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Hackers Offer a DIY Alternative To The $600 EpiPen (ieee.org)
After the pharmaceutical company Mylan raised the price of a 2-pen set of EpiPens by nearly $500 over the course of 9 years, Michael Laufer and his "pharma-hacking confederates at the Four Thieves Vinegar Collective," decided to make their own budget-friendly EpiPens. IEEE Spectrum reports: Today they released a video and instructions showing DIYers how to make a generic EpiPen using materials that can be bought online for about $30. They call it the EpiPencil. "It functions just as well as an EpiPen," Laufer says in the video, after demonstrating the assembly and showing that it works. "With no special training, anybody can use it." An EpiPen is just a spring-loaded syringe filled with the pharmaceutical epinephrine. Laufer's video shows how to assemble the "open source medical device" and provides links for where to buy the components online. He stops short of telling viewers how to get their hands on the drug, noting that you need a prescription for it. But Laufer tells IEEE Spectrum in an interview that it's easy to buy epinephrine online from a chemical supplier, and he hopes viewers will do just that. "There's a small but hopefully growing subculture of people who are buying the active ingredients of drugs," he says. "It's encouraging to see people take control of their own health."
"There's a small but hopefully growing subculture of people who are buying the active ingredients of drugs," he says. "It's encouraging to see people take control of their own health."
Kinda reminds me of Chinese chemical plants selling sildenafil citrate for under 100 USD per kilogram (worth 10k 100mg pills) on alibaba. Those poor "cheap viagra" spammers, the Chinese are going to put them out of business :(
The issue here isn't the materials cost of the epipen. You don't even need an epipen to deliver the medicine, just a syringe and an epinephrine vial. Any school nurse worth her salt will know how to use a needle. If school districts wanted to give a fat middle finger to the pharma industry on this they could go and purchase them.
The issue here is that Mylan (the makers of the pen) lobbied the FDA and government to require its purchase be done by school districts and then jacking the price up to gouge the taxpayer (ie you and me). Now school districts have to purchase the pen instead of going the route I outlined above.
The only way to hack the regulatory process is to donate a retarded sum of money to "charity" of a specific presidential candidate and various other lobbying groups. Though that isn't really hacking. Just, "business as usual" in the fairy tale land known around that stretch of highway known as the beltway.
Though this is admirable, I think they are opening themselves up to some serious lawsuits.
First of all, the EpiPen is certainly covered by some sort of patent, so Mylan is going to sue them into the middle ages for infringing on their patents.
Secondly, when (not if) this thing does not work as expected, some idiot is going to sue them for damages (despite - I imagine - the risks being very clearly stated).
And thirdly, the entities that regulate this sort of thing will force them through an excruciatingly expensive legalization process or simply declare it illegal outright - citing health risks...or something.
This is the kind of sick and twisted world we live on, I'm afraid.
I admire the idea, and the spirit in which this is done, but the whole idea behind the EpiPen is that it is idiot proof.
That does not go well with the idea of making a device yourself. The problem here is that idiots will try this and find ways to fail, and anybody else will not do it for the idiots because it exposes hem to all kind of risks. For example patent litigation when they charge money for it, or liability lawsuits when something does go wrong, which it inevitably will sometime, even when done by none-idiots.
Your fun at partys
It's my non-expert understanding that epinephrine has a short shelf life, and that the dose is fairly critical so using expired vials/doses is not really an option... the recommendation is that Epipens be replaced after 12-18 months but apparently the vials/normal syringes only last about two months. I can only imagine that in a system like this, the exposure to oxygen would shorten it even more.
So you'd probably need to replace the syringe and dose daily, or every other day, for both dose freshness and sterility reasons. I'm sure you're still saving money in the long run but it's now a lot more effort, time and material to make sure it's ready to use...
=Smidge=
I am all in favour of using a cheaper option that is equally as effective as its more expensive alternative - that is simply an expression of one of the bases of most Capitalist economic models, after all - that an existing incumbent in the market can be challenged by a new competitor providing the same or similar service at a lower cost. I also happen to love home-built and self-built solutions to many problems. But I mostly apply that passion when making furniture and tinkering with my car or the innards of my computers.
