is to drop a study, even after sinking massive R&D into the process ?? Guess that's why they pay the decision makers the big bucks... eh?

**whembly**

A Town Called Malus wrote:
I think that the right to equal access to healthcare, regardless of income or employment, will be the next constitutional amendment.

Might take years but I think it will come.

That would be horrible.

I'd rather simply expand Medicare (single payer) for all age groups.

**whembly**

A Town Called Malus wrote:
whembly wrote:
A Town Called Malus wrote:
I think that the right to equal access to healthcare, regardless of income or employment, will be the next constitutional amendment.

Might take years but I think it will come.

That would be horrible.

I'd rather simply expand Medicare (single payer) for all age groups.

It would be horrible for all citizens to have equal access to healthcare regardless of their personal situation? I'm sorry but you are going to have to explain why.

First of all, you need to define equal access better.

By your statement, you are saying that anyone should walk into any clinic/hospital and get their care, because hypothetically it is a right.

Who's going to pay for it? Who pays the doc/pharmacists/nurses/technicians/janitors/electricity/IT infrastructure/building lease/property taxs/medications/equipment rental fees/administration/etc...

If theses entities won't get paid... what's to stop these people from leaving this industry if pay is reduced? Will the government step in and forbid people from leaving? (there's a term for this)

Also, if it's a right, then the government wouldn't be able to introduce end-of-life cost controls.

Also... I don't think you know... but, we sorta have something what I think you are trying to advocate... and that is for emergency treatments called EMTALA:

The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay.

This is a big deal and by far, these organizations almost never get any reimbursements for this.

Hence why it's called "freecare" in the states. The organization I work for... has numerous community hospitals and a big academic campus. The academic hospitals (and a few community hospitals) has given freecare to over 50% of the visits that walks in the ED door.

Got a cold/infection? Go to the local ER to get some tylenol/anti-virus. Simply declare you cannot pay, and the entity is still required to treat you. The only bad thing about this is that you may have to wait awhile to be seen.

**whembly**

Easy E wrote:
whembly wrote:

By your statement, you are saying that anyone should walk into any clinic/hospital and get their care, because hypothetically it is a right.

Who's going to pay for it? Who pays the doc/pharmacists/nurses/technicians/janitors/electricity/IT infrastructure/building lease/property taxs/medications/equipment rental fees/administration/etc...

If theses entities won't get paid... what's to stop these people from leaving this industry if pay is reduced? Will the government step in and forbid people from leaving? (there's a term for this)

Also, if it's a right, then the government wouldn't be able to introduce end-of-life cost controls.

Also... I don't think you know... but, we sorta have something what I think you are trying to advocate... and that is for emergency treatments called [url=https://www.cms.gov/Regulations-and-

All of that would be decided by the Supreme Court, just like normal Constitutional issues. No need to panic about the amendment.

Not really... in fact, it'd be damn near impossible to enforce.

I find Fraz's rejection much more compelling.

Agreed. This is something Congress ought to deliberate.