I’m always excited when Cloudflare starts offering things that I had to use other providers for because I know it will be solid.
We used Statsig at Function. It started out as 2 of us using it on one product and within 12 months, large amounts of our product copy and rollouts were driven off of it.
Statsig has client side evals so you can write rules and rollouts based on internal concepts without Statsig’s servers processing a piece of user data. Hoping Cloudflare can build a sophisticated product here so I don’t have use another product in the future!
> Not only does this obviously not result in lower US prices
Maybe in Pfizer’s portfolio this is true. However, I just watched the Amazon Pharmacy pricing for GLP-1s drop substantially immediately following this. I think you may be being too black and white on claiming this categorically does not work.
Businesses will adapt pricing models, obviously this hurts Pfizer in some way, but Lilly and Novo found the new system was worth negotiating into. Like most things - when people say “always” or “never” - it’s reducing the spectrum of possibilities
Not arguing on broken internal pricing dynamics that are skewed by all sorts of gov programs and payors.
It’s about external, global pricing dynamics. The site clearly isn’t going to be able to give clean payor/pbm/gov subsidized pricing tables - that is almost an impossible exercise in our system.
What the agreement does accomplish is saying Americans will not pay $1150/mo while EU pays $400/mo while Argentina pays $120/mo.
It guarantees drugs will be greater than or equal to US pricing abroad which effectively forces pharma to find deeper profits outside of the US, or lower prices for all countries to acquire demand.
That is extremely effective. Now it’s up to a really complex group of people to figure out what that means inside our weird system of pharma/pbm/rebates/insurance/medicare.
But that’s not what trumprx is aiming to solve for right?
Novo and Lilly spent billions making Semaglutide, Tirzepatide, and future formulations/modalities.
They are going to monetize this heavily while they have IP coverage. There is no world they will let HIMS or any compounding pharmacy of scale undercut them.
On the insurance front - expect your insurance to decline this forever unless you are at serious risk of diabetes. It would make you cost them $3-6k/yr more. Insurance premiums would rise for everyone if insurance was subsidizing this - no free lunch.
Fortunately, the prices are coming down. Amazon pharmacy has Wegovy in an auto-injector starting at $199 without insurance. And that’s delivered to your door in under 24 hrs in most major cities.
I highly recommend checking out the terms of trumprx.gov - not endorsing the entire government here, but it is actually working and quite cleverly written to ensure Americans are getting the lowest cost drugs in the world now. Historically, we subsidized R&D globally by allowing pharma to make most profits on Americans then have cheaper prices abroad. That is changing and hopefully that’s a net positive.
I was talking to someone about this the other day. I was part of a team at NASA that developed a cooling system for the ISS and this whole premise makes no sense to me.
1. Getting things to space is incredibly expensive
2. Ingress/egress are almost always a major bottleneck - how is bandwidth cheaper in space?
3. Chips must be “Rad-hard” - that is do more error correcting from ionizing radiation - there were entire teams at NASA dedicated to special hardware for this.
4. Gravity and atmospheric pressure actually do wonders for easy cooling. Heat is not dissipated in space like we are all used to and you must burn additional energy trying to move the heat generated away from source.
5. Energy production will be cheaper from earth due to mass manufacturing of necessary components in energy systems - space energy systems need novel technology where economies of scale are lost.
Would love for someone to make the case for why it actually makes total sense, because it’s really hard to see for me!
This is the Ruby on Rails version of what Elixir Phoenix Live View and .NET Blazor do.
For those not familiar, rather than using a standard web framework where a lot of processing is done client side, these frameworks allow html buttons etc to call native Ruby, C#, or Elixir functions on the server rather than using some sort of post/get request to do that. Every UI interaction goes over the wire, which is where performance can be hurt.
Having used Blazor in production for nearly a year, it speeds up development, but your server is doing a lot more processing and will not be able to handle an equivalent amount of users that a normal web app would because it’s keeping a copy of the clients DOM in memory. It’s updates the dom on the server then streams that update through websockets to the clients dom, creating your magic Single Page App experience.
I think it’s cool tech, but not necessarily scalable due to the increased server load. I’d be interested to hear from people using it to serve large orders of magnitude of clients at once.
I’m John, a full stack developer with experience doing C#, SQL Server, React, and Python Flask. I am passionate about Clojure, React, and willing to work with any tech stack really!
I am available to begin early February!
I’m John, I’m a full stack developer with experience doing C#, SQL server, and JavaScript. I am passionate about Clojure, React, and willing to work with any tech stack really!
That’s my take. The bigger downside IMO is that the most successful people, i.e. experts, at something exist in the 10^9 social group, rather than the 10^3, and likely multiple experts exist in the 10^9 space.
A strange side effect is that the digital world also amplifies the outliers and makes the others in the large group of people seem non existent, leaving you to feel like you are majorly behind, when the reality is you are likely closer than most.
I would be interested to see if Jamie Dimon or Jeff Bezos could slip by owning a JP Morgan office building or Amazon warehouse, respectively. You pass it off like it is the norm. If it is normal, please cite several examples that come to mind. The examples cannot include private companies where the CEO is the 100% owner.
We used Statsig at Function. It started out as 2 of us using it on one product and within 12 months, large amounts of our product copy and rollouts were driven off of it.
Statsig has client side evals so you can write rules and rollouts based on internal concepts without Statsig’s servers processing a piece of user data. Hoping Cloudflare can build a sophisticated product here so I don’t have use another product in the future!