The reservation that I have with that approach around medicines and pharnaceuticals though, is the dosage, effectiveness of the delivery and consistency of the product. A case in point - Sanofi's Auvi-Q (the main EipPen alternative) which was withdrawn by Sanofi in 2015 because of concerns about its ability to deliver the correct amount of epinephrine. These pens are designed to be used without medical training, so someone with the skill required to recognise an under- or overdose may not be present. Heathkit solutions are great, IF they deliver a consistent (and correct) dose of the medicine, and IF the medicine contains a consistent (and correct) dose of the active ingredients. Without that reliability that the mechanism is going to work and deliver the correct dose, it is difficult to put trust in that solution, especially for for a parent or guardian whose child may have such an extreme allergic reaction that their health or life will be in danger without proper care.
For sure, this is a pretty blatant (in my opinion) example of price-gouging by Mylan. Trying to blame it on the US Healthcare system is weak, but they have been given a pretty clear monopoly in schools thanks to their political lobbying efforts and now they are extracting the maximum value possible from the situation - another example of capitalist economics at work - setting the cost of a product/service at a level the market can bear and that the seller is happy with, rather than the cost the market would like to pay.
The logo showing a merchant is a nice touch!
"There's a small but hopefully growing subculture of people who are buying the active ingredients of drugs," he says. "It's encouraging to see people take control of their own health."
There used to be a time when you could walk to your corner pharmacy and get a bottle of laudanum, or some cocaine. This did not work out well. There are far too many stupid or murderous people to allow this. I'm sure these guys have the best of intentions but when the idiots start rolling up with lawsuits because they didn't assemble their pen correctly or overdosed or used old medicine or got an air bubble into their veins or the cheap needle they used broke off into their leg or any of the infinite number of horrible things that will happen, they will be wiped out.
There are very good reasons we don't allow Doctor Mom to build her own x-ray machine to save a buck. Just because this medical device is simple doesn't mean it isn't a medical grade device that should be constructed in your Maker lab.
The problem with this is safety, I generally would trust an actual -engineered- device that has gone through FDA approval/etc. over my own home maker/hacker contraption... The ONLY reason this is even a story is because similar to insulin https://static4.businessinsider.com/image/57da97c6077dccf2018b5fce-1200/insulin-prices-humalog-novolog-v2.png (graph showing 2 manf. prices over time of insulin) where there is only a couple companies making the product there is a lack of generics to help keep the price down. from: http://www.businessinsider.com/insulin-prices-increase-2016-9
If we had a company producing a 'generic' epiPen for 40$ a pop... then it would help drive the price of the 'original' down to a reasonable price. But without that... we're screwed... And this is why Government funding of basic research (So that the discoveries go into the public domain instead of being monopolized by a single company(or companies who license it too) is beneficial to society... OR even null-and-voiding the patents for an entire field like the US Gov't did for Airplanes after WWI until mid ...70s... (perhaps 60s, if I'm wrong on date) because the US had shit for airplanes in WWI because the Wright Bros. held the patents and refused to let other 'generic' manf. license their patents.... (Sounds familiar) ... But once patents weren't enforceable the US became the center of most Aviation R&D and Manf....
"It's encouraging to see people take control of their own health."
It's also encouraging to see the free market in action rather than hearing the usual whining about how government regulation is the only way to fix the situation.
In the end they will lay their freedom at our feet and say to us, Make us your slaves, but feed us. - Fyodor Dostoyevsky
$600 is nuts but very unwise to mess with such a powerful drug which in very controlled doses treats serious conditions but minor variances outside that dose can lead to death or serious conditions.
I cannot begin to describe how illegal this is (at least in the US).
The name "EpiPencil" clearly infringes on the "EpiPen" trademark by creating the confusion that it has something to do with Mylan.
A spring-loaded syringe infringes upon Mylan's patent for same.
The device has not gained FDA approval and its use is therefore illegal, even to treat ones self.
It is illegal to obtain medication controlled by prescription without said prescription, such as by buying it from a chemical supplier for use in medical treatment (it may have industrial uses which are perfectly legitimate but it is still illegal to use it for medical purposes). It is also illegal to use non medical grade substances not approved by the FDA for medical treatment.
