A Government Guide to Keeping Insulin Unaffordable(fee.org)
fee.org
A Government Guide to Keeping Insulin Unaffordable
https://fee.org/articles/a-government-guide-to-keeping-insulin-unaffordable-3-easy-steps-on-how-to-hogtie-a-market/
69 comments
Agreed 100%. I have T1D myself, in addition to 2 rare autoimmune neurological diseases that affect my peripheral nervous system.
Last time I checked (in March 2019), you could buy 13.5 [10 mL] vials of Novorapid/Novolog in Canada for 1 [10 mL] vial of Novorapid/Novolog in the United States. I am actually going to buy insulin in Canada on a trip in a couple of weeks due to formulary restrictions imposed by my insurance company (cannot obtain this type of insulin via insurance--not due to cost...).
It makes me absolutely sick to my stomach that people with T1D ration insulin. You cannot safely or effectively ration insulin with T1D, ever.
Anyways, I am one of the most stubborn people you will ever meet, but honestly, I do not see a future in this country (the United States). I expect the Affordable Care Act to be either partially or completely overturned next year (June-July 2020), based on the rare cases where the Solicitor General did not defend a case at the Supreme Court. Based on those cases, the likelihood of a partial or complete overturn of the ACA is staggeringly high.
I am trying to warn you that things may get really bad, and to be prepared. Consider other countries, with universal healthcare, in fact, even actually any country in the European Union. They will accept you regardless of the cost of your medical care, as long as you can get a visa. Same goes for citizenship, in the long run. No medical inadmissability restrictions whatsoever.
The Anglo-Saxon countries (US, UK, Canada, Australia) are largely closed to immigration, and the latter 2 have medical inadmissability criteria. Remember that.
Last time I checked (in March 2019), you could buy 13.5 [10 mL] vials of Novorapid/Novolog in Canada for 1 [10 mL] vial of Novorapid/Novolog in the United States. I am actually going to buy insulin in Canada on a trip in a couple of weeks due to formulary restrictions imposed by my insurance company (cannot obtain this type of insulin via insurance--not due to cost...).
It makes me absolutely sick to my stomach that people with T1D ration insulin. You cannot safely or effectively ration insulin with T1D, ever.
Anyways, I am one of the most stubborn people you will ever meet, but honestly, I do not see a future in this country (the United States). I expect the Affordable Care Act to be either partially or completely overturned next year (June-July 2020), based on the rare cases where the Solicitor General did not defend a case at the Supreme Court. Based on those cases, the likelihood of a partial or complete overturn of the ACA is staggeringly high.
I am trying to warn you that things may get really bad, and to be prepared. Consider other countries, with universal healthcare, in fact, even actually any country in the European Union. They will accept you regardless of the cost of your medical care, as long as you can get a visa. Same goes for citizenship, in the long run. No medical inadmissability restrictions whatsoever.
The Anglo-Saxon countries (US, UK, Canada, Australia) are largely closed to immigration, and the latter 2 have medical inadmissability criteria. Remember that.
> s a type-1 diabetic and user of Lilly and Novo Nordisk insulins, this article is spot on. People are literally dying in some cases due to this dysfunction
How many people would be dying if there wasn’t the same level of incentives to research these drugs in the first place?
Diabetes is a common health problem around the world. Nothing stopped say a non-profit or government from beating Lilly and Novo Nordisk to the punch developing these drugs. But profit seeking corporations are simply better at innovation than governments and non-profits.
How many people would be dying if there wasn’t the same level of incentives to research these drugs in the first place?
Diabetes is a common health problem around the world. Nothing stopped say a non-profit or government from beating Lilly and Novo Nordisk to the punch developing these drugs. But profit seeking corporations are simply better at innovation than governments and non-profits.
The basic science behind insulin-the-drug wasn't innovated by profit seeking corporations. Applying that basic science to make a usable drug wasn't innovated by profit seeking corporations either. A cursory glance at the wikipedia page for insulin tells me the innovation was done be german, american, and canadian scientists at public universities, starting in the 1880s and not developing into a usable drug until the 1920s.
