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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 an additional constraint, which is that the autoinjector is intended to be used by untrained people. It has to be, literally, idiot proof. The reason the competing producer got pulled from the market is failure of idiot-proofness - that it would sometimes deliver the wrong dose.
Proving that your device is idiot proof is expensive, putting a high barrier to entry of new market participants. The liability cost of failing idiot-proofness is outrageous. The result is, even with a 95% profit margin, no commercial entity (in the US) wants to start up and compete with the entrenched monopoly on price. Seems rational to me.
The DIY publishers have done a nice job of demonstrating the regulatory walls that protect the US pharmaceutical industry, but the first time someone tries to use an epi-pencil and delivers a wrong dose, gets a venous injection, or an infection, they're going to be targets of civil lawsuits from whomever managed to build or use the device wrong. We need reform of the laws that facilitate monopoly-like entrenchment and reform of the culture that looks at misfortune as a lottery ticket.
Repurposed insulin pen- one-time cost of $100, should last a lifetime. Epinephrine - dirt cheap. Disposable pen-tips - less than 2 for a buck. Used insulin cartridges - free.
I don't see why people haven't been taking insulin pens that take cartridges, emptying the cartridge, and filling it with epinephrine. Simple, cheap, easy to use, and you just replace the epinephrine every 6 months to a year, which is a couple of bucks. The pens last pretty much forever with 3-4x daily use, so one pen should last a lifetime. Using the longest pen tip needle will mean being able to hit the muscle instead of subcutaneous injection, unless you're more than a little obese.
Advantages: Device already approved for injecting drugs. Dial a dose (more accurate than a syringe), stick it in you, push the button with your thumb.. Easily replaceable needle. Available over-the-counter at most pharmacies.
The cartridges you can get free almost empty from anyone who uses them (they were goig to dispose of them at that point anyway), you can use a syringe to inject air into the narrow end of the cartridge until the rubber stopper pops out, rinse VERY well (don't want any traces of insulin), add the epinephrine, stick the rubber stopper back in, you're all set for the next year (no, epinephrine doesn't "go bad" after 6 months. Studies show that at that point it's still at 90% potency or better. Just look for a color change).
The pen is under $100, the cartridges are free, the pentip needles are less than half a buck apiece so if you ask someone with type 1 diabetes they'll probably just give you one, along with the near-empty cartridge they were going to toss, so once you buy the pen, your annual cost will be what - $5.00?
As for ease of use, kids already use them.
"Transparent" is a shit show that trades on every stereotype going. A man in drag is NOT a transsexual.
Most of the western European countries regulate the price of health care. Most of them are NOT single payer. The two do not go hand in hand.
I'm personally a fan of the Swedish model, with minimal national regulation and all the money and implementation details are handled by the provinces. We should pass an amendment forcing the states to provide a certain level of health services. Everyone in the U.S. seems to be fixated on coming to a federal solution as quickly as possible, putting all of our eggs into one basket and ignoring the half of the population that disagrees with them.
You just described the Canadian Health Care system.
Federal Government requires that, in order for a Province to receive funding equal to about 10% of i's Health Care costs, it adheres to the one criteria which can be summed as:
All Health Care is provided by the Provinces, and they set the terms and scope of that care. No two Provinces in Canada have the same Health Care system.
In order to get a payment from the Federal Government, a Province must comply with the Canada Health Act, which basically says:
A Health Care provider must be either all-in or all-out when it comes to accepting Medicare patients. That is, you can accept patients and bill the Province, or you can accept patients and bill the Patient (or his/her insurer) but you cannot accept some of each. In or Out (and there are many Private doctors, clinics, and even entire hospitals in Canada. They are not prohibited).
A Province is free, of course, to forego the Federal Government's cheque and ignore the above, or have no Health Care at all, or comply with the CHA and offer anything at all in terms of what is covered. As it is now, no Province has opted out.
The Federal payment is equal to about 10% of a Province's Health Care costs.