Anyone who does this is looking at a lot of jail time, not to mention civil damages for infringing upon Mylan's intellectual property rights.
mylan keeps filing for new and insignificant patents to "improve" the epipen and keep its patent protection going indefinitely.. just like every other drug company does with their exclusive and expensive drugs.. a tweak here and there (like extended release formulation bullshit), boom, a new patent, another couple decades of gouging patients.
so all that's needed is for some company with the balls and a little money in the bank to go back to the original and NOW EXPIRED patents for epipen and create an injector based upon that, now unencumbered, design; using the fact the same fucking design was approved back in the 80s to get it through the fda approval process.
congress could also give a giant middle finger to big pharma and say the drug and delivery mechanism is crucial and of national security (that's the magic buzz word, and i'm sure the military stocks and uses these damn things) importance, and order the low-cost licensing to a couple third parties.. after all, that's how amd became an actual x86 licensee and no longer had to clean room reverse engineer intel's chips... the government wanted a second source for a critical product. the same thing could be done here.
I plan to keep bees.
One of my adult sons is alergic, does not currently live with me, but I hope will visit once in a while.
At first I thought I would just keep an epi-pen handy, but the shelf life of the medicine is a serious concern.
My father has passed, he was a working Pharmacist, worked his way through Medical school, he would keep some medicines in the fridge and if needed, administer via a syringe.
What is the minimum training required to administer a syringe of anything effectively....bet it is cheaper than the 'idiot-proof' pin with zero risk of administering the wrong dosage....as long as your eyesight is good enough to read the syringe.
Just seems like a Superior solution in the long run all the way around, though I applaude the Hackers DIY alternative and the actual reality that ones health is ones responsibility and we should all do everything in are power to avoid needing the hospital and pharma industry, period.
Sure hope the industry and politicians never manage to restrict or outlaw vitamins...know big pharma wants them too. We gotta stay healthy or we are screwed, as health care will bankrupt us!
The article doesn't say how much (in mg) needs to be loaded in to the pen, but here is one source at USP grade from a highly respected supplier, 200mg for $326.50 in the US. A quick google search suggests .3mg per injection so that 200mg should last quite a while.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
You don't even need an epipen to deliver the medicine, just a syringe and an epinephrine vial. Any school nurse worth her salt will know how to use a needle.
I coach school sports teams so I've been on staff at a number of schools. Most school nurses I've ever met are prohibited from administering any injectable medications and I've met more than a few who were not trained nurses at all. School nurses are not on the school grounds at all times either, particularly after school hours. Schools are certainly not about to start storing syringes and vials of medications. The whole point of something like an epipen is that it can be administered by someone with no medical training whatsoever because there is a very high chance that whoever administers the epipen will not be a trained medical professional.
The issue here is that Mylan (the makers of the pen) lobbied the FDA and government to require its purchase be done by school districts and then jacking the price up to gouge the taxpayer (ie you and me). Now school districts have to purchase the pen instead of going the route I outlined above.
That's a minor part of this problem. Most buyers of epipens are not schools but individuals. School districts might be getting ripped off but that's small potatoes compared with individuals getting ripped off.
You're not a scientist.
You're not a doctor.
Don't do this.
My son needs epipens and I'm a maker, however trusting your life or someone else's life to an amateur made device is irresponsible.
If you go making your own auto-injector syringe, you better have a way to be absolutely damn sure there's no air in the hypo before you let it go.
"Stratigraphically the origin of agriculture and thermonuclear destruction will appear essentially simultaneous" -- Lee
I don't think any amount of regulation will help with this, because it comes down to greed.
Untrue. In most countries the government is in charge of health care and they have a VERY easy way to regulate price gouging such as this. In any single payer system the national health service basically sets the price they are willing to pay and that's what it costs. End of story. We only run into this problem because we have a portion of our population who breaks out in hives anytime they hear the words "socialized medicine".
What we need is mandatory price regulation of the pharmaceutical industry. Will there be less R&D?
The only way to do that is to go to a single payer health care system. Has worked well for a lot of countries so it's not a bad idea.
Possibly, but the majority of new drugs produced now are just new formulations of old compounds that are no longer covered by patents.
That is easily disproven. Yes there are some shenanigans like what you describe but it does not constitute the "majority of new drugs".
It's sad to see that we're now reduced to making our own medical devices.