I don't think a profit seeking corporation would've done that.
I don't think a profit seeking corporation would've done that.
There have been recent peer-reviewed journal articles about how much insulin would cost to produce for each person with type 1 diabetes per year.
It is somewhere between $75-$125 USD for a person with T1D per year.
Remember, T1D is an autoimmune and insulin-dependent form of diabetes. Within 5 years post-diagnosis (if not much sooner) your body basically effectively no longer produces any insulin whatsoever.
It is somewhere between $75-$125 USD for a person with T1D per year.
Remember, T1D is an autoimmune and insulin-dependent form of diabetes. Within 5 years post-diagnosis (if not much sooner) your body basically effectively no longer produces any insulin whatsoever.
The whole point of the article is that the manufacturers aren't developing new drugs. The drugs haven't changed in decades. They're making small changes to delivery systems and other ancillary aspects and then patenting these new variations, as well as engaging in the usual quid pro quo wink wink old boy network anti-competitive manipulation of regulatory regimes.
Insulin has changed quite dramatically over the decades. Earlier iterations of insulin are available as generics. But newer versions act faster and have fewer side effects.
The article referred to specific insulin products and the specific practices of the manufacturers in those cases, not "insulin" in the generic sense. If you feel the article is in error then responding to the incorrect points would have been more useful than issuing a blanket defense of for-profit drug manufacturing.
None in that case - insulin is perhaps the worst specific case to cite. https://en.m.wikipedia.org/wiki/Insulin#History_of_study
As the article explains, we aren’t talking about that original insulin. We are talking about the new fast acting forms with fewer complications.
> Even though insulin treatment itself can’t be patented, improvements in delivery mechanisms can be. These incremental improvements, no matter how small, can be used to extend the 20-year patent on a drug, a process called “patent evergreening.”
I'm confused - wouldn't the new patent only cover the improved method, and the patent on the original, un-improved version would still expire?
I'm confused - wouldn't the new patent only cover the improved method, and the patent on the original, un-improved version would still expire?
It is possible to get a generic of the un-improved version from Walmart for $25: https://www.vox.com/science-and-health/2019/4/10/18302238/in...
The article says some people need up to 6 of those vials per month. So, it can still end up being $1,800 per year.
Other non-US countries are able to provide a yearly supply of the newer biosimilar insulin for just $72-133 per year: https://gh.bmj.com/content/3/5/e000850
The article says some people need up to 6 of those vials per month. So, it can still end up being $1,800 per year.
Other non-US countries are able to provide a yearly supply of the newer biosimilar insulin for just $72-133 per year: https://gh.bmj.com/content/3/5/e000850
Your 2nd reference talks about the theoretical lowest price that a hypothetical manufacturer could manufacture longer-acting insulins at. It doesn't identify any manufacturer actually producing at those prices.
Scoundreller wanted a manufacturer producing "the newer biosimilar insulin for just $72-133 per year". That link doesn't appear to provide that information.
“Evergreening” is a term made up by journalists that has no basis in patent law, and is also actively misleading.
The real issue is that nobody has an incentive to prescribe the older, less good but still acceptable drug. (In the case of insulin, note, it’s not only the delivery mechanisms that have improved, but the insulin itself.) the insurance company, in particular, under the ACA, have no incentive to cut costs to improve profits.
The real issue is that nobody has an incentive to prescribe the older, less good but still acceptable drug. (In the case of insulin, note, it’s not only the delivery mechanisms that have improved, but the insulin itself.) the insurance company, in particular, under the ACA, have no incentive to cut costs to improve profits.
Or, in the case of albuterol inhalers, the companies can actively lobby to prevent the older version from being distributed anymore.
Evergreening is absolutely a thing, and absolutely planned and executed by the companies that profit from it.
Evergreening is absolutely a thing, and absolutely planned and executed by the companies that profit from it.
