the problem is that there is natural (as in, unmodified) cheap generic insulin available, it’s just that it sucks compared to everything else. you see, insulin is a peptide that is supposed to appear, do some signalling, then disappear and unmodified insulin copies this thing exactly. the problem is, most of the time when peptide is supposed to work as a pharmaceutical, you don’t want to do that, you’d like insulin to last longer than usual, which means changes to it that make breakdown slower, or adding something that makes it stick to albumin, which has similar effect because it hides insulin somewhere enzymes can’t reach it and also it makes it start acting slower. this means less frequent dosing and less changes in insulin activity over time. there are also other insulins that start acting faster than natural, and this is also due to a couple of modifications in its structure
for another example, ozempic was not the first drug in its class, it’s also a modified peptide, and it can be injected s.c. once a week, compared to previous iteration (liraglutide) that requires daily injections. if natural peptide is injected i.m. instead, its halflife is half an hour, and in serum it’s only two minutes (it gets released a bit slower than it is metabolized)
manufacturing costs are about the same for any variant, most of it is in purification. patents for a couple of these have expired anyway by now, but if manufacturing is limited then price can be set arbitrarily high (see daraprim)
Correct, but when it’s already been established that people will pay those prices, they keep them high. So instead of going from $800 to $5 out of the goodness of their hearts, they go from $800 to $650 (number made up) to get more business but still make massive profits.
A lot of the benefits people associate with capitalism require a free market. The US problem is that the megacorps have gotten sufficiently powerful to abolish that free market through regularory (and legal) capture, enabling entrenched monopolies.
Every time someone talks about you being supposedly free to choose where to work they should get instant diarrhea. Let alone medicine of course, that’s a hard dependence.
Nobody is truly free without proper UBI and free healthcare and good public transport. Only then true freedom can exist.
Yup, but their products don’t work as well, don’t work for everyone, or have other downsides. Banting’s original insulin would be dirt cheap today, but it’s shit compared to what we have now, so the best products on the market today charge a premium for either efficacy or convenience.
Naive question from a european: Aren’t there companies on the market who can offer a cheaper price and therefore beat greedy competitors?
the problem is that there is natural (as in, unmodified) cheap generic insulin available, it’s just that it sucks compared to everything else. you see, insulin is a peptide that is supposed to appear, do some signalling, then disappear and unmodified insulin copies this thing exactly. the problem is, most of the time when peptide is supposed to work as a pharmaceutical, you don’t want to do that, you’d like insulin to last longer than usual, which means changes to it that make breakdown slower, or adding something that makes it stick to albumin, which has similar effect because it hides insulin somewhere enzymes can’t reach it and also it makes it start acting slower. this means less frequent dosing and less changes in insulin activity over time. there are also other insulins that start acting faster than natural, and this is also due to a couple of modifications in its structure
for another example, ozempic was not the first drug in its class, it’s also a modified peptide, and it can be injected s.c. once a week, compared to previous iteration (liraglutide) that requires daily injections. if natural peptide is injected i.m. instead, its halflife is half an hour, and in serum it’s only two minutes (it gets released a bit slower than it is metabolized)
manufacturing costs are about the same for any variant, most of it is in purification. patents for a couple of these have expired anyway by now, but if manufacturing is limited then price can be set arbitrarily high (see daraprim)
Costs aren’t just research and purification, it’s also good manufacturing practice and quality control.
Oh wow, an actual nuanced response and genuine answer!
Also today I learned!
Correct, but when it’s already been established that people will pay those prices, they keep them high. So instead of going from $800 to $5 out of the goodness of their hearts, they go from $800 to $650 (number made up) to get more business but still make massive profits.
You’d THINK capitalism would cause that to happen, wouldn’t you?
A lot of the benefits people associate with capitalism require a free market. The US problem is that the megacorps have gotten sufficiently powerful to abolish that free market through regularory (and legal) capture, enabling entrenched monopolies.
Doesn’t work when people don’t get to choose not to take it when it gets too expensive! That thing that capitalists always forget about: necessities.
Every time someone talks about you being supposedly free to choose where to work they should get instant diarrhea. Let alone medicine of course, that’s a hard dependence.
Nobody is truly free without proper UBI and free healthcare and good public transport. Only then true freedom can exist.
Amen!
What USA is experiencing is feral Capitalism.
Crony capitalism
Yup, but their products don’t work as well, don’t work for everyone, or have other downsides. Banting’s original insulin would be dirt cheap today, but it’s shit compared to what we have now, so the best products on the market today charge a premium for either efficacy or convenience.