So many problems with this:
1) Dosing is a big issue. Huge. Not just determining the correct dose but mechanically and reliably administering the correct dose. This is NOT a trivial concern. Both under and overdosing with epinephrine can be a very serious matter.
2) Quality control in a device like this is essentially nonexistent. It might work but you can virtually guarantee that it won't always work. If it doesn't then that will very likely result in serious injury or possibly death. I work in a company that makes components for medical devices. The quality control standards are VERY stringent for very good reasons.
3) Sourcing the medication. Sure you might be able to buy it but there are VERY good reasons why we have a controlled supply chain in the pharmaceutical industry. You are seriously rolling the dice if you buy outside the normal supply chain.
4) The person who administers the injection is quite likely to not be the person who built the device. This raises a whole host of problems.
Just buy some herion, horse, smack, hillary, and be done with. Needle? Got tons in my back alley. Yours for the taking. A few dead whores, too. Yours for the taking.
My father has passed, he was a working Pharmacist, worked his way through Medical school, he would keep some medicines in the fridge and if needed, administer via a syringe.
Very few people are trained medical professionals. That is a rare circumstance not relevant to 99% of the population.
What is the minimum training required to administer a syringe of anything effectively....bet it is cheaper than the 'idiot-proof' pin with zero risk of administering the wrong dosage....as long as your eyesight is good enough to read the syringe.
It's cheaper until you kill someone. And rest assured that someone would. Even trained medical professionals screw up with some regularity on dosing drugs. Furthermore the whole point of something like an epipen is that you don't need to be trained. Maybe you live in a hospital but most of my day I am not around anyone who is trained to administer medications and even if they were the supplies are not readily available. Nobody keeps syringes and vials of epinephrine around. In many work places unused syringes would disappear faster than doughnuts at a weight watchers meeting. (Druggies aren't shy about stealing that sort of stuff)
Sure hope the industry and politicians never manage to restrict or outlaw vitamins...know big pharma wants them too.
You mean the same vitamin industry that has been selling fake supplements for years. They ABSOLUTELY should be regulated. The only reason they aren't is that the supplement manufacturers evidently have a very effective lobby and managed to get key members of congress to squash any attempt to regulate them by the FDA despite the fact that it has been proven that in many cases they are selling products that do not contain what is on the label.
We only run into this problem because we have a portion of our population who will sue anyone over anything bad that happens.
You will have either regulation through government or regulation through legal action. You cannot opt out of having one or the other. You don't get both and you don't get neither. Having neither would be a TERRIBLE idea because that's how you get quacks. Without having regulations or tort action you have no means for people to get redress when they are injured. And make no mistake that there are plenty of people who would sacrifice your life to make a few extra bucks.
If you can't afford a $600 EpiPen, buy a $144 Adrenaclick. Only if you can't afford that do you go for the homebrew.
I read the article in IEEE Spectrum (heresy, I know, but bear with me), and it discusses how the group aims to encourage DIY pharma devices and drugs.
The problem is that pharmaceuticals require very tight tolerances for purity, dosage, and inert ingredients. (I wouldn't be surprised if a quality control standard of 6-sigma ain't good enough.) That could be a key reason that the labs used to manufacture medicines cost so much to build and maintain. I wouldn't trust a life-critical medicine from a DIY-er, even if I was that DIY-er.
So hooray for open source design of the device, which can lead to idiot-tolerant assembly instructions. But I want one of those instructions to be assemble and use at your own risk - device not validated for manufacturing reliability. And the medicine should always be obtained from a reliable source.
You are absolutely correct identifying government regulation as the primary expense. And yet, you blame pharma industry?
That a maker of something — anything — would try to sell as much for as much as possible, is perfectly normal. That their lobbying efforts were successful — that's wrong.
And why is some government official (or a group), who aren't even elected, in a position to mandate purchase of stuff — regardless of price? Having created FDA as a corruption magnet, don't be surprised, they do get corrupted...
This is a perfect illustration for the point Libertarians have been pushing all along — there is neither a need nor justification for FDA. People with cavalier attitudes to their health, can use the cheapest remedies they can find — free citizens of a free country are entitled to risking their own lives. Those, who prefer somebody else to test it first, (and who currently rely on FDA approvals) can seek goods and services approved by competing non-governmental reviewers — such as Consumer Reports, Good Housekeeping, or Amazon Reviews, etc.