The older albuterol inhalers are no longer sold because they used CFCs as a propellant. CFC usage was banned internationally by the Montreal protocol in 1987. The propellant could not be immediately replaced due to strict FDA safety guarantees so they carved out a temporary exemption for medical usage. Research and development was done to find a replacement (HFAs) and that work is now being paid for by the patents granted from that process (more expensive inhalers). Whether this was a valid trade-off is a separate discussion but company lobbying is not the reason why they are no longer distributed.
https://www.fda.gov/drugs/questions-answers/transition-cfc-p...
https://www.fda.gov/drugs/questions-answers/transition-cfc-p...
I think his point is that evergreening isn't a feature of the patent system; there's no mechanism to extend a patent, and "extension" patents of minor modifications don't extend the legal monopoly on a drug, but rather function as a marketing mechanism that preys on the industry's willingness to prescribe whatever the newest iteration of a drug is, regardless of evidence.
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I fail to see how the term "evergreening" is misleading. It seems to me to be an accurate term that precisely describes an industry practice responding to market and regulatory incentives. I think journalists are spot on for this one, "evergreening" is an accurate and completely truthful assessment of the situation, and perhaps you are thinking too narrowly within the scope of legal terms in patent law and not enough about real world effects.
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There may be some confusion about "delivery mechanism" here. In this context the only relevant definition would be referring to chemical components in updated formulas for the injectable solution. Delivery _devices_ would have no relevance to the patent of the injectable solution.
tonetheman(1)
As mentioned in the article they are very effective at preventing smaller companies from producing generic versions based on expired patents. Then they just stop manufacturing the old drugs so there is no supply.
That's not the issue. As long as a brand drug is listed by the FDA -- whether or not it's actually being manufactured -- physicians can write prescriptions for generic equivalents.
However, if a brand manufacturer has an old product delisted, then physicians can no longer prescribe generic equivalents. That's become more and more common.
However, there is a workaround: compounding pharmacies. To my knowledge, accredited compounding pharmacies can make, on a customer-by-customer basis, any product that the FDA has ever approved. And many of them are mail-order pharmacies. In my experience, prices are comparable to mass-market generics, or lower.
However, if a brand manufacturer has an old product delisted, then physicians can no longer prescribe generic equivalents. That's become more and more common.
However, there is a workaround: compounding pharmacies. To my knowledge, accredited compounding pharmacies can make, on a customer-by-customer basis, any product that the FDA has ever approved. And many of them are mail-order pharmacies. In my experience, prices are comparable to mass-market generics, or lower.
>As long as a brand drug is listed by the FDA -- whether or not it's actually being manufactured -- physicians can write prescriptions for generic equivalents.
>However, if a brand manufacturer has an old product delisted, then physicians can no longer prescribe generic equivalents. That's become more and more common.
Why is the ability to prescribe a drug tied to whether the branded version in still "listed"?
>However, if a brand manufacturer has an old product delisted, then physicians can no longer prescribe generic equivalents. That's become more and more common.
Why is the ability to prescribe a drug tied to whether the branded version in still "listed"?
Approved drugs are listed here: https://www.accessdata.fda.gov/scripts/cder/daf/
Also: https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
And: https://www.drugs.com/history/
Physicians can only prescribe FDA-approved drugs. Only brand drugs are approved on their own. Generic drugs are approved, with much less documentation required. There's no need to demonstrate effectiveness, safety, etc. Applicants must only demonstrate that products are therapeutically equivalent to approved brand drugs. That's mainly about chemical identity, purity, and rate and degree of absorption.
At Drugs@FDA, search for a brand name. If there are generics, you'll see "Therapeutic Equivalents for NDA ...". Clicking that will display links to them.
If there's no listed brand drug, there's nothing for a generic to be equivalent to.
Also: https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
And: https://www.drugs.com/history/
Physicians can only prescribe FDA-approved drugs. Only brand drugs are approved on their own. Generic drugs are approved, with much less documentation required. There's no need to demonstrate effectiveness, safety, etc. Applicants must only demonstrate that products are therapeutically equivalent to approved brand drugs. That's mainly about chemical identity, purity, and rate and degree of absorption.
