Drug Goes From $13.50 a Tablet to $750, Overnight


#422

I thought part of your position was you think our government overreaches which means certain aspects of our current government you don’t agree with. I wouldn’t presume to know which ones you give value and which you would trash.

It seems like under your role of the government, it would be fine to sell cars without safety testing, houses with no codes, and food without inspection. It would be up to the individual to research everything they buy and use and determine whether they think it’s safe or not?


#423

We literally covered this a short ways back, in response to Adam.

The key is substantive due process. Restrictions on liberty are acceptable if they provide a substantive benefit to society that outweighs the value of the liberty being given up.

I wrote about it in more detail above, at least twice I believe.

There are all sorts of regulations which are good… because they benefit society, and don’t unnecessarily hamper individual liberty.

In the case of things like food inspection or regulation, i think that government certification is great. Requirements on things like milk are great. But at the same time, I know a guy who’s real into natural food and crap, and his family drinks raw milk. I believe he has to sign something when he buys it, acknowledging that it doesn’t meet government standards for pasturization, yada yada yada. I don’t drink raw milk, but I think it’s good that he can if he wants to take that risk. And the system allows him to do so, while also protecting the rest of folks who just want to buy normal milk and not get sick from drinking it.


#424

Your position seems to shift based on your personal experience and whether you personally think something is okay or not. You can’t rule a society based on your whim. You think government certification is great… except when it bothers your friend.

Anyway, thanks for engaging on some level with this.


#425

Those two things I said there are not at all contradictory.

The government has regulations and certification regarding milk… and he is able to voluntarily opt out of them. by acknowledging that he knows the farmer selling him milk has not gone through the processes required to sell milk normally.

You’re able to have regulations that protect consumers, without reducing the liberty of consumers.


#426

Mind, this is a relatively small point compared to several others. However, if the profits begin before certification, there would be moments that the company might say “Why bother?” They can advertise the results of their pre-certification information, applied with far less rigor than certification requires and more easily framed in a positive light, and then market the medicine as a “boutique” offering, available only for those who can pay out of pocket.

Now imagine that there’s some drug in that niche that appears to be remarkably effective compared to the certified options. One might argue that if the (poor by comparison to certification) evidence seems to support its efficacy, insurance should pay for it. Now of course the insurance companies wouldn’t agree - they’re risk averse by their nature - yet someone would eventually break ranks to grab market share. Then someone else does. Then someone else. Suddenly, we have non-certified drugs being supported by health insurance. Laws would have to be passed to PREVENT coverage for these “wild” drugs, and who wants to be the politician that votes to let people suffer just to protect the FDA’s grip on medicine?

(note - I’m aware of the slippery slope nature of this scenario, and I am in no way wanting to present it as an unavoidable result, just a very realistic danger)


#427

And now, acne cream.

It’s prescription only, so most buyers never see the $9k price. They just get hit with the co-pay, so once again we’re all footing the bill for this.


#428

Oh for fuck’s sake.


#429

But don’t worry kids; the profit-motive isn’t having a deleterious effect on medicine!

:)


#430

There are a lot of private companies in regulated fields that make a profit. It’s not the evil of profit here but the complete lack of regulation and the fact that someone who wants a 9k cream is actually spreading the cost of the covered drug to everyone within that insurance company. It’s not transparent. When people realize their 170 dollar premium for insurance keeps covering drugs that increase by incredible amounts each year, then maybe they’ll stop thinking regulation is always a bad thing. Again knee-jerk regulation will help no one which is why I said earlier we should have regulation that;s too specific to one scenario or one drug… it needs a holistic approach.


#431

This would definitely be a profitable debate for us to have again :)


#432

Yeah I think I will pass. If you think the government is going to do a lot better just because it’s the government, let’s go check out how well the VA has been doing.


#433

You may want to get your Sarcasm-o-Meter checked at your friendly local Socialized Medicinal Clinic, comrade!


#434

Oh I realized you were being sarcastic. I would have put an emoji there if we were allowed to. I refuse to use characters I had to use in the 90s!

I still think it’s important to point out we have a very large medical system run by the government… and the VA’s had how many scandals in just the last few years. We also have Medicaid and Medicare products that probably cover the EpiPen not sure about the cream. I’d be curious to know about that one.


#435

The VA “scandals” of a few years ago were pretty non scandalous. Yeah there was some inefficiencies but mostly it was a flimsy excuse for those who want to bitch about government to, well, bitch about government.

By just about any statistical measure the VA provides more care for less money to patients than private hospitals provide to the general public.


#436

You are aware of the fake waiting lists right? Of the fact vets cannot receive services outside of VA system except for very specific conditions and that the waiting list for services within the VA system led to a system of abuse since bonuses were tied to time waiting which led to falsification of how long patients were actually waiting. You’re saying that’s a made up scandal?


#437

Well, I’m not sure how interesting this will be for most people here, since it doesn’t involve the US, but something happened today in Spain re: medical costs.

A while ago a new Hepatitis C medicine was approved for it’s use in the public healthcare system in Spain. while way less expensive than buying the drug in the US, the cost was still significant, and thus adoption took a while until it was broadly available and there was some (justified) uproar about the delay. In most cases drug was administered to more urgent cases first following medical criteria. In Galicia, the managers (political positions) of public healthcare delayed the adoption due to budget concerns, even though some patients met that criteria. Today, the politicians who didn’t approve the budget for the medicines have been charged with homicide.

This is pretty big because it’s the first time the right to healthcare enshrined in our constitution is tested in this way. Basically, it raises the notion that you can’t apply budget cuts to services considered fundamental rights.


#438

Well that is fascinating. I am curious how this will play out. I guess this means for sure that people died who would not have if given medicine? I wonder what level of certainty they have with that.


#439

Not full certainty. Actually the liver degradation that Hepatitis C causes, once in late stages, is not reversible. Yet the point is that doctors prescribed the medicine, and they are the experts (and incidentally the ones that initially sued) . The administrators can’t claim to have known better.

But yes, let’s see how it develops. There’s going to be pushback from the government so they are acquitted (same political party).


#440

I realize this is different country so laws are very different and even here I’m not sure because there is often no guarantee that giving someone medicine would actually save them, there are different levels of certainty though.

It’s the homicide part I’m focusing on, of course, not the wrong doing in general.


#441

Homicide due to negligence. I’m not sure it’s the correct legal translation into English. Maybe it’s manslaughter?? We distinguish (I think) between guilty homicide (involuntary or negligent, like this case) regular homicide and murder.

And you don’t need certainty. In cases like this normally a judge decides and likelihood can be enough.