In Soviet Washington the swamp drains you.
These devices are one-shot deals. You just don't put more than a maximum safe dose of the drug into the pen in the first place. That prevents death or injury due to overdose. Completely negates it. No issue there.
Who is calculating the dose? The problem is that person. It can be REALLY easy to get that wrong. Even trained medical professionals get dosing wrong sometimes. It does NOT eliminate the possibility of an overdose because it does not eliminate the possibility of an error in calculating the correct dose. The assumption that the maximum safe dose will always be properly calculated is not a safe assumption.
Any under-dosing is unlikely to be massive, and as another poster pointed out, the drug has a shelf life anyway, so a pen giving you a lower dose of a fresh drug isn't going to be much different to a perfect dose of an older drug.
If the device fails (which absolutely could happen) there could easily be zero dose and then the person potentially dies from anaphylactic shock.
I'm pretty sure that someone for whom this device working could be a matter of life or death would be absolutely sure to follow these instructions to the letter.
You would think so but in reality that doesn't always happen. My mother tried to use a self injection system like this and her hand was shaking (scared) so bad that the medicine dribbled out on her skin. Nobody was around to help her at the time. Furthermore people in stressful situations are not exactly big on carefully reading instructions. People die because they forget how to do basic things in an emergency or get confused easily.
As sad as it seems, more than 100 million people in the USA have a BIG problem with a $500 investment:
Which is why the correct solution to the problem is to ensure that epipens or properly manufactured equivalents are available for reasonable amounts of money. This is a regulatory problem, not a technological one. If someone really is in a tough spot financially then of course they should do what they need to do and I have no problem with that at all. But that's not the solution to this problem in the long run.
So your answer to the problem is to give the same government that caused the problem to begin with an even greater role in directly controlling prices?
The government didn't cause this problem. LACK of government caused this problem. The company that makes epipens has been given free reign to set the price however they want because of a reluctance by some to get government involved in keeping costs down.
Why would you believe that giving those same people direct price control would result in them lowering the price?
The government has no profit motive. If you need to see the effects of having governments setting prices for medical care I refer you to pretty much every other industrialized country in the world. They manage to keep cost much lower AND have better outcomes in many cases.
So get another kid to do it. There's got to be at least one kid around who's on insulin.
You might want to look up some actual data before spouting off something so stupid and easily disproven. The prevalence among children is somewhere around 1 to 2 per 1000.
And "training"? - it's simple as sh*t. Literally so easy that a kid can do it.
Missing the point. Unless you are going to provide training to basically everyone on injecting drugs then it isn't "easy as shit". Furthermore training the general public on how to administer drugs? The same general public with a HUGE drug problem? Oh yeah, no predictable side effects of that...
Seriously you think public health officials haven't thought about any of this stuff? If it was really that easy there would be no market for something like an epipen.
Kids with diabetes are sticking themselves all the time.
Kids with diabetes receive a lot of coaching and learn how to administer and dose insulin. They do not learn how to administer and dose epinephrine. Nobody is arguing that people are incapable of doing it with adequate instruction. The argument is that THEY HAVEN'T RECEIVED INSTRUCTION and there are a serious logistical problems with ensuring availability and proper dosing of the medication. Anyone who argues this is a trivial problem has no idea what they are talking about.
Just tell your doctor to re-write your prescription from "EpiPen" to "Automatic Epinephrine Injector". There's plenty of generic alternatives that are reasonably priced. It's just that doctors are lazy or unaware.
The Epipen fiasco would have been completely avoided if the FDA didn't have the position that it alone, among all regulatory agencies, is qualified to evaluate generic drugs and devices. The sensible thing, which is not being done because the FDA is protecting its turf, is to recognize generic drug approvals from other advanced countries such as the European countries and Canada. The Epipen has a de-facto monopoly due to FDA foot-dragging. The FDA, ad nauseam, trots out the Thalidomide tragedy to prove that everyone else in the world is incompetent, but the world has changed since 1957, and people can and have learned from their mistakes. Now it's the FDA that's incompetent, introducing needless delays in approving drugs that have already been fully vetted elsewhere.