At Drugs@FDA, search for a brand name. If there are generics, you'll see "Therapeutic Equivalents for NDA ...". Clicking that will display links to them.
If there's no listed brand drug, there's nothing for a generic to be equivalent to.
That didn't answer the question of why companies are allowed to pull drugs from being listed in the first place, after them being listed for years.
I'm not sure what the requirements for delisting products are. It might be as simple as "this is old, and we don't want to be associated with it". Or as specific as "we've learned that it's not as safe and/or effective as it should be, and should be delisted for health and safety reasons."
But the real reason is almost always that they have a new version, which costs much more, and they don't want competition from inexpensive generics to their old product.
There have been some antitrust suits over that. I don't know how they turned out.
But the real reason is almost always that they have a new version, which costs much more, and they don't want competition from inexpensive generics to their old product.
There have been some antitrust suits over that. I don't know how they turned out.
Compounding pharmacies are brilliant. In the course of my treatment, my doctor and I worked with a compounding pharmacist to prescribe me lower dosage amounts of buprenorphine than the major drug companies have ever produced -- which allowed my taper to go smoother than expected.
Yes, the new patent can only cover the new improvement.
The issue is that doctors keep proscribing the newer, slightly improved methods.
Trying to evergreen on purpose is also dangerous since your competitor can patent an improvement on your invention. I somewhat doubt it is a purposeful strategy. But rather it just reflects the iterative nature of invention.
The issue is that doctors keep proscribing the newer, slightly improved methods.
Trying to evergreen on purpose is also dangerous since your competitor can patent an improvement on your invention. I somewhat doubt it is a purposeful strategy. But rather it just reflects the iterative nature of invention.
Yes, the old drug patent will expire, and when this happens the company typically pulls an "oh our old version is now magically unsafe!" to wrestle away competition.
Plus developing a product from the old patent still requires extensive FDA approval. Very expensive stuff.
Plus developing a product from the old patent still requires extensive FDA approval. Very expensive stuff.
Do you have references for that claim? If a company goes out with a claim their old product is unsafe it’s not like it’s rocket science to test the claim. And if their lying and you could literally corner a billion dollar industry by testing the claim I’d expect every producer of generics to do so. On the other hand if the product is actually unsafe that opens up liability claims from costumers.
I've seen companies create "extended release" formulations of their old formulation 1 year before the patent expires to get everyone to switch over to the patented version before the generic comes out.
I've even seen it done when the previous version and the new version were still both once daily (tamsulosin, I'm looking at you!)
Yes, some insurers will hesitate to cover the new formulation when it comes out, but not all.
Sometimes the insurer will make a deal with the manufacturer so that the manufacturer is only getting paid the generic-equivalent price. But who knows what happens behind closed doors.
I've even seen it done when the previous version and the new version were still both once daily (tamsulosin, I'm looking at you!)
Yes, some insurers will hesitate to cover the new formulation when it comes out, but not all.
Sometimes the insurer will make a deal with the manufacturer so that the manufacturer is only getting paid the generic-equivalent price. But who knows what happens behind closed doors.
Changing the release profile of a drug from once daily to once weekly isn’t a minor thing, and no one is forcing customers to pick the once weekly over the once daily. Now with respect to the original claim, are you saying that once there was a new version of tamsulosin the company issued a statement claiming the old version was unsafe? Do you have a reference for that?
Re: "no one is forcing customers to pick the once weekly over the once daily"-
Who's the customer here, the prescriber or the patient? Is a prescription for the weekly formulation valid for the daily one too?
Who's the customer here, the prescriber or the patient? Is a prescription for the weekly formulation valid for the daily one too?
1. The consumers aren’t really choosing, their prescribers are, with a lot of friction required to change against their initial decision.
2. While they still had the patent on the regular tamsulosin formulation, they stopped making it. Effectively forcing everyone onto the XR formulation unless they wanted to change molecules entirely.
