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 Post subject: Re: EpiPen Scandal
PostPosted: Tue Aug 30, 2016 10:46 am 
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I work in the Government affairs department of a Pharma company. There is nothing even remotely free about the market around Pharmaceuticals. The Federal Government caused this problem, plain and simple. The FDA approval process/requirements and the Medicaid rebate program, among others, is why drugs cost what they do.


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 Post subject: Re: EpiPen Scandal
PostPosted: Tue Aug 30, 2016 8:37 pm 
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Baltostiller wrote:
The FDA approval process/requirements and the Medicaid rebate program, among others, is why drugs cost what they do.


That is a factor....But the main driver is single payer/public options in most of the developed world mandate prices at razor thin margins. So pharma gouges the US consumer as primarily the only place to recover their R&D expense. The US subsidizes global pharma.

So the future of single payer in the US, of similarly crammed-down Pharma prices...is R&D dries up even further, and then govt subsidies/grants will have to step-in to fill the gap....and that money comes from the taxpayer. So until the rest of the world starts paying "their fair share" of R&D, the US taxpayer will still be on the hook - it will just be less obvious because the tab is buried in your tax liability rather than your health insurance/drug costs.

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 Post subject: Re: EpiPen Scandal
PostPosted: Wed Aug 31, 2016 10:04 am 
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Kodiak wrote:
Baltostiller wrote:
The FDA approval process/requirements and the Medicaid rebate program, among others, is why drugs cost what they do.


That is a factor....But the main driver is single payer/public options in most of the developed world mandate prices at razor thin margins. So pharma gouges the US consumer as primarily the only place to recover their R&D expense. The US subsidizes global pharma.

So the future of single payer in the US, of similarly crammed-down Pharma prices...is R&D dries up even further, and then govt subsidies/grants will have to step-in to fill the gap....and that money comes from the taxpayer. So until the rest of the world starts paying "their fair share" of R&D, the US taxpayer will still be on the hook - it will just be less obvious because the tab is buried in your tax liability rather than your health insurance/drug costs.



Simply not true. The US Federal Government caused this. The requirements in the rest of the world are so completely different than the US. Trust me, I deal with this every day.


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 Post subject: Re: EpiPen Scandal
PostPosted: Thu Sep 01, 2016 12:14 am 
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Baltostiller wrote:
Simply not true. The US Federal Government caused this. The requirements in the rest of the world are so completely different than the US. Trust me, I deal with this every day.


If there is no protection for patents, and no profit margin on new drugs....then there will be no research for new drugs. Competition doesn't matter when there's no money to be made, only when you can copy a drug someone already spent the R&D creating.

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 Post subject: Re: EpiPen Scandal
PostPosted: Thu Sep 01, 2016 8:04 am 
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superk wrote:
To clarify: Mylan makes the Epipen. There is no monopoly here.

Yeti makes coolers. They are very expensive. For some reason they are very popular, not just with coolers but with merchandise. I find mine cumbersome. Can be hard for people to open and the handles feel flimsy to me. Walmart sells Styrofoam coolers, they are cheap. So is ice.

The consumer makes a choice as to how to keep their desired possession cold, and acts accordingly. So far Yeti doing well. At some point in time they may not do well, and they will go away (they aren't GM).

If you need epinephrine, you don't need an epipen. You can ask your provider for needles/syringes/vial of 1:1000 Epi. Will cost you next to nothing. That's up to the consumer.


This means nothing when the schools are getting subsidized by the government to buy EpiPens.

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 Post subject: Re: EpiPen Scandal
PostPosted: Thu Sep 01, 2016 8:04 am 
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Dan Smith--BYU wrote:
To the critics of the free market:

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And RIP Gene Wilder


It's not corporations that are being railed against...but corporatism.

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 Post subject: Re: EpiPen Scandal
PostPosted: Fri Sep 02, 2016 11:09 am 
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"This means nothing when the schools are getting subsidized by the government to buy EpiPens."

Then once again the government is the irrational actor being taken advantage of.

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 Post subject: Re: EpiPen Scandal
PostPosted: Fri Sep 02, 2016 11:26 am 
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Things have a market value because they have value only as a means. A thing is replaceable and we are satisfied to substitute the value of a thing with a certain amount of money.

Presumably none of us think that humans are things that have only a market value.

Should the health of citizens be subject to free market evaluations?
Should the health of a human being be treated as s market commodity?

I'm all for letting the free market set prices for things as long as there are sensible regulations to prevent harm to citizens.

But I have always been very suspicious that human health should be subject to market forces. I am also suspicious that a nation ought to go bankrupt to keep citizens alive as long as possible.

These drugs cost an immense amount of money to create. No doubt.

NECESSARY EDIT: I do not mean to imply that there is a RIGHT to health care. I do mean to imply on moral grounds (primarily deontological ones, which libertarians, who by and large only like utilitarian arguments, would do well to consider) that human beings are ends and not mere things. Ends are not subject to market value as mere things.


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 Post subject: Re: EpiPen Scandal
PostPosted: Fri Sep 02, 2016 12:44 pm 
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Jeemie wrote:
superk wrote:
To clarify: Mylan makes the Epipen. There is no monopoly here.

Yeti makes coolers. They are very expensive. For some reason they are very popular, not just with coolers but with merchandise. I find mine cumbersome. Can be hard for people to open and the handles feel flimsy to me. Walmart sells Styrofoam coolers, they are cheap. So is ice.

The consumer makes a choice as to how to keep their desired possession cold, and acts accordingly. So far Yeti doing well. At some point in time they may not do well, and they will go away (they aren't GM).

If you need epinephrine, you don't need an epipen. You can ask your provider for needles/syringes/vial of 1:1000 Epi. Will cost you next to nothing. That's up to the consumer.


This means nothing when the schools are getting subsidized by the government to buy EpiPens.


the schools require you to provide your own bigPharma man. I guess it depends on what subsides each school districts 'arranges to get'

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 Post subject: Re: EpiPen Scandal
PostPosted: Fri Sep 02, 2016 1:09 pm 
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Still Lit wrote:
But I have always been very suspicious that human health should be subject to market forces. I am also suspicious that a nation ought to go bankrupt to keep citizens alive as long as possible.

These drugs cost an immense amount of money to create. No doubt.



That's pretty reasonable. You hit on the key point - we can't all go bankrupt trying to cure rare diseases, as noble or heartwarming as that may be. But to varying degrees, that IS when govt is supposed to step in when there's no incentive for the private market to solve something in the public interest (i.e. roads, bridges, etc.).

The problem I have with a lot of these debates is a fundamental misunderstanding of free market theory. Because it doesn't work perfectly, or at least optimally, some equate that to justify nearly limitless govt intervention and govt regulation. But free market theory is based on numerous assumptions, which have varying degrees of real world accuracy/applicability. The major assumption being perfect/complete information and rational consumers, which is obviously not the case. I'd argue almost every free market "failure" can be boiled down to barriers to entry (economies of scale, financing, regulatory, etc...) and imperfect information (the infamous "you don't see the kitchen, so we need to regulate food prep").

The problem is a good bit of regulation doesn't address the real obstacles to a functioning free market, but is instead driven by political pandering, corporatism or just plain well-intentioned ignorance (the latter being a major reason companies employ lobbyists and watch legislation like a hawk).

Also, insurance is a major distortion of any market. From an expected value perspective, insurance is rarely a rational choice. However, potential bankruptcy is something most people are obviously extremely risk averse to.

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