I hated them, the spring sometimes wouldn't trigger unless you hit the button just right....sometimes really scaring the bejesus out of you because it would catch you off guard. Sometimes they wouldn't fire at all.
It got to the point to where I would ask for the old school plastic "insulin" syringes, which were getting pretty hard to come by. I get that they are supposed to be idiot proof, but they really do suck.
Title of my post says it all.
The 2000% markup the current monopoly is charging for this should be a wake-up call to anyone thinking otherwise.
And I'm talking about actual competition, not some bullshit "alliance" of like businesses colluding to create a "standard" price.
That is the reason people break out in hives about socialized medicine. Everywhere that has socialized medicine has to deal with health care rationing. Regardless if the frogs have been slowly boiled to the point where they "don't care" about having to wait endlessly for medical care so that they die before they need expensive treatments, no one wants it.
Oh, and no one wants to pay for people who don't think their health is sufficiently important to pay for themselves, either.
HBI's Law: Frequency of calling others Nazis is directly correlated with the likelihood of the accuser being Communist.
Greed! Monopoly! Regulation! These are fun words to say.
The weird thing is, pharmaceutical companies don't make money consistently more than car companies, food companies, electronics companies, software companies, or any other kind of company. They simply aren't making the ton of money we'd like to complain about. This makes sense, because if drug research, development, and production DID make more money than doing something else, then Apple, Google, Bill Gates, Larry Ellison and Jeff Bezos would invest their money into new pharmaceutical companies, so that they would make a ton more money. Those new companies would be competition for the old, tending to reduce prices.
In fact, when you think about who has a billion dollars to invest, who makes a ton of money, the big names that make crazy money are Apple, Google, Bill Gates, Larry Ellison and Jeff Bezos - it's the computer technology people making crazy money. *We* are the greedy bastards. :â'O
* Like some technology companies, drug companies have bad years, when they spend $2 billion on R&D and nothing gets approved, and good years when they have a hit. Over time, their total returns are similar to other industries with similar volatility, and risk-adjusted returns are inline with the overall economy.
They aren't just in the Ghettos anymore.
They've gone mainstream and are ripping off the public under the protection of the Democrat Establishment in DC.
People have become so risk averse in the western world that we would rather watch someone die a slow suffocating death from an allergy than actually help the person because, "only experts can do that." We have this phobia of doing anything outside of our specialization. A phobia that is largely propagated by the "experts" of various fields to ensure their own job security and their elite status. Several of the commentators on this article need to stop whimpering in the corner, worried about the new, and instead do what it takes to help those around you. Sometimes that means working on changing the laws and changing the way we do things.
As others mentioned, the real key is that the EpiPen is fairly foolproof. However, for the cost, it seems like an extreme hurdle to cross. It is at the point where some facilities, and some families, do not keep one on hand, even when they know there are those that have severe allergies, simply because of the cost.
I would propose that most institutions, and families with allergy sufferers, could bring a lay person to a level of understanding and skill such that they could administer an injection of epinephrine via syringe if needed. This is not rocket science. You could have classes on this administered by the Red Cross (much like some of the CPR and first aid classes). For the $50 to $100 that it would take to take the class, it would more than make up for the savings for the EpiPen, even if you had to renew yearly. Also, you could always scholarship in those that could not afford the class cost. For schools and summer camps, this would be a no brainer as I imagine the policy is that only the trained nurse administers the EpiPen anyway.
This is one of those situations where regulations kill. Because we have private companies steering government policy to keep the competition out, and because these governments and businesses engage in a symbiotic relationship to maintain each other's power (also known as fascism), we run into extremely high costs where literally only the rich and well connected can afford to be ready for a bee sting or other reaction.
But remember, folks: the black market for anything is the real market.
It's worse than that. Most of the quacks actually think they're right and that they're helping people. It's hard to do trials that really prove efficacy (or prove that something is ineffective), and people who are sick are desperate so they'll believe just about anything, and on top of all that the Placebo Effect is a real thing, so we end up with stuff like Homeopathy and Chiropractic. The vast majority of these "practitioners" IMO are not sacrificing your life to make a few extra bucks, they do it because they genuinely believe in their snake oil.