The data showed little difference as I recall in terms of effectiveness because the half life was long enough to take once daily, regardless of formulation.
2. While they still had the patent on the regular tamsulosin formulation, they stopped making it. Effectively forcing everyone onto the XR formulation unless they wanted to change molecules entirely.
The data showed little difference as I recall in terms of effectiveness because the half life was long enough to take once daily, regardless of formulation.
By the way, you can do business without IP...
I recommend the following book: Against Intellectual Property by Stephan Kinsella.
https://mises.org/library/against-intellectual-property-0
I recommend the following book: Against Intellectual Property by Stephan Kinsella.
https://mises.org/library/against-intellectual-property-0
If campaign contributions are called free speech and legislators are happy making laws blatantly favoring contributors, you're going to have a pretty tight loop.
How big is the insulin market? It sounds fairly big considering how many people have diabetes. So where are the Mexican cartels or similar black market organizations when you need them? If we're going to wait for the government, or worse, the industry itself to fix this problem it'll never be fixed. What we need is a proper black market. Is insulin available on the dark web drug markets? If not someone should make it available and cash in while still providing massive savings. That's how you solve a problem like this when your fucking government has stopped working like the US government has.
Proper black market is exactly a part of the industry that the state fights.
One of the things I always wanted was to create a black market for electronics in my home country (Brazil) because taxation here is really high.
You should also know that the government with its patents system is the root cause of this price spike.
I wish black market organizations doing legit and good stuff (like selling medicine that is pricey due to state granted monopolies) was the norm and I hope someday it will be. However, we are not there yet.
One of the things I always wanted was to create a black market for electronics in my home country (Brazil) because taxation here is really high.
You should also know that the government with its patents system is the root cause of this price spike.
I wish black market organizations doing legit and good stuff (like selling medicine that is pricey due to state granted monopolies) was the norm and I hope someday it will be. However, we are not there yet.
Most of thw misunderstanding on this topic has to do on people from outside the patent field trying to figure out what is going on in it, and specifically, how drug companies are gaming it.
Here is a great podcast on the matter. If you want to know about drug patents and how they are gamed, this is your bible.
http://www.econtalk.org/robin-feldman-on-drugs-money-and-sec...
Here is a great podcast on the matter. If you want to know about drug patents and how they are gamed, this is your bible.
http://www.econtalk.org/robin-feldman-on-drugs-money-and-sec...
Obligatory link to essay explaining the issues in pedagogical detail. Section II is on insulin:
https://slatestarcodex.com/2019/04/30/buspirone-shortage-in-...
https://slatestarcodex.com/2019/04/30/buspirone-shortage-in-...
It's unaffordable because there is a monopoly on Insulin. Why is there a monopoly? Because it takes decades of work and close to a billion dollars to get a new drug through FDA approval.
We need to work on bringing these costs down, so more companies can actually compete. Government regulation schemes will only reduce the amount of companies willing to go through the process and give us less choice in the end.
We need to work on bringing these costs down, so more companies can actually compete. Government regulation schemes will only reduce the amount of companies willing to go through the process and give us less choice in the end.
There isn’t a monopoly. It doesn’t take decades to get a generic on the market. Insulin is available in wallmart for 25$ per vial.
There is a definite problem in the US with drug pricing, and middlemen gauging the market, but it’s a straw man to claim new insulin products don’t bring any change. If you ask the patients there’s a world of difference between the cheap genetics and the main brand products, which is why they want the newer products and not the generics. But of cause patients also want the newer products at the same price as the generics which will never happen, even if the government fixes the drug pricing market.
There is a definite problem in the US with drug pricing, and middlemen gauging the market, but it’s a straw man to claim new insulin products don’t bring any change. If you ask the patients there’s a world of difference between the cheap genetics and the main brand products, which is why they want the newer products and not the generics. But of cause patients also want the newer products at the same price as the generics which will never happen, even if the government fixes the drug pricing market.