Every time you save someone with an EpiPen Charles Darwin rolls over in his grave.
Our County med staff cranks them out for about $10 each, so they can be really cheap to make.
Remember: you are being ripped off.
A lot.
-- Tigger warning: This post may contain tiggers! --
epinephrine and a spring loaded syringe don't turn into an epipen when you combine them, they turn into FIRE
The biggest value of this project is the message, "If you try to f*** us over, we have the power to f*** you."
of things that will get me on yet another list.....
i am so very tired....
In most countries the government is in charge of health care and they have a VERY easy way to regulate price gouging such as this. In any single payer system the national health service basically sets the price they are willing to pay and that's what it costs. End of story.
Well, not quite.
In any price control regime, the authority sets the price, and there are three options:
1. They HAPPEN to hit the "market clearing" price on the nose.
2. They set the price lower.
3. They set the price higher.
1. is a small target, and very hard to get right even if you're trying. (Even market economies only get there by constant feedback in the form of purchase decisions.) Further, there are strong political pressures on regulators on where to set prices, so they aren't even trying. So 1 just doesn't happen.
2. means the consumer gets gouged. (But now he can't go to some competitive supplier to get the product or service at a better price. EVERYBODY who is selling is selling at that price. So the gouging is institutionalized. The only way to get a lower price is to apply pressure to the regulators (see 1.) or go to a black market (with lots of risks, including issues of quality, reliability, contract enforcement, and bad encounters with law enforcement and the rest of the legal system).
3. is where the regulators usually end up. But a price lower than market-clearing means suppliers chose to spend their resources supplying something else, so the supply dries up. You could buy it at a sale price IF you could buy it at all. But it isn't available, so you can't buy it at any price.
A free market has its own problems. For starters, with a single supplier (a monopoly) market forces encourage gouging. With two suppliers they encourage an approximately even division of the market (a duopoly) and, again, gouging, with only price signals, not collusion, to coordinate their behavior. The incentive to engage in competition that drives the prices down to market-clearing level doesn't appear until there are three players, and doesn't become strong until there are four or more.
(Unfortunately, US regulations generally have a built-in assumption that two suppliers are "competition". Thus you get things like the landline/cable internet duopoly, or the built-into-channel-allocations local duopoly (collapsing to local monopolies) of the early, analog, cellphone system.)
Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
of things that will get me on yet another list.....
I want to be on as many government 'lists' as possible.
The more resources they waste on me, the fewer resources they have for the ones that will put them down and wreck their dreams of ultimate wealth, power, and control.
Or maybe I'm actually one of those 'ones'. I guess they'll have to keep devoting resources to find out. :)
Strat
Progressivism (aka US 'Liberalism'): Ideas so good they need a police/surveillance-state to enforce.
Don't need to DIY them, just need to sort out the ridiculous situation in the USA. The Epipen I have here in the UK which comes from a company called Meda cost me £8.40 on prescription. Obviously the NHS don't pay that little but a quick cursory search shows that here and in France it costs $85 for two.
I only please one person per day. Today is not your day. Tomorrow isn't looking good either. - Scott Adams
Yeah, I want to trust my life to some random hack found on the net, without safety/effectiveness testing. (I mean for the "pen" part.)
All your supposed problems with 'socialized medicine' is still allowing corporations to make money off the suffering and pain of human beings' health problems. THAT is truly sick.
That's a very unusual metric by which to measure the profit on an investment. Yes, you're right, pharmaceutical companies do tend to employ higher skill/pay/productivity workers than fast food or assembly line companies do, on average. I'm not sure what that has to do with anything, though.
The normal way to measure gain/profit is as a percentage of the amount invested, often then adjusted for risk/volatility. Jeff Bezos could spend $2 billion dollars to develop and market a new drug, or he could spend that $2 billion developing and marketing a new mobile device, or developing and marketing some software. In ANY case, he would anticipate a profit of about 10%-12%, on average. Developing
and marketing medicine is not more profitable than developing and marketing other types of products. If it WAS especially profitable, most of the billionaires, and the largest companies, would do it.
Btw that $2 billion number to develop a new medicine and get it FDA approved in the US isn't an arbitrary example - that's how much it actually costs.
On a somewhat different topic:
> And every business goes through a rough spell or has a bad product, just look at the big three auto makers.
And some industries and companies have far more variation, dry spells and good years, than others. General Mills is pretty consistent, Apple hopes the new iphone is a hit, Exxon swings up and down daily with the price of gas. Since you can invest in multiple projects or multiple companies, it's possible to offset your risks. Because literally every business has volatility, you can do a bit of math and find the formula for risk-adjusted return. That is, you can say "a 50% chance of making 20% has the same value as a 75% chance of making 10%". That's called risk-adjusted return. (Profit minus risk, basically.) The risk-adjusted return of pharma is right in line with every other industry. Which is why greedy bastards like Larry Ellison and Jeff Bezos aren't all starting new pharma companies - they can get the same or better profit vs risk in other endeavors.
If the Epi-Pen fiasco is due to "corporate greed", then why doesn't every drug carry a $500/dose price tag? Are the corporations that make those other drugs any less greedy? No, the prices of other drugs are held down by competition. Epi-pen prices are through the roof due to lack of competition, and that lack of competition is due to FDA arrogance and incompetence.
Right now, today, Valeant looks to be on the verge of bankruptcy.
Many, many drug companies have run out of money when they didn't get a "hit" for a few years, and been acquired by competitors. Google "pharmaceutical acquisitions" and look at the numbers for any of the acquired companies for the year before the acquisition. Many that had to sell out were having rough times. (Some weren't, of course).
> 1) Spend more on marketing and management than research,
Name ANY big company in ANY industry that doesn't spend more on the combination of both marketing and administration than they do on pure research. In pharma the three are about equal, roughly 15% for each.
The army used cyanoacrylate glue to seal soldiers' wounds in the Vietnam war- and today many hospitals use cyanoacrylates to do the same. You may know it by its popular name- superglue. The medical grade, approved stuff costs a staggering 165,000% more than the stuff Loctite sell.
Bravo !
At best it is a temporary fix to the overall problem - Mylan's own deeds.
Twitter supports and protects racists - by smearing their critics with the "Hate Speech" label.
OR even null-and-voiding the patents for an entire field like the US Gov't did for Airplanes after WWI until mid ...70s
WTF are you talking about? According to Wikipedia the government pressured the Wright and Curtiss companies and others to form a patent pool and pay fees to use each others' patents. There was no null-and-voiding, and the whole issue was over by 1918 as Wilbur had died and Orville had retired and sold out of the business. Moreover, they didn't refuse to license their patents, they did license them, but Curtiss and the Wrights got into a legal war over them.
More guys like this and Snowden, and it will be our country again!!!
You listed the profit margins for Apple, Google, and Oracle, comparing them to Pfizer, Johnson & Johnson, and Mylan, Did you not notice that the *all* of the tech companies had higher profits than *any* of the medical? Other than the single unprofitable company on the list, Amazon.
> By this argument, Google and Apple should go into real estate, which has truly insane profit margins.
Over the last ten years, the median sales price per square foot has gone from $140 to $148, an increase of 6% in ten years. Less than 1% isn't what I call "truly insane profit".
1) Buying an Android smartphone or ordering something from Amazon is a choice. Needing treatment for a medical condition is not.
2) There is competition in the tech world. Don't want that Android? Buy an iPhone. Don't want to order from Amazon? Wal-Mart ships all kinds of things online. The cancer treatment that will save your life is patented by one company? You're fucked if your insurance company isn't willing to fork over six figures for one year's treatment.
3) Tech companies, like pharma, pay their top executives obscene salaries and spend great sums on marketing. What they don't do is have anything close to the incestious relationship Pharma has with public universities, by which they take taxpayer-funded research, patent it, and then fuck the taxpayer sideways on the drugs she paid to develop.
4) Software companies haven't gotten laws passed to explicitly prevent the government from negotiating on software prices, nor on banning the importation of their products (thought they might not be happy about it).
You brought up many different topics that might be interesting to discuss. Sometimes on Slashdot we also discuss spyware embedded in mainstream software, anti-poaching agreements, and Obama's green slush fund. The topic of the post you replied to was the claim that major pharma companies are making extremely high profits. That claim is false. Their profits are lower than many other industries, including the tech companies most of us work for.