> If you ask the patients there’s a world of difference between the cheap genetics and the main brand products
The main problem is the $25 insulin is R and not fast-acting. It's not the difference between generic and name-brand, it's about using an insulin that takes over twice as long to be absorbed by your body.
The main problem is the $25 insulin is R and not fast-acting. It's not the difference between generic and name-brand, it's about using an insulin that takes over twice as long to be absorbed by your body.
It really boggles my mind that every article on insulin goes through this cycle: “the producers are scammers it the same product put out a hundred years ago but they have new patents!!!” “It’s cheaply available in the old form” “but that’s not the same product!!”
You can’t have it both ways. Cheap alternatives are available. But yes newer main brand products are better in tons of ways, which is not surprising as they are culmination of decades of research. You can’t both claim there are no differences and than want those differences in the cheaper generics.
You can’t have it both ways. Cheap alternatives are available. But yes newer main brand products are better in tons of ways, which is not surprising as they are culmination of decades of research. You can’t both claim there are no differences and than want those differences in the cheaper generics.
The patent is expired on the “new version,” Humalog. It expired sometime in the early 2010s. However, because it is produced biologically (altering RNA in bacteria) instead of chemically, additional regulations prevent a genetics from entering the market.
It is this additional regulation that should be subject to scrutiny, since the price of humalog has continued to rise, even after its patent expired. A vial of humalog costs~$5-10 to manufacture, while its list price is nearly $300 and rising quickly. I’m guessing because pharmas want to milk their golden cow while these regulations are still in place. We could drop the price of Humalog 90% within a matter of days by simply cutting regulation against import, as it is already being manufactured safely abroad.
By the way, when Humalog was under patent, on day one, the list price was something like $30 per vial.
Using cheaper alternatives is also strongly correlated with worse outcomes, including amputations and death.
In a word, yes, it literally is exactly as unconscionable and greedy as it looks on the tin.
It is this additional regulation that should be subject to scrutiny, since the price of humalog has continued to rise, even after its patent expired. A vial of humalog costs~$5-10 to manufacture, while its list price is nearly $300 and rising quickly. I’m guessing because pharmas want to milk their golden cow while these regulations are still in place. We could drop the price of Humalog 90% within a matter of days by simply cutting regulation against import, as it is already being manufactured safely abroad.
By the way, when Humalog was under patent, on day one, the list price was something like $30 per vial.
Using cheaper alternatives is also strongly correlated with worse outcomes, including amputations and death.
In a word, yes, it literally is exactly as unconscionable and greedy as it looks on the tin.
> I’m guessing because pharmas want to milk their golden cow
It’s a wired definition of milking a product to lower your take home year after year. The PBMs have rebates close to 70% they are literally making more on the drugs than both the companies producing them and the companies providing them through insurance. List prices are high because the people who own the consumer side of the market don’t care how high the prices go as long as they can set up rebates that increase their own profits.
It’s a wired definition of milking a product to lower your take home year after year. The PBMs have rebates close to 70% they are literally making more on the drugs than both the companies producing them and the companies providing them through insurance. List prices are high because the people who own the consumer side of the market don’t care how high the prices go as long as they can set up rebates that increase their own profits.
I agree that the reporting is sub-par but that's not really what's going on. Insulin R and rapid-acting insulin are two separate medications. All insulin manufacturers produce both types and a generic is only available for NPH, despite the fact that the overwhelming majority of Type 1 diabetics are prescribed fast-acting. Additionally most diabetics are prescribed to take a long-lasting insulin as well since the body needs insulin 24-hours a day, there is no generic for this variant either.
[deleted]
If the generics are $25, then I don't see a problem. It's cheaply available and this article is wrong.
Not all insulin is created equal, as the Vox article posted in this thread shows - https://www.vox.com/science-and-health/2019/4/10/18302238/in... - different formulations vary in their effectiveness person-to-person regarding regulating blood sugar levels. For one person, the cheap ReliOn insulin from Walmart might allow them to manage their T1 diabetes, but for another person it might cause more incidences of hypo/hypergylcaemia.
The expensive, newer, patent-covered formulations like Lantus are what are prescribed over here in the UK - lucky that the NHS shields us from the ridiculous prices!
The expensive, newer, patent-covered formulations like Lantus are what are prescribed over here in the UK - lucky that the NHS shields us from the ridiculous prices!
I don't get it. If the generic unimproved versions... unimprovedness is riskier, and an improved version is researched and created that removes that risk, than why should the new formula of the new version not be under patent?
If you think about the rules of our current system, your conclusion makes perfect sense. I and others don't think the rules of the current system are very good if they're preventing us from giving people better quality of life.
I purchased an OS 8 years ago, if I want to buy the same modern OS from the maker it now cost more money.
I purchased a car from a manufacturer, the base price was 20,000. Now the same model car has the base price 25,000. Sure, they added side impact airbags, backup cameras and lane assist but why can't I buy it for 20,000?
If you and others who think like you dislike the current system and want to improve everyone's quality of life, you are quite welcome to invest the time and capital to start a drug research lab, invent new and novel medicine, patent it, get it FDA approved then license it to anyone who wants to make and sell it.
Volvo was committed to the idea of safety that when they developed a seatbelt system they did just that.
The idea of taking someone's work with out paying them fair compensation is akin to slavery. The only difference it that slavery is forcing someone to do something and this is promising someone compensation then withholding it.
Now, if we believe that this new formulation is so revolutionary and would be such a great benefit then why not just buy the patent from the maker? Put together a company, raise the funds. Anything can be bought and sold. The only question is price. Trying to force the government to use a version of eminent domain by lying about the situation to the public to spark outrage is scummy.
I purchased a car from a manufacturer, the base price was 20,000. Now the same model car has the base price 25,000. Sure, they added side impact airbags, backup cameras and lane assist but why can't I buy it for 20,000?
If you and others who think like you dislike the current system and want to improve everyone's quality of life, you are quite welcome to invest the time and capital to start a drug research lab, invent new and novel medicine, patent it, get it FDA approved then license it to anyone who wants to make and sell it.
Volvo was committed to the idea of safety that when they developed a seatbelt system they did just that.
The idea of taking someone's work with out paying them fair compensation is akin to slavery. The only difference it that slavery is forcing someone to do something and this is promising someone compensation then withholding it.
Now, if we believe that this new formulation is so revolutionary and would be such a great benefit then why not just buy the patent from the maker? Put together a company, raise the funds. Anything can be bought and sold. The only question is price. Trying to force the government to use a version of eminent domain by lying about the situation to the public to spark outrage is scummy.
I'm not going to try to persuade you that the negatives of capitalism outweigh the positives, but if you're interested in learning why I believe what I do I'd be happy to direct you to where you can find out.
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The new version is not under patent, the patent expired on it several years ago.
The problem is that the generics are equivalent to insulin from the 70's, when complications of type-1 diabetes were considered almost unavoidable. You can be super diligent and figure out how to manage your diet to make it work with the cheaper stuff, but that takes years of practice and conditioning. If you have to switch from something like humalog and an insulin pump, to injections of Regular insulin a two times a day or so, you are gonna be screwed.
The generic insulin is very low quality. Yes it could save my life, but it would incredibly hard to manage a healthy one.
Most people will not be healthy with the generic insulin. There are wide verieties of treatment methods for vastly different people and medicine has come a long way. This "generic" human insulin replacement is a 40 year setback in treatment and will likely cause more secondary costs due to bad treatment.
Since patents expire after 20 years, it would be max a 20 year setback.
Do you have some more information about this? It's interesting to me and I'd like to learn more.
One thing that is not mentioned is that the dynamics of prescription-writing in the first place is anti-competitive in terms of price. Fiasp and Humalog are equivalent fast acting insulins from Novo-Nordisk and Lilly - competition will only happen when patients can decide which one to take instead of their doctors, who are not sensitive to small price differences (and in most cases are not themselves taking the drug).